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PSA with Gallagher Benefit Services, Inc. 01°1S-02z c • PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI BEACH AND GALLAGHER BENEFIT SERVICES, INC. FOR Health Care Benefits Consultant Services, PURSUANT TO RFP 2015-195-LR is entered into this day of T is Professional Services Agreement ("Agreement") y Qs'- k 2016, between the CITY OF MIAMI BEACH, FLORIDA, a municipal corporation organized and existing under the laws of the State of Florida, having its principal offices at 1700 Convention Center Drive, Miami Beach, Florida, 33139 ("City"), and GALLAGHER BENEFIT SERVICES, INC., a Delaware corporation, authorized to do business in Florida, whose address is 2255 Glades Road, Suite # 200E, Boca Raton, FL. 33431 ("Consultant"). SECTION 1 DEFINITIONS Agreement: This Agreement between the City and Consultant, inclusive of the RFP, any addenda to the RFP, and the Consultant's proposal, as well as any exhibits and amendments to the documents referenced. City Manager: The chief administrative officer of the City. The City Manager's designee shall be the City's Human Resources Director. Consultant: For the purposes of this Agreement, Consultant shall be deemed to be an independent contractor, and not an agent or employee of the City. Services: All services, work and actions by the Consultant performed or undertaken pursuant to the Agreement. Fee: Amount paid to the Consultant as compensation for Services. Proposal Documents: Proposal Documents shall mean City of Miami Beach Request for Proposals, No.2015-195-LR for Health Care Benefits Consultant Services, together with all amendments thereto, issued by the City in contemplation of this Agreement (the "RFP"), and the Consultant's proposal in response thereto (the "Proposal"), all of which are hereby incorporated and made a part hereof; provided, however, that in the event of an express conflict between the Proposal Documents and this Agreement, the following order of precedent shall prevail: this Agreement; the RFP; and the Proposal. Risk Manager: The Risk Manager of the City, with offices at 1700 Convention Center Drive, Third Floor, Miami Beach, Florida 33139: telephone number (305) 673-7000, Ext. 6515: and fax number(305) 673-7023. 1 Minimum Requirements. The Minimum Eligibility Requirements for this solicitation are listed below. Proposer shall submit detailed verifiable information affirmatively documenting compliance with each minimum requirement. Proposers that fail to comply with minimum requirements will be deemed non-responsive and will not be considered. 1. 'Proposers must be licensed in the State of Florida as a Type 21, Class 05 Agency (Resident)or Type 91, Class 05 Agency(Non-Resident). Submittal Requirements: Provide a copy of'Proposer's current license. 2. Have on staff an actuary with experience in employee benefits and in particular self funded plans. Submittal Requirements: Resume of staff member who will be assigned to the City with actuary experience. 3. Proposer to have provided services similar to those defined herein to three (3) public sector clients within the last five-(5)years. Submittal Requirements: 'Provide a list of public sector clients to include .contact name, title, agency, telephone number,email address, and contract dates. Statement of Work Required. It is a requirement of any resulting agreement that the following services be provided as part of-the Consultant's fee: 1. Review and evaluate existing City benefit related agreements, including but not limited to administrative service agreements with insurance carriers, new case documents and service agreements to provide recommendations for possible improvement in price,terms and conditions. 2. Assist in preparation of the City's Request for Proposal process for its self-insured medical, dental, life and voluntary coverage benefit plans which include, but may not be limited to, short and long-term disability coverage, critical illness coverage, accident care, dependent life and supplemental care coverage. 3. Manage negotiations of reimbursement rates. 4. Evaluate stop loss coverage and make related recommendations to ensure the City's self-insurance benefits are protected from catastrophic losses. 5. Provide all actuarial services, by a professional actuary who is either a staff member or sub-contractor of the successful proposer, as required by the City in relation to health and benefit plans to provide information to decision-makers and reduce risks. 6. Suggest and/or develop additional medical plans, providing employee choice in delivery of healthcare and help reduce premium costs to all parties. 7.. Provide unlimited actuarial services to analyze all benefit programs including plan design, claims, utilization trends, and contribution rates for the self-insured plans • •.,+.,s�, ..i ..• `,•• , .a...- .±,a-� ......... RFP 2015-1'95-LR prior to open enrollment, by June 1 of each year. 8. Work with City's Human Resources Department and medical and dental health safe coverage providers to develop an in depth analysis of current self-funded programs. 9. Provide guidance on Transitional Reinsurance program and calculate Transitional Reinsurance Fee. 10. Assist with all compliance issues including the Patient Protection and Affordable Care Act, Health Insurance Portability and Accountability Act (HIPAA), Medicare Part D, Consolidated Omnibus Budget Reconciliation Act (COBRA) and Governmental Accounting Standards Board (GASB) and any legislation that has an impacton employee benefits. 11. Provide guidance on Medicare Part D Retiree Drug Subsidy and submit actuarial attestation. 1.2. Prepare full bi-annual Governmental Accounting Standards Board (GASB) 45 ,evaluation and reporting. 13. Provide the City with guidance on its Obligations for Postemployment Benefits other than pensions-(OPEB)Trust. 14. Prepare an annual report of the City's OPEB liability as of September 30 each year by October 15 of the same year. 15.-Conduct the City's Healthcare-Reform Forecasting Analysis. 1.6. Review vendor summary plan descriptions for accuracy in benefits provided and ensure compliance with all governmental'regulations. 17. Prepare reports informing the City Administration of benefit market conditions (Market Analysis) that may affect the City's policies and risk exposures prior to policy renewals. 18. Conduct quarterly meetings with the City's Human Resources, Finance and Budget staff to provide claims experience, plan costs and projections of claims and revenues. 19. Provide annual recommendations for changes in plan premiums,plan design, and plan employer subsidy for the upcoming fiscal year by June 1 of each year. 20. Review agreements and policies purchased by the City to assure their accuracy and appropriateness. 21. Provide assistance in resolving complex claims issues. 22. Provide other services that may be necessary in the future. RFP 2015-195-1R ATTACHMENT A RESOLUTION COMMISSION ITEMS AND COMMISSION MEMORANDUM RESOLUTION NO. 2015-29245 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE RECOMMENDATION OF THE CITY MANAGER PERTAINING TO THE RANKING OF FIRMS, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO. 2015-195-LR FOR HEALTH CARE BENEFITS CONSULTING SERVICES; AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH THE TOP-RANKED PROPOSER, GALLAGHER BENEFIT SERVICES, INC.; AND IF UNSUCESSFUL IN NEGOTIATING AN AGREEMENT WITH GALLAGHER BENEFIT SERVICES, INC., AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH AON CONSULTING INC.; AND IF UNSUCESSFUL IN NEGOTIATIONS WITH AON CONSULTING INC., AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH WELLS FARGO INSURANCE SERVICES USA, INC.; AND FURTHER AUTHORIZING THE MAYOR AND CITY CLERK TO EXECUTE AN AGREEMENT UPON CONCLUSION OF SUCCESSFUL NEGOTIATIONS BY THE ADMINISTRATION. WHEREAS, Request for Proposals (RFP) No. 2015-195-LR was released on July. 9, 2015; and WHEREAS, a pre-proposal conference was held on July 23, 2015; and WHEREAS, the City received proposals from Aon Consulting Inc., Gallagher Benefit Services, Inc., and Wells Fargo Insurance Services USA, Inc.; and WHEREAS, on October 20, 2015, the City Manager, via Letter to Commission, appointed an Evaluation Committee (the"Committee") consisting of the following individuals: • Sonia Bridges, Risk Manager, Human Resources Department, City of Miami Beach • Kathie Brooks, Assistant City Manager, City of Miami Beach • Tameka Otto-Stewart, Budget Officer, Budget Department, City of Miami Beach • Anne-Marie Sharpe, Risk Manager, City of Miami • Allison Williams, Interim Acting Assistant Director, Finance Department, City of Miami Beach; and The following Alternates were also appointed: • Jim Buschman, Risk Manager, City of Hallandale Beach • Ramon Suarez, Finance Manager, Finance Department, City of Miami Beach; and WHEREAS, the Committee convened on November 5, 2015 to consider all proposals; and WHEREAS, the Committee was provided an overview of the project, information relative to the City's Cone of Silence Ordinance and the Government Sunshine Law, general information on the scope of services, references, and a copy of the proposal; and WHEREAS, the Committee was instructed to score and rank the proposals pursuant to the evaluation criteria established in the RFP; and WHEREAS, the Evaluation Committee's ranking was as follows: Gallagher Benefit Services, Inc. as the top ranked proposer; Aon Consulting, Inc., second highest ranked proposer; and Wells Fargo Insurance Services USA, Inc., third highest ranked proposer; and WHEREAS, at the December 9, 2015 City Commission meeting, in accordance with the Evaluation Committee's ranking, the City Manager recommended that the Mayor and the City Commission authorize the Administration to enter into negotiations with Gallagher Benefit Services, Inc., as the top ranked proposer; and if the Administration was unsuccessful in its negotiations with Gallagher Benefit Services, Inc., authorize the Administration to negotiate with the second highest ranked proposer, Aon Consulting, Inc.; and if unsuccessful in its negotiations with Aon Consulting, Inc., then the Administration would negotiate with the third highest ranked proposer, Wells Fargo Insurance Services USA, Inc.; and . WHEREAS, at the December 9, 2015 City Commission meeting, Aon Consulting, Inc. • requested that the contract be awarded to them, based upon the fact that Aon Consulting, Inc.'s proposal had a cost value of $30,000 less than the cost proposed by Gallagher Benefit Services, Inc.; and WHEREAS, the City Commission deferred the item to the December 16, 2016 Presentation and Awards meeting, asking the City Manager to conduct further due diligence; and WHEREAS, since the December 9, 2015 City Commission meeting, the City Manager reviewed, once again, the results of the Evaluation Committee and conducted additional due diligence, and recommends that the Mayor and City Commission accept the ranking provided by the Evaluation Committee, which unanimously ranked Gallagher Benefit Services, Inc. as the top ranked proposer, based upon a combination of qualifications, scope and cost. NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City Commission hereby accept the recommendation of the City Manager pertaining to the ranking of firms, pursuant to Request for Proposals (RFP) No. 2015-195-LR for Health Care Benefits Consulting Services; authorize the Administration to enter into negotiations with Gallagher Benefit Services, Inc.; and if unsuccessful in negotiating an agreement with Gallagher Benefit Services, Inc., authorize the Administration to enter into negotiations with Aon Consulting, Inc.; and if unsuccessful in negotiating an agreement with Aon Consulting, Inc., authorize the Administration to enter into negotiations with Wells Fargo Insurance Services USA, Inc.; and further authorize the Mayor and City Clerk to execute an agreement upon conclusion of successful negotiations by the Administration. PASSED AND ADOPTED this 16th da of December 2015. � ••i i 4 / -�"'•:•-•�Phi I L; L. ? , MAYOR ATTES 1NCORP ORATED:* ' ' .~I 26 �� RAFAEL E. GRANADO, CIT CLERK ��< APPROVED AS TO <\ "FORM&LANGUAGE T:wGENDA\2016\January\Procurement\RFP 2015-195-LR '-- are Benefits Consulting Serviceg- TION c9 —(Z 'City Attorney .-K, Dote COMMISSION I I tM SUMMARY Condensed Title: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH,FLORIDA, ACCEPTING THE RECOMMENDATION OF THE CITY MANAGER PERTAINING TO THE RANKING OF FIRMS, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO. 2015-195-LR FOR HEALTH CARE BENEFITS CONSULTING SERVICES. 1 Key Intended Outcome Supported: Ensure expenditure trends are sustainable over the long term. Supporting Data(Surveys, Environmental Scan,etc: N/A . Item Summary/Recommendation: • The Administration issued RFP 2015-195-LR to seek proposals from qualified firms to provide health care benefits consulting services. The RFP was approved for issuance July 8,2015. The RFP was released on July 9,2015.A pre-proposal conference to provide information to the proposers submitting a response was • held on July 23, 2015. On September 11, 2015, the City received proposals from,the following firms:Aon Risk Solutions, Gallagher Benefit Services, Inc., and Wells Fargo Insurance. • On November 5,2015,the Evaluation Committee appointed by the City Manager convened to consider the responsive proposals received. The Committee was instructed to score and rank the proposals received pursuant to the evaluation criteria established in the RFP.The results of the evaluation committee process were presented to the City Manager for his recommendation to the City Commission. After reviewing the submissions and the Evaluation Committee's ranking of the proposals received,the City Manager exercised his due diligence and is recommending that the Mayor and the City Commission, pursuant to Request for Proposal (RFP) No. 2015-195-LR, for Health Care Benefits Consulting Services, authorize the Administration to enter into negotiations with the highest ranked proposer, Gallagher Benefit Services,Inc.The City Manager further recommends that the Mayor and City Clerk be authorized to execute an Agreement upon completion of successful negotiations by the Administration. UPDATE FROM THE DECEMBER 9T"CITY COMMISSION MEETING. On December 9, 2015, the City Commission, pursuant to item C71, considered the City Manager's recommendation to negotiate with Gallagher Benefit Services.At the meeting,the second-ranked proposer, Aon Risk Solutions, despite acknowledging that every member of the Evaluation Committee ranked Gallagher as the top proposer based on qualifications,scope offered and methodology,presented to the City Commission that it should be awarded the contract solely because its cost is apparently$30,000 less than the cost proposed by Gallagher Benefit Services.The City Commission deferred the item to December 16th, asking the City Manager to conduct further due diligence. • The City Manager conducted additional due diligence (as noted on the attached memorandum) and reconsidered the results of the Evaluation Committee process,which, again, resulted in Gallagher Benefit Services being unanimously ranked as the top proposer based on a combination of qualifications,scope and cost, and reaffirms his recommendation to award the contract to Gallagher Benefit Services. RECOMMENDATION ADOPT THE RESOLUTION. Advisory Board Recommendation: Financial Information: The annual cost associated with the health care benefits consulting services is subject to the funds availability approved through the City's budgeting process. Source of Amount Account Funds: 1 2 Total Financial Impact Summary: City Clerk's Office Legislative Tracking: I Alex Denis, Extension 6641 Sign-Offs: Departmen is irector ' � tant City Manager City + na er SCT -I AD ►. . _l�?; JLM' v T • T:(AGENDA1201510ctober\PROCUREMENT\RFP ' _-195-LR Health Care Benefits Consulting Services-Swim ary.doc �� _,b I_ MIAMIBEACH AGENDA ITM DATE 1.2 - i mot r MI,A,M1BEACH City of Miami Beach, 1755 Meridian Avenue,3`d Floor,Miami Beach,Florida 33139,www.miamibeachfl.gov PROCUREMENT DEPARTMENT Tel: 305-673-7490 December 3, 2015 • TO: Gallagher Benefit Services, Inc. jeff angello anaiq.com AON Consulting, Inc.operating as Aon Hewitt adam.lickstein(@,aon.com Wells Fargo Insurance Services USA, Inc. susan.white2wellsfargo.com RE: REQUEST FOR PROPOSAL (RFP) NO. 2015-195-LR HEALTH CARE BENEFITS CONSULTANT SERVICES This letter shall serve as notification that the City Manager will recommend to the Mayor and City Commission (the"Commission")at its December 9, 2015, meeting, that the Commission authorize the administration to enter into negotiations with Gallagher Benefit Services, Inc.for the Health Care Benefits Consultant Services, and further authorizing the Mayor and City Clerk to execute an agreement upon completion of successful negotiations by the Administration. • The City will allow a bid protest to be submitted by 5 p.m.,on December 4,2015. Any protest shall state the particular grounds on which it is based and shall include all pertinent documents and evidence. Protests not timely filed shall be barred. Any basis or ground for a protest not set forth in the letter of protest shall be deemed waived. If the protest Is not resolved by mutual agreement,the City Manager and the City Attorney,or their respective designees, shall promptly issue a decision in writing.The decision shall specifically state the reasons for the action taken and inform the protestor of his or her right to challenge the decision.The parties to the protest shall be bound by the determination of the City Manager and the City Attorney. The City may request reasonable reimbursement for expenses incurred in processing any protest, which expenses shall include, but not be limited to, staff time, legal fees and any other related expense. Should you have any questions or need additional information, please address said inquiries in writing to William Garviso, e-mail:williamgarviso(a miamibeachfl.gov,with a copy to the City Clerk's Office. • Th.1 you, irr Ale I-nis Dir- for Procurement Department c: Rafael Granado, City Clerk We are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, a • historic community. MIAMI BEACH City Commission Meeting SUPPLEMENTAL MATERIAL 2 City Hall,Commission Chambers, 3rd Floor, 1700 Convention Center Drive December 16,2015 Mayor Philip Levine Commissioner John Elizabeth Aleman Commissioner Ricky Arriola Commissioner Kristen Rosen Gonzalez Commissioner Michael Grieco Commissioner Joy Malakoff Commissioner Micky Steinberg City Manager Jimmy L. Morales City Attorney Raul J.Aguila City Clerk Rafael E. Granado Visit us at www.miamibeachfl.gov for agendas and video "streaming"of City Commission Meetings. ATTENTION ALL LOBBYISTS Chapter 2,Article VII, Division 3 of the City Code of Miami Beach entitled "Lobbyists" requires the registration of all lobbyists with the City Clerk prior to engaging in any lobbying activity with the City Commission, any City Board or Committee, or any personnel as defined in the subject Code sections.Copies of the City Code sections on lobbyists laws are available in the City Clerk's office. Questions regarding the provisions of the Ordinance should be directed to the Office of the City Attorney. SUPPLEMENTAL AGENDA R7 - Resolutions R7A A Resolution Accepting The Recommendation Of The City Manager Pertaining To The Ranking Of Firms,Pursuant To Request For Proposals(RFP)No.2015-195-LR For Health Care Benefits Consulting Services. (Procurement/Human Resources) (Deferred from December 9, 2015 -C7I) (Memorandum) 1 Supplemental Material 2, December 16, 2015 R7C Expediting The Proposed South Beach Component Of The Beach Corridor Transit Connection Project Consisting Of A Light Rail Transit/Modern Streetcar System In South Beach 1. A Resolution Approving And Authorizing The Mayor And City Clerk To Execute A Memorandum Of Understanding Between City Of Miami Beach, Florida, City Of Miami, Florida, Miami-Dade County, Florida And Florida Department Of Transportation,District No.6, For The Beach Corridor Direct Connection Project, Including Authorizing The City Contribution Of$417,000, Or 4.17% Of The Overall Study Cost. 2. Discussion On Options To Advance The Proposed South Beach Component Of The Beach Corridor Transit Connection Project, Consisting Of A Light Rail Transit/Modern Streetcar System In South Beach, Including Action With Respect To June, 2015 Unsolicited Proposal Received From Greater Miami Tramlink Partners. (Transportation) (Additional Information) R7E A Discussion Regarding Work Related To The West Avenue Bridge Across Collins Canal, A Pedestrian Bridge, Raising Of Dade Boulevard And Ancillary Improvements For The City. (Public Works) (Memorandum) ii 2 COMMISSION I I tM SUMMARY Condensed Title: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH,FLORIDA, ACCEPTING THE RECOMMENDATION OF THE CITY MANAGER PERTAINING TO THE RANKING OF FIRMS, PURSUANT TO REQUEST FOR PROPOSALS(RFP) NO. 2015-195-LR FOR HEALTH CARE BENEFITS CONSULTING SERVICES. Key Intended Outcome Supported: Ensure expenditure trends are sustainable over the long term. Supporting Data(Surveys, Environmental Scan,etc: N/A Item Summary/Recommendation: The Administration issued RFP 2015-195-LR to seek proposals from qualified firms to provide health care benefits consulting services. The RFP was approved for issuance July 8,2015. The RFP was released on July 9,2015.A pre-proposal conference to provide information to the proposers submitting a response was held on July 23, 2015. On September 11, 2015, the City received proposals from the following firms:Aon Risk Solutions, Gallagher Benefit Services, Inc., and Wells Fargo Insurance. On November 5,2015,the Evaluation Committee appointed by the City Manager convened to consider the responsive proposals received. The Committee was instructed to score and rank the proposals received pursuant-to the evaluation-criteria-established-in-the-RFP.—T-he-resuits-of the-evaluation-committee-process-were presented to the City Manager for his recommendation to the City Commission. After reviewing the submissions and the Evaluation Committee's ranking of the proposals received,the City Manager exercised his due diligence and is recommending that the Mayor and the City Commission, pursuant to Request for Proposal(RFP) No. 2015-195-LR, for Health Care Benefits Consulting Services, authorize the Administration to enter into negotiations with the highest ranked proposer, Gallagher Benefit Services,Inc.The City Manager further recommends that the Mayor and City Clerk be authorized to execute an Agreement upon completion of successful negotiations by the Administration. UPDATE FROM THE DECEMBER 9T"CITY COMMISSION MEETING. On December 9, 2015, the City Commission, pursuant to item C7I, considered the City Manager's recommendation to negotiate with Gallagher Benefit Services.At the meeting,the second-ranked proposer, Aon Risk Solutions, despite acknowledging that every member of the Evaluation Committee ranked Gallagher as the top proposer based on qualifications,scope offered and methodology,presented to the City Commission that it should be awarded the contract solely because its cost is apparently$30,000 less than the cost proposed by Gallagher Benefit Services.The City Commission deferred the item to December 16th, asking the City Manager to conduct further due diligence. The City Manager conducted additional due diligence (as noted on the attached memorandum) and reconsidered the results of the Evaluation Committee process,which, again, resulted in Gallagher Benefit Services being unanimously ranked as the top proposer based on a combination of qualifications,scope and cost, and reaffirms his recommendation to award the contract to Gallagher Benefit Services. RECOMMENDATION ADOPT THE RESOLUTION. Advisory Board Recommendation: Financial Information: The annual cost associated with the health care benefits consulting services is subject to the funds availability approved through the City's budgeting process. Source of Amount Account Funds: 1 2 Total , Financial Impact Summary: City Clerk's Office Legislative Tracking: Alex Denis, Extension 6641 Sign-Offs: Departmen irector 1 !\tant City Manager City na er SCTPL--/ AD �:��`' JLM T:\AGENDA1201510ctober\PROCUREMENTIRFP • -195-LR Health Care Benefits Consulting Services-Suni m ry.doc AGENDA ITEM Kr1 Mir 3 DATE I.2-jb-I� MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov COMMISSION EMORANDUM TO: Mayor Philip Levine and Members of e City Co •sion FROM: Jimmy L. Morales, City Manager DATE: December 16, 2015 SUBJECT: A RESOLUTION OF THE MAYO-1 AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEP ING THE RECOMMENDATION OF THE CITY MANAGER PERTAINING TO THE RANKING OF FIRMS, PURSUANT TO REQUEST FOR PROPOSAL (RFP) NO. 2015-195-LR HEALTH CARE BENEFITS CONSULTING SERVICES. ADMINISTRATION RECOMMENDATION Adopt the resolution. FUNDING The annual cost associated with the health care benefits consulting services is subject to the funds availability approved through the City's budgeting process. BACKGROUND On July 8, 2015, the City Commission approved the issuance of Request for Proposals (RFP) No. 2015-195-LR for Health Care Benefits Consulting Services. The Administration issued RFP 2015-195- LR to seek proposals from qualified firms to provide health care benefits consulting services for the City of Miami Beach. RFP PROCESS The RFP was released on July 9, 2015. A pre-proposal conference to provide information to potential proposers was held on July 23, 2015. On September 11, 2015, the City received proposals from Aon Risk Solutions, Gallagher Benefit Services, Inc., and Wells Fargo Insurance. On October 20, 2015, the City Manager appointed, via letter to Commission (LTC) No. 447-2015, an Evaluation Committee(the Committee), consisting of the following individuals: • Sonia Bridges, Risk Manager, Human Resources Department, City of Miami Beach • Kathie J. Brooks, Assistant City Manager, City of Miami Beach • Tameka Otto-Stewart, Budget Officer, Budget Department, City of Miami Beach • Anne-Marie Sharpe, Risk Manager, City of Miami • Allison Williams, Interim Acting Assistant Director, Finance Department, City of Miami Beach The following Alternates were also appointed: • Jim Buschman, Risk Manager, City of Hallandale Beach • Ramon Suarez, Finance Manager, Finance Department, City of Miami Beach Ms. Brooks and Ms. Sharpe were unable to participate, and were replaced by the listed alternates. The Committee convened on November 5, 2015, to consider the proposals received. The Committee was provided an overview of the project, information relative to the City's Cone of Silence Ordinance and the Government in the Sunshine Law. The Committee was also provided general information on the scope of services, references, and a copy of each proposal. The Committee was instructed to score and rank the proposals pursuant to the evaluation criteria established in the RFP. 4 Commission Memorandum—RFP 2015-195-LR Health Care Benefits Consulting Services December 9,2015 Page 2 ' -:, ..Eyaluatiori�Criteri r -44 Total Proposer Experience and Qualifications, including Financial Capability 45 Scope of Services Proposed 15 Approach and Methodology 20 Cost Proposal 20 The RFP also stipulated that additional points would be applied, if applicable, pursuant to the City's Veteran's Preference Ordinance. However, none of the proposers were eligible for the veteran's preference. After proposer's presentations and interviews, the Committee discussed the proposers' qualifications, experience, and competence, and further scored the proposers in accordance with the qualitative criteria established in the RFP (experience & qualifications, scope of services, and approach/_methodol_og_y_)_As_stipulated_i.n the RFP,cost_proposal scores (indicated below) were added _ to the qualitative scores established by the committee members. The final rankings are as follows: r a RFP#2015-195-LR Health vh d Care Benefits Consulting 'o r E u N Services m C Y o C O g CO 0 d ce Ranking cc Ranking � Ranking � Ranking a O Aon Risk Solutions 76 2 81 2 91 2 95 2 80 2 10 2 Gallagher Benefit Services,Inc. 95 1 91 1 96 1 97: 1 87 1 _ 5 1 Wells Fargo Insurance 68 3 80 3 88 3 87 3 68 3 15 3 Cost Points Maximum Allowable Total Points Proposer Annual Cost Points Awarded` Aon Risk Solutions $150,000.00 20 20 Gallagher Benefit Services,Inc. $180,000.00 20 17 Wells Fargo Insurance $200,000.00- 20 15 In determining responsiveness and responsibility of the firm, the Procurement Department verified compliance with the minimum requirements established in the RFP, financial capacity as contained in the Dun & Bradstreet Supplier Qualifier Report, and past performance through client references submitted by each proposer. MANAGER'S DUE DILIGENCE After reviewing the submissions and the Evaluation Committee's ranking of the proposals received, the City Manager exercised his due diligence and is recommending that the Mayor and the City Commission, pursuant to Request for Proposal (RFP) No. 2015-195-LR, for Health Care Benefits Consulting Services, authorize the Administration to enter into negotiations with the highest ranked proposer, Gallagher Benefit Services, Inc. The City Manager further recommends that the Mayor and City Clerk be authorized to execute an Agreement upon completion of successful negotiations by the Administration. The City Manager notes that Gallagher Benefit Services, Inc. is the City's current contractor for benefits consulting services. According to staff, Gallagher Benefit Services, Inc. has performed well over the 5 year term of the current agreement. Their services have also been attained by other local municipal agencies such as Palm Beach County Board of County Commissioners, the City of Boca Raton and the School Board of Broward County. I 5 Commission Memorandum—RFP 2015-195-LR Health Care Benefits Consulting Services December 9,2015 Page 3 UPDATE FROM DECEMBER 9, 2015 CITY COMMISSION MEETING On December 9, 2015, the City Commission, pursuant to item C7I, considered the City Manager's recommendation to negotiate with Gallagher Benefit Services. At the meeting, the second-ranked proposer, Aon Risk Solutions, despite acknowledging that every member of the Evaluation Committee ranked Gallagher as the top proposer based on qualifications, scope offered and methodology, presented to the City Commission that it should be awarded the contract solely because its cost is apparently $30,000 less than the cost proposed by Gallagher Benefit Services. The City Commission deferred the item to December 16th, asking the City Manager to conduct further due diligence. Accordingly, the City Manager conducted additional due diligence and reconsidered the RFP (which awarded 80 points to non-cost factors and 20 points to cost factors), and the results of the Evaluation Committee process, which, again, resulted in Gallagher Benefit Services being unanimously ranked as the top proposer based on a combination of qualifications, scope and cost. Based on the following, the City-Manager-reaffirms-his-recommendation to award the contract-to Gallagher-Benefit-Services. Cost. Aon's primary argument is that the City would save money by awarding it the contract. First, given the nature of the services envisioned and services provided in the past, the$30,000 difference between the two proposals is negligible. Second, when Aon's responses to certain portions of the RFP are considered, the apparent cost savings may quickly disappear. This is because in its proposal, Aon failed to agree to unlimited actuarial services as requested in the RFP and as agreed to by Gallagher. As an example of how Aon's material alteration of the requirements of the RFP may affect pricing, some actuarial reports previously acquired by the City in other areas (e.g., pension related) have ranged in cost between $400 and $27,000. In fact, with Aon's failure to agree to unlimited actuarial services makes it impossible for the City to determine the full cost of its proposal. In contrast, under the current contract Gallagher has provided actuarial reports and assistance to the Budget Advisory Committee and staff at no additional cost. For these reasons, the apparent cost savings claimed by Aon may not actually exist and Aon's proposal may result in higher costs than the City is currently paying for the required services. Exceptions to RFP Requirements. In addition to its failure to agree to unlimited actuarial services, Aon took other exceptions to the Requirements of the RFP that cause concern. Aon's proposal attempts to limit its liability pursuant to the required services or for errors'in its work. Its proposal included a limitation of liability stating that, "Should any errors in our work occur, we will correct our work product without any additional charge. In addition, to the extent we failed[sic]to satisfy our obligations under this letter, our liability to you will not exceed a mutually agreed amount. As our sole responsibility under this letter is to the City, the City will be responsible for any third party claims against you or us arising out of or in connection with the service. Third parties include your affiliates, the plans, any trustees and any employees, participants or their representatives. If it is determined that any damages to such third parties resulted from our error, we will reimburse the City up to the amount agreed upon in the contract."This attempt to limit liability by Aon pursuant to the services it would provide is concerning to the City. Finally, the RFP required that the proposer provide guidance on the transitional fee reinsurance program and calculate the transitional reinsurance fee. While Aon agreed to provide the City guidance, it made no mention of calculating of the transitional reinsurance fee, a critical component for the City. Current Services Provided by Gallagher. The contract requires that the consultant's work include, but not be limited to: unlimited actuarial support and analysis of the self-funded medical and dental health care coverage plans, negotiations with carriers to obtain the best prices and terms and conditions available, support and guidance in the implementation and impact of the Patient Protection and Affordability Act and interpretation and application of any other benefit related regulation, actuarial analyses and reporting as required for the Government Accounting Standard Board (GASB) 45 filing, and review and approval of the carriers' summary plan descriptions. Through the current consultant agreement,the City has had unlimited access to the lead consultant, two benefit consultants/account managers, an actuary and a benefits attorney, who are all local. 6 Commission Memorandum—RFP 2015-195-LR Health Care Benefits Consulting Services December 9,2015 Page 4 Projects/assignments to Gallagher Benefits Consulting in the recent past include, but are not limited to, reviewing a pharmacy cost containment program, assisting the City with defining the scope of work for the wellness program RFP and preparing the City to comply with the new IRS reporting requirement as of March 2016. Perhaps the most complex and labor-intensive project, not specifically identified in the scope of work was working with the Budget Advisory Committee in 2012 on an analysis of the City's health plan services. On August 29, 2012, the premiums paid by the City and its enrolled active employees and retirees for health care insurance coverage for general employees enrolled in the City's self-funded plan was discussed by the Committee of the Whole as part of the Mayor's and Commissioner's proposed budget for FY 2012/13. With Humana's loss of the Baptist network, the consultant assisted with an expedited solution through an informal process to continue providing the City's insured employees and retirees access to the Baptist network providers. Consequently, the City Commission approved a two self-funded arrangement to included AvMed as the carrier to provide access to the Baptist network. A mini-open enrollment period was opened and the City's insured employees and retirees had the opportunity to make a change. It was a seamless process and continuity of care was not disrupted. When the City needed an experienced benefits manager as part of its staff, Gallagher actively, and for no additional cost, assisted the City in finding the right person to come in and assume the role, at least on a temporary basis, while firmer plans were developed. In the recent past, Gallagher conducted all the actuarial work to assist the City in offering transgender health insurance benefits. Their work demonstrated that offering this benefit would not have a considerable effect on the City's health insurance cost, but could result in a significant recruitment tool and goodwill among the community. Past Performance. Throughout the years Gallagher has worked closely with the Human Resources Department, Budget Office and Assistant City Manager, Kathie Brooks. Staff has been responsive to our needs and desires and has delivered as requested. Quarterly meetings are held to go over our experience and actuarial projections for the rest of the benefit year. Their knowledge of the City's experience providing health care benefits is exhaustive. The staff attorney and current account manager have spent a significant amount of time familiarizing City staff with the Patient Protection and Affordability Act, and assisted City staff to ensure fees were correctly paid and on time. Gallagher staff responds to calls and emails promptly, including weekends and evenings. Aon and Broward County entered into a five-year, with two one-year options to renew, agreement for Owner's Control Insurance Program (OCIP). Upon expiration of the five-year agreement, Broward County did not exercise its options to renew; instead, hired their current broker of record, Arthur J. Gallagher, to continue the administration of their program. In addition to the four cases in which Aon is named as a defendant, that appears on Aon's Dunn and Bradstreet Report, the City has learned that Aon has outstanding issues with Broward County and Miami-Dade County Aviation Department. CONCLUSION The Administration continues to recommend that the Mayor and City Commission of the City of Miami Beach, Florida, approve the resolution accepting the recommendation of the City Manager, pursuant to Request for Proposal(RFP) No. 2015-195-LR, for Health Care Benefits Consulting Services, authorizing the Administration to enter into negotiations with Gallagher Benefit Services, Inc. and further authorizing the Mayor and City Clerk to execute an agreement with Gallagher Benefit Services, Inc., upon completion of successful negotiations by the Administration. JLM/MT/SCT/AD T:\AGENDA■2015\October\PROCUREMENT\RFP 2015-195-LR Health Care Benefits Consulting Services-Memo(FINAL).doc 7 RESOLUTION TO BE SUBMITTED 8 R7 - Resolutions R7A A Resolution Accepting The Recommendation Of The City Manager Pertaining To The Ranking Of Firms, Pursuant To Request For Proposals (RFP) No. 2015-195-LR For Health Care Benefits Consulting Services. (Procurement/Human Resources) (Deferred from December 9, 2015- C7I) (Item to be Submitted in Supplemental) Agenda Item 1 7 A Date 12-16-15 117 THIS PAGE INTENTIONALLY LEFT BLANK 118 agst loses Aitanscmomi,"i, COLIMMINIMAMAITAlag ton ormworeasetamw.a , FALAMIBEACH City of Miami Beach, 1755 Meridian Avenue,3'd Floor,Miami Beach,Florida 33139,www.miamibeachfl.gov PROCUREMENT DEPARTMENT Tel: 305-673-7490 December 3,2015 TO: Gallagher Benefit Services, Inc. Jeff angello(a,aig.com AON Consulting, Inc.operating as Aon Hewitt adam.licksteinaon.com Wells Fargo Insurance Services USA, Inc.. susan.white2(cwelisfargo.com RE: REQUEST FOR PROPOSAL (RFP) NO. 2015-195-LR HEALTH CARE BENEFITS CONSULTANT SERVICES This letter shall serve as notification that the City Manager will recommend to the Mayor and City Commission (the"Commission")at its December 9,2015, meeting, that the Commission authorize the administration to enter into negotiations with Gallagher Benefit Services, Inc.for the Health Care Benefits Consultant Services, and further authorizing the Mayor and City Clerk to execute an agreement upon completion of successful negotiations by the Administration. The City will allow a bid protest to be submitted by 5 p.m.,on December 4,2015. Any protest shall state the particular grounds on which it is based and shall include all pertinent documents and evidence. Protests not timely filed shall be barred. Any basis or ground for a protest not set forth in the letter of protest shall be deemed waived. If the protest is not resolved by mutual agreement,the City Managerand the City Attorney,or their respective designees, shall promptly issue a decision in writing.The decision shall specifically state the reasons for the action taken and inform the protestor of his or her right to challenge the decision. The parties to the protest shall be bound by the determination of the City Manager and the City Attorney. The City may request reasonable reimbursement for expenses incurred in processing any protest, which expenses shall include, but not be limited to, staff time, legal fees and any other related expense. Should you have any questions or need additional information, please address said inquiries in writing to William Garviso, e-mail:williamgarviso(a miamibeachfl.gov,with a copy to the City Clerk's Office. Th.1 you, Ale Dir- tor Procurement Department c: Rafael Granado, City Clerk We are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community. ATTACHMENT B REQUEST FOR PORPOSAL (RFP) AND ADDENDUMS _ % INENNIMINNEENNENNEESSESINIU 1`•2Gfl. City of Miami Beach, 1755 Meridian Avenue, 3rd Floor,Miami Beach,Florida 33139,www.miamibeachfl.gov PROCUREMENT DEPARTMENT Tel: 305-673-7490 ADDENDUM NO. 6 REQUEST FOR PROPOSALS NO. 2015-195-LR HEALTH CARE BENEFITS CONSULTING SERVICES September 3, 2015 This Addendum to the above-referenced RFP is issued in response to questions from prospective proposers, or other clarifications and revisions issued by the City. The RFP is amended in the following particulars only. I. RESPONSES TO QUESTIONS RECEIVED: Q1. Would the City be willing to negotiate a mutually agreeable limit of liability for this contract? Al. Please refer to Section 0200, Instructions to Respondents and General Conditions, Number 34 entitled Exceptions to RFP. Q2. Appendix E, Proposal Tender Form, reflects a commission percentage of premium as the method of compensation. Does the City desire a commission or fee arrangement for this contract? A2. The method of compensation requested is a commission as a percentage of Administrative Services Only(ASO) provider fees. Q3. If you desire proposing firms to adhere exactly to the Cost Proposal Form, - - Appendix E, as written and provide a proposed commission rate, what is the current premium volume in order to complete the form? A3. The current fee arrangement is based on enrollment, where the medical provider pays a flat fee of $10/per employee/per month, not to exceed $200,000. The enrollment is approximately 1400 Active and 500 Retirees. Q4. Your current contract reflects a fixed annual fee of $190,000 without Government Accounting Standards Board (GASB) 45 and $200,000 with GASB 45. Is this the current arrangement with the City? A4. Yes. 1 IPage Addendum No.6 RFP 2015-194-LR Health Care Benefits Consultant Services Q5. Does the City desire pricing from proposing firms that INCLUDES Government Accounting Standards Board (GASB) 45, Medicare Part D, annual Obligations Postemployment Benefits (OPEB) liability reporting and OPEB guidance? A5. Yes. Q6. Is the Government Accounting Standards Board (GASB) work requested in the RFP for the current fiscal year or fiscal year 2016? A6. It is for the current fiscal year. Q7. What is the City currently paying for the Government Accounting Standards Board (GASB)work and who provides this service to the City? A7. Government Accounting Standards Board work is included in the flat fee to the Consultant. The flat fee is $10 per employee/per month who are enrolled in the medical plans Q8. Similarly, who currently performs the actuarial services for your FS 112.08 filings and what is that fee? A8. The actuarial services are provided by Gallagher Benefits Consulting. Gallagher performs the Government Accounting Standards Board (GASB) and Actuarial services. The current agreement states that they will be paid $190,000 annually without completion of an actuarial analysis or $200,000 with completion of an actuarial analysis. The consultant is compensated from fees received directly from the Administrative Services Only(ASO) provider. Q9. Do you need calculations determined under the new Government Accounting Standards Board (GASB) 75 requirement that are replacing GASB 45 for fiscal year September 30, 2018? A9. Yes Q10. If there are exceptions or clarifications, can Prospective Proposer include those on the Proposal Certification Form? A10. Please refer to Section 0200, Instructions to Respondents and General Conditions, Number 34 entitled Exceptions to RFP. Q11. Item 7 of C2. Statement of Work Required indicates "unlimited actuarial services". As unlimited services are difficult to price, would the City be willing to accept "appropriate", or"required" actuarial services? A11. The City would like to keep the"unlimited"wording in this section. 2 I Page Addendum No.6 RFP 2015-194-LR Health Care Benefits Consultant Services Q12. In Section 0300, TAB 3, Scope of Services Proposed requests "Submit detailed information addressing how Proposer will achieve" the scope of services and TAB 4 requests "Submit detailed information on how Proposer plans to accomplish" the scope of services. In the view of the City, what differentiates "achieve" and "accomplish"? Al2. Tab 3 should address the scope of services offered by the Proposer and the extent to which those services address the City's stated requirements or desired scope of services. Tab 4 should address the Proposer's methodology, analysis, communications plan, market research to assure that the City is received the high standards in brokerage and advisory services. Q13. Are there any preference points or special consideration for being an Minority Business Enterprise (MBE)? A13. No. Q14. How is retiree coverage handled? A14. The pension office makes a monthly deposit of retiree's contributions to a dedicated account that is managed by the City's Human Resources Benefits Division. Any questions regarding this Addendum should be submitted in writing to the Procurement Management Department to the attention of the individual named below, with a copy to the City Clerk's Office at RafaelGranado@miamibeachfl.gov. Procurement Contact: Telephone: Email: Lourdes Rodriguez 305-673-7000, ext. 6652 LourdesRodriguez @miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submission. Potential proposers that have elected not to submit a response to the RFP are requested to complete and return the "Notice to Prospective Bidders" questionnaire with the reason(s) for not submitting a .proposal. y, / le ,. .Denis Prod, rement Director 3 I Page t Bern oee o a City of Miami Beach, 1755 Meridian Avenue, 3`d Floor,Miami Beach, Florida 33139,www.miamibeachfl.gov PROCUREMENT DEPARTMENT Tel: 305-673-7490 ADDENDUM NO. 5 REQUEST FOR PROPOSALS NO. 2015-195-LR HEALTH CARE BENEFITS CONSULTING SERVICES AUGUST 27, 2015 This Addendum to the above-referenced RFP is issued in response to questions from prospective proposers, or other clarifications and revisions issued by the City. The RFP is amended in the following particulars only. I. REVISION: Deadline for the receipt of proposals is hereby changed to September 11, 2015 at 3:00 pm. Any questions regarding this Addendum should be submitted in writing to the Procurement Management Department to the attention of the individual named below, with a copy to the City Clerk's Office at RafaelGranado @miamibeachfl.gov. Procurement Contact: Telephone: Email: Lourdes Rodriguez 305-673-7000, ext. 6652 LourdesRodriguez @miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submission. Potential proposers that have elected not to submit a response to the RFP are requested to complete and return the "Notice to Prospective Bidders" questionnaire with the reason(s) for not submitting a proposal. j4i !- , � %%=pis Procurement Director { AMP stianClar.. 40=2:N., IMO 4111129131111111511M WIMP City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov PROCUREMENT DEPARTMENT Tel: 305-673-7490 ADDENDUM NO. 4 REQUEST FOR PROPOSALS NO. 2015-195-LR HEALTH CARE BENEFITS CONSULTING SERVICES AUGUST 20, 2015 This Addendum to the above-referenced RFP is issued in response to questions from prospective proposers, or other clarifications and revisions issued by the City. The RFP is amended in the following particulars only. I. REVISION: Deadline for the receipt of proposals is hereby changed to September 4, 2015 at 3:00 pm. II. Please also be reminded that proposals are to be delivered to: City of Miami Beach Procurement Department 1755 Meridian Avenue, 3rd Floor Miami Beach, FL 33139 Any questions regarding this Addendum should be submitted in writing to the Procurement Management Department to the attention of the individual named below, with a copy to the City Clerk's Office at RafaelGranado @miamibeachfl.gov. Procurement Contact: Telephone: Email: Lourdes Rodriguez 305-673-7000, ext. 6652 LourdesRodriguez @miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submi"ssion. - Potential proposers that have elected not to submit a response to the RFP are requested to complete and return the "Notice to Prospective Bidders" questionnaire with the reason(s) for not submitting a proposal. e Alex 1 nis Procur ent Director 1 ' a00111011w 4011.1 ▪ �� ▪ egamimissommitailimemixastomova �. I gS•2L1 City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov PROCUREMENT DEPARTMENT Tel: 305-673-7490 ADDENDUM NO. 3 REQUEST FOR PROPOSALS NO. 2015-195-LR HEALTH CARE BENEFITS CONSULTING SERVICES AUGUST 7, 2015 This Addendum to the above-referenced RFP is issued in response to questions from prospective proposers, or other clarifications and revisions issued by the City. The RFP is amended in the following particulars only. I. REVISION: The following has been added to Appendix F — Insurance Requirements: Professional Liability (Errors & Omissions) Insurance appropriate to the Consultant's profession, with limit no less than $1,000,000 per occurrence or per claim, $2,000,000 aggregate. II. RESPONSES TO QUESTIONS RECEIVED: Q1. Prospective Proposer's attorney and risk manager have reviewed the full RFP to ensure compliance with all of the City's requirements. There are two items they have made inquiries about in the section labeled Appendix F, Insurance Requirements and have requested a change to the language provided within the RFP and we are seeking the City's approval to do so. In the first sentence of the paragraph just below bullet point C: A waiver of subrogation in favor of the City must be provided for the insurance required above. Prospective proposer asks that the following be added to the end of that sentence: except for Workers' Compensation. Does the City of Miami Beach approve the change in the sentence, so that it now reads: A waiver of subrogation in favor of the City must be provided for the insurance required above except for Workers' Compensation? Al. The City's Risk Manager will not agree to the requested change. Q2. In the sentence just above where the address is located with instructions for the name of the certificate holder at the bottom of the page, Prospective proposer is proposing different language, that which does not change the intent of the requirement. The sentence in the RFP reads as follows: City of Miami Beach RFP - Current: Certificates will indicate no modification or change in insurance shall be made without thirty (30) days in advance notice to the certificate holder. L. e ®ate® PPM.1101.1=IMMillialli ts 4g I f '4 D �° 4(tom Li Proposed: The vendor will provide that no modification or material change in insurance that results in noncompliance with the insurance requirements outlined herein shall be made without thirty (30) days in advance notice to the certificate holder. A2. The City's Risk Manager approves proposed language for advanced notice of change to coverage. Any questions regarding this Addendum should be submitted in writing to the Procurement Management Department to the attention of the individual named below, with a copy to the City Clerk's Office at RafaelGranado @miamibeachfl.gov. Procurement Contact: Telephone: Email: Lourdes Rodriguez 305-673-7000, ext. 6652 LourdesRodriguez @miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submission. Potential proposers that have elected not to submit a response to the RFP are requested to complete and return the "Notice to Prospective Bidders" questionnaire with the reason(s) for not submitting a proposal. Sind- Alex ►► is P = u ement Director NM AMR Eh. • Min City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov PROCUREMENT DEPARTMENT Tel: 305-673-7490 ADDENDUM NO. 2 REQUEST FOR PROPOSALS NO. 2015-195-LR HEALTH CARE BENEFITS CONSULTING SERVICES JULY 29, 2015 This Addendum to the above-referenced RFP is issued in response to questions from prospective • proposers, or other clarifications and revisions issued by the City. The RFP is amended in the following particulars only. 1. Please be advised that the Procurement Department is moving to a new location as listed below and therefore, responses are to be delivered to following address: City of Miami Beach Procurement Department 1755 Meridian Avenue, 3rd Floor Miami Beach, FL 33139 Note: THIS LOCATION IS NOT IN CITY HALL. Vendors are cautioned to become familiar with the new location prior to the due date for bids or proposals. Late bids or proposals will not be accepted. Any questions regarding this Addendum should be submitted in writing to the Procurement Management Department to the attention of the individual named below, with a copy to the City Clerk's Office at RafaelGranado@miamibeachfl.gov. Procurement Contact: Telephone: Email: Lourdes Rodriguez 305-673-7000, ext. 6652 LourdesRodriguez @miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submission. Potential proposers that have elected not to submit a response to the RFP are requested to complete and return the "Notice to Prospective Bidders" questionnaire with the reason(s) for not submitting a pro - / A1/ enis Procurement Director .--r MAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov PROCUREMENT DEPARTMENT Tel: 305-673-7490 ADDENDUM NO. 1 REQUEST FOR PROPOSALS (RFP)NO. 2015-195-LR FOR HEALTH CARE BENEFITS CONSULTING SERVICES(the RFP) JULY 9,2015 This Addendum to the above-referenced RFP is issued in response to questions from prospective proposers, or other clarifications and revisions issued by the City. The RFP is amended in the following particulars only. I. REVISIONS: The Responses Due date listed on Section 0200, 3. Solicitation Timetable has been corrected as follows: 3.SOLICITATION TIMETABLE.The tentative schedule for this solicitation is as follows: RFP Issued July 9,2015 Pre-Proposal Meeting July 23,2015 at 10 a.m. Deadline for Receipt of Questions August 14, 2015 by 5 P 9 � Y p.m. Responses Due August 247 25,2015 @ 3 p.m. Evaluation Committee Review TBD Proposer Presentations TBD Tentative Commission Approval Authorizing TBD Negotiations Contract Negotiations Following Commission Approval Any questions regarding this Addendum should be submitted in writing to the Procurement Management Department to the attention of the individual named below, with a copy to the City Clerk's Office at RafaelGranado @miamibeachfl.gov. Contact: Telephone: Email: Lourdes Rodriguez 305-673-7000 ext. 6652 LourdesRodriguez @miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submission. Potential proposers that have elected not to submit a response to the RFP are requested to complete and return the"Notice to Prospective Bidders"questionnaire with the reason(s)for not submitting a proposal. Sincerely, Alex Denis Procurement Director RFP No.2015-195-LR Addendum#1 7/9/2015 REQUEST FOR PROPOSALS ( RFP HEALTH CARE BENEFITS CONSULTANT SERVICES 2015-195-LR RFP ISSUANCE DATE: JULY 9, 2015 PROPOSALS DUE: AUGUST 25, 2015 @ 3:00 PM ISSUED BY: LOURDES RODRIGUEZ .41= MIAMIBEACH Lourdes Rodriguez PROCUREMENT DEPARTMENT 1700 Convention Center Drive, Miami Beach, FL 33139 305.673.7000 x 6652 I Fax: 786.394-4075 I www.miamibeachfl.gov CI MIAMI BEACH TABLE OF CONTENTS SOLICITATION SECTIONS: PAGE 0100 NOT UTILIZED N/A 0200 INSTRUCTIONS TO PROPOSERS & GENERAL CONDITIONS 3 0300 PROPOSAL SUBMITTAL INSTRUCTIONS & FORMAT 10 0400 PROPOSAL EVALUATION 12 APPENDICES: APPENDIX A PROPOSAL CERTIFICATON, QUESTIONNAIRE AND AFFIDAVITS APPENDIX B "NO PROPOSAL" FORM APPENDIX C MINIMUM REQUIREMENTS & SPECIFICATIONS APPENDIX D COST PROPOSAL FORM APPENDIX E INSURANCE REQUIREMENTS RFP 2015-195-LR 2 MIAMI BEACH SECTION 0200 INSTRUCTIONS TO RESPONDENTS&GENERAL CONDITIONS 1. GENERAL. This Request for Proposals (RFP) is issued by the City of Miami Beach, Florida (the "City"), as the means for prospective Proposers to submit their qualifications, proposed scopes of work and revenue sharing proposals (the "proposal") to the City for the City's consideration as an option in achieving the required scope of services and requirements as noted herein. All documents released in connection with this solicitation, including all appendixes and addenda, whether included herein or released under separate cover, comprise the solicitation, and are complementary to one another and together establish the complete terms, conditions and obligations of the Proposers and, subsequently, the successful Proposer(s) (the"contractor[s]°)if this RFP results in an award. The City utilizes PublicPurchase (www.publicpurchase.com) for automatic notification of competitive solicitation opportunities and document fulfillment, including the issuance of any addendum to this RFP. Any prospective Proposer who has received this RFP by any means other than through PublicPurchase must register immediately with PublicPurchase to assure it receives any addendum issued to this RFP. Failure to receive an addendum may result in disqualification of proposal submitted. 2. PURPOSE. The City of Miami Beach is requesting proposals from qualified firms to assist the City with administering its employee self-funded medical and dental health care coverage plans. 3.SOLICITATION TIMETABLE.The tentative schedule for this solicitation is as follows: RFP Issued July 9,2015 Pre-Proposal Meeting July 23,2015 at 10 a.m. Deadline for Receipt of Questions August 14,2015 by 5 p.m. Responses Due August 24,2015 @ 3 p.m. Evaluation Committee Review TBD Proposer Presentations TBD Tentative Commission Approval Authorizing TBD Negotiations Contract Negotiations Following Commission Approval 4. PROCUREMENT CONTACT. Any questions or clarifications concerning this solicitation shall be submitted to the Procurement Contact noted below: Procurement Contact: Telephone: Email: Lourdes Rodriguez 305-673-7000 x 6652 lourdesrodriquez a(�miamibeachfl.gov Additionally, the City Clerk is to be copied on all communications via e-mail at: RafaelGranado(c miamibeachfl.gov; or via facsimile,: 786-394-4188. The Bid title/number shall be referenced on all correspondence. All questions or requests for clarification must be received no later than ten (10)calendar days prior to the date proposals are due as scheduled in Section 0200-3. All responses to questions/clarifications will be sent to all prospective Proposers in the form of an addendum. RFP 2015-195-LR 3 MIAMI BEACH 5. PRE-PROPOSAL MEETING OR SITE VISIT(S).Only if deemed necessary by the City, a pre-proposal meeting or site visit(s) may be scheduled. A Pre-PROPOSAL conference will be held as scheduled in Solicitation Timeline above at the following address: City of Miami Beach City Hall—4rd Floor City Manager's Small Conference Room 1700 Convention Center Drive Miami Beach, Florida 33139 Attendance (in person or via telephone) is encouraged and recommended as a source of information, but is not mandatory. Proposers interested in participating in the Pre-Proposal Submission Meeting via telephone must follow these steps: (1) Dial the TELEPHONE NUMBER: 1-888-270-9936(Toll-free North America) (2) Enter the MEETING NUMBER: 5804578 Proposers who are interested in participating via telephone should send an e-mail to the contact person listed in this RFP expressing their intent to participate via telephone. 6. PRE-PROPOSAL INTERPRETATIONS. Oral information or responses to questions received by prospective Proposers are not binding on the City and will be without legal effect, including any information received at pre- submittal meeting or site visit(s). Only questions answered by written addenda will be binding and may supersede terms noted in this solicitation.Addendum will be released through PublicPurchase. 7. CONE OF SILENCE. Pursuant to Section 2-486 of the City Code, all procurement solicitations once advertised and until an award recommendation has been forwarded to the City Commission by the City Manager are under the "Cone of Silence." The Cone of Silence ordinance is available at http://library.municode.com/index.aspx?clientlD=13097&statelD=9&statename=Florida. Any communication or inquiry in reference to this solicitation with any City employee or City official is strictly prohibited with the of exception communications with the Procurement Director, or his/her administrative staff responsible for administering the procurement process for this solicitation providing said communication is limited to matters of process or procedure regarding the solicitation. Communications regarding this solicitation are to be submitted in writing to the Procurement Contact named herein with a copy to the City Clerk at rafaelgranado @miamibeachfl.gov. 8. SPECIAL NOTICES. You are hereby advised that this solicitation is subject to the following ordinances/resolutions, which may be found on the City Of Miami Beach website: http://web.miamibeachfl.gov/procurement/scroll.aspx?id=23510 • CONE OF SILENCE CITY CODE SECTION 2-486 • PROTEST PROCEDURES CITY CODE SECTION 2-371 • DEBARMENT PROCEEDINGS CITY CODE SECTIONS 2-397 THROUGH 2-485.3 • LOBBYIST REGISTRATION AND DISCLOSURE OF FEES CITY CODE SECTIONS 2-481 THROUGH 2-406 • CAMPAIGN CONTRIBUTIONS BY VENDORS CITY CODE SECTION 2-487 • CAMPAIGN CONTRIBUTIONS BY LOBBYISTS ON PROCUREMENT ISSUES CITY CODE SECTION 2-488 • REQUIREMENT FOR CITY CONTRACTORS TO PROVIDE EQUAL BENEFITS FOR DOMESTIC PARTNERS CITY CODE SECTION 2-373 • LIVING WAGE REQUIREMENT CITY CODE SECTIONS 2-407 THROUGH 2-410 RFP 2015-195-LR 4 MIAMI BEACH • PREFERENCE FOR FLORIDA SMALL BUSINESSES OWNED AND CONTROLLED BY VETERANS AND TO STATE-CERTIFIED SERVICE- DISABLED VETERAN BUSINESS ENTERPRISES CITY CODE SECTION 2-374 • FALSE CLAIMS ORDINANCE CITY CODE SECTION 70-300 • ACCEPTANCE OF GIFTS,FAVORS&SERVICES CITY CODE SECTION 2-449 9. POSTPONEMENT OF DUE DATE FOR RECEIPT OF PROPOSALS.The City reserves the right to postpone the deadline for submittal of proposals and will make a reasonable effort to give at least three (3) calendar days written notice of any such postponement to all prospective Proposers through PublicPurchase. 10. PROTESTS. Protests concerning the specifications, requirements, and/or terms; or protests after the proposal due date in accordance with City Code Section 2-371, which establishes procedures for protested proposals and proposed awards. Protests not submitted in a timely manner pursuant to the requirements of City Code Section 2- 371 shall be barred. 11. VETERAN BUSINESS ENTERPRISES PREFERENCE. Pursuant to City of Miami Beach Ordinance No. 2011- 3748, the City shall give a five (5) point preference to a responsive and responsible Proposer which is a small business concern owned and controlled by a veteran(s)or which is a service-disabled veteran business enterprise. 12. DETERMINATION OF AWARD. The final ranking results of Step 1 & 2 outlined in Section 0400, Evaluation of Proposals, will be considered by the City Manager who may recommend to the City Commission the Proposer(s) s/he deems to be in the best interest of the City or may recommend rejection of all proposals. The City Manager's recommendation need not be consistent with the scoring results identified herein and takes into consideration Miami Beach City Code Section 2-369, including the following considerations: (1)The ability, capacity and skill of the Proposer to perform the contract. (2)Whether the Proposer can perform the contract within the time specified,without delay or interference. (3)The character, integrity, reputation,judgment, experience and efficiency of the Proposer. (4)The quality of performance of previous contracts. (5)The previous and existing compliance by the Proposer with laws and ordinances relating to the contract. The City Commission shall consider the City Manager's recommendation and may approve such recommendation. The City Commission may also,at its option, reject the City Manager's recommendation and select another Proposal or Proposals which it deems to be in the best interest of the City,or it may also reject all Proposals. Upon approval of selection by the City Commission, negotiations between the City and the selected Proposer(s) will take place to arrive at a mutually acceptable Agreement. 13. ACCEPTANCE OR REJECTION OF PROPOSALS. The City reserves the right to reject any or all proposals prior to award. Reasonable efforts will be made to either award the Contract or reject all proposals within one- hundred twenty (120) calendar days after proposals opening date. A Proposer may not withdraw its proposals unilaterally before the expiration of one hundred and twenty(120)calendar days from the date of proposals opening. 14. PROPOSER'S RESPONSIBILITY. Before submitting a Proposal, each Proposer shall be solely responsible for making any and all investigations, evaluations, and examinations, as it deems necessary, to ascertain all conditions and requirements affecting the full performance of the contract. Ignorance of such conditions and requirements, and/or failure to make such evaluations, investigations, and examinations, will not relieve the Proposer from any obligation to comply with every detail and with all provisions and requirements of the contract, and will not be accepted as a basis for any subsequent claim whatsoever for any monetary consideration on the part of the Proposer. RFP 2015-195-LR 5 MIAMI BEACH 15. COSTS INCURRED BY PROPOSERS.All expenses involved with the preparation and submission of Proposals, or any work performed in connection therewith, shall be the sole responsibility (and shall be at the sole cost and expense)of the Proposer, and shall not be reimbursed by the City. 16. RELATIONSHIP TO THE CITY. It is the intent of the City, and Proposers hereby acknowledge and agree, that the successful Proposer is considered to be an independent contractor, and that neither the Proposer, nor the Proposer's employees, agents, and/or contractors, shall, under any circumstances, be considered employees or agents of the City. 17.TAXES.The City of Miami Beach is exempt from all Federal Excise and State taxes. 18. MISTAKES. Proposers are expected to examine the terms, conditions, specifications, delivery schedules, proposed pricing, and all instructions pertaining to the goods and services relative to this RFP. Failure to do so will be at the Proposer's risk and may result in the Proposal being non-responsive. 19. PAYMENT. Payment will be made by the City after the goods or services have been received, inspected, and found to comply with contract, specifications, free of damage or defect, and are properly invoiced. Invoices must be consistent with Purchase Order format. 20. PATENTS&ROYALTIES. Proposer shall indemnify and save harmless the City of Miami Beach, Florida, and its officers, employees, contractors, and/or agents, from liability of any nature or kind, including cost and expenses for, or on account of, any copyrighted, patented, or unpatented invention, process, or article manufactured or used in the performance of the contract, including its use by the City of Miami Beach, Florida. If the Proposer uses any design, device or materials covered by letters, patent, or copyright, it is mutually understood and agreed, without exception, that the proposal prices shall include all royalties or cost arising from the use of such design, device, or materials in any way involved in the work. 21. MANNER OF PERFORMANCE. Proposer agrees to perform its duties and obligations in a professional manner and in accordance with all applicable Local, State, County, and Federal laws, rules, regulations and codes. Lack of knowledge or ignorance by the Proposer with/of applicable laws will in no way be a cause for relief from responsibility. Proposer agrees that the services provided shall be provided by employees that are educated,trained, experienced, certified, and licensed in all areas encompassed within their designated duties. Proposer agrees to furnish to the City any and all documentation, certification, authorization, license, permit, or registration currently required by applicable laws, rules, and regulations. Proposer further certifies that it and its employees will keep all licenses, permits, registrations, authorizations,or certifications required by applicable laws or regulations in full force and effect during the term of this contract. Failure of Proposer to comply with this paragraph shall constitute a material breach of this contract. Where contractor is required to enter or go on to City of Miami Beach property to deliver materials or perform work or services as a result of any contract resulting from this solicitation, the contractor will assume the full duty, obligation and expense of obtaining all necessary licenses, permits, and insurance, and assure all work complies with all applicable laws. The contractor shall be liable for any damages or loss to the City occasioned by negligence of the Proposer, or its officers, employees, contractors,and/or agents,for failure to comply with applicable laws. 22. SPECIAL CONDITIONS. Any and all Special Conditions that may vary from these General Terms and Conditions shall have precedence. RFP 2015-195-LR 6 P__ MIAMI BEACH 23. ANTI-DISCRIMINATION. The Proposer certifies that he/she is in compliance with the non-discrimination clause contained in Section 202, Executive Order 11246, as amended by Executive Order 11375, relative to equal employment opportunity for all persons without regard to race, color, religion, sex or national origin. 24. DEMONSTRATION OF COMPETENCY. A. Pre-award inspection of the Proposer's facility may be made prior to the award of contract. B. Proposals will only be considered from firms which are regularly engaged in the business of providing the goods and/or services as described in this solicitation. C. Proposers must be able to demonstrate a good record of performance for a reasonable period of time, and have sufficient financial capacity, equipment, and organization to ensure that they can satisfactorily perform the services if awarded a contract under the terms and conditions of this solicitation. D. The terms "equipment and organization", as used herein shall, be construed to mean a fully equipped and well established company in line with the best business practices in the industry, and as determined by the City of Miami Beach. E. The City may consider any evidence available regarding the financial, technical, and other qualifications and abilities of a Proposer, including past performance(experience), in making an award that is in the best interest of the City. F.The City may require Proposer s to show proof that they have been designated as authorized representatives of a manufacturer or supplier,which is the actual source of supply. In these instances, the City may also require material information from the source of supply regarding the quality, packaging, and characteristics of the products to be supply to the City. 25. ASSIGNMENT. The successful Proposer shall not assign, transfer, convey, sublet or otherwise dispose of the contract, including any or all of its right, title or interest therein, or his/her or its power to execute such contract, to any person,company or corporation,without the prior written consent of the City. 26. LAWS, PERMITS AND REGULATIONS. The Proposer shall obtain and pay for all licenses, permits, and inspection fees required to complete the work and shall comply with all applicable laws. 27. OPTIONAL CONTRACT USAGE. When the successful Proposer(s) is in agreement, other units of government or non-profit agencies may participate in purchases pursuant to the award of this contract at the option of the unit of government or non-profit agency. 28. VOLUME OF WORK TO BE RECEIVED BY CONTRACTOR. It is the intent of the City to purchase the goods and services specifically listed in this solicitation from the contractor. However, the City reserves the right to purchase any goods or services awarded from state or other governmental contract, or on an as-needed basis through the City's spot market purchase provisions. 29. DISPUTES. In the event of a conflict between the documents, the order of priority of the documents shall be as follows: A. Any contract or agreement resulting from the award of this solicitation; then B. Addendum issued for this solicitation,with the latest Addendum taking precedence;then C. The solicitation; then D. The Proposer's proposal in response to the solicitation. RF P 2015-195-LR 7 ® MIAMI BEACH 30. INDEMNIFICATION. The contractor shall indemnify and hold harmless the City and its officers, employees, agents and instrumentalities from any and all liability, losses or damages, including attorney's fees and costs of defense, which the City or its officers, employees, agents or instrumentalities may incur as a result of claims, demands, suits, causes of actions or proceedings of any kind or nature arising out of, relating to or resulting from the performance of the agreement by the contractor or its employees, agents, servants, partners, principals or subcontractors. The contractor shall pay all claims and losses in connection therewith, and shall investigate and defend all claims, suits or actions of any kind or nature in the name of the City,where applicable, including appellate proceedings, and shall pay all costs,judgments, and attorney's fees which may be incurred thereon. The contractor expressly understands and agrees that any insurance protection required by this Agreement or otherwise provided by the contractor shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The above indemnification provisions shall survive the expiration or termination of this Agreement. 31. CONTRACT EXTENSION. The City reserves the right to require the Contractor to extend contract past the stated termination date for a period of up to 120 days in the event that a subsequent contract has not yet been awarded.Additional extensions past the 120 days may occur as needed by the City and as mutually agreed upon by the City and the contractor. 32. FLORIDA PUBLIC RECORDS LAW. Proposers are hereby notified that all Bid including, without limitation, any and all information and documentation submitted therewith, are exempt from public records requirements under Section 119.07(1), Florida Statutes, and s. 24(a),Art. 1 of the State Constitution until such time as the City provides notice of an intended decision or until thirty (30) days after opening of the proposals, whichever is earlier. Additionally, Contractor agrees to be in full compliance with Florida Statute 119.0701 including, but not limited to, agreement to (a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the services; (b) provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law; (c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law; (d) Meet all requirements for retaining public records and transfer, at no cost, to the public agency all public records in possession of the contractor upon termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the public agency in a format that is compatible with the information technology systems of the public agency. 33. MODIFICATION/WITHDRAWALS OF PROPOSALS. A Proposer may submit a modified Proposal to replace all or any portion of a previously submitted Proposal up until the Proposal due date and time. Modifications received after the Proposal due date and time will not be considered. Proposals shall be irrevocable until contract award unless withdrawn in writing prior to the Proposal due date, or after expiration of 120 calendar days from the opening of Proposals without a contract award. Letters of withdrawal received after the Proposal due date and before said expiration date, and letters of withdrawal received after contract award will not be considered. 34. EXCEPTIONS TO RFP.Proposers must clearly indicate any exceptions they wish to take to any of the terms in this RFP, and outline what, if any, alternative is being offered. All exceptions and alternatives shall be included and clearly delineated, in writing, in the Proposal. The City,at its sole and absolute discretion, may accept or reject any or all exceptions and alternatives. In cases in which exceptions and alternatives are rejected,the City shall require the Proposer to comply with the particular term and/or condition of the RFP to which Proposer took exception to (as said term and/or condition was originally set forth on the RFP). RFP 2015-195-LR 8 MIAMI BEACH 35.ACCEPTANCE OF GIFTS, FAVORS, SERVICES. Proposers shall not offer any gratuities, favors, or anything of monetary value to any official, employee, or agent of the City, for the purpose of influencing consideration of this Proposal. Pursuant to Sec. 2-449 of the City Code, no officer or employee of the City shall accept any gift, favor or service that might reasonably tend improperly to influence him in the discharge of his official duties. Balance of Page Intentionally Left Blank RFP 2015-195-LR 9 m► MIAMI BEACH SECTION 0300 PROPOSAL SUBMITTAL INSTRUCTIONS AND FORMAT 1. SEALED RESPONSES. One original Proposal (preferably in 3-ring binder) must be submitted in an opaque, sealed envelope or container on or before the due date established for the receipt of proposals. Additionally, ten (10) bound copies and one (1) electronic format (CD or USB format) are to be submitted. The following information should be clearly marked on the face of the envelope or container in which the proposal is submitted: solicitation number, solicitation title, Proposer name, Proposer return address. Proposals received electronically, either through email or facsimile, are not acceptable and will be rejected. 2. LATE BIDS. Bid Proposals are to be received on or before the due date established herein for the receipt of Bids. Any Bid received after the deadline established for receipt of proposals will be considered late and not be Y P P P accepted or will be returned to Proposer unopened. The City does not accept responsibility for any delays, natural or otherwise. 3. PROPOSAL FORMAT. In order to maintain comparability, facilitate the review process and assist the Evaluation Committee in review of proposals, it is strongly recommended that proposals be organized and tabbed in accordance with the sections and manner specified below. Hard copy submittal should be tabbed as enumerated below and contain a table of contents with page references. Electronic copies should also be tabbed and contain a table of contents with page references. Proposals that do not include the required information will be deemed non- responsive and will not be considered. TAB 1 Cover Letter&Minimum Qualifications Requirements 1.1 Cover Letter and Table of Contents.The cover letter must indicate Proposer and Proposer Primary Contact for the purposes of this solicitation. 1.2 Proposal Certification, Questionnaire & Requirements Affidavit (Appendix A). Attach Appendix A fully completed and executed. 1.3 Minimum Qualifications Requirements. Submit verifiable information documenting compliance with the minimum qualifications requirements established in Appendix C, Minimum Requirements and Specifications. TAB 2 Experience&Qualifications 2.1 Qualifications of Proposing Firm. Submit detailed information regarding the firm's history and relevant experience and proven track record of providing the scope of services similar as identified in this solicitation, including experience in providing similar scope of services to public sector agencies. Submit at least three (3) projects within the last five (5) years where the Proposer has performed services similar to the scope of this RFP for a public sector agency. For each project that the Proposer submits as evidence of similar experience,the following is required: project description, agency name,agency contact, contact telephone&email,and year(s)and term of engagement. 2.2 Qualifications of Proposer Team. Provide an organizational chart of all personnel and consultants to be used for this project if awarded,the role that each team member will play in providing the services detailed herein and each team members' qualifications. A resume of each individual, including education, experience, and any other pertinent information, shall be included for each Proposal team member to be assigned to this contract. 2.3 Financial Capacity. Each Proposer shall arrange for Dun & Bradstreet to submit a Supplier Qualification Report (SQR)directly to the Procurement Contact named herein. No proposal will be considered without receipt, by the City, of the SQR directly from Dun & Bradstreet. The cost of the preparation of the SQR shall be the responsibility of the Proposer.The Proposer shall request the SQR report from D&B at: https:llsupplierportal.dnb.com/webapp/wcs/stores lservletlSupplierPortal?storeld=11696 Proposers are responsible for the accuracy of the information contained in its SQR. It is highly recommended that each Proposer review the information contained in its SQR for accuracy prior to submittal to the City and as early as possible in the solicitation process. For assistance with any portion of the SQR submittal process, RFP 2015-195-LR 10 MIAMI BEACH contact Dun&Bradstreet at 800-424-2495. TAB 3 Scope of Services Proposed Submit detailed information addressing how Proposer will achieve each portion of the scope of services and technical requirements outlined in Appendix C, Minimum Requirements and Specifications. Responses shall be in sufficient detail and include supporting documentation, as applicable, which will allow the Evaluation Committee to complete a fully review and score the proposed scope of services. TAB 4 Approach and Methodology Submit detailed information on how Proposer plans to accomplish the required scope of services, including detailed information, as applicable, which addresses, but need not be limited to: review and evaluate existing City benefit related agreements to provide recommendations; assist in preparation of City's request for proposals for its medical, dental, life, disability and voluntary benefit plans; provide plan design and contribution design modeling; manage negotiations of premium rates, etc. TAB 5 Revenue Proposal Submit a completed Revenue Proposal Form (Appendix E). Note: After proposal submittal, the City reserves the right to require additional information from Proposers (or Proposer team members or sub-consultants) to determine: qualifications (including, but not limited to, litigation history, regulatory action, or additional references); and financial capability (including, but not limited to, annual reviewed/audited financial statements with the auditors notes for each of their last two complete fiscal years). RFP 2015-195-LR 11 MIAMI BEACH SECTION 0400 PROPOSAL EVALUATION 1. Evaluation Committee. An Evaluation Committee, appointed by the City Manager, shall meet to evaluate each Proposal in accordance with the requirements set forth in the solicitation. If further information is desired, Proposers may be requested to make additional written submissions of a clarifying nature or oral presentations to the Evaluation Committee. The evaluation of proposals will proceed in a two-step process as noted below. It is important to note that the Evaluation Committee will score the qualitative portions of the proposals only. The Evaluation Committee does not make an award recommendation to the City Manager. The results of Step 1 & Step 2 Evaluations will be forwarded to the City Manager who will utilize the results to make a recommendation to the City Commission. 2. Step 1 Evaluation. The first step will consist of the qualitative criteria listed below to be considered by the Evaluation Committee. The second step will consist of quantitative criteria established below to be added to the Evaluation Committee results by the Department of Procurement Management. An Evaluation Committee, appointed by the City Manager, shall meet to evaluate each Proposal in accordance with the qualifications criteria established below for Step 1, Qualitative Criteria. In doing so, the Evaluation Committee may: • review and score all proposals received,with or without conducting interview sessions;or • review all proposals received and short-list one or more Proposers to be further considered during subsequent interview session(s)(using the same criteria). Step 1, Qualitative Criteria Maximum;Points, Proposer Experience and Qualifications,including Financial Capability 45 Scope of Services Proposed 15 Approach and Methodology 20 TOTAL AVAILABLE STEP 1 POINTS. 80 3. Step 2 Evaluation. Following the results of Step 1 Evaluation of qualitative criteria, the Proposers may receive additional quantitative criteria points to be added by the Department of Procurement Management to those points earned in Step 1, as follows. Step 2 Quantitative Criteria Cost Proposal 20 Veterans Preference 5 TOTAL AVAILABLE STEP 2 POINTS' 25 RFP 2015-195-LR 12 M. MIAMI BEACH 4. Cost Proposal Evaluation.The cost proposal points shall be developed in accordance with the following formula: Sample Objective Formula for Allocation of Cost Proposal Points Vendor Proposed Example Maximum Formula for Calculating Points Total Points Cost Allowable Points (lowest cost I cost of proposal being Awarded (Points noted are for evaluated X maximum allowable illustrative purposes only. points=awarded points) Actual points are noted above.) Round to Vendor A $100.00 20 $1001$100 X 20=20 20 Vendor B $150.00 20 $1 0 0/$1 5 0 X 2 0=1 3 13 Vendor C $200.00 20 $100 I$200 X 20=10 10 5. Determination of Final Ranking. At the conclusion of the Evaluation Committee Step 1 scoring, Step 2 Points will be added to each evaluation committee member's scores by the Procurement Department. Step 1 and 2 scores will be converted to rankings in accordance with the example below: Proposer A Proposer'B Proposer C. Step 1 Points 82 76 80 Step 2 Points 22 15 12 Committee Total 104 91 92 Member 1 Rank 1 3 2 Step 1 Points 79 85 72 Step 2 Points 22 15 12 Committee Total 101 100 84 Member 2 Rank 1 2 3 Step 1 Points 80 74 66 Step 2 Points 22 15 12 Committee Total 102 89 78 Member 2 Rank 1 2 3 Low Aggregate Score- 3 7 8 Final Ranking* 1 2 3 * Final Ranking is presented to the City Manager for further due diligence and recommendation to the City Commission. Final Ranking does not constitute an award recommendation until such time as the City Manager has made his recommendation to the City Commission,which may be different than final ranking results. RFP 2015-195-LR 13 APPENDIX A m MIAMI BEACH Proposal Certification , Questionnaire & Requirements Affidavit RFP 2015- 1 95-LR Health Care Benefits Consultant Services PROCUREMENT DEPARTMENT 1700 Convention Center Drive Miami Beach, Florida 33139 RFP 2015-195{R 14 Solicitation No: Solicitation Title: 2015-195-LR Health Care Benefits Consultant Services Procurement Contact: Tel: Email: Lourdes Rodriguez 305.673.7000 x 6652 lourdesrodriguez @miamibeachfl.gov PROPOSAL CERTIFICATION, QUESTIONNAIRE& REQUIREMENTS AFFIDAVIT Purpose: The purpose of this Proposal Certification, Questionnaire and Requirements Affidavit Form is to inform prospective Proposers of certain solicitation and contractual requirements, and to collect necessary information from Proposers in order that certain portions of responsiveness, responsibility and other determining factors and compliance with requirements may be evaluated. This Proposal Certification, Questionnaire and Requirements Affidavit Form is a REQUIRED FORM that must be submitted fully completed and executed. 1. General Proposer Information. FIRM NAME: No of Years in Business: No of Years in Business Locally: No.of Employees: OTHER NAME(S)PROPOSER HAS OPERATED UNDER IN THE LAST 10 YEARS: FIRM PRIMARY ADDRESS(HEADQUARTERS): CITY: STATE: ZIP CODE: TELEPHONE NO.: TOLL FREE NO.: FAX NO.: FIRM LOCAL ADDRESS: CITY: STATE: ZIP CODE: PRIMARY ACCOUNT REPRESENTATIVE FOR THIS ENGAGEMENT: ACCOUNT REP TELEPHONE NO.: ACCOUNT REP TOLL FREE NO.: ACCOUNT REP EMAIL: FEDERAL TAX IDENTIFICATION NO.: The City reserves the right to seek additional information from Proposer or other source(s),including but not limited to:any firm or principal information,applicable licensure,resumes of relevant individuals,client information,financial information,or any information the City deems necessary to evaluate the capacity of the Proposer to perform in accordance with contract requirements. RFP 2015-195-LR 15 1. Veteran Owned Business.Is Pro oser claiming a veteran owned business status? YES NO SUBMITTAL REQUIREMENT: Proposers claiming veteran owned business status shall submit a documentation proving that firm is certified as a veteran-owned business or a service-disabled veteran owned business by the State of Florida or United States federal government,as required pursuant to ordinance 2011-3748. 2. Conflict Of Interest.All Proposers must disclose,in their Proposal,the name(s)of any officer,director,agent,or immediate family member (spouse, parent, sibling, and child)who is also an employee of the City of Miami Beach. Further, all Proposers must disclose the name of any City employee who owns, either directly or indirectly, an interest of ten (10%) percent or more in the Proposer entity or any of its affiliates. SUBMITTAL REQUIREMENT: Proposers must disclose the name(s)of any officer, director, agent, or immediate family member (spouse,parent,sibling,and child)who is also an employee of the City of Miami Beach. Proposers must also disclose the name of any City employee who owns,either directly or indirectly,an interest of ten(10%)percent or more in the Proposer entity or any of its affiliates 3. References&Past Performance.Proposer shall submit at least three(3)references for whom the Proposer has completed work similar in size and nature as the work referenced in solicitation. SUBMITTAL REQUIREMENT: For each reference submitted, the following information is required: 1) Firm Name, 2) Contact Individual Name&Title,3)Address,4)Telephone,5)Contact's Email and 6)Narrative on Scope of Services Provided. 4. Suspension,Debarment or Contract Cancellation.Has Proposer ever been debarred,suspended or other legal violation,or had a contract cancelled due to non-performance by any public sector agency? �� YES II NO SUBMITTAL REQUIREMENT: If answer to above is"YES," Proposer shall submit a statement detailing the reasons that led to action(s). 5. Vendor Campaign Contributions. Proposers are expected to be or become familiar with, the City's Campaign Finance Reform laws, as codified in Sections 2-487 through 2-490 of the City Code. Proposers shall be solely responsible for ensuring that all applicable provisions of the City's Campaign Finance Reform laws are complied with,and shall be subject to any and all sanctions, as prescribed therein,including disqualification of their Proposals,in the event of such non-compliance. SUBMITTAL REQUIREMENT: Submit the names of all individuals or entities (including your sub-consultants)with a controlling financial interest as defined in solicitation. For each individual or entity with a controlling financial interest indicate whether or not each individual or entity has contributed to the campaign either directly or indirectly,of a candidate who has been elected to the office of Mayor or City Commissioner for the City of Miami Beach. 6. Code of Business Ethics.Pursuant to City Resolution No.2000-23879, each person or entity that seeks to do business with the City shall adopt a Code of Business Ethics("Code")and submit that Code to the Department of Procurement Management with its proposal/response or within five(5)days upon receipt of request.The Code shall,at a minimum, require the Proposer,to comply with all applicable governmental rules and regulations including, among others, the conflict of interest, lobbying and ethics provision of the City of Miami Beach and Miami Dade County. SUBMITTAL REQUIREMENT: Proposer shall submit firm's Code of Business Ethics. In lieu of submitting Code of Business Ethics,Proposer may submit a statement indicating that it will adopt,as required in the ordinance,the City of Miami Beach Code of Ethics,available at www.miamibeachfl.gov/procurement/. RFP 2015-195-LR 16 • . • i i ■•• �i 1 • - • •.• ! - .. 8. Equal Benefits for Employees with Spouses and Employees with Domestic Partners. When awarding competitively solicited contracts valued at over$100,000 whose contractors maintain 51 or more full time employees on their payrolls during 20 or more calendar work weeks,the Equal Benefits for Domestic Partners Ordinance 2005-3494 requires certain contractors doing business with the City of Miami Beach, who are awarded a contract pursuant to competitive proposals, to provide"Equal Benefits"to their employees with domestic partners, as they provide to employees with spouses. The Ordinance applies to all employees of a Contractor who work within the City limits of the City of Miami Beach,Florida;and the Contractor's employees located in the United States, but outside of the City of Miami Beach limits, who are directly performing work on the contract within the City of Miami Beach. A. Does your company provide or offer access to any benefits to employees with spouses or to spouses of employees? YES NO B. Does your company provide or offer access to any benefits to employees with(same or opposite sex)domestic partners*or to domestic partners of employees? YES NO C. Please check all benefits that apply to your answers above and list in the `other" section any additional benefits not already specified. Note: some benefits are provided to employees because they have a spouse or domestic partner, such as bereavement leave; other benefits are provided directly to the spouse or domestic partner,such as medical insurance. BENEFIT Firm Provides for Firm Provides for Firm does not Employees with Employees with Provide Benefit Spouses Domestic Partners Health Sick Leave Family Medical Leave Bereavement Leave If Proposer cannot offer a benefit to domestic partners because of reasons outside your control, (e.g., there are no insurance providers in your area willing to offer domestic partner coverage)you may be eligible for Reasonable Measures compliance. To comply on this basis, you must agree to pay a cash equivalent and submit a completed Reasonable Measures Application (attached)with all necessary documentation.Your Reasonable Measures Application will be reviewed for consideration by the City Manager, or his designee.Approval is not guaranteed and the City Manager's decision is final. Further information on the Equal Benefits requirement is available at www.miamibeachfl.gov/procurement/. RFP 2015-195-LR 17 9. Public Entity Crimes.Section 287.133(2)(a),Florida Statutes,as currently enacted or as amended from time to time,states that a person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a proposal, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a proposal, proposal,or reply on a contract with a public entity for the construction or repair of a public building or public work;may not submit proposals, proposals,or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier,subcontractor,or consultant under a contract with any public entity;and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017 for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. SUBMITTAL REQUIREMENT: No additional submittal is required. By virtue of executing this affidavit document, Proposer agrees with the requirements of Section 287.133,Florida Statutes,and certifies it has not been placed on convicted vendor list. 10. Acknowledgement of Addendum. After issuance of solicitation,the City may release one or more addendum to the solicitation which may provide additional information to Proposers or alter solicitation requirements. The City will strive to reach every Proposer having received solicitation through the City's e-procurement system, PublicPurchase.com. However, Proposers are solely responsible for assuring they have received any and all addendum issued pursuant to solicitation.This Acknowledgement of Addendum section certifies that the Proposer has received all addendum released by the City pursuant to this solicitation. Failure to obtain and acknowledge receipt of all addendum may result in proposal disqualification. Initial to Confirm Initial to Confirm Initial to Confirm Receipt Receipt Receipt Addendum 1 Addendum 6 Addendum 11 Addendum 2 Addendum 7 Addendum 12 Addendum 3 Addendum 8 Addendum 13 Addendum 4 Addendum 9 Addendum 14 Addendum 5 Addendum 10 Addendum 15 If additional confirmation of addendum is required,submit under separate cover. RFP 2015-195-LR 1 8 DISCLOSURE AND DISCLAIMER SECTION The solicitation referenced herein is being furnished to the recipient by the City of Miami Beach (the"City")for the recipient's convenience. Any action taken by the City in response to Proposals made pursuant to this solicitation,or in making any award,or in failing or refusing to make any award pursuant to such Proposals,or in cancelling awards, or in withdrawing or cancelling this solicitation,either before or after issuance of an award,shall be without any liability or obligation on the part of the City. In its sole discretion, the City may withdraw the solicitation either before or after receiving proposals, may accept or reject proposals, and may accept proposals which deviate from the solicitation,as it deems appropriate and in its best interest. In its sole discretion,the City may determine the qualifications and acceptability of any party or parties submitting Proposals in response to this solicitation. Following submission of a Bid or Proposal, the applicant agrees to deliver such further details, information and assurances, including financial and disclosure data, relating to the Proposal and the applicant including, without limitation, the applicant's affiliates, officers, directors,shareholders,partners and employees,as requested by the City in its discretion. The information contained herein is provided solely for the convenience of prospective Proposers. It is the responsibility of the recipient to assure itself that information contained herein is accurate and complete.The City does not provide any assurances as to the accuracy of any information in this solicitation. Any reliance on these contents,or on any permitted communications with City officials,shall be at the recipient's own risk.Proposers should rely exclusively on their own investigations,interpretations,and analyses.The solicitation is being provided by the City without any warranty or representation,express or implied,as to its content, its accuracy,or its completeness. No warranty or representation is made by the City or its agents that any Proposal conforming to these requirements will be selected for consideration,negotiation,or approval. The City shall have no obligation or liability with respect to this solicitation,the selection and the award process,or whether any award will be made.Any recipient of this solicitation who responds hereto fully acknowledges all the provisions of this Disclosure and Disclaimer,is totally relying on this Disclosure and Disclaimer,and agrees to be bound by the terms hereof.Any Proposals submitted to the City pursuant to this solicitation are submitted at the sole risk and responsibility of the party submitting such Proposal. This solicitation is made subject to correction of errors,omissions,or withdrawal from the market without notice. Information is for guidance only,and does not constitute all or any part of an agreement. The City and all Proposers will be bound only as, if and when a Proposal (or Proposals), as same may be modified, and the applicable definitive agreements pertaining thereto, are approved and executed by the parties, and then only pursuant to the terms of the definitive agreements executed among the parties.Any response to this solicitation may be accepted or rejected by the City for any reason,or for no reason,without any resultant liability to the City. The City is governed by the Government-in-the-Sunshine Law,and all Proposals and supporting documents shall be subject to disclosure as required by such law. All Proposals shall be submitted in sealed proposal form and shall remain confidential to the extent permitted by Florida Statutes, until the date and time selected for opening the responses.At that time, all documents received by the City shall become public records. Sosal, the Proposer acknowledges and agrees that the City has the right to make any inquiry or investigation it deems appropriate to substantiate or supplement information contained in the Proposal,and authorizes the release to the City of any and all information sought in such inquiry or investigation. Each Proposer certifies that the information contained in the Proposal is true, accurate and complete, to the best of its knowledge,information,and belief. Notwithstanding the foregoing or anything contained in the solicitation,all Proposers agree that in the event of a final unappealable judgment by a court of competent jurisdiction which imposes on the City any liability arising out of this solicitation, or any response thereto, or any action or inaction by the City with respect thereto, such liability shall be limited to$10,000.00 as agreed-upon and liquidated damages.The previous sentence, however, shall not be construed to circumvent any of the other provisions of this Disclosure and Disclaimer which imposes no liability on the City. In the event of any differences in language between this Disclosure and Disclaimer and the balance of the solicitation,it is understood that the provisions of this Disclosure and Disclaimer shall always govern. The solicitation and any disputes arising from the solicitation shall be governed by and construed in accordance with the laws of the State of Florida. RFP 2015-195-LR 19 -PROPOSER CERTIFICATION I hereby certify that: I, as an authorized agent of the Proposer, am submitting the following information as my firm's proposal; Proposer agrees to complete and unconditional acceptance of the terms and conditions of this document, inclusive of this solicitation,all attachments,exhibits and appendices and the contents of any Addenda released hereto, and the Disclosure and Disclaimer Statement; Proposer agrees to be bound to any and all specifications, terms and conditions contained in the solicitation, and any released Addenda and understand that the following are requirements of this solicitation and failure to comply will result in disqualification of proposal submitted; Proposer has not divulged, discussed,or compared the proposal with other Proposers and has not colluded with any other Proposer or party to any other proposal; Proposer acknowledges that all information contained herein is part of the public domain as defined by the State of Florida Sunshine and Public Records Laws; all responses,data and information contained in this proposal, inclusive of the Proposal Certification,Questionnaire and Requirements Affidavit are true and accurate. Name of Proposer's Authorized Representative: Title of Proposer's Authorized Representative: Signature of Proposer's Authorized Representative: Date: State of ) On this day of ,20_,personally appeared before me who County of ) stated that (s)he is the of , a corporation, and that the instrument was signed in behalf of the said corporation by authority of its board of directors and acknowledged said instrument to be its voluntary act and deed.Before me: Notary Public for the State of Florida My Commission Expires: RFP 2015-195-LR 20 APPENDIX B MIAMI BEACH " No Bid " Form RFP2O15- 195-LR Health Care Benefits Consultant Services PROCUREMENT DEPARTMENT 1700 Convention Center Drive Miami Beach, Florida 33139 Note It is important for those vendors who have received notification of this solicitation but have decided not to respond, to complete and submit the attached "Statement of No Bid. The "Statement of No Bid" provides the City with information on how to .improve .the ,solicitation process. Failure to submit a "Statement of No Bid" may result in not being notified of future solicitations by the City. • RFP 2015-195-LR 21 Statement of No Bid WE HAVE ELECTED NOT TO SUBMIT A PROPOSAL AT THIS TIME FOR REASON(S) CHECKED AND/OR INDICATED BELOW: Workload does not allow us to proposal Insufficient time to respond Specifications unclear or too restrictive Unable to meet specifications Unable to meet service requirements Unable to meet insurance requirements Do not offer this product/service OTHER. (Please specify) We do_do not_want to be retained on your mailing list for future proposals of this type product and/or service. Signature: Title: Legal Company Name: Note: Failure to respond, either by submitting a proposal or this completed form, may result in your company being removed from our vendors list. PLEASE RETURN TO: CITY OF MIAMI BEACH PROCUREMENT DEPARTMENT ATTN: Lourdes Rodriguez PROPOSAL#2015-195-LR 1700 Convention Center Drive, 3rd Floor MIAMI BEACH, FL 33139 RFP 2015-195-LR 22 APPENDIX C m MIAMI BEACH Minimum Requirements & Specifications RFP 2015- 195-LR Health Care Benefits Consultant Services PROCUREMENT DEPARTMENT 1700 Convention Center Drive Miami Beach, Florida 33139 RFP 2015-195{R 23 Cl. Minimum Requirements. The Minimum Eligibility Requirements for this solicitation are listed below. Proposer shall submit detailed verifiable information affirmatively documenting compliance with each minimum requirement. Proposers that fail to comply with minimum requirements will be deemed non-responsive and will not be considered. 1. Proposers must be licensed in the State of Florida as a Type 21, Class 05 Agency (Resident)or Type 91, Class 05 Agency(Non-Resident). Submittal Requirements: Provide a copy of Proposer's current license. 2. Have on staff an actuary with experience in employee benefits and in particular self-funded plans. Submittal Requirements: Resume of staff member who will be assigned to the City with actuary experience. 3. Proposer to have provided services similar to those defined herein to three (3) public sector clients within the last five(5)years. Submittal Requirements: Provide a list of public sector clients to include contact name, title, agency, telephone number,email address, and contract dates. C2. Statement of Work Required. It is a requirement of any resulting agreement that the following services be provided as part of the Consultant's fee: 1. Review and evaluate existing City benefit related agreements, including but not limited to administrative service agreements with insurance carriers, new case documents and service agreements to provide recommendations for possible improvement in price,terms and conditions. 2. Assist in preparation of the City's Request for Proposal process for its self-insured medical, dental, life and voluntary coverage benefit plans which include, but may not be limited to, short and long-term disability coverage, critical illness coverage, accident care,dependent life and supplemental care coverage. 3. Manage negotiations of reimbursement rates. 4. Evaluate stop loss coverage and make related recommendations to ensure the City's self-insurance benefits are protected from catastrophic losses. 5. Provide all actuarial services, by a professional actuary who is either a staff member or sub-contractor of the successful proposer, as required by the City in relation to health and benefit plans to provide information to decision-makers and reduce risks. 6. Suggest and/or develop additional medical plans, providing employee choice in delivery of healthcare and help reduce premium costs to all parties. 7. Provide unlimited actuarial services to analyze all benefit programs including plan design, claims, utilization trends, and contribution rates for the self-insured plans RFP 2015-195-LR 24 prior to open enrollment, by June 1 of each year. 8. Work with City's Human Resources Department and medical and dental health care coverage providers to develop an in depth analysis of current self-funded programs. 9. Provide guidance on Transitional Reinsurance program and calculate Transitional Reinsurance Fee. 10. Assist with all compliance issues including the Patient Protection and Affordable Care Act, Health Insurance Portability and Accountability Act (HIPAA), Medicare Part D, Consolidated Omnibus Budget Reconciliation Act (COBRA) and Governmental Accounting Standards Board (GASB) and any legislation that has an impact on employee benefits. 11. Provide guidance on Medicare Part D Retiree Drug Subsidy and submit actuarial attestation. 12. Prepare full bi-annual Governmental Accounting Standards Board (GASB) 45 evaluation and reporting. 13. Provide the City with guidance on its Obligations for Postemployment Benefits other than pensions(OPEB)Trust. 14. Prepare an annual report of the City's OPEB liability as of September 30 each year by October 15 of the same year. 15. Conduct the City's Healthcare Reform Forecasting Analysis. 16. Review vendor summary plan descriptions for accuracy in benefits provided and ensure compliance with all governmental regulations. 17. Prepare reports informing the City Administration of benefit market conditions (Market Analysis) that may affect the City's policies and risk exposures prior to policy renewals. 18. Conduct quarterly meetings with the City's Human Resources, Finance and Budget staff to provide claims experience, plan costs and projections of claims and revenues. 19. Provide annual recommendations for changes in plan premiums, plan design, and plan employer subsidy for the upcoming fiscal year by June 1 of each year. 20. Review agreements and policies purchased by the City to assure their accuracy and appropriateness. 21. Provide assistance in resolving complex claims issues. 22. Provide other services that may be necessary in the future. RFP 2015-195-LR 25 APPENDIX D m MIAMI BEACH Special Conditions RFP2O15- 195-LR Health Care Benefits Consultant Services Procurement Department 1700 Convention Center Drive Miami Beach, Florida 33139 RFP 2015-I VSiR 26 1. TERM OF CONTRACT. The contract shall commence upon the date of notice of award and shall be effective for a period of two(2)years. 2. OPTIONS TO RENEW. The City, through its City Manager,will have the option to extend for three(3)additional one (1)years periods. 3. ADDITIONAL SERVICES. If during the contractual period additional services are needed, the selected Contractor may, at the option of the City of Miami Beach, be engaged to perform these services. The selected contractor shall upon receipt of the written request from the City's Human Resources Director or designee, provide a proposal for such services and the City reserves the option to issue a purchase order for the specified work as approved by both parties. RFP 2015-195-LR 27 APPENDIX E m MIAMIBEACH Cost Proposal Form RFP2O15- 195-LR Health Care Benefits Consultant Services PROCUREMENT DEPARTMENT 1700 Convention Center Drive Miami Beach, Florida 33139 RFP 2015-195-LR 28 APPENDIX E COST PROPOSAL FORM Failure to Revenue Proposal Form, in its entirety and fully executed, by the deadline established for the receipt of proposals will result in proposal being deemed non-responsive and being rejected. Proposer affirms that the Proposed Cost Proposal Rate stated on the Cost Proposal Form are inclusive of all costs borne by the Proposer relating to the scope of the project; and Proposer affirms that no claim will be made on account of any increase in research costs, wages, material prices, delivery delays, taxes, insurance, cost indexes or on any other account. The Cost Proposal Form shall be completed mechanically or, if manually, in ink. Cost Proposal Form completed in pencil shall be deemed non-responsive. All corrections on the Cost Proposal Form shall be initialed. Proposed% Premium Annual Cost Description of Premium (for calculation purposes only) Rate to the City 1. %of Premium $100,000 $ Total Cost of Services per year $ Bidder's Affirmation Company: Authorized Representative: Address: Telephone: Email: Authorized Representative's Signature: *The total cost of annual services shall be the basis for calculated cost points pursuant to Section 0400,4.Cost Proposal Evaluation. RFP 2015-195-LR 29 APPENDIX F Insurance Requirements RFP2O15- 195-LR Health Care Benefits Consultant Services PROCUREMENT DEPARTMENT 1700 Convention Center Drive Miami Beach, Florida 33139 rtrA MI A MI INSURANCE REQUIREMENTS The vendor shall furnish to the Department of Procurement, City of Miami Beach, 1700 Convention Center Drive, 3rd Floor, Miami Beach, Florida 33139, Certificate(s) of Insurance which indicate that insurance coverage has been obtained which meets the requirements as outlined below: A. Worker's Compensation Insurance for all employees of the vendor as required by Florida Statute 440. B. Commercial General Liability Insurance on a comprehensive basis, to include Contractual Liability, and Products/Completed Operations, in an amount not less than $1,000,000 combined single limit per occurrence for bodily injury and property damage. City of Miami Beach must be included as an additional insured with respect to this coverage. C. Automobile Liability Insurance covering all owned, non-owned and hired vehicles used in connection with the work, in an amount not less than $1,000,000 combined single limit per occurrence for bodily injury and property damage. A waiver of subrogation in favor of the City must be provided for the insurance required above. All insurance policies required above shall be issued by companies authorized to do business under the laws of the State of Florida, with the following qualifications: The company must be rated no less than "B+" as to management, and no less than "Class VII" as to financial strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent, subject to the approval of the City Risk Management Division. or The company must hold a valid Florida Certificate of Authority as shown in the latest "List of All Insurance Companies Authorized or Approved to Do Business in Florida" issued by the State of Florida Department of Insurance and are members of the Florida Guaranty Fund. Certificates will indicate no modification or change in insurance shall be made without thirty (30) days in advance notice to the certificate holder. CERTIFICATE HOLDER MUST READ: CITY OF MIAMI BEACH 1700 CONVENTION CENTER DRIVE 3`d FLOOR MIAMI BEACH, FL 33139 Compliance with the foregoing requirements shall not relieve the vendor of his liability and obligation under this section or under any other section of this agreement. ATTACHMENT C CONSULTANTS RESPONSE TO THE (RFP) Health Care Benefits Consultant Services RFP 201 5-1 95 -LR Submitted: September 11, 2015 Prepared for the City of Miami Beach e4 MIAMI BEACH Prepared by: Gallagher Benefit Services, Inc. Jeffrey P.Angello,Area President 2255 Glades Road, Suite 200E Boca Raton, FL 33431 Phone: 561-998.6802 Fax:800-676-4004 1 TAB 1 -COVER LETTER& MINIMUM QUALIFICATION REQUIREMENTS 7 1.1 Cover Letter and Table of Contents Ms. Lourdes Rodriguez Procurement Department City of Miami Beach 1700 Convention Center Drive Miami Beach,Florida 33139 Re: RFP No. 2015-195-LR for Health Care Benefits Consultant Services Dear Ms. Rodriguez: Gallagher Benefit Services,Inc. (Gallagher"),the employee benefits division of Arthur J.Gallagher&Co., is a national employee benefits consulting firm with local offices in both Miami,Florida(8333 NW 53r Street, Suite 600, Miami, FL 33166)and Boca Raton,FL(2255 Glades Road,Suite 200E, Boca Raton, FL 33431. Jeff Angello is the Area President for both the Miami and Boca Raton offices. We have assigned a full Team including consultants, actuaries,attorneys and other professionals so that we can continue to meet all of the City's anticipated and unanticipated needs.You will continue to have direct access to all personnel as you have in the past. Based on our 14 year relationship,Gallagher and the team assigned to the City of Miami Beach,is intimately familiar with the City's staff,goals,and needs,and can completely fulfill the scope of services outlined in the RFP. We will continue to provide creative,customized employee benefit solutions and are committed to providing the best in customer service as we have over the years of our longstanding relationship. Gallagher understands the work to be performed and will continue to work in partnership with the City's HR,finance, legal and procurement departments. We have a unique approach that cannot be duplicated in the marketplace and will continue to be an excellent fit for the City for the following reasons: • Staff intimately familiar with the City,products offered,and markets available • Proven history of providing creative and customized solutions • Proven ability to negotiate aggressively and effectively with carriers • Ability to provide a consolidated approach to employee benefits • Proprietary tools that are built to maximize the City's procurement efforts. The following persons are authorized to make representations for our firm: Jeffrey P.Angello,Area President Paul A. Hebert,Area Vice President,Compliance Counsel Gallagher Benefit Services,Inc. Gallagher Benefit Services, Inc. 2255 Glades Road, Suite 200E 2255 Glades Road,Suite 200E Boca Raton, Florida 33431 Boca Raton,Florida 33431 Office: 561-995-6802; Fax: 561-998-6731 Office:561-995-6746; Fax:561-998-6731 Email:jeff_angello @ajg.com Email:paul_hebert@ajg.com Richard G. Schell,Area Vice President Glen R.Volk,Area Vice President,Consulting Actuary Gallagher Benefit Services, Inc. Gallagher Benefit Services,Inc. 2255 Glades Road, Suite 200E 2255 Glades Road,Suite 200E Boca Raton, Florida 33431 Boca Raton, Florida 33431 Office: 561-995-6706;Fax:561-998-6731 Office: 561-995-6755; Fax:561-998-6731 Email: richard_schell @ajg.com Email:glen_volk @ajg.com 3 Garrett W.Moore, Senior Consultant Gallagher Benefit Services, Inc. 2255 Glades Road, Suite 200E Boca Raton,Florida 33431 Office: 561-995-6743; Fax:561-998-6731 Email:garrett_moore @ajg.com As requested,we agree to indemnify and hold harmless the City under any resulting Agreement and,unlike many of our competitors, will not include a monetary cap on our liability. We have most recently been operating under a Professional Services Agreement with the City since January 1, 2011 under which we indemnify and hold harmless the City against any negligent acts and omissions, breaches of the contract or intentional misconduct and we request we continue the same Indemnification provision if awarded the RFP. We greatly appreciate our 14+year relationship with the City and would welcome the opportunity to meet with you to review our proposal,and to address any questions. Sincerely, Jeffrey P.Angello Area President Gallagher Benefit Services, Inc. 2255 Glades Road, Suite 200E Boca Raton, Florida,33431 (561)995-6802 4 Table of Contents TAB 1-COVER LETTER& MINIMUM QUALIFICATION REQUIREMENTS 2 1.1 Cover Letter and Table of Contents 3 1.2 Proposal Certification, Questionnaire&Requirements Affidavit(Appendix A) 6 DISCLOSURE AND DISCLAIMER SECTION 11 1.3 Minimum Qualifications Requirements. 13 C1. Minimum Requirements. 13 TAB 2—EXPERIENCE&QUALIFICATIONS 15 2.1 Qualifications of Proposing Firm. 16 2.2 Qualification of Proposer Team. 22 2.3 Financial Capacity 23 TAB 3—SCOPE OF SERVICES PROPOSED- 24 C2. Statement of Work Required 25 TAB 4—APPROACH AND METHODOLOGY 44 TAB 5—REVENUE PROPOSAL 46 TAB 6—GALLAGHER DOCUMENTS Code of Ethics Florida License Insurance Proof Dun&Bradstreet Submission Proof/Supplier Qualifier Report TAB 7—GALLAGHER TEAM.RESUMES TAB 8—SAMPLES OF PROJECTS/DELIVERABLES Healthcare Reform Overview OPEB Actuarial Valuation as of November 13,2013 Health Options—Baptist Network Powerpoint 112.08 Filing Cadillac and 60%Plan Analysis Budget Advisory Committee Powerpoints for Medical RFP Stop Loss Options Large Claims-4 Years Status Report—June 2015 Medicare Part D Subsidy Analysis GASB 45 Annual OPEB Cost and Annual Required Contribution 5 1.2 Proposal Certification, Questionnaire & Requirements Affidavit (Appendix A) • Solicitation No: Solicitation Title: 2015-195-LR Health Care Benefits Consultant Services Procurement Contact: Tel: Email: Lourdes Rodriguez 305.673.7000 x 6652 lourdesrodri uez miamibeachfl. v g o 9 @ g PROPOSAL CERTIFICATION, QUESTIONNAIRE & REQUIREMENTS AFFIDAVIT Purpose: The purpose of this Proposal Certification, Questionnaire and Requirements Affidavit Form is to inform prospective Proposers of certain solicitation and contractual requirements, and to collect necessary information from Proposers in order that certain portions of responsiveness, responsibility and other determining factors and compliance with requirements may be evaluated. This Proposal Certification, Questionnaire and Requirements Affidavit.Form is a REQUIRED FORM that must be submitted fully completed and executed. 1. General Proposer Information. FIRM NAME: Gallagher Benefit Services,Inc. No of Years in Business: 54 - No of Years in Business Locally:38 No.of Employees: 3000 OTHER NAME(S)PROPOSER HAS OPERATED UNDER IN THE LAST 10 YEARS N/A FIRM PRIMARY ADDRESS(HEADQUARTERS): 2255 Glades Road,Suite 200E CITY: Boca Raton STATE: ZIP CODE: Florida 33431 TELEPHONE NO.: 561-995-6706 TOLL FREE NO,: 800.676.4004 FAX NO.: 561-998-6731 FIRM LOCAL ADDRESS: Same CITY: Same STATE: ZIP CODE: Same Same PRIMARY ACCOUNT REPRESENTATIVE FOR THIS ENGAGEMENT: Jeffrey P.Angello ACCOUNT REP TELEPHONE NO.: 561-998-6706 ACCOUNT REP TOLL FREE NO.: 800-676-4004 ACCOUNT REP EMAIL: Jeff angello@ajg.com FEDERAL TAX IDENTIFICATION NO.: 36-4291971 The City reserves the right to seek additional Information from the Proposer of other source(s), including but not limited to: any firm or principal information, applicable licensure, resumes of relevant individuals, client information, financial information, or any information the City deems necessary to evaluate the capacity of the Proposers to perform in accordance with contract requirements. 6 1. Veteran Owned Business. Is Proposer claiming a veteran owned business status? No 2. Conflict of Interest:All Proposers must disclose, in their Proposal, the name(s)of any officer,director, agent, or immediate family member (spouse, parent, sibling, and child) who is also an employee of the City of Miami Beach. Further, all Proposers must disclose the name of any City employee who owns, either directly or indirectly, an interest of ten (10%) percent or more in the Proposer entity or any of its affiliates. Gallagher Benefit Services, Inc. has no conflicts of interest or officer, director, agent or immediate family member who is also an employee of the City of Miami Beach. There are no City employees who own, either directly or indirectly, an interest of ten (10%) percent or more in Gallagher or any of Gallagher's affiliates. 3. References & Past Performance. Proposer shall submit at least three (3) references for whom the Proposer has completed work similar in size and nature as the work referenced in solicitation. SUBMITTAL REQUIREMENT: For each reference submitted, the following information is required: 1) Firm Name, 2) Contact Individual Name &Title, 3)Address,4) Telephone,.5) Contact's Email and 6) Narrative on Scope of Services Provided. Firm Name Contact Individual Name& Address Telephone Email • Title 1. Palm Beach County Nancy L.Bolton 100 Australian (561)223-4500 nbolton @pbcgov.org Board of County Director,Risk Avenue,Suite 200 Commissioners Management West Palm Beach, FL 33406 Narrative on Scope of Services Provided: We are a full service Broker/Consultant for Group Health,ADO,Stop Loss,Dental,Vision,Life and Voluntary Life 2. Jean A.Heald,ARM, 201 West (561)393-7766 jheald @ci.boca-raton.fl.us City of Boca Raton Risk Manager Palmetto Park Road,Boca Raton,FL 33432 Narrative on Scope of Services Provided: We are a full service Broker/Consultant for Group Health, Stop Loss,Dental and Vision 3. School Board of Dildra Martin-Ogbum, 7770 W,Oakland (754)321-3100 dildra.ogburn @browardschools.com Broward County PH.D. Park Blvd. Director,Benefits& Sunrise,FL 33351 Employment Services Narrative on Scope of Services Provided: We are a full service Broker/Consultant for Group Health,ASO,Stop Loss, Dental,Vision,Life and Voluntary Life 4. Suspension, Debarment or Contract Cancellation. Has Proposer ever been debarred, suspended or other legal violation,or had a contract cancelled due to non-performance by any public sector agency? No 5. Vendor Campaign Contributions. Proposers are expected to be or become familiar with, the City's Campaign Finance Reform laws, as codified in Sections 2-487 through 2-490 of the City Code. Proposers shall be solely responsible for ensuring that all applicable provisions of the City's Campaign Finance Reform laws are complied with, and shall be subject to any and all sanctions, as prescribed therein, including disqualification of their Proposals,in the event of such non-compliance SUBMITTAL REQUIREMENT: Submit the names of all individuals or entities (including your sub- consultants) with a controlling financial interest as defined in solicitation. For each individual or entity with a controlling financial interest indicate whether or not each individual or entity has contributed to the campaign either directly or indirectly, of a candidate who has been elected to the office of Mayor or City Commissioner for the City of Miami Beach. Read,Understood and Agreed.Gallagher is in full compliance with these provisions."Controlling financial interest• is defined as the ownership, directly or indirectly, of ten percent or more of the outstanding capital stock in any corporation or any direct or indirect interest of ten percent or more in a firm. The term "firm" shall mean a corporation, partnership, business trust or any legal entity other than a natural person." City Code section 2-487A(4) (a) 2. Neither Gallagher Benefit Services, Inc.nor its parent company,Arthur J. Gallagher&Co., have anyone with a "controlling financial interest" as defined by City Code. Therefore, no individual or entity with a controlling financial interest has contributed to the campaign, either directly or indirectly, of a candidate who has been elected to the office of Mayor or City Commissioner for the City of Miami Beach. 6. Code of Business Ethics. Pursuant to City Resolution No.2000-23879,each person or entity that seeks to do business with the City shall adopt a Code of Business Ethics("Code") and submit that Code to the Department of Procurement Management with its proposal/response or within five (5) days upon receipt of request. The Code shall, at a minimum, require the Proposer, to comply with all applicable governmental rules and regulations including, among others, the conflict of interest, lobbying and ethics provision of the City of Miami Beach and Miami Dade County. Read, Understood and Agreed. Please see Gallagher's Code of Business Ethics under Tab 6. As a recipient of Ethis here s 2015 World's Most Ethical Companies Award, Gallagher and our parent P P P P company, Arthur J. Gallagher&Co., are committed to ethical business behavior and full transparency. Adhering to a code of ethics is paramount to our business relationships. Gallagher Benefit Services has a well-established code of ethics.All of our employees are required to go through a regular training and certification process. Our people are held to the highest standards in the industry which guarantees an ethical and transparent business relationship which will meet and exceed the ethics provision for the City of Miami Beach and Miami Dade County. 7. Living Wage. Pursuant to Section 2-408 of the Miami Boaeh-Gity-GedeTas same may be amended from time to time, Proposers •. :- -• -: 'e . -••e e - :..e- Services pursuant to this Agreement,the hourly living wage rates listed below: . - :- - . : • • --- • benefits,and$12.92/hr without benefits. ode-axed annually for inflation '•,: t-- •■_ ' _ .:- : - - : • _:• -•-. r_. N-et'd- : e - : • '•: v •- ... --e - .- - -+ -0 , ly _ • - _ •_ - • • • •�,'•. -- ►+ •1 e. - - :r;, ■s .. -••■.. .l- •: •.-,- same(in a particular year). 8 D.err, r•"r V' r. • i. c I ._ -rl n I .rnn - Ir■.. + i , .•:- ; •' • •- ••.", at its sc!c option, immediately doom said Proposer as non City's Living Wage Ordinance, as amended. Further information on th it ge requirement-is SUBMITTAL REQUIREMENT: No additional submittal is required. By virtue of executing this 8. Equal Benefits for Employees with Spouses and Employees with Domestic Partners. When awarding competitively solicited contracts valued at over$100,000 whose contractors maintain 51 or more full time employees on their payrolls during 20 or more calendar work weeks, the Equal Benefits for Domestic Partners Ordinance 2005-3494 requires certain contractors doing business with the City of Miami Beach, who are awarded a contract pursuant to competitive proposals, to provide"Equal Benefits"to their employees with domestic partners, as they provide to employees with spouses. The Ordinance applies to all employees of a Contractor who work within the City limits of the City of Miami Beach, Florida; and the Contractor's employees located in the United States, but outside of the City of Miami Beach limits, who are directly performing work on the contract within the City of Miami Beach. A. Does your company provide or offer access to any benefits to employees with spouses or to spouses of employees? Yes B. Does your company provide or offer access to any benefits to employees with (same or opposite sex)domestic partners*or to domestic partners of employees?Yes C. Please check all benefits that apply to your answers above and list in the "other" section any additional benefits not already specified. Note: some benefits are provided to employees because they have a spouse or domestic partner, such as bereavement leave; other benefits are provided directly to the spouse or domestic partner, such as medical insurance. Firm Provides for Firm Provides for Firm does BENEFIT Employees with Employees with not Provide Spouses Domestic Partners Benefit Health Yes Yes Sick Leave Yes Yes Family Medical Leave Yes Yes Bereavement Leave Yes Yes If Proposer cannot offer a benefit to domestic partners because of reasons outside your control, (e.g., there are no insurance providers in your area willing to offer domestic partner coverage) you may be eligible for Reasonable Measures compliance. To comply on this basis, you must agree to pay a cash equivalent and submit a completed Reasonable Measures Application (attached) with all necessary documentation. Your Reasonable Measures Application will be reviewed for consideration by the City Manager, or his designee. Approval is not guaranteed and 9 the City Manager's decision is final. Further information on the Equal Benefits requirement is available at www.miamibeachfl.gov/procurement/. Gallagher offers the same benefits to domestic partners as it does to spouses and therefore fully complies with or exceeds all requirements under the City's Equal Benefits for Domestic Partners Ordinance 2005-3494. Public Entity Crimes. Section 287.133(2)(a),Florida Statutes, as currently enacted or as amended from time to time,states that a person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a proposal, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a proposal, proposal, or reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit proposals, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017 for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. • SUBMITTAL REQUIREMENT: No additional submittal is required. By virtue of executing this affidavit document, Proposer agrees with the requirements of Section 287.133, Florida Statutes, and certifies it has not been placed on convicted vendor list. Read, Understood and Agreed. Gallagher and all Gallagher employees are in full compliance with this requirement and requirements of Section 287.133, Florida Statutes. 9. Acknowledgement of Addendum. After issuance of solicitation, the City may release one or more addendum to the solicitation which may provide additional information to Proposers or alter solicitation requirements. The City will strive to reach every Proposer having received solicitation through the City's e-procurement system, PublicPurchase.com. However, Proposers are solely responsible for assuring they have received any and all addendum issued pursuant to solicitation.This Acknowledgement of Addendum section certifies that the Proposer has received all addendum released by the City pursuant to this solicitation. Failure to obtain and acknowledge receipt of all addendum may result in proposal disqualification. Initial to Confirm 4 Initial to Confirm Initial to Confirm Receipt Receipt , Receipt Gallaghe_ Addendum 1 Gallagh Addendum 6 Addendum 11 Gallagher ; Addendum 2 'J Addendum 7 Addendum 12 Gallagh Addendum 3 Addendum 8 Addendum 13 9 Gallagher, Addendum 4 Addendum 9 Addendum.14 Gallagh€ �r, Addendum 5 Addendum 10 Addendum 15 10 o ISC :OSU' J1: ib;DISC ,AID. Z:MAg0 :K ►fir~ ' � a„ �,> �. ,'` " ... The solicitation referenced herein is being furnished to the recipient by the City of Miami Beach (the "City") for the recipient's convenience. Any action taken by the City in response to Proposals made pursuant to this solicitation, or in making any award, or in failing or refusing to make any award pursuant to such Proposals, or in cancelling awards, or in withdrawing or cancelling this solicitation, either before or after issuance of an award,shall be without any liability or obligation on the part of the City. In its sole discretion, the City may withdraw the solicitation either before or after receiving proposals, may accept or reject proposals, and may accept proposals which deviate from the solicitation, as it deems appropriate and in its best interest. In its sole discretion, the City may determine the qualifications and acceptability of any party or parties submitting Proposals in response to this solicitation. Following submission of a Bid or Proposal, the applicant agrees to deliver such further details, information and assurances, including financial and disclosure data, relating to the Proposal and the applicant including, without limitation, the applicant's affiliates, officers, directors, shareholders, partners and employees,as requested by the City in its discretion. The information contained herein is provided solely for the convenience of prospective Proposers. It is the responsibility of the recipient to assure itself that information contained herein is accurate and complete.The City does not provide any assurances as to the accuracy of any information in this solicitation. Any reliance on these contents, or on any permitted communications with City officials, shall be at the recipient's own risk. Proposers should rely exclusively on their own investigations, interpretations, and analyses. The solicitation is being provided by the City without any warranty or representation, express or implied, as to its content, its accuracy, or its completeness. No warranty or representation is made by the City or its agents that any Proposal conforming to these requirements will be selected for consideration, negotiation,or approval. The City shall have no obligation or liability with respect to this solicitation,the selection and the award process, or whether any award will be made.Any recipient of this solicitation who responds hereto fully acknowledges all the provisions of this Disclosure and Disclaimer, is totally relying on this Disclosure and Disclaimer, and agrees to be bound by the terms hereof,Any Proposals submitted to the City pursuant to this solicitation are submitted at the sole risk and responsibility of the party submitting such Proposal. This solicitation is made subject to correction of errors, omissions, or withdrawal from the market without notice. Information is for guidance only,and does not constitute all or any part of an agreement. The City and all Proposers will be bound only as, if and when a Proposal (or Proposals), as same may be modified, and the applicable definitive agreements pertaining thereto, are approved and executed by the parties, and then only pursuant to the terms of the definitive agreements executed among the parties. Any response to this solicitation may be accepted or rejected by the City for any reason, or for no reason, without any resultant liability to the City. The City is governed by the Government-in-the-Sunshine Law, and all Proposals and supporting documents shall be subject to disclosure as required by such law. All Proposals shall be submitted in sealed proposal form and shall remain confidential to the extent permitted by Florida Statutes, until the date and time selected for opening the responses. At that time, all documents received by the City shall become public record. 11 Sosal, the Proposer acknowledges and agrees that the City has the right to make any inquiry or investigation it deems appropriate to substantiate or supplement information contained in the Proposal, and authorizes the release to the City of any and all information sought in such inquiry or investigation. Each Proposer certifies that the information contained in the Proposal is true, accurate and complete, to the best of its knowledge,information, and belie Notwithstanding the foregoing or anything contained in the solicitation, all Proposers agree that in the event of a final unappealable judgment by a court of competent jurisdiction which imposes on the City any liability arising out of this solicitation, or any response thereto, or any action or inaction by the City with respect thereto, such liability shall be limited to $10,000.00 as agreed-upon and liquidated damages. The previous sentence, however, shall not be construed to circumvent any of the other provisions of this Disclosure and Disclaimer which imposes no liability on the City. In the event any differences I language between this Disclosure and the balance of the solicitation, it is understood that the provisions of this Disclosure and Disclaimer shall always govern.The solicitation and any disputes arising from the solicitation shall be governed by and construed in accordance with the laws of the State of Florida. �,n T r,, A .,r --�Q __"�'CE TR I'FICA'� �_ '7.711 P.R POSER, Tlai I hereby certify that: I, as an authorized agent of the Proposer, am submitting the following information as my firm's proposal; Proposer agrees to complete and unconditional acceptance of the terms and conditions of this document, inclusive of this solicitation,all attachments,exhibits and appendices and the contents of any Addenda released hereto, and the Disclosure and Disclaimer Statement; Proposer agrees to be bound to any and all specifications, terms and conditions contained in the solicitation, and any released Addenda and understand that the following are requirements of this solicitation and failure to comply will result in disqualification of proposal submitted; Proposer has not divulged, discussed, or compared the proposal with other Proposers and has not colluded with any other Proposer or party to any other proposal; Proposer acknowledges that all information contained herein is part of the public domain as defined by the State of Florida Sunshine and Public Records Laws; all responses, data and information contained in this proposal, inclusive of the Proposal Certification,Questionnaire and Requirements Affidavit are true and accurate. Name of Proposers Authorized Representative: Title of Proposer's Authorized Representative: Jeffrey P.Angello Area President Signature of Proposer's ulhorized:Representai -• .' Date: S TE',-i 6 er. /D 20/5 State of /2-/2-04'/0 /1.4 ) On this day of .S etkih i'2Q f.57erso I appeared before me A�i9A/C624who County of P4-2-114 1;E—h) state that s(�e is the lESIbtV of crirs ex tacos, 7nrc• ,a corporation,and that the instrument of its board of directors and acknowledged,said instrument be its voluntary act and deed Before me. c z de4d/'<ICA-Z) Nptary.•Fublic for the State of Florida Illy Commission Expires 4/ .. +'i ,, JANE CENTORRINO �� MY COMMISSION#FF 115426 .yam:a' EXPIRES:August 17,2018 'e N '' Banded Thru Notary Public Underwrites 12 1.3 Minimum Qualifications Requirements. Submit verifiable information documenting compliance with the minimum qualifications requirements established in Appendix C,Minimum Requirements and Specifications. Minimum Requirements&Specifications. Gallagher not only meets but exceeds all requirements under this RFP. Our service model is unique and has been built to support our numerous Governmental clients. We have provided detailed descriptions of examples that comply with each section or requirement and additional descriptions of the additional services provided as part of our proposal. Cl. Minimum Requirements. The Minimum Eligibility Requirements for this solicitation are listed below. Proposer shall submit detailed verifiable information affirmatively documenting compliance with each minimum requirement. Proposers that fail to comply with minimum requirements will be deemed non- responsive and will not be considered. 1. Proposers must be licensed in the State of Florida as a Type 21, Class 05 Agency (Resident)or Type 91, Class 05 Agency(Non-Resident), Read, Understood and Agreed. Gallagher Benefit Services, Inc. is a Type 91, Class 05 Agency(Non-Resident). A copy of Gallagher's current license is included under Tab 6. 2. Have on staff an actuary with experience in employee benefits and in particular self- funded plans. Read, Understood and Agreed. Gallagher Benefit Services not only meets this requirement but we exceed it. Over the last 14 years, our actuarial team has worked directly with various City of Miami Beach departments and personnel and have continually demonstrated the value of our unique model. Our actuarial consulting practice is made up of more than 40 professionals including 15 actuaries,various analysts and numerous clinical and systems support personnel.The City of Miami Beach has had and will continue to have direct access through our local team of 3 actuaries, all of whom are extensively involved in Governmental accounts and self-funded health plans. The City's actuarial needs over the past 14 years have been significant and well beyond what is identified in the RFP or even available through most of our competitors. Our senior actuary Glen Volk and his team have provided all of the routine filings and certifications such as GASB 45, FS 112.08 and Medicare Part D Attestation and Analysis.In addition to these routine actuarial needs, Glen has worked with the City on renewal analysis,benefit modeling,contribution modeling,strategic planning, Health care reform modeling and impact, Cadillac Tax issues and numerous other critical issues that arose over the years; many of which were not originally contemplated or addressed in our scope of service.Our available local resources and flexible approach have enabled the City to respond to the ever changing marketplace seamlessly and without the significant additional costs that most consulting firms would charge. Our hands on partnership with the City of Miami Beach staff is unique and has proven beneficial to the City in both direct dollars and reduction of risk. A copy of Glen Volk's resume is under Tab 7. 13 3. Proposer to have provided services similar to those defined herein to three (3) public sector clients within the last five(5) years. Read, Understood and Agreed. We have included resumes of our local actuaries and team, along with a list of three local Governmental clients other than the City of Miami Beach. While we expect all of our references to speak highly of our actuarial expertise, it is our unique approach that we are most proud of. For the last 14 years, the City of Miami Beach has been the direct beneficiary of the commitment and flexibility we offer. We truly do not believe that anyone can duplicate our model or our results. Firm Name Contact Individual Address Telephone Email Contract Name&Title Dates 1 Palm Beach Nancy L.Bolton 100 Australian (561)223- nbolton @pbcgov. 1995- . County Board of Director,Risk Avenue,Suite 200 4500 org Current County Management West Palm Beach, Commissioners FL 33406 Narrative on Scope of Services Provided: We are a full service Broker/Consultant for Group Health,ASO, Stop Loss,Dental and Vision,Life and Voluntary Life 2 Jean A.Heald,ARM, 201 West Palmetto (561)393- jheald @ci.boca- Oct. . City of Boca Raton Risk Manager Park Road,Boca 7766 raton.fl.us 2012— Raton,FL 33432 Current Narrative on Scope of Services Provided: We are a full service Broker/Consultant for Group Health,Stop Loss,Dental and Vision 3 School Board of Dildra Martin- 7770 W,Oakland (754)321- Dildra.ogburn @br 1999- Broward County Ogburn„PH.D. Park Blvd. 3100 owardschools.co Current Director,Benefits& Sunrise,FL 33351 m Employment Services Narrative on Scope of Services Provided: We are a full service Broker/Consultant for Group Health,ASO, Stop Loss,Dental.Vision,Life and Voluntary Life 14 TAB 2-EXPERIENCE& QUALIFICATIONS 15 2.1 Qualifications of Proposing Firm. Submit detailed information regarding the firm's history and relevant experience and proven track record of providing the scope of services similar as identified in this solicitation, including experience in providing similar scope of services to public sector agencies. Submit at least three (3) projects within the last five(5)year where the Proposer has performed services similar to the scope of this RFP for a public sector agency. For each project that the Proposer submits as evidence of similar experience, the following is required. For each project that the Proposer submits as evidence of similar experience, the following is required: project description, agency name, agency contact. Contact telephone & email and year(s) and term of engagement. Firm's History In 1927 Arthur J. Gallagher,opened his own insurance agency. His philosophy was to really get to know his clients. He knew that by understanding their unique needs, he could better assist them in reducing their risks while insuring them against losses. He believed that treating people right was good business. Today,Arthur J. Gallagher&Co. ("AJG") is headquartered in Itasca, Illinois, has operations in 30 countries, offers client service capabilities in more than 140 countries and has over 20,000 employees in hundreds of offices around the world. Arthur J. Gallagher&Co. is the third largest insurance brokerage firm in the World and has more than $4.6 billion in revenue. We lead in the way we serve our customers,the way we develop our employees and the way we support our communities. The Gallagher Way serves as a roadmap to guide our team and drive our actions.They help us make critical decisions that affect our clients, our coworkers and the communities in which we live and work. These are concepts that we passionately adhere to, and are as follows: 1. We are a Sales and Marketing Company dedicated to providing excellence in Risk Management Services to our clients. 2. We support one another.We believe in one another. We acknowledge and respect the ability of one another. 3. We push for professional excellence. 4. We can all improve and learn from one another, 5. There are no second-class citizens—everyone is important and everyone's job is important. 6. We're an open society. 7. Empathy for the other person is not a weakness. 8. Suspicion breeds more suspicion. To trust and be trusted is vital. 9. Leaders need followers. How leaders treat followers has a direct impact on the effectiveness of the leader. 10. Interpersonal business relationships should be built. 11. We all need one another.We are all cogs in a wheel. 12. No department or person is an island. 16 13. Professional courtesy is expected. 14. Never ask someone to do something you wouldn't do yourself. 15. I consider myself support for our Sales and Marketing.We can't make things happen without each other. We are a team. 16. Loyalty and respect are earned—not dictated. 17. Fear is a turn-off. 18. People skills are very important at Arthur J. Gallagher&Co. 19. We're a very competitive and aggressive Company. 20. We run to problems—not away from them. 21. We adhere to the highest standards of moral and ethical behavior. 22. People work harder and are more effective when they're turned on—not turned off. 23. We are a warm,close Company.This is a strength—not a weakness. 24. We must continue building a professional Company—together—as a team. 25. Shared values can be altered with circumstances—but carefully and with tact and consideration for one another's needs. AJG has helped clients around the globe address risk, protect their assets and recover from losses. The products and services we provide keep businesses and institutions running, and enable individuals and families to rebuild their lives. AJG is well positioned to take advantage of the unlimited,growth potential in this industry. AJG was one of the first brokers to transition from simply selling insurance to providing true risk management services–by identifying exposures, then developing and implementing ways to reduce those risks. Clients appreciated this approach, which allowed them, rather than the insurers,to direct their own activities. AJG has consistently partnered with clients in developing innovative solutions to their needs, continually challenging the status quo and noting milestones throughout the decades. Below are a few of the milestones in Arthur J. Gallagher's history. With this pioneering spirit, in 1938 Gallagher was at the forefront of the industry and designed the first retrospective rating program,which gave customers credit for holding down their losses and was considered a radical innovation. The 1960's was a revolutionary decade for both AJG and the insurance industry. It marked AJG's earliest forays into life and benefits as a distinct business unit. • Gallagher Benefit Services ("Gallagher')was founded in 1961 as a unit of Arthur J. Gallagher& Company. • Gallagher Bassett was formed in 1962 to administer claims and loss control activities. In 1975, Gallagher's employee benefits division wrote Gallagher's first self-funded employee benefits plan. During the 1980's Gallagher achievements included: • In 1984, AJG went public with an initial common stock offering. • In 1987, AJG was invited to join the prestigious New York Stock Exchange. Traded under the symbol"AJG"industry publications often highlighted Gallagher as one of the up-and-coming brokers. • In 1985, Forbes magazine declared AJG one of the 200 Best Small Companies in America. 17 During the 1990's, with AJG's reputation as an innovator in the alternative marketplace, global expansion and new services were critical to continued growth. By 1999, based on 1998 revenues of more than$500 million,AJG was recognized as the fourth-largest broker in the world. In the decade beginning in 2000 AJG began to develop and introduce technological innovations to support operations. These technological innovations included a powerful Web-based claims and loss control information system; coveragefirst.com,which provides one-stop access to a variety of insurance programs and services for independent agents and brokers; and Gallagher Insight, a Web-based suite of integrated online services. In 2004,AJG was recognized by Fortune magazine among the Fortune 1000—an honor that was repeated in 2008.And in 2004 and 2005, Gallagher was recognized as one of Forbes magazine's Platinum 400 Best Big Companies in America. In 2008, Gallagher was awarded the prestigious 2008 Readers Choice Awards, by Business Insurance magazine ranked Gallagher among the top five employee benefits consulting firms. In 2009, Gallagher was awarded the Business Insurance readers'choice Silver Circle Award in its Best Employee Benefits Consultant category. In 2013 • Chief Executive Magazine named AJG one of the Best Companies for Leaders. 9 P • CEO Pat Gallagher was named Insurance Broking CEO of the Year by Reactions magazine • Ethisphere Institute again named Arthur J. Gallagher&Co. one of the World's Most Ethical Companies In 2015 • Business Insurance Magazine-Arthur J. Gallagher&Co. 5th—in the world for largest Brokers • Voted one of America's Best Employer's by Forbes. The magazine considered 1,100 U.S.-based employers with more than 2,500 domestic employees. Best Employers were selected across 25 industry sectors, including insurance, based on the results of an independent, anonymous survey of 20,000 employees who work for large companies. Respondents were consulted via online access panels,with questions focused on six categories: atmosphere at work and potential for development; image; working conditions;salary/wage; workplace; and diversity. • Named a World's Most Ethical Company®by the Ethisphere Institute for Fourth Consecutive Year. The World's Most Ethical Companies designation recognizes those organizations that have had a material impact on the way business is conducted by fostering a culture of ethics and transparency at every level of the company. Being an honoree for four consecutive years underscores Arthur J. Gallagher&Co.'s commitment to leading ethical business standards and practices,ensuring long- term value to key stakeholders including customers,employees, suppliers, regulators and investors. In 2015, 132 honorees from 21 countries and five continents were recognized with this award.Arthur J. Gallagher&Co. was the only recipient in the Insurance Brokerage category Gallagher Benefit Services, Inc. ("Gallagher")was founded in 1961 as a unit of Arthur J. Gallagher&Co. From the beginning, our commitment has been to Think Ahead about cost-effective ways to help our clients attract, retain, and reward the best performers in their field. 18 Gallagher is the benefits consulting subsidiary of Arthur J. Gallagher&Co. and is the preeminent provider of consulting services to public entities, demonstrated by hundreds of municipal, county and school district clients nationwide. Gallagher maintains a Public Entity niche practice group, so that our professionals can share and leverage their knowledge and expertise across the country. We have extensive experience in benefit strategies, plan design, financial analysis, employee communications, administration and compliance. With more than 3,000 employees and more than 70 offices throughout the U.S.,we can remain close to you while also providing the resources of our national organization. Gallagher is highly respected in the marketplace. Gallagher established a Florida presence by creating a Florida Corporation in 1977,establishing an office in Miami and,later, in Boca Raton and Tampa. We have now grown to 7 offices in the State. Gallagher—Boca Raton, in Palm Beach County, will serve as the primary source of consulting expertise for the City of Miami Beach account. Locally, Gallagher is recognized as a leader in the Governmental sector. Over the 38 years that Gallagher has operated in the State of Florida, we have developed and maintained consulting relationships with numerous governmental entities. We have extensive experience in benefit strategies, plan design, financial • analysis, employee communications, administration and compliance, with a focus on the specific challenges and needs of our Public Entity clients. One of the advantages of having Gallagher as the City's benefits consultant is we offer the advantages of a National consulting house with a very local approach. We are perhaps the only firm with a complete set of skills and people locally in this market. We clearly understand Public Entities, including your necessity of lowering cost while providing high value benefits to your employees, and we have tremendous expertise with all aspects of benefit design,funding and structure. We have focused a team of people, technology resources, and systems to meet your objectives. In addition, Gallagher has a very flat structure so that decisions affecting our clients can be made quickly. Staying current in our profession is vital to the success of the City of Miami Beach's employee benefits program. Gallagher is known industry-wide for the expertise and capability of our client-focused teams of professionals. We combine our commitment to excellence with a tradition of innovation and creativity to create customized employee benefits programs for each client. Our proactive, in front of the curve stance and"can do" attitude makes Gallagher the City's expert, advocate, and guide. In short, Gallagher is your experienced partner who is continually Thinking Ahead. You will have appropriate and innovative reporting, actuarial services,communication and technology applications for HR and your employees, and we are local and accessible immediately. Gallagher is distinctively different from other consultants and brokerage firms in many ways. Our primary differences are the depth and experience of our executives and account managers and our team model, which encourages the involvement of ALL of our executives to work for and in support of our employer clients. Most of our executives have either led or managed health plans,or have held senior executive 19 positions with many of the largest insurance carriers and administrators in the country. This depth and breadth of experience is truly a difference. Our ability to achieve solutions for our clients is in no small part due to our in-depth understanding of how the products and services offered to employers were developed and built by health plans, insurance carriers, and provider networks. Another distinguishing feature of our group is the constant attention to detail brought about by our disciplined approach to benefit management. The Gallagher approach is focused on making sure that no stone is left unturned in achieving the best results for our clients. Finally, a clear distinguishing feature of the approach Gallagher takes with our clients is the partnership we have been able to achieve with many of our clients. Unfortunately, it is not often that you see partnerships develop between broker/consultants and their clients. While defining roles and responsibilities and developing common goals is clearly possible,often the broker/consultant has other goals as well,outside of those commonly developed (such as increasing revenue through increased medical costs). We offer complete transparency of compensation and attention to your objectives exclusively. Projects Submit at least three (3) projects within the last five (5) year where the Proposer has performed services similar to the scope of this RFP for a public sector agency. For each project that the Proposer submits as evidence of similar experience, the following is required. For each project that the Proposer submits as evidence of similar experience, the following is required: project description, agency name, agency contact. Contact telephone&email and year(s)and term of engagement. 1. Healthcare Reform Individual and Employer Mandate Overview Project Description: Starting with the adoption of the Patient Protection and Affordable Care Act, Gallagher met in-person with the City's staff on numerous occasions to explain key provisions of the Act and its impact on the City. Attached in Tab 8 is one of the presentations that was delivered to the City. Agency Name: The City of Miami Beach Agency Contact: Sylvia Crespo—Tabak Contact Telephone: (305) 673-7524 Contact Email: Sylvia Crespo-Tabak @miamibeachfl.gov Years and Term of Engagement: Project delivered February 12, 2013 under Contract Term January 1, 2011 -Current 20 2. Actuarial Valuation of Postemployment Benefit Plan as of October 1,2013 Project Description: Gallagher has provided guidance to the City related to its obligations for its OPEB trust as part of our GASB 45 valuation support. It is important to follow the established funding policy in order to take maximum credit for the higher discount rate that can be used for a funded plan and we have worked with the City to ensure that this has taken place. We have always been available, both in person and by phone, to discuss all issues related to the trust, and we will continue to provide that service as we navigate the pending changes in GASB 45. Please find a copy under Tab 8. Agency Name: The City of Miami Beach Agency Contact: Sylvia Crespo—Tabak Contact Telephone: (305)673-7524 • Contact Email: SylviaCrespo-Tabak @miamibeachfl.gov Years and Term of Engagement: Project delivered November 13,2013 under Contract Term January 1, 2011 —Current 3. Health Options—Baptist Network PowerPoint Project Description: With the loss of Baptist from the Humana network, the City needed an expedited solution to continue providing the City's employees, retirees, and their dependents access to Baptist facilities. Gallagher prepared an informal RFQ process with AvMed which produced the desired results—a two carrier self-funded arrangement with Baptist as part of the AvMed network,with estimated savings$500,000 to$750,000 per year. This resulted in no disruption to the continuity of care for the City's health plan participants who were given a choice to enroll in a plan with access to the Baptist network. Please see powerpoint under Tab 8. Agency Name: The City of Miami Beach Agency Contact: Sylvia Crespo—Tabak Contact Telephone: (305)673-7524 Contact Email: SylviaCrespo-Tabak @miamibeachfl.gov Years and Term of Engagement: Project delivered November 13,2014 under Contract Term January 1, 2011 -Current 4. 112.08 Filing Project Description: Self-funded government employers in Florida are required to submit an annual filing to the Office of Insurance Regulation ("OIR")summarizing the plan's experience and funded status. The submission must include a certification from a qualified actuary that the plan is "actuarially sound". Gallagher has prepared and submitted the filing each year and as part of that process we have worked with the City to ensure that the funding rates and accumulated plan assets are sufficient to satisfy OIR requirements. The OIR has approved the filing each year, ensuring that the City can continue to operate the self-funded plan. A copy of the most recent 112.08 filing prepared by Gallagher for the City is attached under Tab 8. 21 Agency Name: The City of Miami Beach Agency Contact: Sylvia Crespo—Tabak Contact Telephone: (305)673-7524 Contact Email: SylviaCrespo-Tabak @miamibeachfl.gov Years and Term of Engagement: Project delivered February 3, 2015 under Contract Term January 1, 2011 -Current 5. Cadillac Tax and 60% Plan Analysis Project Description: Gallagher provided an analysis to the City on the Cadillac Tax exposure the City will face starting in 2018. By way of background the PPACA will impose an excise tax on employers and insurers starting in 2018 if the value of the plan that is offered exceeds certain thresholds.A copy of the Analysis is attached under Tab 8. Agency Name: The City of Miami Beach Agency Contacts: Sylvia Crespo—Tabak Contact Telephone: (305)673-7524 Contact Email: SylviaCrespo-Tabak @miamibeachfl.gov Years and Term of Engagement: • Project delivered April 30, 2015 under Contract Term January 1, 2011 -Current 2.2 Qualification of Proposer Team. Provide an organization chart of all personnel and consultants to be used for this project if awarded, the role that each team member will play in providing the services detailed herein and each team members' qualifications. A resume of each individual, including education,experience, and any other pertinent information shall be included for each Proposal team member to be assigned to this contract. Gallagher is providing the City a full team of professionals with an array of diverse professional backgrounds in order to meet the City's known and unanticipated needs. We have included an organization chart below, and also resumes of key team members under Tab 7. The resumes include each team member's education, experience and role. 22 Core Consulting.Team for City of Miami Beach Actuarial/Analytics Client Services Consulting Compliance j Specialty Consultants Lead Actuary 7 Sr.Account Manager T Lead Consultant Lead Attorney 1 Medical Case Manager Glen Volk,FSA,MAAA Kelly Dunn Richard G.Schell E Paul Hebert,-JD Theresa Noone,RN Actuary Account Manager i National Compliance Benefits Administration Mark Bogart Yvonne Blackford ? Co Consultant p 09 Unit Rhonda Marcucci • Garrett Moore 'R Zonal Compliance Individual Medical Wellness&Health e a 9 p� Actuary Wellness Communications 'Consulting Helpdesk ; Insurance Wenchin Li ! p o ultmg 9 (slatted by Anomeys) Yvette Shambro -- _Support -- Shiva Wilensky - -- ---------- i _ ,._ . � .-- I ,. _ • Analytics Optional Voluntary Benefits Contracted Legal Retirement Services Unit Cat Center Resources . - -- Jennifer Bennett Karl Nembach Pharmacy Consulting Mike Thomas Pharm D _ Red Box indicates , Boca Raton/Palm Private Exchange Beach County'office Dennis Boyle --_...__., ___� **Red—Boca Raton Office 2.3 Financial Capacity. Each Proposer shall arrange for Dun & Bradstreet to submit a Supplier Qualification Report directly to the Procurement Contact named herein. No proposal will be considered without receipt, by the City, of the SQR directly from Dun & Bradstreet. The Cost and Preparation of the SQR shall be the responsibility of the Proposer. Proposers are responsible for the accuracy of the information contained in its SQR. It is highly recommended that each Proposer review the information contained in its SQR for accuracy prior to submittal to the City and as early as possible in the solicitation process. For assistance with any portion of the SQR submittal process Gallagher has complied with the request and we have also included under Tab 6 confirmation of the Dun& Bradstreet submission to the City as well as to copy of the SQR. 23 TAB 3-SCOPE OF SERVICES PROPOSED 24 C2. Statement of Work Required. It is a requirement of any resulting agreement that the following services be provided as part of the Consultant's fee: 1. Review and evaluate existing City benefit related agreements, including but not limited to administrative service agreements with insurance carriers, new case documents and service agreements to provide recommendations for possible improvement in price,terms and conditions. Read, Understood and Agreed. Gallagher formally reviews all group insurance policies, ASO agreements and other benefit-related group policies or contracts issued to the City as a result of our work. We undertake this review to ensure the documents accurately reflect the appropriate provisions, services and coverages placed on your behalf. Gallagher checks the documents against the applications, proposals, prior policies andlor renewals. We are intimately familiar with the insurance and contractual provisions as well as the procurement requirements and process. This has enabled the City to significantly benefit in numerous areas that have been considered insignificant by consultants less familiar with the governmental procurement process. At a minimum, Gallagher reviews the following areas: • • General Provisions/Contract Changes • Eligibility/Elections • Description of Benefits • Termination/Continuation/COBRA • Expressed or implied client expectations of review • RFP, Requirements, Procurement Requirements, Statutory and Regulatory applicability including indemnification and hold harmless provisions. Upon completion of our review and evaluation, Gallagher provides recommendations which include suggested areas of improvement or change for review by the City's staff and legal counsel. 2. Assist in preparation of the City's Request for Proposal process for its self-insured medical, dental, life and voluntary coverage benefit plans which include, but may not be limited to, short and long-term disability coverage, critical illness coverage, accident care, dependent life and supplemental care coverage. Read, Understood and Agreed. Within the last 5 years, Gallagher has prepared many Request for Proposals("RFP")and provided evaluation tools for the City. Some of these have been designed to address an acute problem or need whereas others have been released formally in detailed fashion to assist the City with its procurement process. 25 RFP's that Gallagher has worked on as directed by the City include: • Self-Funded Health Plan RFP in 2008 During 2008, Gallagher worked with the City on a medical RFP that solicited both fully insured and self-funded proposals. The fully insured analysis consisted of our normal comparison of carrier financial strength and capabilities, premium rates, networks, and carrier retention. In order to compare the fully insured quotes to expected self-funded costs, it was necessary for Gallagher to do a much deeper analysis of carrier discounts and convert that analysis to expected claim costs. We combined that analysis with the quoted fixed costs for administrative expenses and reinsurance to get a total projected cost under each self-insured proposal. The discount analysis consisted of evaluating carrier responses to a number of RFP questions relating to hospital discounts, physician fee schedules, and prescription drug costs. In the long term,we expect self-funding to be less costly than fully insured coverage because of the elimination of fully insured risk and profit charges,premium taxes that are payable on insured plans only,and more recently the Health Insurer fee payable under the federal healthcare reform law. In addition, carriers will often be overly conservative on their claim projections under fully • insured plans, while under a self-funded plan the employer determines (with the advice of its consultant)how conservatively to forecast claims, and ultimately any margins stay with the plan rather than being lost to the carrier. In 2009,the City's first year of self-funding,we were able to compare the actual self-funded plan cost with the fully insured premium proposed as part of the RFP. We estimate that the City saved nearly$800,000 by changing to self-funding that year. In subsequent years,the estimate gets more difficult because we have to make assumptions about what the fully insured rate increases would have been. We used the City's claim experience to develop estimated fully insured increases over the years, and we estimate that through 2014 the City saved approximately$6.8 million by changing to self-funding in 2009. By the end of the 2014/15 fiscal year,we expect the cumulative savings will be in excess of$8 million. • Voluntary RFP in 2011 o The City awarded two carriers for their Voluntary products as a result of this RFP- Trustmark and Colonial. • Health Plan RFP in 2012—2013 o The City's Budget Advisory Committee("BAC") was tasked with the redesign of the City's Health Plan. o The BAC and the City asked Gallagher to query everything including: • Fully-Insured Rates • Self-Funded Administrative Fees • Pharmacy Solutions • Reinsurance • Retiree Solutions • Plan Design Changes • Network Access &Disruption 26 EAP&Wellness Services o A"Quoting Vendor Matrix"has been included as an example in the following page. o The BAC and the City approved of the results and the findings were presented to the Commissioners for input/approval. o The full analysis of the RFP are included in two PowerPoints under Tab 8. • FSA RFP in 2014 o At the City's request, Gallagher released an FSA RFP in order to comply with Procurement requirements. o WageWorks was the successful proposer as a result of this RFP • Wellness RFQ in 2014 o Based upon the results of the Health Plan RFP, Wellness vendors were asked to respond to a more thorough query. However,with the change in plan year and the Baptist network issue, the results of this RFQ were tabled for future deliberation. • Baptist Network RFQ in 2015 o With the loss of Baptist from the Humana network, an expedited solution was needed to continue providing the City's employees, retirees, and their dependents access to Baptist facilities. o An informal RFQ process with AvMed produced the desired results—a two carrier self- funded arrangement with Baptist as part of the AvMed network—Estimated savings $500,000 to$750,000 per year. o This resulted in no continuity of care being disrupted and all of the City's health plan participants had a choice to enroll in a plan with access to the Baptist network. • Wellness RFP in 2015 o Gallagher and the City released a more thorough Wellness RFP in 2015 in order to select the best vendor to provide Wellness Services. o Humana was selected as the winning bidder and implementation is expected to take place in the Fall of 2015 for a January 1, 2016 effective date. • Health Plan RFP in 2016 o Gallagher has already participated in tentative discussions with the City concerning the Health Plan RFP to be released in 2016 with an effective date of October 1,2016. o Gallagher's experience with the City and the RFP process will ensure that the work performed will be done efficiently and designed to meet the City's needs. o Today, Gallagher has extensive knowledge of the City's employee benefits programs. Because of our history with the City,we can accurately state that we are more prepared and better qualified to perform this work than any other broker/consultant. 27 Gallagher prides itself COMB RFr Nn.201343 Appendix M not just on the large Mooring vendor Maui. block of public sector Pledrinl Ftx clients within Florida, but our processes that FollWrrswed Self-Funded Funy.inrurerl Se1.•1'unded are customized and ( I I Yes y No admin.Fees 1 AilminFees include in Fl J FaLew tools built to support wRhPau.63 1 without Pak- ProP".l Troves retirees '65 retirees Procedure public sector entities. w Re "o.ut 0Go n t ne oo Retirees_a Etc tirees 'Warne We conduct hundreds of RFPs and always dmit:ae, Stop Advan:a6e provide the best PartD Standalone or I MAw/Par1D EuJuslYe_ Medical possible outcome for `ale MA Ex ha, Othgr Ratites our clients. We have w/woPartD solution with pa.GS I Wittmut:Post. Reamer 65 Pvirees the information and Wellness knowledge of each of the competing carriers Standalone 1- tredid Standalone 1 Medivi vendor C�rriec vendor Carrier` in any of the local marketplaces. We understand the products and benefit designs offered by the various insurance companies and health care providers. We have a vast collection of data for each carrier's provider network and have the statistical information concerning the size, scope and discount efficiencies of their networks. Gallagher will work with all appropriate departments to establish RFP objectives, including such things as minimum eligibility, experience and qualifications, scope of services, provider networks, performance guarantees, wellness initiatives and cost. During the development of any RFP we will review areas that could lead to future cost avoidance,cost savings, and control overall spend for the City. Some of the steps that Gallagher and the City will go through during the preparation of the RFP include: • Strategic planning sessions with the City and all vendors that offer medical plans within South Florida to ensure vendors understand the minimum eligibility requirements • Multiple meetings at several levels within the City's structure • Establish timelines for the RFP process • Develop benefit goals and objectives • Develop financial goals and objectives"Benefit to Budget" • Discuss funding methodologies where appropriate(fully insured vs. self-funding) • Develop selection criteria • Develop RFP benefit design parameters • Develop administrative requirements • Develop provider network parameters • Develop medical claims and Rx re-pricing models for medical and Rx RFP • Develop Rx savings solutions including formulary redesign and cost containment programs for Rx RFP • Wellness incentives • Performance guarantees 28 As noted earlier, procurement of non- commodities is difficult and we have built processes that support the procurement process and avoid the common surprises realized when less experienced consultants are relied on. 3. Manage negotiations of reimbursement rates. Read, Understood and Agreed. Gallagher will help the City drill down deeply to understand the real cost of programs and not just simply rely on the responses and information provided by carriers/vendors. Unfortunately, transparency has yet to take hold in the healthcare industry. "Potential Proposers" provide substantial data which may or may not accurately reflect their positioning against their peers. Effectively evaluating reimbursement rates is not possible in most RFP processes. Common enrollment assumptions are used for all vendors. Access fees that are expressed as a percentage of charges or discounts need special attention and we generally negotiate to minimize their use. Projecting claim costs is much more complex. We will request sample reimbursement rate schedules for participating physicians and hospitals, and we will ask vendors to re-price selected claims to check for consistency with their reported discounts. We use client-specific data to weight the discount data. As additional tools, we request discount guarantees and per member per month claim guarantees that we also use to validate discounts. The process still relies on self-reported vendor data but we make every effort to validate the data. Gallagher negotiates hundreds of renewals, including network reimbursement rates in Florida each year. Nationally, Gallagher negotiates thousands of renewals each year. The same can be said regarding rate negotiation and claims experience analysis. With the expertise Gallagher has accumulated through decades of in-depth analysis of claims experience, we are able to negotiate the best possible stop loss, ASO rates and contract terms available for our clients. Gallagher Consultants and Actuaries are well-versed in all funding mechanisms. As one of the industry's largest employee benefit consulting firms, Gallagher has strong working relationships with all of the top vendors in the industry. This allows us to leverage our knowledge to your benefit. We only seek out best-in-class providers of products and services, both established and new.With Gallagher,you have access to the broadest,most effective range of benefits solutions available in the marketplace. We request detailed information on how these programs are structured and how the vendors measure their own performance. We compare the performance metrics to our own normative standards. We use our analytical tools, such as our data warehouse (GBS Insider), to identify key areas of clinical concern based on our client's data and pay particular attention to those programs that address these areas. We also utilize the GBS Insider platform to compare vendor targets against actual client experience to quantify anticipated improvements. 29 gbsins der '�'` 11 a P f 1•].1 ... 1'I.I_1__I•J.1 ___j3t3 1r_' �n>yt' - - ''1 --..`..— -- 1aH0n1aw.lr]S.-1114,7/./aawltb xm... „< .Disease JBi..urrlen-Analvsis .4 a.. A, ..�, i t,_ �j i"-.1;_�_.� :How cLoes this Itelp f U•r,-a v.n.WTn"._J1 mow.-+•e•h:2-1-12-Can.n a3 `:`VID II :lt:a 11,5 Itas , 15 a,..a.r.t2<22mGamOel7..0e 7Y1a-. `.2au ,■ Identifies sgeaficdiseasestates and/Or tt,,,,,...well GTC.1, -e di<2!1 . 27..1 _ 27)•2 021T 1210 - - ' ' ,-f ,..2-15..2 ew•1 1.4`5 1.,... . conditions that are.the'most relevant for :,a2e'_-4 Cw.2,1r On -Jn.Man.n TO S1,0.1 112 777, 1.2.7•e 1.111 yol lY population. `^On Lm�.Gruen:Oe.244e•Ievr� aft 427-'11::0 .:a2'.; :J,)1<5 17:3 �t • il...,11,1a:-r ll:n LIZI.Vr: co sr*412 721, 1219 1,114 lelea>�C�<au-.:m••:ttl All:anlYa - l.1 S7,aic�223 1,7-a, 1,1711'2 1,112 cal C_na:e-Crme.�,l er Gaal�a .f )•.110.] -fD I., 12.21; ua:nsl<1ea-un:::eacO.-nnan.r-a,w,craa 12 ":Scans 121> 1..0v 1.220 r. ,'• Are your-Snledscalman'agement strategies we::n•1 I Aa a acm liae::anu.vt fan vlrl 9a 5.-".5.02 1,22, 1:5, 0.1:7 f gon t}le right conditions? it-.2e Mu,Carton 11.1:-1 2:rJ-2:tea:1e70 aerl.2L !a 11,2-,te 2711•' ]1:7/ 2.017 1,./.,1111101.1,.."1:11.1 Gacict2 1.1. 31.11.,10 4.5 151, 0.15 I''' yc•:sate-v:+M:ri allw<me 5G 5475,2 ,22, I.", 2xa• 4 5 .-!t Gtl 2.11`= 7.176 0.9)2 - It , ... , - .s^--•_. •—•- - ---^-' I. One of the greatest advantages of our GBS Insider application is the ability to develop client-specific benchmarks as well as market averages. We use market averages to evaluate provider discounts, and we use client specific data to evaluate utilization and disease management targets. All of this together provides a robust platform to evaluate and negotiate best-in-class reimbursement rates. We have an extensive pharmacy pricing database as a result of our work with large employers from around the country. This database has information about discounts, fees, rebates, and formulary development. • 30 4. Evaluate stop loss coverage and make related recommendations to ensure the City's self-insurance benefits are protected from catastrophic losses. Read, Understood and Agreed. Gallagher is a leader in the self-insured marketplace and has substantial background in reinsurance analysis and placement. Gallagher has regularly explored whether different terms and/or stop loss deductibles would be in the best interest of the City. The City, through an analysis performed by Gallagher,decided to self- fund their health plan beginning January 1, 2009.An integral part of self-funding the health plan was the procurement of reinsurance. At the City's behest Gallagher marketed the reinsurance and it was recommended that Symetra be chosen as the reinsurance vendor. Throughout the years, the City and Gallagher have monitored the claims experience and renewal increases proposed by Symetra. As part of Gallagher Benefit Services,Inc. the renewal process, Gallagher has always explored STOP LOSS OPTIONS I City of Miami Beach coecom1 :to. whether different terms and/or stop loss deductibles Reinsurance Options 5y =. would be in the better interest of the City. A complete "`�"�°`�°�`�' Specific. 40 Total Pleml°ml ssnk;,rcae;:.la�cn.,t-uldsr._ ssocs analysis of 4 years of large claimants as compared to t ,:0a4 , «.•L„ 5 S1 reinsurance premium has been included under Tab 8. �Ret[nrolhee°t. 15•_1 �.em•�� The summary information to the right provides a Sample Largeelaimants snapshot of the reinsurance analysis Gallagher _-- :011 2010. performs for the City on an annual basis.The City has ° 61A 1209,7 1441175 IS.7U1 1397.611 P Y Y ;50.9- la�� ;;33 Im99f0 routinely reviewed their stop loss deductible with this a E '0. W s � 1247.107» , 6L °4u>naat i 1119.770 1214015 1277.164 f 115.855 information and Gallagher continues to monitor s 1241542 ,'; 157I 7 { ; 10.:5 O rvltu l 1121.492 1174611 1179.441 :44651 claims experience while managing the vendor aaa ;;;6„ :1=1;41 ;;: 5 relationship with Symetra. - °° °°°S 4 Siulw'�s#>CtYG'r1NftJ� ,IMun17oa sr7sitao .50302111 .;,s7eo sO•• . Liam" whit, ZsitAiii4k 'Pro.=1°2013•'_010 hasbsea 116.646117 110/do'rem.4re7 747711 Gc6r.ause dn.parte& Gallagher has negotiated special terms with Symetra Summary bv5,edflcDeductible o•uosl and many other first tier reinsurers who have agreed s.r,r`'�°`�'" 70D0° •4�"trf"�1` °urdbl� '°°` 20U thry Od 2917 2410 2014 R6rw.Pncs Pnrhm 121:67459 111°;917 f1,224579 0.1154125 to Gallagher's national preferred reinsurance 1260.12a07 a.>a, 1/114.569 1//50.761 11478Y„ 124/4)1. 0je lnars.soeat. 0:60w 1627,]5 121470.214 014 011 prt Coa 71601,047 53,42,844 5154/■44 S3.734310 contract eliminating much of the risk and contractual nuance that can create gaps in reinsurance •. Z0112616 2111 0►• 2010 eemvram Precis• SL060,,65 5,.094947 11.1244 51.211720 Tapa rave C4a4 {/124.560 5214.■762 13.478:14 42424,11• coverage. Typically, most standard reinsurance .C44 --=s:. 15450 S 1 1I,01275 274 M 7 71 5 contracts have exclusions, limitations, and timeframes that may not be in the best interests of 2°S4 7.SSO 2674 2616 4tlneraa44 Pr4°Im 1467,580 1907591 1I007,575 I1.071519 Top Coinsal Clams 11124569 1144476/ 01476.714 124=4.114 the client. At Gallagher,we have taken our large national footprint of clients throughout the United 54_4116-0eduruhlr, 3a0DDD6 �Ar r.1116 fl eeiflr°r66rt161[ I OIl tttty Oa sou 2014 =000 States and used this leverage to negotiate national W ° ;°;_ 9 ; ;5;6, $3.47,214 1.2.421,114 partnerships with reinsurance vendors that are in the "� 'e�m"'" 1100611 t1J 0:659 0747.211 5,33.612 AR Cof 5:,091156 f17410:8 S3N1S65 17.21?..:l best interest of our clients. The City relied on these"ironclad" reinsurance agreements that Gallagher has provided over the years through our proprietary partnerships. The City has never had a claim denied or challenged as the direct result if our agreement and this has provided the City$2,9 million in unchallenged reimbursement.The City's reliance on Gallagher and the partnership we have created has provided the utmost protection from catastrophic loss within the health plan. 31 5. Provide all actuarial services, by a professional actuary who is either a staff member or sub-contractor of the successful proposer, as required by the City in relation to health and benefit plans to provide information to decision-makers and reduce risks. Read, Understood and Agreed.Gallagher Benefit services meets and exceeds this requirement.As noted throughout our proposal and as demonstrated throughout our years of working with the City, Gallagher Benefit Services directly employs a full time staff of actuaries who will be more involved, more accessible and more effective in working with all City personnel and departments than any of our competitors in the marketplace.We deploy our Actuarial team on a face to face, day to day basis.Our Actuaries are not just certifying the various required financial attestations, they are leading the thought and analysis. It would be impossible to duplicate this access or gain the return through an independent, less accessible, out of area actuarial group. OUR TEAM UTILIZES SATE OF THE ART PROPRIETARY TOOLS that give them the latest real- time data to produce the most accurate forecasts and assumptions in the industry.This has helped save millions of dollars for the City over the last 14 years and has enabled the City to identify and respond to emerging trends.All of this has been provided under a single and relatively limited scope of services without any additional cost. 6. Suggest and/or develop additional medical plans, providing employee choice in delivery of healthcare and help reduce premium costs to all parties. Read, Understood and Agreed. The City of Miami Beach, like most public entities in the state, provides benefits to attract and retain quality employees. The City has several bargaining groups and agreements in place and a very high retiree participation even for a Municipality. These factors have made the implementation of cost savings measures and alternatives far more challenging than in most employer settings.Gallagher has worked with the City over the last 14 years to educate City officials and staff about the driving forces behind health care inflation. Early in our relationship we helped the City design and implement additional plan options that enhanced the choices available to employees and met the requirements within the various labor agreements.Through various renewal evaluations and subsequent RFP's, Gallagher helped identify the real effect of the roughly 50% retiree participation. The marketplace believed that this was a substantial risk and carriers were unwilling to participate in that process.Through detailed actuarial analysis and communication in the RFP process, we were able to increase the number of vendors available to the City and its employees. Gallagher worked with the City in the last RFP to assess the feasibility and viability of Self Insuring your benefit programs which produced $800,000 savings in the first year and similar savings in subsequent years.Most recently the City's health carrier/Third Party Administrator lost its agreement with Baptist Hospital.Gallagher was able to negotiate with another local provider to either piggy back or direct contract through another Gallagher client, which allowed the City to offer two full networks with similar benefits all under a single self-insured arrangement and single reinsurance agreement. This is quite possibly the only such arrangement in South Florida and has realized a substantial savings of$500,000 in out of pocket expenses for employees,which is a benefit to both the City and its employees. Due to the fee agreement between Gallagher and the City we did not contemplate this additional work and actually realized a decrease in our fee based on migration. We believe this 32 is just one single demonstration of our commitment to the City and its employees. 7. Provide unlimited actuarial services to analyze all benefit programs including plan design, claims, utilization trends, and contribution rates for the self-insured plans prior to open enrollment, by June 1 of each year Read, Understood, and Agreed. We meet and exceed this requirement. The City's request for unlimited actuarial services for design, claims, utilization, trend and rate modeling is significant and warranted in light of the evolving health care marketplace. This provision was problematic for many of the potential bidders during the last RFP and we fully expect that many if not all of our competitors will qualify or limit their services in this area. Gallagher is unique in that we employ our actuaries not just as support for our consulting team but as integral members of the day to day operation.As such we provide better access, utilization and flexibility within our core fee structure for these types of resources than our competitors. We fully recognize the services needed by the City and have contemplated those in our fee structure. We also understand the evolving marketplace and the changing demand for resources and as we have in the past, have the flexibility to include services and work product which may not be addressed above without adjusting our cost. Lastly, should something unique arise that was not contemplated within our fee and well outside of our agreement and beyond the scope, we are always willing to negotiate a favorable outcome for the City. 8. Work with City's Human Resources Department and medical and dental health care coverage providers to develop an in depth analysis of current self-funded programs. Read, Understood and Agreed. Gallagher was the City's consultant and assisted in the analysis that led to the City moving from a fully- Health Plan Self-Funding Analysis—Plan Year, insured to a self-funded arrangement. We 7700 1775 1779 16'9. f1530�760 115.506,73 routinely update the City with claims expense 7 .� 77I 716256.0779 337.01.43 7771.100 1030 909 46: 16=1 31121034 716219,101 712.107 and funding reports including self-funded 811 707: 91% 1.53 711351716 710711.33 MAI 054 317 7129 1719 1.911 S19.63 623 110,11167 71:19+0 health plan projections. Samples of these 7017 019 1679 1.31 731.731.704 7m 7,6 1010061 trr1 �_ :., ens 65.1 r' reports have been included under Tab 8. °`" °°" '°'°" °��' '-:�1.A"'°�'�"'�° 1�' 1�r'�4ma. .idya.cotl Ve.am�-le meaJa uicm7F�a°prs.mwom.ye°N boa gsfr.nnx°um mN 70414 SC. JCH, C11. i 4TA Further,Gallagher routinely provides the City with L7, t:A6 - r4 1 '@ Qm 0.0 ,177 with an in-depth analysis of whether the ;r _ ____ _ _ 11Y1 :23 �: l ,� 741 'J'11 M17 3017 Taal decision to move to a self-funded arrangement1ie.e.ara,m uuea. . c1ay, 1 asal� maor CaUay;hcr Public Entity t SchnlavCC Gmup - as compared to fully-insured was a cost '*-�."!�r. �. • effective transition. To date, the savings estimate in moving to a self-funded arrangement. We estimate that through 2014 the City saved approximately$6.8 million by changing to self-funding in 2009. By the end of the 2014/15 fiscal year, we expect the cumulative savings will be in excess of $8 million. The City should be congratulated for the strategic approach it has taken to saving health plan expense and ultimately using the taxpayers'dollars efficiently. 33 9. Provide guidance on Transitional Reinsurance program and calculate Transitional Reinsurance Fee. Read, Understood and Agreed. Under the Affordable Care Act ("ACA"), the City is required to pay a Transitional Reinsurance Fee for 2014, 2015 and 2016. The Fee is based on the average number of lives covered by the City's medical plans, and the ACA permits different methodologies to calculate the average number. The fee for 2014 equaled$63 times the average number of covered lives. Gallagher calculated the number of covered lives, and the fee, based on the permitted methods (the actual count method; the snapshot count method; and the snapshot factor method). Based on that analysis, Gallagher recommended using the snapshot factor method, which resulted in a total fee of approximately $113,000. This compares to the other methods that would have cost the City closer to $157,000, resulting in a savings of approximately$44,000. Gallagher will continue to provide similar analysis for the calculation of the 2015 and 2016 Fee and provide the best scenario to the City. In addition to the Fee calculation, Gallagher provided ongoing information to the City regarding the Transitional Reinsurance Program and Fee, including the following: Articles: • Transitional Reinsurance Fee • Transitional Reinsurance Fee—Just the Facts • Regulators Release Transitional Reinsurance Fee Form, Supporting Manuals, and Job Aid • Getting Ready for the Transitional Reinsurance Fees: o Checklist for Self-Insured Plan Sponsors o Counting Method Examples for Contributing Entities o Transitional Reinsurance Fee Worksheet for Self-Insured Plans Webinars: • Transitional Reinsurance Fee The above articles and webinars are part of a larger "Healthcare Reform Fees Toolkit" prepared by Gallagher for our clients which also address topics including the Patient- Centered Outcomes Research Institute Fee, the Annual Health Insurer Fee, and the Cadillac Tax. 10. Assist with all compliance issues including the Patient Protection and Affordable Care Act, Health Insurance Portability and Accountability Act (HIPAA), Medicare Part D, Consolidated Omnibus Budget Reconciliation Act(COBRA)and Governmental Accounting Standards Board (GASB) and any legislation that has an impact on employee benefits. Read, Understood and Agreed. The City will continue to have access to Gallagher's full suite of compliance support, including our in house attorney, Paul Hebert, who will remain 34 an integral part of the City's team of consultants. Paul is supported by Gallagher's regional and national compliance units. Through the years, Gallagher has assisted the City on a wide variety of compliance matters, including the Patient Protection and Affordable Care Act, HIPAA, Medicare Part D, COBRA, and newly issued legislation and regulations. Because Gallagher provides the City with a team of professionals which includes a local in- house attorney, we are able to address more than just simple compliance questions. Our resources allow us to provide in-depth compliance support not typically available from other consultants. Specific examples include,but are not limited to: • Multiple in-person presentations to City's staff on the Affordable Care Act since its inception in 2010 • Working with the City's legal department to address the Affordable Care Act's potential impact on the City's Living Wage Ordinance • In-person Compliance Review to ensure the City is meeting its compliance obligations, particularly in the areas of documentation, required disclosures, compliance with federal and state mandates, and reporting requirements. • Assistance in preparing and reviewing employee communications • Reviewing plan documents to ensure mandated benefits are included appropriately • Assistance with the Early Retiree Reinsurance Program ("ERRP") that allowed the City to claim a rebate for insurance it provided to early retirees • Helping the City address its domestic partner coverage, including grossing up wages to help cover the imputed income on employees with domestic partners • All of the above is in addition to the day-to-day assistance we provide to the City on benefits compliance questions Gallagher's national compliance unit will continue to provide the City with information in the form of newsletters, technical bulletins, and webinars so that the City can keep abreast of relevant and late-breaking topics as they arise and on an as-needed basis. 11. Provide guidance on Medicare Part D Retiree Drug Subsidy and submit actuarial attestation. Read, Understood and Agreed. Gallagher has prepared the actuarial attestation that is required as part of the application process each year for the City. For a plan of the City's size, we use a blend of actual Medicare retiree claim experience and our manual pricing model to run the cost projections required under the attestation. Although it has not happened with the City, our Part D Attestation model has been subject to random audits by CMS in conjunction with our work for other clients and we have never had any negative findings of any kind. Please refer to the City of Miami Beach-2016 Plan Year Medicare Part D Subsidy Analysis under Tab 8. 35 12. Prepare full bi-annual Governmental Accounting Standards Board (GASB) 45 evaluation and reporting. Read, Understood and Agreed. Since the City was first required to comply with GASB 45, Gallagher has prepared the full valuations required every other year, as well the more simplified roll-forward valuations that can be used in the years a full valuation is not required. The City's valuation is complicated by the fact that your retiree medical plan is partially funded and the reporting has to be split into a number of subgroups. Gallagher has worked with the City's financial reporting area to develop a template that includes historical results and serves as a basis for current year reporting. We were also instrumental in helping the City develop a retiree subsidy schedule that moved away from a percentage of premium subsidy in favor of a flat subsidy per year of service. This removed medical trend from the-liability calculation and that had a significant impact on the reported liability and expense. We understand that new governmental accounting standards (GASB 75) will go into effect for fiscal years beginning after June 15, 2017. These changes will have a significant impact on the City. As always, Gallagher will be ready to assist you with this evaluation and reporting under the new rules. A copy of Gallagher's most recent GASB 45 OPEB analysis for the-City is attached under Tab 8. 13. Provide the City with guidance on its Obligations for Postemployment Benefits other than pension (OPEB)Trust. Read, Understood and Agreed. In addition to the GASB 45 valuation, Gallagher Benefit Services has provided guidance to the City related to its obligations for its OPEB trust as part of our GASB 45 valuation support. It is important to follow the established funding policy in order to take maximum credit for the higher discount rate that can be used for a funded plan and we have worked with the City to ensure that this has taken place. We have always been available, both in person and by phone, to discuss all issues related to the trust, and we will continue to provide that service as we navigate the pending changes in GASB 45. 14. Prepare an annual report of the City's OPEB liability as of September 30 each year by October 15 of the same year. Read,Understood and Agreed. We will prepare the required valuation report documenting the City's OPEB liability as of September 30 just as we have in the past. The report will be developed in full every other year and then in the intervening years we will prepare a roll-forward based on the prior year's valuation. This is consistent with GASB's guidance. The report will include all required accounting entries as well as a reconciliation comparing the current liability to the prior valuation. We will also provide all necessary confirmation letters to the City's auditors regarding our work and will respond to any questions or requests for information that the auditors might have. 15. Conduct the City's Healthcare Reform Forecasting Analysis. 36 Read, Understood and Agreed. Gallagher has developed a healthcare reform forecasting tool that addresses all financial aspects of healthcare reform, including: a. Penalties payable for failing to offer qualifying coverage at affordable rates,as defined by the Patient Protections and Affordable Care Act(°PPACA°). b. Fees and taxes payable under.PPACA, including the Patient Centered Outcomes Research Institute fee and the Transitional Reinsurance fee. c. The impact of lives currently waiving or not eligible for coverage who might elect to join the plan based on mandated changes in eligibility or in order to satisfy the individual mandate under PPACA d. The impact of making changes to the plan design and employee contributions to avoid or offset penalties e. The potential impact of the Cadillac tax in 2018 and beyond. We will review the results of the model with you and explain the key issues. The City provides rich enough plans at a reasonable enough single premium that it is unlikely to be subject to penalties for not offering affordable coverage. You have already taken steps to manage the change in eligibility required by PPACA. In our opinion,the Cadillac tax is the greatest area of concern,particularly given the City's premium equivalent structure today. We are still waiting for final guidance on determining how the cost of a plan will be determined for purposes of the tax, but even without knowing all the details it is clear that in its present format, the Cadillac tax has the potential to be a problem for the City. We will update the analysis and work with the City to develop a plan to minimize the potential Cadillac tax liability, while ensuring that you continue to avoid any other penalties under PPACA. 16. Review vendor summary plan descriptions for accuracy in benefits provided and ensure compliance with all governmental regulations. Read, Understood and Agreed. Gallagher reviews the summary plan descriptions, certificates of coverage, insurance policies, administrative service agreements, and other benefit-plan related documents for all lines of coverage. We review these documents to: (1) ensure they mirror the coverage the City wants to offer to its employees, (2) contain accurate information, and (3) accurately reflect mandated federal and state benefit requirements. These reviews have been critical over the recent years because of the numerous changes that have been required due to Florida mandated benefit changes and also the Affordable Care Act. Gallagher reviewed the City's documents to ensure compliance with such things as: Florida mandates • Autism Spectrum Disorder treatment • Coverage of"overage dependent"children Affordable Care Act mandates • Grandfathered status disclosure • Elimination of lifetime maximums, preexisting condition exclusions • Coverage of preventive services with no cost sharing • Coverage of dependent children, including interplay with Florida's mandated 37 overage dependent child coverage • Inclusion of external appeals process • Coverage of clinical trials Gallagher will continue to provide these reviews as part of our continued agreement. 17. Prepare reports informing the City Administration of benefit market conditions (Market Analysis) that may affect the City's policies and risk exposures prior to policy renewals. Read, Understood and Agreed. Unlike many of our competitors,the reporting that you'll receive from Gallagher will be produced by our in-house actuaries and their financial support staff. This reporting process produces the high level of financial accuracy that is required in today's public sector environment. Depending on the City's specific requirements and available data from the carriers, Gallagher has the ability to provide some of the following reports. As noted, many of the reports are already being provided or used to support the forecasting process. Monthly Reports • Summary of plan costs • Analysis of actual cost versus budget • Identification of employee contributions • Tracking of large claims "^ • • Comparison of total claims to aggregate stop loss • Identification of plan costs by specific line of "' = _ •-,:.: coverage i.e. medical, dental, pharmacy,etc.) Quarterly Reports •- 0: _ �--�, • Gallagher will provide the Quarterly Plan Status Report as requested by the City '"��= • Comparison of plan costs to projections • Identification of services provided • Utilization review —�►� -/�' • Comparisons to prior claims periods ,,� "`'`�•; • Plan trends " ;' `''�• Annual Reports • Executive summary of program expenses '-"'— • Comparison of current costs to renewal costs S • Renewal alternatives • Future plan cost projections • Dollars saved by contract negotiation • Percent of benefit dollars paid by employee • Claims by size • Physician visit details • Benefits paid by type of service • Benchmarking 38 18. Conduct quarterly meetings with the City's Human Resources, Finance and Budget staff to provide claims experience, plan costs and projections of claims and revenues. Read, Understood and Agreed. Gallagher meets and exceeds this requirement. Gallagher Benefit Services uses an annual planning Calendar to outline all standard deliverables and meetings. We would include in that service plan and process the regular experience reviews outlined above.Those meetings would be done in conjunction with our core consulting team,our actuarial group and/or any special resources that might be needed based on the evolving trends and experience. While regular and scheduled processes are essential, it has been our experience with the City and with other similar entities that it is not the routine predictable service needs that are the most critical. It is the unforeseen and unexpected issues that pose the greatest challenge. Over the past several years the City has had to adapt to the benefit provisions within the Affordable Care Act. The costs associated with benefit changes and eligibility changes needed to be quantified and mitigated, hourly tracking had to be established, healthcare reporting under IRC 6055 and 6056 are on the horizon,and the looming impact of the proposed Cadillac Tax will need to be addressed. None of these items were contemplated under the scope of services currently in place.We believe that the routine and systematic review and communication is only the foundation of a good service model and experience. It has been and will most likely continue to be the unforeseen issues which are the most critical and pose the most risk. It is our ability to respond to both the routine and unforeseen, immediately and effectively, and we do that without asking the City for additional financial consideration. That is what sets us apart. 19. Provide annual recommendations for changes in plan premiums, plan design, and plan employer subsidy for the upcoming fiscal year by June 1 of each year. Read, Understood and Agreed. Gallagher and the City have partnered together for many years in the annual recommendation process. This partnership has consistently delivered optimum benefits at cost-efficient premium levels to the City's employees. Part of this process includes annual contribution modeling which determines the employer subsidy to the health plan. Gallagher not only meets the City's June 1st deadline but will provide constant updates throughout the year to allow the City ample time to anticipate, review and respond to the pending June 1 recommendation. Gallagher has a time tested approach to providing annual recommendations to our clients including the City. This approach as outlined below begins with completing open enrollment after the latest annual recommendations have been implemented and provides a timeline for the next annual planning process. Annual Planning 0 Recommendation Aid lijog C 1.Assist with annual open enrollment and provide the ability for on-line registration(On- line portal)if applicable 2.Using current City health and medical benefit plans as benchmarks,research,design and propose employee benefit plans for the City as appropriate. 39 Annual Planning I Recommendation Timeline Checklist 3. Meet with the City as necessary to discuss benefit plan options and establish goals and objectives for the City's Benefits program. 4. Provide analysis of renewal of current plan,reviewing past performance. 5. Review additional available cost savings plan alternatives and creative funding options. 6. Determine the appropriate employee and employer benefit contribution levels. ✓1 7. Review and recommend annual contribution strategy from active participants and retirees. 8. Provide the City with information on what other Public Sector employers of comparable size and geography are including within their benefit programs in the upcoming plan year. 9. Conduct renewal negotiations and develop appropriate information for management purposes. 10. Upon the City's request,assist in coordinating a comprehensive Request for Proposal"(RFP),a brokerage process to identify potential high quality insurance carriers, according to established City guidelines.The scope of this RFP may include,but is not d� limited to:Medical, Dental,Vision, Basic Life,Voluntary Life,Accidental Death and Dismemberment,Short Term and Long Term Disability insurance providers. 11. Act as Lead Negotiator and Consultant to the City during benefit contract negotiations Er and renewals. 12. Prepare and present a written analytical report of the proposals received including recommendation(s)and supporting documentation for recommendations. 13. Review plan documents(employee booklets)and master contracts before adoption and printing. 14. Assist with the planning and implementation of selected changes including transition from the current to new vendors,the renewal proposal,and other benefits changes. 15.Assist with developing the City's employee benefit program communication materials. Coordinate the design,printing and production of those materials,as edited and approved by the City's Benefits Manager. 16.Advise and assist the City's Employee Benefits Manager with the review of contracts, plan documents,insurance policies and other documents for applicability,accuracy, Q consistency,and legal compliance. 17.Assist the City with the development of performance guarantees relating to vendors' performance of services to The City,and evaluation of the performance of vendors. 20. Review agreements and policies purchased by the City to assure their accuracy and appropriateness. Read, Understood and Agreed. Gallagher reviews all group policies, ASO agreements and other related group policies or contracts issued to the City of Miami Beach to help ensure that they accurately reflect the appropriate provisions,services and/or coverages placed on behalf of the City. 40 The review includes a check against such documents as the application(s), proposal(s), and/or renewals and are part of our due diligence. Various factors are considered in the policy review process. The checklist we utilize includes but is not limited to: • General Provisions/Contract Changes • Eligibility/Elections • Description of Benefits • Termination/Continuation/COBRA • Expressed or implied client expectations of review • Documentation • Request any corrections from the vendor Review and Share with the Client 21. Provide assistance in resolving complex claims issues. Read, Understood and Agreed. Gallagher works with all of our clients on complex claims concerns as they may arise. Our goal is to maintain productive vendor and carrier •interactions that both prevent and resolve issues. Using a specific example, in June — August of 2013 a member in the City's health plan was transitioned between a physician's office and a hospital for a drug infusion related to immunodeficiency. The cost of the Rx infusion in the physician's office was$5,000—$9,000 per month. When the member was transitioned to a hospital for the drug infusion, the hospital's insurance contract allowed for billing the City approximately$290,936 over three(3) months of treatment. Gallagher identified this issue after receiving the monthly large claimant report and worked with Humana and the City to determine a way to reduce this expense. The following is a timeline of the work Gallagher, the City, and Humana performed to help save the health plan, and the taxpayers,considerable expense: • February 2010 o Health plan participant began seeking treatment from a specialist physician for an immunodeficiency disorder. o The participant did not agree to case management when contacted by the Humana Medical Case Manager. • February 2012 o The specialist physician moves drug infusion treatment from the office setting to the outpatient setting at their contracted hospital. • June—August 2013 o The City's health plan receives a bill from the hospital for $290,936 for drug infusion services for this health plan participant o Gallagher's data analytics team identified the large claimant anomaly and brought it to the attention of the City. o The City directed Gallagher to work with Humana to determine if there was any acceptable course of action to help address this+800%increase in health plan spend for this participant. • August 2013 o After bringing this to Humana's attention, all charges at the physician's contracted hospital for this participant were audited by Humana's Special 41 Investigation Unit(SIU) o A J-Code analysis(drugs that are delivered via the physician setting)was performed by Gallagher and it was determined that this health plan participant was the only member to have significantly higher drug infusion costs in a hospital setting • The next highest J-Code category was for chemotherapy ($29,335) which is generally administered in a hospital setting and significantly less expensive than the immunotherapy infusion being investigated. o Humana's Medical Case Management/Provider Contracting Department contacted the specialist physician to determine if the health plan participant was able to return to the office setting for drug infusions without risk of adverse event during the course of therapy. The specialty physician responded affirmatively. o Humana Provider Relations reached out to the specialist physician and entered into a Letter of Agreement(LOA)for infusion services for August and moving forward. If the health plan participant has success returning to the office setting for ongoing treatment, the specialist provider and Humana will work to extend the LOA moving forward. ® October 2013 o After the Letter of Agreement was in place, the health plan participant received their next three months of drug infusions in the specialty physician's office. o This resulted in a savings of approximately $260,000 over three (3) months. The savings due to the combined efforts of the City, Gallagher, and Humana to redirect care to a more appropriate setting saved over$1 million in health plan expense if annualized. o Further, this gave Humana the opportunity to renegotiate their contract with the specialty physician for improved pricing in an office visit setting producing additional savings(estimated $5,000 -$10,000 per year). o Lastly, with the resolution of this complex claim issue, the City's health plan reinsurer agreed to lower the stop loss renewal premium in 2014 by approximately$25,000 based upon 1,508 employees/retirees enrolled at the time. As evidenced above, Gallagher brings a unique perspective to claims and provider resolutions as we manage the third party appeals process for many of our clients. Thus, we are very hands on and understand the quickest way to the right results. Once Gallagher's data analytics identified the issue, the timeline in correcting this very expensive,complex claim issue was extremely fast and efficient. Directing provider contracting and complex claims efforts is usually a lengthy process due to a number of laws, regulations, and provider contracting confidentiality. At the City's direction with Humana's support, Gallagher completed this process in less than three(3) months while producing significant savings to the health plan without compromising the healthcare quality of the health plan participant. 42 i 1\ \\ • ldentifed the complex claim issue and brought it to the Gallagher's 1 attention of the City -- Data Analytics • Advocated for the City throughout the process and leveraged the appropriate resources to communicate effectively with Humana • The City \\ • Asked Gallagher to act on their behalf and provide a solution, if any, to the complex claim } ` • Provided guidance as the process unfolded yi • Provided the support necessary to help resolve the complex claim Humana ` • Investigated the claim and renegotiated an agreement with the physician r? • Health plan saved unnecessary expense Resolution • Continuity of care undisrupted for participant • Lowered the cost of health insurance for all of the City's employees, their dependents,and the taxpayer Gallagher has extensive resources and employs highly qualified actuaries and clinicians to help the City and our client's with these complex claims issues. We will always act on the City's behalf but not without the City's approval. We will work with the health plan participant,human resources, the insurance carrier and the provider to ensure that a complex claim is paid appropriately. In the event that we believe the carrier/provider is not delivering the correct response, we will elevate the claim to senior management 22. Provide other services that may be necessary in the future. Read, Understood and Agreed. In addition to our Core consulting services Gallagher has a full array of other consulting services, including Human Resources, Actuarial, Clinical, Compensation, Pharmacy, Exchange, and Retirement and we also make Individual coverage options available. As we have reiterated throughout our response and demonstrated over the past 14 years, the routine and predictable deliverables are the easiest and, to a great degree, the least significant part of the City's needs. Our ability to identify emerging risks and deliver immediate and effective solutions on issues that were not and could not have been contemplated within a scope services is our biggest differentiator. This is where we truly have set ourselves apart and where ever possible we will continue to do so. 43 TAB 4-APPROACH AND METHODOLOGY 44 Tab 4 v Approach and Methodology Submit detailed information on how Proposer plans to accomplish the required scope of services, including detailed information, as applicable, which addresses, but need not be limited to: review and evaluate existing City benefit related agreements to provide recommendations; assist in preparation of City's request for proposals for its medical, dental, life, disability and voluntary benefit plans; provide plan design and contribution design modeling; manage negotiations of premium rates,etc. Read, Understood and Agreed. Gallagher's approach is different and far more effective than any of the other proposers you may evaluate. We will develop a service plan and calendar that addresses all of the routine timelines and deliverable. Renewal calendars and enrollment schedules will be outlines and time for necessary bargaining, evaluation and implementation will be included. This portion of our response may look very similar to that of our competitors and the sample materials included may also appear similar. What begins to set us apart is first our background and experience. We are the most significant brokerage concern in the public entity market and have over 2,000 public sector clients nationally. Add to this a much broader expertise of the "operational"team and the service experience and outcomes that we can bring, we begin to look very different. In May of 2013 we undertook a significant evaluation project working with the Budget Committee on a redesign and re-evaluation of overall plan offerings. This was a formative effort and through the utilization of our most senior actuaries, clinicians systems personnel and Governmental niche directors the output and potential for savings was well into the millions. While the City Council was not ready for many of the items brought forward by the budget committee and Gallagher the work product and strategic value was immense and served as a template, even today, for future direction. Our team approach not only enabled us to help the City set strategic direction but was a regular resource for some of the routine blocking and tackling of every day benefit and human resource management. When staff was needed we helped identify qualified candidates, when systems became a burden we helped identify alternatives and when resources were stretched we helped identify and evaluate independent opportunities to reduce burden on staff and improve the enrollment and communication process. Our unique team process is what enables us to effectively deliver in so many different areas. We will take great care in identifying and delivering on all of the routine and necessary services and will do so as effectively as anyone in the market. In addition we will also help you identify the needs that were below the surface or still emerging and will do so in a time and fashion to keep you in front of the curve with the solutions needed to mitigate or manage the challenge. • 45 TAB 5-REVENUE PROPOSAL 46 APPENDIX E COST PROPOSAL FORM Failure to Revenue Proposal.Form, in its entirety and fully executed, by the deadline established for the receipt of proposals will result in proposal being deemed non-responsive and being rejected. Proposer affirms that the Proposed Cost Proposal Rate stated on the Cost Proposal Form are inclusive of all costs borne by the Proposer relating to the scope of the project; and Proposer affirms that no claim will be made on account of any increase in research costs,wages, material prices,delivery delays, taxes, insurance, cost indexes or on any other account. The Cost Proposal Form shall be completed mechanically or, if manually, in ink. Cost Proposal Form completed in pencil shall be deemed non-responsive.All corrections on the Cost Proposal Form shall be initialed. Proposed% ! Premium Annual Cost Description I of Premium I (for calculation purposes only) • l Rate to the City. ! 1. Flat Amount per employee per month $10.00 1,500 $ 180,000 Total Cost of Services per year $ 180,000 Since there is no direct premium in the self-funded program we are proposing a continuation of the current flat fee methodology and are using an assumption of 1,500 enrolled employees.As a%of total funding this would equal roughly 1.4%of total funding or 23.8%125.3% of the ASO fee for October 1, 2015 for AvMed and Humana respectively.The proposed flat fee includes all items specifically addressed in the RFP scope of service.The actual services that have been provided over the years were at times significantly greater and broader than those outlined in the scope of services.Prospectively as Health Care reform and the changing marketplace creates new requirements on the City we will be there to help you through those challenges.As we have in the past we will always try to meet those needs within our existing fee structure. Should the City need additional services that are well beyond the scope of services we would negotiate reasonable costs for such items.Those items may include systems support, staffing, enrollment support, additional actuarial reporting, retirement services,audits,clinical services and/or any other unforeseen need.We are also agreeable to establishing reasonable minimum and maximum compensation provisions based on the full scope of services agreed upon. • Bidder's Affirmation Company:Gallagher Benefit Services,Inc. Authorized Representative:Jeffrey P.Angello Address: 2255 Glades Road, Suite 200E,Boca Raton, FL 33431 Telephone: (561)998-6802 Email:Jeff_Angello @ajg.com Authorized Representative's Signatu?e=- ,y:,' � e` *The total cost of annual services shall be the basis for calculated cost per points pursuant to Section 0400,4.Cost Proposal Evaluation. 47 TAB 6- GALLAGHER DOCUMENTS ARTHUR J. GALLAGHER&CO. CO IL!E OF BUSINESS CONDUCT AND ET(111,CS This Code of Business Conduct and Ethics applies to all of the employees,officers and directors of Arthur J. Gallagher&Co. and its subsidiaries. Any employee or officer who violates the letter or spirit of these policies is subject to disciplinary action, up to and including termination of employment. Every employee, officer and director has the responsibility to obey the law and act honestly and ethically. To that end,this Code of Business Conduct and Ethics is a guide that is intended to sensitize employees, officers and directors to significant legal and ethical issues that arise frequently and to the mechanisms available to report illegal or unethical conduct. It is not, however,a comprehensive document that addresses every legal or ethical issue that an employee, officer or director may confront,nor is it a summary of all laws and policies that apply to Gallagher's business. Ultimately,no code of business conduct and ethics can replace the thoughtful behavior of an ethical employee,officer or director. Please read this Code of Business Conduct and Ethics carefully and consider how the provisions relate to your daily business interactions. Each employee, officer and director should also read and be familiar with the portions of our other company policies applicable to such employee, officer and director,none of which are a part of this Code of Business Conduct and Ethics. Any questions you may have on this Code of Business Conduct and Ethics or its administration should be referred to your immediate supervisor or a member of the Legal Department. No one at Arthur J.Gallagher&Co. has the authority to make exceptions to these policies,other than our Board of Directors. 11. COMPLIANCE WITH LAWS,RULES AND REGULATIONS All employees, officers and directors must comply fully with all applicable foreign,federal, state and local laws,rules and regulations that govern Gallagher's business activities and conduct, including, without limitation,antitrust laws,employee health and safety laws,insider trading laws,the Foreign Corrupt Practices Act and any applicable trade restrictions,export controls,or antiboycott laws and regulations. All governmental inquiries or investigations must be referred to our Legal Department. It is our policy to fully cooperate with any governmental or regulatory investigation,and all employees,officers and directors are expected to fully cooperate with any internal or external investigations. Since the laws governing our activities are often complex, any questions that you may have regarding their applicability and interpretation,should,after review with your supervisor,be referred to our Legal Department. In general,employees,officers and directors who have access to,or knowledge of,material nonpublic information from or about our company are prohibited from buying,selling or otherwise trading in our company's stock or other securities. "Material nonpublic"information includes any information,positive or negative,that has not yet been made available or disclosed ARTHUR J.GALLAGHER& CO. CODE OF BUSINESS CONDUCT AND ETHICS This Code of Business Conduct and Ethics applies to all of the employees,officers and directors of Arthur J. Gallagher& Co. and its subsidiaries. Any employee or officer who violates the letter or spirit of these policies is subject to disciplinary action,up to and including termination of employment. Every employee,officer and director has the responsibility to obey the law and act honestly and ethically.. To that end,this Code of Business Conduct and Ethics is a guide that is intended to sensitize employees,officers and directors to significant legal and ethical issues that arise frequently and to the mechanisms available to report illegal or unethical conduct. It is not, however, a comprehensive document that addresses every legal or ethical issue that an employee, officer or director may confront,nor is it a summary of all laws and policies that apply to Gallagher's business. Ultimately,no code of business conduct and ethics can replace the thoughtful behavior of an ethical employee,officer or director. Please read this Code of Business Conduct and Ethics carefully and consider how the provisions relate to your daily business interactions. Each employee,officer and director should also read and be familiar with the portions of our other company policies applicable to such employee, officer and director,none of which are a part of this Code of Business Conduct and Ethics. Any questions you may have on this Code of Business Conduct and Ethics or its administration should be referred to your immediate supervisor or a member of the Legal Department. No one at Arthur J. Gallagher& Co. has the authority to make exceptions to these policies,other than our Board of Directors. I. COMPLIANCE WITH LAWS,RULES AND REGULATIONS All employees, officers and directors must comply fully with all applicable foreign, federal, state and local laws, rules and regulations that govern Gallagher's business activities and conduct, including, without limitation,antitrust laws,employee health and safety laws,insider trading laws,the Foreign Corrupt Practices Act and any applicable trade restrictions,export controls,or antiboycott laws and regulations. All governmental inquiries or investigations must be referred to our Legal Department. It is our policy to fully cooperate with any governmental or regulatory investigation,and all employees,officers and directors are expected to fully cooperate with any internal or external investigations. Since the laws governing our activities are often complex, any questions that you may have regarding their applicability and interpretation, should,after review with your supervisor,be referred to our Legal Department. In general,employees,officers and directors who have access to, or knowledge of, material nonpublic information from or about our company are prohibited from buying, selling or otherwise trading in our company's stock or other securities. "Material nonpublic"information includes any information, positive or negative,that has not yet been made available or disclosed to the public and that might be of significance to an investor,as part of the total mix of information, in deciding whether to buy or sell stock or other securities. • Such insiders also are prohibited from giving"tips"on material nonpublic information,that is directly or indirectly disclosing such information to any other person, including family members, relatives and friends, so that they may trade in our stock or other securities. Furthermore, if, during the course of your service with our company,you acquire material nonpublic information about another company, such as one of our customers or suppliers,or you learn that we are planning a major transaction with another company(such as an acquisition),you are restricted from trading in the securities of the other company as well as ours. Such"insider trading" is both unethical and illegal, with criminal penalties of up to$5 million and a jail term of up to 20 years and civil penalties of up to three times the illegal profit gained or loss avoided. Please refer to our Insider Trading Policy for a more complete description of our company's policies on insider trading which can be found on our web portal. II. CONFLICTS OF INTEREST Business decisions must be made in the best interest of our company,not motivated by personal interest or gain. Therefore, as a matter of Gallagher policy,all employees,officers and directors must avoid any actual or perceived conflict of interest. A "conflict of interest"occurs when an individual's personal interests interfere or conflict in any way (or even appear to interfere or conflict)with the interests of our company. A conflict of interest situation can arise when an employee,officer or director takes actions or has interests (financial or other)that may make it difficult to perform his or her company work objectively and effectively. Conflicts of interest also may arise when an employee,officer or director,or a member of his or her family,receives improper personal benefits as a result of his or her position in Gallagher,regardless of whether such benefits are received from us or a third party. Loans to, or guarantees of obligations of,employees,officers and directors and their respective family members are of special concern. Federal law currently prohibits Gallagher from making loans to directors and executive officers. It is difficult to identify exhaustively what constitutes a conflict of interest. For this reason, employees, officers and directors must avoid any situation in which their independent business judgment might appear to be compromised. Questions about potential conflicts of interest situations,and disclosure of these situations as they arise,should be addressed and reported to the Legal Department. III. ACCURATE ACCOUNTING AND PUBLIC DISCLOSURE The accurate and full recording of company business activities is essential to our ability to fulfill our financial and legal obligations. Under no circumstances should you alter any business record or destroy any records except in conformity with our policy on records retention. 2 Financial transactions are to be recorded in accordance with generally accepted accounting principles and applicable governmental rules and regulations. You are expected to comply fully with internal accounting and audit policies and procedures designed to protect the integrity of our corporate records and are also to cooperate with the Accounting Department and internal and external auditors. All employees,officers and directors are encouraged to report any concerns that they may have regarding the accounting, internal accounting controls,or auditing matters of the company directly to the Audit Committee. All submissions by employees of concerns regarding questionable accounting or auditing matters will be received by the Audit Committee on a confidential and anonymous basis. We want to assure all of our employees,officers and directors that they have no need to fear retaliation or retribution for having acted in good faith in reporting their concerns. As a result of our status as a public company, Gallagher is required to file periodic and other reports with the Securities and Exchange Commission. Gallagher takes its public disclosure responsibility seriously to ensure that these reports and other public communications furnish the marketplace with full,fair,accurate,timely and understandable disclosure regarding the financial and business condition of the company. IV. CONFIDENTIALITY Employees, officers and directors must maintain the confidentiality of all information entrusted to them by us,our clients or suppliers,or others with whom we may conduct business, except when disclosure of such information is specifically authorized by our Legal Department or required as a matter of law. Confidential information includes all non-public information that might be of use to competitors,or harmful to us or our clients, if disclosed. V. PROTECTION AND PROPER USE OF COMPANY ASSETS All employees,officers and directors must protect our assets and ensure their efficient use. Such assets include,without limitation, intellectual property such as the Gallagher name, logos, trademarks,patents,copyrights,confidential information, ideas,plans and strategies. Theft, carelessness and waste have a direct impact on our profitability. All company assets must be used for legitimate business purposes.Any misuse or infringement of our assets should be reported to the Legal Department. VI. CORPORATE OPPORTUNITIES Employees, officers and directors are prohibited from: (a)taking for themselves personally opportunities that properly belong to the company or are discovered through the use of corporate property, information or position;(b)using corporate property, information or position for personal gain; and(c)competing with the company. Employees, officers and directors owe a duty to the company to advance its legitimate interests when the opportunity to do so arises. Any questions as to the appropriateness of the conduct of any employee,officer or director should be brought to the attention of the Legal Department immediately. 3 1 VII. FAIR DEALING Each employee, officer and director must endeavor to deal fairly and in good faith with our customers,suppliers,competitors, stakeholders and employees. No employee,officer or director shall take unfair advantage of anyone through manipulation,concealment,abuse of privileged information, misrepresentation of material facts or any other unfair dealing practices. VIII. EQUAL EMPLOYMENT OPPORTUNITY AND HARASSMENT Through specific policies issued by our Human Resource Department,we strive to select,place and work with all our employees and officers without discrimination based on race,color, national origin, gender,age,religion,disability, veteran's status,or actual or perceived sexual orientation. Equal opportunity is one of our firmest and most basic beliefs. Please see the Company's Human Resources Manual for a fuller description of the Company's Equal Employment Opportunities,Anti-Discrimination and Americans With Disabilities Act policies. Further, it is the responsibility of each of us to help the company provide a work atmosphere free of harassing,abusive,disrespectful,disorderly, disruptive or other nonprofessional conduct. Sexual harassment in any form,verbal or physical, by any employee,officer or director will not be tolerated. It is also a violation of our policy to retaliate against anyone who in good faith complains about harassing behavior or participates in an investigation. A violation of the Company's harassment policy will be treated with appropriate discipline, up to and including termination of employment. Please see the Company's Sexual Harassment policy found in the Company's Human Resources Manual for further details. IX. REPORTING VIOLATIONS AND COMPLIANCE All of our employees,officers and directors have a duty to adhere to this Code of Business Conduct and Ethics. It is our intention to enforce the policies expressed in this Code of Business Conduct and Ethics. If confronted with an ethical question, employees are strongly urged to discuss this matter either with their supervisor or the Human Resources Department. As discussed in Section III of this Code of Business Conduct and Ethics,concerns regarding questionable accounting or auditing matters should be brought to the attention of the Audit Committee. We will respect the confidentiality of all such discussions,and we further want to assure all of our employees,officers and directors that they need have no fear of retaliation or retribution for having acted in good faith'in calling unethical conduct to the attention of our management. All allegations will be investigated by the proper corporate, business unit or department personnel,and,upon the advice and approval of the Legal Department, will be reported to the appropriate authorities. In order to facilitate implementation of this Code of Business Conduct. and Ethics, employees,officers and directors have a duty to cooperate fully with the investigation process and to maintain the confidentiality of investigative information unless specifically authorized to disclose such information. 4 Employees,officers and directors who provide information to or assist in any investigation or proceeding by the Company, federal governmental or law enforcement agency regarding any alleged violation of fraud laws or SEC rules and regulations will not be subject to retaliatory action for their cooperation in such matters. It is a violation of this policy and federal law for any employee,officer or director to retaliate against an employee because the employee provides such cooperation. Any employee who believes he or she has been the subject of retaliation should report the matter to his or her supervisor or the Human Resources Department. If the employee's manager is involved in the alleged retaliation,the employee should contact the Human Resources Department directly. Employees, officers or directors who fail to comply with the standards of behavior that we have described in this booklet are subject to disciplinary action that may include termination of service,referral for criminal prosecution,and reimbursement to Arthur J.Gallagher&Co. for any losses or damages resulting from the violation. Discipline may also be imposed for conduct that is considered unethical or improper even if the conduct is not specifically covered by our Code of Business Conduct and Ethics. No code or set of values can address every ethical choice we face in business;no communication system or oversight group can ensure complete compliance. Each of us must use good common sense and judgment in our personal conduct. X. AMENDMENT,MODIFICATION AND WAIVER This Code of Business Conduct and Ethics may be amended,modified or waived by the Board of Directors of the Company. Any change to,or waiver of,this Code of Business Conduct and Ethics for executive officers or directors must be disclosed promptly to our stockholders either by a Form 8-K filing or by publishing a statement on our website. 5 CHI 2759667v7 __ �__ '�� __ _ -____ _______ ________ _�_�-_ • • � � | � \ i | / � � / '| � ( ` � � | | / / \ i ' � ' ' ` ! � � i ` ~--� .~' � � � | | 4 . : l za'�Z••`u I,As; `.r'-s* VA-ii • %'•" •y •'z-a �%1:<a•''t>•;70.. •��i`ss i ti i ss'i,/�•<a;.. •,` •<`,••--i- � ® � ® � � � ®^fir® ® � ® ® �® � ® ® �=® � ® ® � � .? � � i �n a � ► n � II n R R a t F R R R R R a n p rt n c x tt R II a• -s("r„'`•."'t?•; f;IV i stIs ,•e?.•...•, r. I%->,,%-x•,...2 es?i :• ..tr•��;•rsi.tis�i •',••S7•tiiA•. ai 1•'s1c' •��-r t- i n it �"•1 Cr S. } A<- �> y yr i '��•) i74.n 4.1 .• ... +41' ---le .---, 41.tx el: 9'tt• •�. := ` �� =- y k'�h p,,, •Rat 1._:,... .4:4, F 7 1' -®:' _ rr ti r . (i • s ---`.� P: `�R•�. •.tl _ ry_' �� r n•'. VT at. •A• ic: s _.. 1 rte.• _. apt-.•` Ir. -•p* •a•. 1 Ate- y ��! , ADO WE fPv, Z a•. ``q,,�� y, �g g[�� {fit ®. 7 S Si��15��!� �� u i i� 6lla� r, t- s ,l gla I certify the attached is a true and correct copy of the application by 'A 1 =n GALLAGHER BENEFIT SERVICES, INC., a Delaware corporation, authorized to R• •A f transact business within the State of Florida on December 9, 1999 as shown by =¢•40 ° the records of this office. •n• au+' 4 s The document number of this corporation is F99000006362. . -1® s a a 0• art• .® S' 70< • • �a I n 7r®‘ vvy < C• •IS• 71 0.,V �; sSi. >0L f%. ... •R 0 IS aC •a• S r103;- > t, •a•- •R• nS .11 41, •Ra p - r.13-_ •A•: •R• y®` 11,0‘-;, • R• •tt• 7! S tior,• 1.0" Given under my hand and the 1 R 40 : Great Seal of the State of Florida •®• 0 at Tallahassee, the Capitol,this the 0,v Ninth day of December, 1999 411 0 ti®�. s � ,� Via•.. an4 �� r r- ®. L 1 R• r ,,�� ,: ,, � ^F fl%fi0. (0,„ 0,....12.04 ---3K- '•E b ° SQL; ■b 00- •.r[.! r Uri ///((( f S ,�� Any >Qy, �v IjiltlTM-11e 1arris +�fib A CR2E022 (1-99) rrrt'tzirti cif .tote fl<; ✓ S 7 C •II. y ss• L €- ss : ' ys•v > , s s _ 'i rti•.e.%• a`•I sa•'y. • •_s •�' ea es _ _. .r-�✓. _ss .,--e-4 Ai,. r- � U •nCDa••a®R®n®=CDR®a tt�°® ®II® ® V ®A�n®n�°® ®a a®ttWa®Rtqn®11�tt®II R, • . •«i ,,,iNW,!s-r,4zistItYI _Ai'Ve�isOtir,f1s•1X _,�• .1 ,/s s,1 ,.i_ <s • a;•' ��iti r.•'W.•.ti•c • a•w ,•%->•S. •‘ • 1 APPLICATION BY FOREIGN CORPORATION FOR AUT'HO1':IZATf ON TO TRAN YKt1 BUSINESS IN FLORIDA IN COMPLIANCE WITH SECTION 607.1503. FLORIDA STATUTES. THE FOLLOWING IS SUBMITTED TO ■-9 �U G REGISTER A FOREIGN CORPORATION TO TRANSACT BUSINESS IN THE STATE OF FLORIDA. J I Gallagher Benefit Services, Inc. -7 (Name of corporation; must include the word"INCORPORATED","COMPANY","CORPORATION"or s®� words or abbreviations of like import in language as will clearly indicate that it is a corporation instead of a v' natural person or partnership if not so contained in the name at present.) 2. Delaware 3 36-4291971 (State or country under the law of which it is incorporated) (FEI number,if applicable) 4 4/20/99 5 Perpetual (Date of incorporation) (Duration: Year corp.will cease to exist or"perpetual") 6. Upon Qualification (Date first transacted business in Florida.) (SEE SECTIONS 607.1501, 607.1502 and 817,155, F.S.) 7 Two Pierce Place Itasca, IL 60143 (Current mailing address) Insurance Agency and Brokerage 8. (Purpose(s)of corporation authorized in home state or country to be carried out in state of Florida) 9. Name and street address of Florida registered agent: (P.O.Box or Mail Drop Box NOT acceptable) Name: Corporation Service Company Office Address: 1201 Hays Street • Tallahassee ,Florida, 32301 (Zip code) 10. Registered agent's acceptance: Having been named as registered agent and to accept service of process for the above stated corporation at the place designated in this application.I hereby accept the appointment as registered agent and agree to act in this capacity. I further agree to comply with the provisions of all statutes relative to the proper and complete performance of my duties,and I am familiar with and accept the obligations of my position as registered agent. Corporation Service Company B : l,Jo , Q ' I AJ11 \.Registered agent's signature) 4 11. Attached is a certificate of existence duly authenticated,not more than 90 days prior to delivery of this application to the Department of State,by the Secretary of State or other official having custody of corporate records in the jurisdiction under the law of which it is incorporated. • 12. Names and addresses of officers and/or directors: (Street address ONLY a P.O.Box NOT acceptable) • �{y A. DIRECTORS(Street address only-P.O.Box NOT acceptable) "0 Chairman: See attached officers/directors rider ®cr%� 0 17 1o ^, Address: _ `G y. Vice Chairman: tr3 Address: _ Director. Address: Director: _ Address: _ B. OFFICERS(Street address only-P.O.Box NOT acceptable) President: See attached officers/directors rider Address: • Vice President: Address: Secretary: , Address: , Treasurer: Address: _ NOTE: If necessary.you may attach an addendum to the application listing additional officers and/or directors. 13. irz�:�_.� . &LL) (Signature of Chairman,Vice Chairman,or any officer listed in number 12 of the application) • N. Christine D. Greb, Assistant Secretary (Typed or printed name and capacity of person signing application) v • GALLAGHER it EINEI"IIT SERVICES, EI1NNC. Incorporated : Delaware o Date 04/20/99 % Ownership: 100%Arthur J. Gallagher& Co. a-c crl o ,- Iederal ID# : 36-4291971 ..0 `_'�rn �pG CAPITAL STOCK 1g, 8,cr Common °0 fi Price/Par Value: $1.00 Authorized: 1,000 Cr, o Outstanding: 1,000 1, DIRECTORS: Michael J. Cloherty Director James W. Durkin,Jr. Director J. Patrick Gallagher, Jr. Director OFFICERS: J. Patrick Gallagher,Jr. Chairman James W. Durkin,Jr. President Jeffrey P.Angello Area President Gail Ann Lynch . Area President. Glenn D. Morrison Area President James W. Powell,Jr. Area President Peter V. Wright Area President J. Michael Brewer Executive Vice President Angelo M.Nardi Executive Vice President David M.Ziegler Executive Vice President. John C. Rosengren Vice President and General Counsel Michael J. Cloherty Vice President David R. Long Vice President Dennis M. DeJesu Area Vice President . John C. Erb Area Vice President John K. King Area Vice President James J. Murray,Jr. Area Vice President James E. Relyea Area Vice President William E. Ure Area Vice President Jerome P. Zacny Area Vice President Gregg R. Aleman Area Asst.Vice President David W. Carrell Area Asst.Vice President Douglas R. Mize Area Asst.Vice President E. John Neurnaier Area Asst. Vice President Jerry E. Perkins Area Asst. Vice President Mark P. Strauch Treasurer John J.Caraher Chief Financial Officer Michael J. Cloherty Secretary Christine D. Greb Assistant Secretary purpose of Business: • Insurance Agency and Brokerage Primary Address: ' Two Pierce Place Itasca, IL 60143 CO U 'L • .--� o o G ++ Q i cn 17,' ‘14 .:.,.c &I •V •0 ' _ v 4- 'a O U r. a� _.. In v G W o • 3 . Cr) bA ~ � -0Z.„‹. Z PM! ,� = Q �. °° v, - y.. 'p' 0 rn v::) l) a P = U V W W az ~y Q F4 Z W N v� Q� o � Z = >, CA MM 0 � O v ^.a W cn N 0 W O 4 GO -o = p — • 2 F.—L., U C`1 a� :.• cs t CD - 0 0 n C N }.• •i+ N tj C.)y c Rill, < CD 0 ;3 H J • Q H O A .. 1::: C� ^ N LA C)) .4 G • s c v a. cA 2. 1 0 . I � '-- ---'- - / ----' ---- -_- ^,--__-_'_-__-___--_____' `�� _,_-_ ' ! � ! , � / � ` / � | � � � / ( / } � ! / ` � i , � | ` \ / \ ' ' > � ' ) � ) ` i� Ac® CERTIFICATE OF LIABILITY INSURANCE 08/25 NCE DATE 1DDlYYYY, 08/25/2014 ■ THIS CERTIFICATE RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 'ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED ■ REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER _ IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the , certificate holder in lieu of such endorsement(s). 1-312-704-0100 CONTACT PRODUCER NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX (NC.No,Ext): (NC.No): E-MAIL Chi_Certificates@ajg.com 300 South Riverside Plaza ADDRESS: Suite 1900 HdSURER(S)AFFORDING COVERAGE NAIC Chicago, IL 60606 LEXINGTON INS CO 19437 Direct all inquires to email INSURERA: INSURED INSURER B: XL SPECIALTY INS CO 37 885 Gallagher Benefit Services, Inc. INSURER C: 2255 Glades Road INSURER!): Suite 200E INSURER E. Boca Raton, FL 33431 INSURER F: COVERAGES CERTIFICATE NUMBER: 41151391 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY i POLICIES.LIMI INSURANCE MAFHARD BEEN THE REDUCED BY PAID CLAIMS. HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF S INSR ADDL SUER POLICY EFF POLICY EXP I LIMITS LTR TYPE OF INSURANCE INSR INVD, POLICY NUMBER (MM/DD)YYYY),(MMIDDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ ' GENERAL AGGREGATE $ GEM.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG _$ ,F-7 PRO $ POLICY JECT LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $ BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ - HIRED AUTOS AUTOS (Per accident) $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR ^ CLAIMS-MADE AGGREGATE $$ DED RETENTION$ WC STATU- OTH- WORKERS COMPENSATION I TORY LIMITS I ER AND EMPLOYERS'LIABILITY YlN E.L EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE I I N!A OFFi /M CEREMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S (Mandatory in NH) N yes,describe under E.L DISEASE-POLICY LIMB DESCRIPTION OF OPERATIONS below - _ A Errors & Omissions 015012431 09/01/1 09/01/15 Each Wrongful Act 20,000,000 B (Claims Made) ELII13573314 09/01/1 09/01/15 Aggregate 20,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE g /� ee 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD lavanyachi 41.11C1101 I Ac®® CERTIFICATE OF LIABILITY INSURANCE DATE 'Y) t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS ;ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 1-312-704-0100 CONTACT Direct All Inquiries to Email NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX (A/C.No.De): (A/C,No): 300 South Riverside Plaza DDRREESS: Chi_Certificates@AJG.com Suite 1900 Chicago, IL 60606 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: ARCH INS CO (A Ell) 11150 INSURED INSURER B: COMMERCE & INDUSTRY INS CO 19410 Gallagher Benefit Services, Inc. INSURER C: 2255 Glades Road, Suite 400E INSURERD: INSURER E: Boca Raton, FL 33431 INSURER F: COVERAGES CERTIFICATE NUMBER: 41762717 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADOL SUER POLICY NUMBER (MMIDDIIYYYY) (MMIDDIIYYYY) LIMITS L INSR VVVD A GENERAL LIABILITY 41GPP4938407 10/01/141 10/01/15 EACH OCCURRENCE $1,000,000 X DAMAGE TO RENTED $100,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 X Gen Agg per loc subj. PERSONAL&ADV INJURY $1,000,000 X to $10 NIL policy agg. GENERALAGGREGATE $3,000,000 GENt AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $3,000,000 PRO- X $ 7 POLICY JECT LOC A AUTOMOBILE LIABILITY 41CAB4939007 (MA) 10/01/14 10/01/15 COMBINED SINGLE LIMB 3,000,000 (Ea accident) $ A % 41CAB4938307 (AOS) 10/01/14 10/01/15 BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ X X A OWNED (Per accident) HIRED AUTOS AUTOS $ B X I UMBRELLALIAB X OCCUR BE5842691 10/01/19 10/01/15 EACH OCCURRENCE $25,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $25,000,000 DED I X RETENTIONS 10,000 $ WORKERS COMPENSATION 41WCI4938107 (AOS) 10/01/19 10/01/15 X TORY IMITS ER A AND EMPLOYERS'LIABILITY Y/ry 10/01/15 EL EACH ACCIDENT $ 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE 41WCI4938107 (WI) 10/01/14 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) EL DISEASE-EA EMPLOYEE$1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE Evidence of Coverage THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 I 3 AUTHORIZED REPRESENTATIVE ,(/� '/ ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD pushpachi 0 1 ® DATE(MM/DD/YYY`n CERTIFICATE ®� PROPERTY INSU INSURANCE 10/06/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 3ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. If this certificate is being prepared for a party who has an insurable interest in the property,do not use this form. Use ACORD 27 or ACORD 28. 1-312-704-0100 CONTACT PRODUCER NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX (AIC,No.Ext): (AIC,No): 300 South Riverside Plaza E-MAIL ADDRESS: Chi_Certificates@AJG.com Suite 1900 PRODUCER Chicago, IL 60606 CUSTOMER ID: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:LIBERTY MtT FIRE INS CO 23035 Gallagher Benefit Services, Inc. - Boca Raton INSURER B: INSURER C: 2255 Glades Road, Suite 400E INSURER 0: Boca Raton, FL 33431 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 41765914 REVISION NUMBER: LOCATION OF PREMISES I DESCRIPTION OF PROPERTY(Attach ACORD 101,Additional Remarks Schedule,If more space is required) 1 I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION COVERED PROPERTY OMITS LTR DATE(MWDDIYYYY)I DATE(MMIDD/YYYY) A X I PROPERTY YU2L9L452870014 10/01/14 10/01/15 BUILDING g • - CAUSES OF LOSS DEDUCTIBLES PERSONAL PROPERTY $ 7 BASIC BUILDING BUSINESS INCOME $ i BROAD CONTENTS _ EXTRA EXPENSE $ X SPECIAL RENTAL VALUE $ EARTHQUAKE BLANKET BUILDING $ WIND X BLANKET PERS PROP $Included • FLOOD BLANKET BLDG&PP $ X Policy Limit $ 5,000,000 X Deductible s 100,000 ' INLAND MARINE TYPE OF POLICY $ CAUSES OF LOSS $ I NAMED PERILS 1 POLICY NUMBER $ $ ICRIME $ TYPE OF POLICY $ BOILER&MACHINERY! $ EQUIPMENT BREAKDOWN $ $ SPECIAL CONDITIONS I OTHER COVERAGES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 'vidence of Coverage THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN • ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE pushpachi ©1995-2009 ACORD CORPORATION. All rights reserved. ACORD 24(2009109) The ACORD name and logo are registered marks of ACORD 41765914 ! 1 Kelly Dunn From: Kelly Dunn Sent: Wednesday, September 09, 2015 5:30 PM To: Kelly Dunn Subject: FIN: D&B SQR-RFP 2015-195-LR From: Rodriguez, Lourdes [mailto:LRodriguez @miamibeachfl.govj Sent:Thursday,September 03,2015 1:59 PM To:Garrett Moore<Garrett Moore @ajg.com> Cc:Denis,Alex<AlexDenis @miamibeachfl.gov>;Granado, Rafael<RafaelGranado @miamibeachfl.gov> • Subject: RE: D&B SQR-RFP 2015-195-LR Garrett, Confirming receipt. MIAMI L� �� Lourdes Rodriguez,CPPB Contracting Officer Procurement Department 1755 Meridian Avenue,3rd Floor,Miami Beach,FL 33139 Tel:(305)673-7000,ext.6652,fax:(786)394-4075 From: Garrett Moore[mailto:Garrett Moore @aig.com] Sent:Thursday, September 03, 2015 1:37 PM To: Rodriguez, Lourdes Cc: Denis, Alex; Granado, Rafael Subject: D&B SQR- RFP 2015-195-LR Importance: Low Hi Lourdes, I just went through the online process of requesting the D&B SQR report to be sent to your email address for the firm I represent,Arthur J.Gallagher&Co. Could you please confirm receipt? The online system won't tell me if you are in receipt of the report or not and we want to meet all of the City's requirements. Thanks so much! Garrett Moore,MBA,IBA,GBA,SPHR Senior Benefits Consultant Arthur J.Gallagher&Co. 2255 Glades Road, Suite 200E I Boca Raton,FL 33431 P:561.998.6743 I F:561.998.6731 I M:305.905.6924 www.ajg.com www.linkedin.comlin/garrettmoore/ Gallagher Benefit Services,Inc. This e-mail and any files transmitted with it are intended only for the person or entity to which it is addressed and may contain confidential material and/or material protected by law.Any retransmission or use of this information may be a violation of that law.If you received this in error,please contact the sender and delete the material from all computers. 1 dun bradsfreet Supplier Qualifier Report To save report(s) to your PC, click here for instructions. Print this Report Copyright 2015 Dun & Bradstreet- Provided under contract for the exclusive use of subscriber 100150009 ATTN: ARTHUR J. GALLAGHER &CO. Report Printed: SEP 03 2015 • In Date ARTHUR 3.GALLAGHER&CO. 2 Pierce PI Itasca,IL 60143 This is a headquarters location. D-U-N-S® Number: 07-442-4540 Branch(es) or division(s) exist. Telephone: 630 773-3800 D&B Rating: ER1 Number of employees: ER1 is 1000 or more Fax: 630 285-4000 employees. D&B Supplier Risk: 1 Chief executive: 3 PATRICK GALLAGHER JR, CHB-CEO SUPPLIER EVALUATION RISK(SER) RATING FOR THIS FIRM : 1 Stock symbol: AJG -, . Year started: 1927 9 8 7 & 5 4 3 2 7 Employs: 20,459 (700 here) High Medium Low All amounts are displayed in local currency. Finandal statement date: JUN 30 2015 Sales F: 4,626,500,000 Net worth F: 3,711,500,000 History: CLEAR Financing: SECURED D&E PA VD::�i4® D&B PAYDEIG 67 When weighted by dollar amount, payments to i suppliers average 18 days beyond terms. 0 100 120 days stow 30 days slow Prompt Anticipates Based on up to 24 months of trade. SUMMARY ANALYSIS transaction were not disclosed. 06/29/2015 MERGER/ACQUISITION: According to published reports, Arthur J Gallagher & Co, DUNS 074424540, (Itasca, IL) announced that it has acquired Monument LLC, DUNS 155337913, (Malvern, PA).Terms of the transaction have not been disclosed. 06/23/2015 OFFICER CHANGE: According to published reports, Arthur J. Gallagher&Co. announced that its Board of Directors has appointed Walter P. Bryce, Sean P. Connelly, James J. Murray, Russell G. Parsons, Russell J. Pass and Jonathon M. Winsbury as Corporate Vice Presidents. 06/17/2015 ANNOUNCED MERGER/ACQUISITION: According to published reports, Arthur J. Gallagher & Co., DUNS 074424540, (Itasca, IL) announced that it has signed a definitive agreement to acquire substantially all the assets of William Gallagher Associates Insurance Brokers, Inc., DUNS 962414913, (Boston, MA), which has annualized revenues of approximately $50 million. The transaction is subject to customary closing conditions and is expected to close in the third quarter of 2015. Additional terms were not disclosed. 06/08/2015 MERGER/ACQUISITION:According to published reports, Arthur J. Gallagher&Co., DUNS 074424540, (Itasca, IL) announced the acquisition of Solid Benefit Guidance.Terms of the transaction were not disclosed. 05/22/2015 MERGER/ACQUISITION:According to published reports, Arthur J. Gallagher&Co., DUNS 074424540, (Itasca, IL) announced the acquisition of James R. Weir Insurance Agency, Inc., DUNS 097895981, (Mankato, MN). Terms of the transaction were not.disclosed. CUSTOMER.S C If you have questions about this report, please call our Customer Resource Center at 1.800.234.3867 from anywhere within the U.S. If you are outside the U.S. contact your local D&B office. *** Additional Decision Support Available *** Additional D&B products, monitoring services and specialized investigations are available to help you evaluate this company or its industry. Call Dun & Bradstreet's Customer Resource Center at 1.800.234.3867 from anywhere within the U.S. or visit our website at www.dnb.com. The following information was reported 08/20/2015: Officer(s): J PATRICK GALLAGHER JR, CHB-PRES-CEO+ DOUGLAS K HOWELL, CORP V PRES-CFO SUSAN E PIETRUCHA, CORP V PRES-CHIEF HR OFFICER WALTER D BAY, CORP V PRES-GENERAL COUNSEL-SEC RICHARD C CARY, CAO-CONTRL WALTER P. BRYCE, CORP V PRES SEAN P. CONNELLY, CORP V PRES JAMES J. MURRAY, CORP V PRES RUSSELL G. PARSONS, CORP V PRES RUSSELL J. PASS, CORP V PRES JONATHON M. WINSBURY CORP V PRES THE OFFICER(S) and Sherry S Barrat, William L Bax, D John Coldman, Frank E English Jr, Elbert 0 Hand, David S Johnson, Kay W McCurdy and Norman L Rosenthal. The Delaware Secretary of State's business registrations file showed that Arthur J. Gallagher&Co. was registered as a Corporation on March 30, 1972, under the file registration number 0780509. Business started 1927. The company was founded in 1927 and was reincorporated as a Delaware corporation in 1972. In November 2014, the company completed the acquisition of Discovery Benefit Solutions, Inc., San Diego, CA, Scanlon &Associates Insurance Brokers Inc. doing business as SGB-NIA Insurance Brokers, Woodland Hills, CA, The Titan Group LLC, Richmond, VA, and Miller&Harrison Inc., Muscatine, IA. In October 2014, the company completed the acquisition of Bennett&Shade Company, Decatur, IL, Insurance Associates, Inc. and Forker Company. In August 2014, the company completed the acquisition of certain assets of Minvielle &Chastanet Limited, Insurance Point, LLC, Dezelan Insurance Agency and Trip Mate, Inc., Kansas City, MO. In July 2014, the company acquired Noraxis Capital Corporation paying cash consideration of approximately $420.0 million and Foundation Strategies Inc. In June 2014, the company acquired the Wesfarmers Insurance Brokerage operations and Insurance Point, LLC. On May 1, 2014, the company acquired Shilling Limited. On April 1, 2014, the company completed the acquisition of Mike Henry Insurance Brokers Limited and acquired the Oval Group of Companies for net cash consideration of approximately 199.0 million (approximately $331.3 million). In March 2014, the company completed the acquisition of Spataro Insurance Agency Inc., Tudor Risk Services LLC and L&R Benefits LLC. On February 20, 2014, the company completed the acquisition of Kent& Kent Partnership. In December 2013, the company acquired Bergvall Marine AS, Barmore Insurance Agency, Inc., McIntyre Risk Management LLC, Cleaveland Insurance Group Inc. and The Jenkins Group Inc. In November 2013, the company completed the acquisition of Parks Johnson Agency LLC, and Employee Benefits Analysis Corporation. In October 2013, the company completed the acquisition of R.J. Dutton Incorporated, and G.S. Levine Insurance Services Inc. In September 2013, the company acquired R. W. Scobie Inc., Dickinson &Associates, Inc., and Belmont International. On August 12, 2013, the company completed the acquisition of Bollinger, Inc. On July 5, 2013, the company acquired D&E Benefits Solutions LLC. In May 2013, the company acquired Property &Commercial Limited for$65.1M and Garza Long Group LLC. J PATRICK GALLAGHER JR. Director since 1986. He has served as Chairman of the Board since 2006. He has spent his entire career with the company in a variety of management positions n 1974. He currently serves as the company's President since 1990 and CEO since 1995. DOUGLAS K HOWELL. He serves as Corporate Vice President and CFO since 2003. SUSAN E PIETRUCHA. She serves as Corporate Vice President and Chief Human Resource Officer since 2007. WALTER D BAY. He serves as Corporate Vice President, General Counsel and Secretary since 2007. RICHARD C CARY. He serves as Controller since 1997 and CAO since 2001. WALTER P. BRYCE. 1995-present active here. SEAN P. CONNELLY. Served as Global Chief Information Officer. JAMES J. MURRAY. 1992-present active here. RUSSELL G. PARSONS. 1985-present active here. RUSSELL J. PASS. 2011-present active here. JONATHON M. WINSBURY. 1998-present active here. f1USTf;1. "R4,°.137STR, rICM This business is at the head of its corporate family tree. It is not a subsidiary of any other business. A UNSPSC (United Nations Standard Product and Services Code) is a globally accepted commodity (Product and Services) classification system. ARTHUR J. GALLAGHER &CO. offers the following product(s) and service(s): 80100000 Management advisory services 84121700 Investment advice 84130000 Insurance and retirement services Beginning in 1997, the Standard Industrial Classification (SIC) was replaced by the North American Industry Classification System (NAICS).This six digit code is a major revision that not only provides for newer industries, but also reorganizes the categories on a production/process-oriented basis.This new, uniform, industry-wide classification system has been designed as the index for statistical reporting of all economic activities of the U.S., Canada, and Mexico. 524210 Insurance Agencies and Brokerages 524298 All Other Insurance Related Activities 523930 Investment Advice 561110 Office Administrative Services SirC Based on information in our file, D&B has assigned this company an extended 8-digit SIC. D&B's use of 8-digit SICs enables us to be more specific to a company's operations than if we use the standard 4-digit code. 64110302 Insurance brokers, nec 64110100 Insurance information and consulting services 62820000 Investment advice 874!!10102. Financial management for business '�il 13 P'"-'.rDt X. The D&B PAYDEX is a unique, dollar weighted indicator of payment performance based on up to 197 payment experiences as reported to D&B by trade references. 3-Month D&B PAYDEX: 66 j i D&B PAYDEX: 67 When weighted by dollar amount, payments to 1 R `When weighted by dollar amount, payments to suppliers average 19 days beyond terms. i suppliers average 18 days beyond terms. tx toy ,r too 120 days stow 30 days slow Prompt Anticipates 120 days slow 30 days slow Prompt Anticipates Based on trade collected over last 3 months. Based on up to 24 months of trade. When dollar amounts are not considered, then approximately 84% of the company's payments are within terms. P. V y SLPMi Y The Payment Summary section reflects payment information in D&B's file as of the date of this report. Below is an overview of the company's dollar-weighted payments, segmented by its suppliers' primary industries: Total Total Dollar Largest High Within Days Slow Rcv'd Amts Credit Terms <31 31-60 61-90 90> (#) (s) (5) (%) (%) Ppt 7,500 0 0 ! . 4-5 mos Ppt 5,000 ! 0 0 2-3 mos Ppt 2,500 0 0 . 4-5 mos Ppt 2,500 0 0 2-3 mos Ppt 2,500 2,500 0 • 1 mo Ppt 2,500 250 0 1 mo Ppt 1,000 0 0 . 4-5 mos Ppt 1,000 0 0 ; 6-12 mos Ppt 1,000 0 0 ; 6-12 mos Ppt 1,000 1,000 1 mo Ppt - 1,000 : 1,000 0 Lease Agreemnt 1 mo Ppt 1,000 ; 0 1 mo Ppt 1,000 0 0 1 mo • Ppt 1,000 1,000 0 1 mo Ppt 1,000 0 0 : : 6-12 mos Ppt • 750 , 750 0 ; 1 mo Ppt 750 250 250 N30 1 mo Ppt 750 500 0 Lease Agreemnt ; 1 mo Ppt 500 0 0 ' 4-5 mos Ppt 250 : 0 0 1 mo Ppt 250 : 0 0 N15 I 1 mo Ppt 250 i 0 0 • N15 6-12 mos Ppt 250 ! 250 0 • 1 mo Ppt 250 ; 250. 0 N30 1 mo ; Ppt 250 : 250 : 0 ; Lease Agreemnt 1 mo Ppt 250 0 0 : . 4-5 mos Ppt 250 i 0 0 ; 6-12 mos Ppt 100 ; 0 0 ' N30 4-5 mos Ppt 100 0 0 ; 4-5 mos I Ppt 100 ' 0 0 , • 1 mo i Ppt 100 ! 0 0 2-3 mos Ppt i 100 0 0 N30 • 6-12 mos Ppt 50 1 mo Ppt 50 0 , 0 N30 1 mo Ppt 50 50 ' 0 ; 1 mo Ppt 50 • 50 • 0 N30 1 mo Ppt 50 . 1 mo Ppt 50 . 0 ; 0 , , 6-12 mos . Ppt 50 1 0 0 ` N30 4-5 mos • Ppt 50 ` 50 . 0 . 1mo Ppt 501 0 0 j N30 1 mo • Ppt 50 , 0 0 _. 1mo Ppt 501 1 ! 1 mo . Ppt 0 0 ; 0 1 mo • Ppt-Slow 30 2,500 : 0 : 0 , 4-5 mos Ppt-Slow 30 ‘ 100 0 - 0 6-12 mos Ppt-Slow 45 2,500 0 ; 0 2-3 mos Ppt-Slow 60 5,000 0 • 0 Regular terms 2-3 mos • Slow 25 10,000 ! 10,000 2,500 : N30 1 mo Slow 30 750 0 0 , 6-12 mos Slow 60 1,000 0 : 0 ; 6-12 mos Cash 321,700,000 Premiums Pay-Insur & 2,901,100,000 100,000 Reinsur Co Restricted Cash 1,443,800,000 Accruals 633,100,000 Premiums & Fees 1,764,500,000 Unearned Fees 63,800,000 Receivable Other Curr Assets 731,400,000 Corporate Related 155000,000 Borrowings ' Other Curr Liabs 152,400,000 Curr Assets 4,261,400,000 Curr Liabs 3,905,400,000 Equip Corporate Related Fixt& E 4 P 198 200 000 Borrowings 2,125,000,000 Deferred Income Taxes 438,000,000 L.T. Liab-Other 974,200,000 Goodwill-Net 3,569,400,000 COMMON STOCK 174,500,000 Amortizable Intangible 1,761,500,000 ADDIT. PD.-IN CAP 3,091,900,000 Assets-Net Other Assets 487,600,000 ACCUM OTHER (338,700,000) COMPREHENSIVE LOSS RETAINED EARNINGS 710,800,000 NONCONTROLLING 73,000,000 INTERESTS Total Assets 10,716,100,000 Total 10,716,100,000 From JAN 01 2015 to JUN 30 2015 sales $2,602,700,000; cost of goods sold $616,100,000. Gross profit $1,986,600,000; operating expenses $1,827,200,000. Operating income $159,400,000; net income before taxes $159,400,000; Federal income tax $(20,600,000); net income $180,000,000. Statement obtained from Securities And Exchange Commission. Accountant: Ernst&Young LLP, Chicago, Illinois. Prepared from books without audit. Explanations The net worth of this company includes intangibles; Other Current Liabilities consist of premium financing debt and other current liabilities. FINANCE 05/18/2015 Three-year statement comparative: Fiscal Fiscal Interim Consolidated Consolidated Consolidated Dec 31 2013 Dec 31 2014 Mar 31 2015 'Current Assets 2,875,600,000 3,811,200,000 3,594,800,000 'Current Liabs 3,284,800,000 3,642,700,000 3,438,700,000 Current Ratio 0.88 1.05 1.05 ;Working Capital (409,200,000) 168,500,000 156,100,000 ;Other Assets 3,984,900,000 6,198,800,000 6,136,100,000 Net Worth 2,085,500,000 3,305,100,000 3,219,600,000 Sales 3,179,600,000 4,626,500,000 `Long Term Liab 1,490,200,000 3,062,200,000 3,072,600,000 'Net Profit(Loss) 268,600,000 303,400,000 Interim Consolidated statement dated MAR 31 2015: Assets Liabilities Cash 276,800,000 Premiums Pay-Ins/Reins 2,447,000,000 Companies Restricted Cash 1,186,600,000 Accruals 654,100,000 Date filed: 07/02/2013 Latest Info Received: 07/03/2013 Original UCC filed date: 08/28/2008 Original filing no.: 080028816215 Type: Termination Sec. party: US BANK NA, OSHKOSH, WI Debtor: FORE, BRAD, ROCKWALL,TX Filing number: 1500251775 Filed with: SECRETARY OF STATE/UCC DIVISION, AUSTIN, TX Date filed: 08/06/2015 Latest Info Received: 08/07/2015 Original UCC filed date: 08/28/2008 Original filing no.: 080028816215 The public record items contained in this report may have been paid, terminated, vacated or released prior to the date this report was printed. Activity summary Borrower (Dir/Guar): NO Administrative debt: NO Contractor: YES Grantee: NO Party excluded from federal program(s): NO Congressional District: 08 The details provided in the Government Activity section are as reported to Dun & Bradstreet by the federal government and other sources. Copyright 2015 Dun & Bradstreet- Provided under contract for the exclusive use of subscriber 100150009 TAB 7-GALLAGHER TEAM RESUMES Jeffrey P.Angell() /Area President / 56.1..998.6802 / jeff_angello @ajg.com Role:Area President/ Account Management Jeff is the Area President for Gallagher Benefit Services'Miami and Boca Raton offices. He has management responsibility for both offices and has worked for Gallagher for over 30 years. itti ii,„w- c.Axt_..„,G t, Key Activities/ e Responsible for sales,marketing and client service for the South Florida offices. Responsibilities e Director of Florida Educational and Governmental Niche • Responsible for Gallagher Retirement Services Florida operations Education • Harper College,Palatine,Illinois Employment History e Arthur J.Gallagher&Co.,Area President,1986 to present. o Penn General Service 1981 to 1986 Licenses, a Florida Insurance Licenses:Life,Health&Variable Annuity Designations & Professional Organizations Glen R.Volk/Area Vice"President.,Sr.Consulting Actuary/561.998.6755/glen_volk @ajg.com Role:Actuarial Consultant Glen is a Consulting Actuary with GBS HealthCare Analytics(HCA),a division of Gallagher Benefit Services, Inc. He has 25 years of varied experience in the actuarial field,and has been with the Gallagher family of companies since April 2000. Glen's primary responsibility with HCA is to work with plan sponsors in the design,pricing,and financial management of their benefit plans. He works with several Gallagher offices around the country,typically with their largest and most complicated clients. He also provides consulting support to health plans and provider organizations. Prior to joining Gallagher in 2000,Glen held various positions in the management consulting and insurance industries. He has extensive experience in managed care and in the reinsurance field. He has also served on several health care reform panels and committees. Key Activities / ® Actuarial support including fund rate analysis,reserve calculations,retiree medical valuations Responsibilities • Consulting on underwriting,budgeting,plan design and claim reserve development • Network evaluations with a focus on provider discounts • Provider negotiations for managed care plans,including risk arrangements • Review stop loss reinsurance arrangements,rates and terms/conditions • Employee contribution modeling • File actuarial reports with regulators Education • B.S.in Mathematics,University of Regina(Saskatchewan) • Masters in Applied Mathematics,University of Waterloo(Ontario) Employment • Neighborhood Health Partnership,Chief Actuary History • John Alden Insurance Company,Vice President • Great American Reserve Insurance Company,Assistant Vice President • A.Foster Higgins,Consulting Actuary • Confederation Life Insurance Company,Actuarial Assistant Licenses, • Member of the American Academy of Actuaries(MAAA) Designations • Fellow of the Society of Actuaries(FSA) &Professional Organizations Paul A. Hebert/Area Vice President,Compliance Counsel/561.998.6746/paul_hebert @ajg.com Role: Compliance Consultant Paul is an attorney with extensive experience in the employee benefits field. He works out of Gallagher's Boca Raton,Florida office and is a dedicated resource to Gallagher's Florida offices. Paul's responsibilities include advising both public and private sector clients on the design,implementation and operation of health and welfare, = and retirement,arrangements;conducting plan operational and compliance reviews;performing research and consulting on Internal Revenue Code and ERISA compliance issues;and assisting clients with vendor changes. g P g � Paul also tracks and evaluates recently adopted and proposed federal and state legislation,regulations and rulings 11 ; in the employee benefits field(such as PPACA,HIPAA,COBRA,cafeteria plans,and Medicare)and performs internal and external training on new laws and requirements. Key Activities/ • Day-to-day compliance support Responsibilities • Contract/policy reviews • Quality/peer review of client deliverables • Monitoring and educating clients on legislative/regulatory changes at the federal and state level • Speeches and webinars on compliance topics Education • Masters in the Laws of Taxation,New York University • Juris Doctor OD)with Tax Honors,Rutgers University School of Law • Bachelor of Arts,Vassar College Employment • Arthur J.Gallagher&Co.,Compliance Counsel,2005 to present History • Reid and Ricge,Associate Attorney,Hartford,CT 2002—2005 • KPMG LLP,Manager,Philadelphia,PA 1997—2002 • Capehart&Scatrhard,P.A.,Associate Attorney,Mount Laurel,NJ,1994-1997 Licenses, • Connecticut Bar Designations • New Jersey Bar &Professional • Pennsylvania Bar(inactive status) Organizations • Richard Schell / Area Vice President / 561.998.6733. /tichard_schell@ajg.com • Role:Lead Consultant Richard is an Area Vice President with over 30 years of experience in the employee benefits/insurance industry. He will be responsible for the overall client relationship. While at Gallagher,Richard primarily works with public sector employers and has developed and manages two public sector health purchasing cooperatives. Key Activities/ e Health plan management Responsibilities ® Underwriting and budgeting o Plan design and cost-containment • Sales and marketing. o Network/Provider development,pricing and management. • Development of shared-risks arrangements. Representative • Panhandle Area Educational Consortium Group Health Trust Clients • Public Risk'Management of Florida Group.Health Trust City of Miami Beach Employment o Arthur J.Gallagher&Co.,Area Vice President,1994 to present History o Prudential • American International Group ® Acordia • Licenses, ® Florida Insurance Licenses:Life,Health&Variable Annuity Designations &Professional Organizations Garrett Moore / Senior Benefits Consultant/561.993.6743/garrett_moore @ajg.com Role:Co-Lead Consultant Garrett is a Senior Consultant with varied and extensive experience in employee benefits,compensation,leave management,and financial/statistical analysis. He works out of Gallagher's Boca Raton,Florida office and is a dedicated client resource for Gallagher's Florida offices.Garrett's responsibilities include advising clients on many aspects of their employee benefits programs including their design,structure,overall strategy,funding mechanism,implementation of new programs or vendors,benefit program opportunity assessment, 4,61‘ risk/reinsurance management of stop loss placement,voluntary/worksite benefits,enrollment strategy,and related compliance issues. Garrett stays current in the employee benefits field through industry designations,seminar participation,and participation in local benefits and risk management organizations such as CEBS and PRIMA. Key Activities/ • Health plan management including underwriting and budgeting,plan design,and sales/market Responsibilities development. • Strategic total rewards development and pricing. • Development of shared-risks arrangements. • Underwriting,rate development,funding analysis and reinsurance placement. • Account management,renewal analysis,and vendor negations. • Education • Master of Business Administration,University of Miami • Bachelor of Engineering,Civil Engineering,Vanderbilt University Employment • Arthur J.Gallagher&Co.,Senior Benefits Consultant,2011 to present History • Huron Consulting Group,Consultant,Chicago,IL, 2010—2011 • Mercer Health&Benefits,Consultant,Atlanta,GA,2007—2010 • Humana,Underwriter,Atlanta,GA, 2004-2007 Licenses, • Florida Insurance Licenses: Health,Life,Variable Annuity&Commercial Lines(P&C) Certifications& • Health Insurance Associate(HIA)Designation Professional • Group Benefits Associate(GBA)Designation Organizations • Advanced Microsoft Office skill set. • PRIMA Member II Kelly Ann Dunn/Senior Account Manager/ 561.998.6734/ ketly_dunn @ajg.corn Role:Account Management Kelly is a senior account manager with 15 years of management experience in both the public and private sector. Kelly's primary function is to work as the day-to-day account manager for her clients. She has over 15 years of experience in employee benefits and over 6 years of voluntary benefits.The majority of her base is governmental entities. Key Activities/ • Assists with day-to-day client service needs Responsibilities • Negotiates Renewals • Assists with open enrollment activities • Performs vendor management and claim dispute/resolution. • Provides administrative services,including peer review of client deliverables • Plan Contract and Benefit Reviews • Financial Report Analysis Education • B.A.Business,Flagler College. Employment • Gallagher Benefit Services,Inc.2014 to Present History • EBS Advisors,Inc.,2000-2014 • State Farm,1990-2000 Licenses, • Florida Insurance Licenses:Life,Health&Variable Annuity Designations &Professional Organizations • . . - - I* - _....., . . — . •S'-'-*•••••. , „ . ,...• . , ,1 i‘ ' ° - 1,hp.--1 .,:.,..7.,,:r,1::•.'.,1,'I'Ml-, .'..**4.i-,,V, - .,10 ,rtti:...t.s. A. 4.. lyig.he,:,-, •-.., ..‘,. .,. G-- -'------ ------- -..- ) „.:..- . -- -1 r--------„- tr, , ,,- \.1.. :,,,,, E' ry-1•4*.ii,,W,Wisli@Ole' 11:nttl t ' $110,.-' - ,.r 'I'..P1,... -.48 c-,..4.,.-•4. ,,--z' •Ir.,AR. . 1___-_-•-•--i ''---1-:..;;;,, "-&-ii;. e:-_,,,.....-7;;/ 414 4$0 1 t',i---i.4-1,,,,i---.14',ILli-iviv 1 _ I . 1 • ' i ) . I , . Healthcare Reform - Individual and Employer „.. Trr, Mandate Overview „..,,i. .., . __ . .., . 4-11i1Vil. . . •ffrlit.:-A„Hr . City of Miami Beach February 12, 2013 . ,Plisl fill!t• a• • ii .,r.:,-!---_. --4,,—,.....,_, Li_' 1,.. .i ..; ,-. a. .a 7!� Y:, ( -.0,;1 7i,,p j l9 1 a; ,,I 1 t if' : J 7.1 c- 111`'.0.--,. 1-414 I .:rr ' F”' -) �' �} 7 o ,4,10;a:E xi art 1.t IA.'i -- � f; .• za. .-3 . , , E, t :t ,,„,i g -jar.F ,x, '∎_- �� i- „i.-t, ..h t`L I T,1 1 a..,,3. a 'k t H-. . , t s k"gt'k�P'€: €a3 E'7..�'�ti 1 -..�-. I�I i.id^ 1 t 'I I E, a �} •> s t �., ,'} I -�'E i� .,4 ?.I I t"N x- , t ^t 4 ell �k „5 7 — "I� .1' tii '3 gi r ' {+�c �1 . 1 . .1 C ir-� kl Y i 'tai"}(-"y Mi i� Tf ptp� F` 3E1+,'" (Iiha F it F.�1. � e( .t..,1' �•^ '1,191` t-fit...' A':i ''�1 f;, � .;'ja dt ,,1 k'a.4!` t ",Y.t+; ;1 -. :: �a ii= � ' YUTa`��to `€N qnl,�4 A, I: ,� n 'e µ, � m�i�eJl ��vti' '.1.'� E:. . �=+� �i ;� FlyTM e B as i <<,.,` s r'�FPFr 1 C3 i ., 4 k 17! i G°119 1, .....4,,.:, ' " ` 'h•a 4 w6 i 1 Awl� 6::,Ed41:r, :tTr.E� I k); . .,_ r �.A --1-':•.,_.'i..,.. i4._„ '... 7,e lx4.•Ez_�� ,tL ti ,r W'r._ ,3-. . 'i ' -i-_-�)' - ° Starting January 1, 2014, individuals will be required to . - maintain health insurance that meets minimum actuarial standards Failure to maintain health insurance will generally result in a tax equal to the greater of a flat dollar penalty (below) or a percentage of the individual's household income (1%for 2014; 2%for 2015; 2.5%for 2016) Flat$ 2014 2015 2016 Penalty $95 $325 , $695 Per Child $47.50 $162.50 $347.50 Family $285 $975 $2,085 8/18/2015 Recent Developments in Healthcare Reform 2 1 B�. Y .`F a L� 'lip.�! ONER,r i,:0 _„I. 3 C.. i to 1_ � c[��+1 '"i <t `�.41r� 7�.��[�i`,31+• N ,+ 11��is��s�� -�'*s :Itc {� �_� 1q I[i'(['�kA,,l �{ C' }(�Ili,. p),_ J:� tya��. 1 h 1 (�� J.. {�}f �.,f i' J � � 1 j '.:!� ,• .,041-•S 1 jWp�tt� r. x{�I Ct y C. $.q0.• .q +try T R.�w C 1 ,'. r , j{ I 'I I� s® !- 1I 1] 3 ; 6.'.x �} aJ C ��rj' 'J I +I• :i' �91�,€ T h{ H .,� f r ; 33=i1 71 1.�._ ! 'Fv�{^'-.vi i -ki, .c.i }� �, 4 It 1�€. .n i t i 1 r ♦ ,,=,,„,,,.,,,...' ,a.� . ;,2.,,i,•. I lip - y 1 1 .ET I k oti- _ �■ t,Irgrina u [, uai�( 03nllit' It- , 0, ��es's- tc ,6,, � 7: 4,r 1 e� o` r ■ 'v ,I1., 3- ',s 1 . 3 �[[m $II E d e . t wt r, c e t t, .TW ,. j.- , N.` a,,,,��,� 1 1 ti� t l L '�•� I l� Ed�I:i¢€ a �: [ n�� ' � i� -� � r� � �h � t ! ' rIw_€ rr s �,;�I T, yl t 3r gt 1 ,i E 1 y.I t_ 1. Irk tt fpF7�;{� i§� t� � } r,�.3t.w�,�-11 ,i, �''' 4� �t u d,.F� _r� F•. 9 rte•, r_ In addition to current access to insurance (group L health plans, government programs (e.g., Medicaid), individual market), each State will have an Exchange/Marketplace through which individuals can purchase health insurance — States that don't create their own Exchange/Marketplace will have one administered by the Health and Human Services — Individuals may qualify for financial assistance to help them purchase coverage through the Exchange/Marketplace 8/18/2015 Recent Developments in Healthcare Reform 3 I P l a x.a i_g lc', {sj�rq o � u �..°'- +r,� a y '(�`.r""'s ,i ,,., , a t d ,`� -4 rn ,�. 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I, P'$. f tt�•� fr . 1,::; { 6:� {�5 S4Q tQ :'F?�v ,xgr t t :• i�� w'� tL��,:i, ? �, ;1 ., Individuals may qualify for financial assistance to help them purchase coverage through the Exchange/Marketplace - To qualify for financial assistance, an individual's household income must fall between: - Medicaid eligibility (either 100%or 133% of Federal Poverty Level (FPL), depending on State law); and - 400% of FPL Household Size 100% FPL 133%FPL • 400% FPL • 1 $11,170 $15,574 $44,680 2 $15,130 $20,122 $60,520 3 $19,090 $25,389 $76,360 4 $23,050 $30,656 $92,200 8/18/2015 Recent Developments in Healthcare Reform 4 ••I0':'3. a?? a ik' F, tip,f -`".aE 7. ;ate a_ a -a J '.s k1:- rr'W -,s!l -1 e I-" -!c 4 W'7 . a i i = ��`�q .,7 y , .giii. � 8 , .01-1,4.4_ . c.9 5-H-,ldtl'r ,'in.", a CAE :'.f{��' . t i ;,.- 4`''2F� , A l �,d�iiyi. d � :� 1 t d f-to -Farci k- s�4 ss� _ tom- ' __. 1 u....S T=c 1-O.,...0:9-"� fMJ -t � .t = F yC�.'et_{. ��i �� s p -, �, .' l ,, 4 . ' r. i Z9c tea- , SI` i.1,..r r. 1 M i ?,a, i.r -r-1 } ,- r t " �F �I t r 2 J °a e 1 S �x 'KJ O+ a �T �c �"i t�i�� I a� � i �r �'k a ' I.1,,t: 4 r 4. I r r 1 -01,F . ° 7.I , i.guy ' '� , r6 .. r`.- 9! S m _ -r .1vr 4�.. t,;1,,-I {�� s �� 1 . ,�`5 i � k- 16,,,; d ° ,4}R_:,. zg �- g,.i 1 `'! a@�!� mid :013e4i%al- � 4 i. _ ,...,dt_ -7a.7 �-..� ii J. • The following individuals will have to make decisions about health insurance, and may come onto the City's plan, to avoid the individual mandate taxes - Employees who waived coverage under the City's plan - Spouses/dependents who are not covered under the City's j plan ' p i • Individual will factor the following into their decisionmaking: - Medicaid eligibility - Ability to purchase Exchange/Marketplace insurance with the help of financial assistance 8/18/2015 Recent Developments in Healthcare Reform 5 ..,0-,.-,cry j i,.•_ r s �, ,,,4 -•� rrr,,i , iii _ E-m 'n1.. ,. 1€ 1 F ' ``.M, ?: ?i -'1_- y�, •7 ', ,,,.,. 5, '-9i � --ii, +1 ,,fir may+A_ ir t, v i —ti31q @"i ,sssy . ,-Ii ,, I, } •, 1tl a„�•1 F 1 , �}-1' Sze.iq,F _ir'��i3 i_ t`k i�a.� t. : r , (f3 id ti , a 1 JJ _.L �I r di 3•'�e 1 � : � t-1µ "r� i-i_ i � 3i;� 6,.,,,.4.—.• d a�� fi•. },I P ,,,i } i:- pi"g,a T `- s i• tv r 7 its i' i L i _ �f , Kii'e N�',p•� Tt ..if...77,_ L a r'{�,L4�i'' lire' y"_+- ''i' 4:-'f-E• l- E. ,� F"�q 1 .. _ t yes - �.� '_1•- {, ...K�/^�t Gib 1N-;4, F ":F t.f ®L r„H, . i,R, g t I{yl '• .�''''r I e 4 t o e r J �v, n �t� Tier . I s.!,, : i, .. ,r, . 5; F7 A c� � i(iY ® Y"� i � y r� $x �1 1 1 d ;Cetxe.'6 f i , ,- u- �i ,,, F `'�s�t;,:d --�—�• 1�. ' x1 fil l t a.� .T,,..,-.. �'—,..4:44C, P .1 ; n°rie,:-1,111-Ia:-'1I ' f� , 7e.�o r 'i, ,_ rcr 2.+_`�P f 11"F 04 R axis 1.1 S !L p -,,' 1 f x Y, m, A, .- -�i '� a a35k� 1 �. _ip p ' it-., P.1 3 , b ""��,''��''�� ;44 { N .�( '14, i" .v ,.%,.,,f .'j i�1, ,J,._ fia„4, ,s,�k;_, 7 "N�, -4?.f�i1Sa�ud:iY:i 1,4 S. a J'Amo iv`'' `=. -1w t N_ kirp. ., o Starting January 1, 2014, employers with more than 50 full-time employees (FTEs) (defined later) will face potential penalties (an excise tax) based on the decisions they make with their group health I insurance coverage Discontinue group health i o nsurance ("Pay") - Penalty = $2,000 x FTEs (minus 30) — For City: Total FTEs = 1,727; minus 30= 1,697 x $2,000= $3.394M • Continue group health insurance ("Play") - Penalty = $3,000 for each FTE who enrolls in Exchange plan with financial assistance 8/18/2015 Recent Developments in Healthcare Reform 6 a iu;g 1 t lu r Wi ' z- �t..Vh11 T m x V 6 C 1 3� d�hi .a I . {r , i ,,j 1- ;� (\t F �{-t.]el ,q Iraq a?M $1 r y 4"al��J 1j�y + R 111 I• t� �.. t� F,�;lFy'.-7r• y r, g iQ�l�� •3;�Jp.i 'e F "i -E i,c — , E kri , 3c� 1 n1 *'.. E I II - .',aid 1>a 1 F"7'' x,'6 i ,til' ry`.�0 R I xx f= 4C`'i 1 �I 1''� I F F � _a .trt' i !t , ge,JFáV'K.li 1 o 44 pp 4:(4140',.$3-.14r-t,„= k. !��l��`a ��r �t�"�+��]i' :.1 ) '�``m ;2.{S44)�E� i;`�1.� ��}�5l �1 k;i' ��k g� .3 -0-� �� 6` r FLJ t'i'S yQlra I,L L rg ,git :9-��3 at}[ � . lit a 1 J I'1" aV I ] `k+' _ 1 r( 4.r -I�Y"' s i'�.I S _F m,1 °E,� ' '*Tam.1"TI 9 324a . y !I 'r ! ,r ii r p. i n'] + o 1-•p 1z. Li' c a .1,.'i} 'F:. r. 1 63�1 y{ .�F]tf--�_,__, ..h "- 2=A4ii7It':'.411;F }. 'Ri' p E `'''1 4, a 4r ! _.�) k^3,' '�:F -- ' • -_•If }4` !!'��r' t —� �_t-�•.�'. ,e't .'�:� ! r:l A1�._�'-tf,.� i�I �t . Y +-� .�"te `4 — - Employers not subject to "Play" penalties if the coverage L p they offer is: Minimum essential coverage • - A 60% actuarial value c Affordable to the employee - Based on the employee only tier for the lowest cost plan - Monthly Premium charged to employee is less than 9.5% of: - Form W-2 wages(Box 1) paid to employee;or - Monthly rate of pay c If the City offers coverage to at least 95% of its FTEs, and the coverage is "minimum essential" and "affordable" for each FTE, then the City will face no penalties under the 1 "Play" scenario 8/18/2015 Recent Developments in Healthcare Reform 7 r�i�iy�, tr T r:..1 s.r 0;174E: z> °" y,Q_r `[3� r i -, -+T' � � r—1 1', SC'lq -1 y I, j it Y_ , ri �3 daft E{{ll�.k 'v G a .L. -t t y�i� T., 6_..,c F.,., � I t\ ll p..a t it. a'� a `:' _r G 1 4 I mo " i ;,, r �r7 -.,-hw o ' ,�� I,'•4 $ PS s'.z. -,,' ! , .•�► ;E� pvlo�ye°r lay zdat�e= h 0 zffe i ��.g f ..verafge*uo• �j+ _ ��; - 3 j 1W r r u'•a4'f k ;114"1 .`� i� ��-r<:> ty F76.g 1,1 ��y2:t , ',pp,. l •lr i� x 1 9 r' ,•Sd.o -1-11,,), 4 :1�r� fl1,i ` ?z—.414,- �' ,, 1 t r�,j} y :vi° .i a' D : � � y1 z t 1. w! � **,-.-.,,,k,,,ry f ya .t1 � -'I_�i"t d-.ar, �3`� .!r 11'111 _ z-d !gu I l , grill '#a Pe E � . o l e�e� r3}" 3 r 4.,.Y d y - ..' 3.3Y .`[i:, Fran 1k. s. it: %i �'P !; s: 1 e ..',.i` . u 4r. -'.11 r;A tt `y i e i 1,,,iR '., ; i 1 i #.r r rl�1�p ' = F,i ..v�^a. 4 t 7 -'7 "5 '1 .. ,��,gg,,,�,,i id�-' - . :.Rtes.. .3.:.r<f+" ice :..['- i . 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MLsf1k 0 "Full Time Employee" is defined as an employee who L- works on average at least 30 hours per week - Regardless of City's definition of full time, it must look at the hours worked by its entire workforce (part time, seasonal, etc.) for penalty purposes To determine "on average", the City will establish a "measurement period" (of between 3 and 12 months). - If an employee works "on average" 30 or more hours per week during the measurement period, then that employee will be considered a full time employee during the immediately following "stability period" (plan year). - If an employee works less than 30 hours per week during measurement period, then that employee will not be considered full time during the immediately following "stability period" (plan year). 1 8/18/2015 Recent Developments in Healthcare Reform 8 1 w n '�ham. i. ] F �'r �I("" "' n �ti a 41i P S_ �p 1 - �-''.n i °,§ ,f C 7 "A y 0!=q��7.� ok Y n ,,r h. `..S ,F 2 : r. 1'� +n { y n.r h xl rr} 1't 4�S r' t F%,":'41.',;,,5"-:7:. 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Itri a -u �. 1 I ' iip s},Ck'� �� 11.,�r�F�s i�f .r"'i1J�� ;R� d�_. a4 � � •=i �.�}�,5tr�, � _ ��`''s�"� � 4P'"`., I"fi .�t� w.a �mil_� ' �' E I 1N fir'1I �.4� yt,Yl ' i- J i + x r b Ql�Id m F{ 3�i'� 3 i i e i' I' r n ® r' `64_ p Ey n, ,, ,. t a, o.rs A_js,uarntppti . s• � �:'F tl � k1 �t�'�'� � � � 011' �I l'-, "�' �;�,� t ppp�'"'l.�1f la �"-� ® t t� i r l 4 P ,;, .;i t, Y- r p ,..1'1,,:t. 1 t , 1.. i t t ;rt.. i II P""�l-Ct$i �F u 1• (•1) t I}}y� `'FF , 1T '2 irk � F t c,)7 P K,_�Yl! t yr �ALy, y 1� - 4,''.n' �”4.04.-p i f i t, "�. !'o-�j'ar•.. 1 t i pp�-ip i ,.Cx J- ',7, j , yr• 1 ..`,.', :.-A it f - '. dm,•. $r, -1, t i1,1 -ii: �8 1 .e. ql, d"r�. t C i '+d• i r= E i� / _. ..'_ - �.,� 'Y� ; r� _w e. . ch it pp 4"tyl� �1 '!f •.U..it Ai-°.E a..t1:1- -T.�.+•dw..�. ,,la`�l.:'4_'ax �fY. , .-hr' - M 'f'rwliti�'Sa i� ....ta- '`- w. , o To avoid penalties, the City's must offer at least one plan ,.that is: - minimum essential coverage (which all of the City's I g ( y s p ans do); and - "affordable" to each employee, based on each employee's wages/rate of pay - Based on census data,the only employees below the affordability safe harbor of 9.5%would be the Commissioners and the Mayor Penalties are potentially triggered based on "Full Time Employees" as defined by the legislation - City employees may not be currently eligible for benefits based on the City's classification of those employees - Failure to offer at least 95% of "Full Time Employees" coverage may trigger penalties to the City - The City may be penalized for a "Full Time Employee" not eligibl,e j for City benefits 1 8/18/2015 Recent Developments in Healthcare Reform 9 _ _ - 1111 • • 0 rD n RI r ' n s CO co o 0 CD _ N f fp 7, y x I 0 5 1. 1•I0j � ,; rf, • V/ in < > < T. / > _ > > n 2 < ) } I _ ) / R , § § > » b 2 z » E 12 r m o / / g \ \ / ) § ) \ = \ ) \ § k f { § c ( \ \ \ / \ § \ / rD (D .\ ® k 2 @ v § { ° n / ( k ' / E - 2 - ~ - e E 3 ■ a ; [ .2 [ = 7 > \ ; ' IR \ } J £ > 5 = P. § 7 & " . f § 2 c. 0 x f m 2 " « E. & . 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R. ()• _ r�� • 1 City of Miami Beach 15 Valuation Results by Employee Group The following tables provide the valuation results for police,fire and other employee groups(in thousands). POLICE FIRE OTHER 1 Spedal TOTAL October 1,2012 1 General Total General $pedal Enterprise Internal Total Fire Revenue Service Fund Fund Revenue mice Total Fund - Fund Fund Fund Other Actuarial Accrued Liability $88,150 $3,619 591,769 556,660 $7,759 $1,789 $22,256 511,120 542,924 $191,353 Assets City Funding $3,917 $534 $4,450 $2,132 $976 $568 $7,078 $3,607 $12,230; $18,812 Interest $42 56 I 548 $23 $11 SG $76 $39 $132 $203 Actuarial Value of Assets $3,959 $539 I $4,498 $2,155 5987 $574 $7,155 $3,646 $12,362 419,015 Unfunded Accrued Liability _ $84,191 53,079 f $87,271 $54,505 1 $6,772 $1,215 $15,102 $7,474 $30,562 I $172,333 POLICE FIRE OTHER, Special, Internal General Special Revenue Total General Revenue Enterprise Service Total Annual Required Contribution 'Fund -Fund Police Fire Fund. . Fund Fund " Fund Fund, Other TOTAL Normal Cost $1,797 $74 $1,871 $828 $311 $72 $891 $445 $1,719 $4,418 Interest on Normal Cost $144 $6 $150 $65 $25 $6 $71 $36 $138 $353 Amortization Payment $4,865 5178 $5,043 $3,150 $391 $70 $873 $432 $1,766 $9,959 Interest or,Amortization Payment $389 $14 $403 $253 $31 $6 $70 $34 $141 $797 TOTAL $7,195 $272 $7,487 $4,296 $758 $153 $1,905_ $948 $3,764 $15,527 • I ). Healthcare Analytics a Di:v'ian cf Gallrghar bcs^fit Su.-•.es.Inc. I City of Miami Beach 16 Valuation Results by Employee Group POLICE FIRE ; OTHER Special I Special ' Internal General Revenue Total . Fire , General' Revenue Enterprise Service Total Fund Fund. Police Fund I Fund_ . _Fund ' __Fund Fund Other _TOTAL Net OPEB Obligation-October 1,2012 $14,665 $0 $14,665 $10,203 $5,967 SO $0 $0 55,967 $30,835 FY 2013 ARC $7,195 $272 $7,467 $4,296 $758 $153 $1,905 $948 $3,764 $15,527 Interest on Net OPEB Obligation $1,173 $0 $1,173 $817 $477 $0 $0 $0 $477 $2,467 Adjustment to ARC ....$3,7 S,Q 31421 ,..,$ ) $5 5 $2 LI -345 -182 Annual OPEB Cost $7,521 $272 $7,793 $4,523 $890 $153 $1,9G5 $948 $3,896 $16,212 Employer Contributions:Pay-as-you-to 2 477 5.91 52.571 52,002 557 122 $1,399 696 $2,764 7 337 Increase in Net OPEB Obligation 55,044 $178 $5,222 $2,521 $333 $41 $506 $252 $1,132 $8,875 Employer Contributions:OPEB Trust $2 178 5178 $D 41 506 252 5799 1= Total Increase in Net OPEB Obligation $5,044 $0 $5,044 $2,521 $333 $0 $0 50 $333 $7,898 Net OPEB Obligation-September 30,2013 $19,709 $0 $19,709 $12,724 $6,300 $0 $0 $0 $6,300 $38,733 1 Go Healthcare A ia1--fics a Diri;ian of Gallather Benai. .-ice;,la:. 0 !IiL m o v a .7 _I - m Tli- ,4 ,g r° O m m n ; D io a R G F m ,o+ g I I I T d E so o s �jl7o O v a \ D D D ry _ c o 19a �, ° m 'D I v v � a � c_ � � o :°. � `''• ^°. fD�- as ao ap A> v, .1C,a c 2 v m �Iw =° c .. 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O' = y O ='H O O. o g• N• o, '^ (aD K fD 0' C d oO (flD Oi. r,• j O (D 3 „ D T a n N C W C 0 = fCD T 2 N N • O Qa 3 g. ; nom, = fl:' p D D D o — n O s n o s' c n N o•C O T N O 3 d O C �C G, C C = "� (D = •O O �.cm � (p O N •O L •O n �' � a, = 0 a O _-m a m 0 -' N 8• K S' * m o o 2;i1,' E F. m c O :: E D < <w o +o, .0 r'• ..N n. n o,gi 7 ao - ' R G - n n, N v 13 3 N 0 ip a rD O a O O' a c (OD LC, 2. o . 0 a E rD n ^_,. .7 O< =on' a (G > rL a y n y a°�o = '^ o iD °i o 0 o ,o rD , - Vf g . C T r D = a rD c . r' - 2, Oo G.rD (D CD R yn p 'd+ o=i . ' p a d ii. -0+ N aD 0 -. v 3 Q' 0. d d - _ o ra D rD rD E. C r, w▪ c y K rD (D 0 R. _ s 0- _ O CO oa -..,m flv__ oo a St d • ,Oi, C•a CU G iLr 3 "n, i ' ' o a' In - r • C o D g n, 3 < s n (o = g_ - ° ? ti a m = VQ N D 2 �. N N E G1 in▪ m O" .. rD n O T rD rD +�J C O O N (C 1n •O 7 O 2- O �� • G N a O L• 0 y O d N 0 ,^ R on on E- o • co Z ''' ►"—.' Co < •O 0 d C S y 0 0 0 O r: iD m — (D d C 0 C S .,- S i' O rt 4 O co 6. !D •o a — ° 3 a m c a rD ..L o a rD 3 = s L ^ _ -0 00 o < g c ao o, a -r, rD s - y _1 L� N a O, N C co • _____ ___-_-______-___ '` /-` | | ` . • � \ � ' \ � ! I • • _____' ' •'-__-_-' �'__'____ - ^ f i • • • • The Cit y of Miami Beach Health Plan Options — Baptist Network Presented by Richard Schell Area Vice President Public Entity&Scholastic Senior Leadership Team November 13,2414 (,aIl gher Service. Ink_ t h i n k i n g a h e a d Prelude • Contractual negotiations between Humana and the Baptist network resulted in a deadlock • Baptist is now considered an out-of-network provider for all commercial Humana group and individual insurance policies — The Baptist Hospitals were out-of-network effective August 14, 2014 — The Baptist Doctors were out-of-network effective September 14, 2014 • The City of Miami Beach has requested that Gallagher explore some solutions that would allow their employees, retirees and dependents to access the Baptist network on an in-network basis Gallaher Benefit Services,Inc. Baptist Utilization • In order to assess the impact of losing Baptist as an in-network provider, Gallagher has reviewed the existing claims experience and utilization of this provider: Baptist Utilization Paid Claims and Claim Count $50,000,000 60,000 $45,000,000 -50.000 $40,000,000 $35,000,000 I 40,000 $30,000,000 $25,000,000 . / -30,000 S20,000,000 / MEM -I -20,000 $15,000,000 191W. _- __ $15,000,000 --- — _v 7W/ - - 10,000 $5,000,000 7 $0 0 No I Yes No I Yes No I Yes No I Yes 2011 2012 2013 Jan-Jun 2014 Yes/No EMINI Billed Amount $46,358,166 $4,850,264 S38,357,032 $4,343,619 $40,044,236 $3,449,971 $19,007,163 $1,808,360 refers to two Net Paid Amount $12,347,149 $2.206,925 $9,181,523 $1,981,221 $9,435,661 $1,545,196 $4,776,476 $521,997 a Baptist ■ Claim Count 49,381 989 45,773 942 43.892 909 20,032 418 Claim Call er Benefit Services,Inc. Baptist Utilization • Baptist represents between 9.9% - 17.7% of health plan spend depending on the time period reviewed: Paid Claims,Paid Claims to Baptist and % of Total Paid to Baptist $45,000,000 20.0% $40,000,000 - 18.0% $35,000,000 - 16.0% $30,000,000 $25,000,000 - 14.0% $20,000,000 - 12.0% $15,000,000 - 10.0% ::: - 8.0% $0 I,-6.0°,2011 2012 2013 Jan-Jun 2014 I Grand Total Imo Net Paid Amount $14,554,074 $11,162,744 $10,980,858 $5,298,473 $41,996,148 Ilmt Baptist Net Paid Amount $2,206,925 $1,981,221 $1,545,196 $521,997 1 $6,255,339 ••••■%Baptist Net Paid Amount 15.2% 17.7% 14.1% 9.9% j 14.9% Gall her Benefit Services,Inc. High Level Discount Analysis • In order to assess the financial implications of Impact of 1%Discount Loss to Health Plan "solving"the Baptist network issue,Gallagher Claims through Baptist reviewed the City of Miami Beach Baptist data with $5°°0°�0°° ?o.o% Humana and Miami-Dade County Baptist data with $4,500,000 AvMed - 60.0% • Please note,considering there is no current ,000,000 contractual arrangement between Baptist and $3,500,000 - 50.0% Humana,the City's Huma n a d ata is historical—the $3,000,000 intent of this analysis is to show to what extent 40.0% claims may increase/decrease if the Baptist network $2,500,000 issue is solved via another carrier solution(AvMed). - 000 -30.0°x° • Please note that the mixture of inpatient,outpatient, and physician claims will likely be different when 81,500,000 III ■ I-20.0% comparing the City and County and may affect the $1,000,000 discount levels III - 10.0% • Only through a full re-pricing exercise by AvMed will 8500,000 we have the exact results based on past experience $o 0.0% Humana AvMed • However,a worst case scenario might be that 20% Baptist Baptist Difference Discounts Discounts of claims flow through Baptist with a discount 8%Claims at Baptist $1,743,418 , 81,760.852 (817.434) difference of 5%-this would likely increase the cost mum 20%Claims at Baptist $4,358,545 $4,402,131 ($43,585) of the health plan by approximately$215,000 �"D10O Charg Billed 66.6% 65.0% 1.6% Gallaher Benefit Services,Inc. i Baptist In-Network Solutions Switch Add an Add a No Change Carriers Additional Rental in Carrier • Piggyback off Carrier Network • Keep Humana the Miami- • Piggyback off • Add an • Request that Dade AvMed the Miami- additional Humana make Contract Dade AvMed network with every effort to • Full Contract Baptist re-contract replacement • Dual Offering • Ask Humana with Baptist of Humana to Administer , . Please note,AvMed may require some form of guarantee to devote the time and resources to explore switching carriers or adding them as an additional carrier GI," Calla_her Benefit Services,Inc Switch Carriers • AvMed — Piggyback off the Miami-Dade County Contract — Access to Baptist Network — Current Adrnin Fee $32.08 (after the $8.00 pharmacy rebate)x 1,500 x 12= $577,440 • Considerations: — Verify that the current administrative fee paid by the County will be offered to the City — Request a full re-pricing of claims by AvMed to assess the financial implications of a full replacement — Analyze the access and disruption of providers comparing the AvMed and Humana networks — Implement the City's current plan designs on AvMed's platform — Assess the financial impact of the run-out provisions in the Humana contract(8% of claims for 2 months to process 12 months of run-out) Calla er Benefit Services,Inc. Add an Additional Carrier • Humana and AvMed — Humana Admin Fee$39.48(with Humana Rx network) — AvMed Admin Fee$32.08(with Catamaran Rx network) — Current Enrollment— 1,500 (assume 25%of enrollment would migrate to AvMed) • Humana—1,125 ($39.48 x 1,125)=$44,415 x 12=$532,980 • AvMed—375 ($32.08 x 375)=$12,030 x 12=$144,360 — Total of$677,340 • Considerations: — Verify that the current administrative fees illustrated above will not change under a dual carrier offering and that Humana will participate in a dual carrier offering — Request a full re-pricing of claims by AvMed to assess the financial implications of a partial replacement — Analyze the access and disruption of providers comparing the AvMed and Humana networks to educate those employees who might choose AvMed — Implement the City's current plan designs on AvMed's platform — Assess the financial implications of Rx management(rebate credits/pricing)and whether Rx management could also be provided on a dual carrier offering and/or if it is more advantageous or even available to continue Rx management with a single carrier Gal c her Benefit Services,Inc. Add a Rental Network • Humana - Current Carrier — Current Admin Fee $39.48 x 1,500 = $59,200 x 12 = $710,640 — Estimated Rental Network Cost (Baptist) $4.00 x 1500 = $6,000 x 12 = $72,000 — Total Amount = $782,640 • Considerations: — Verify that a rental network addition does not compromise the current Humana contractual pricing — Analyze the financial implications of a rental network—rental networks typically do not have the discount levels that the insurance carriers have negotiated GallagherBenefit Services,Inc. No Change in Carrier • Humana — Admin Fee $39.48 x 1500 = $59,200 x 12 = $710,640 • Considerations — City employees, retirees, and their dependents will only have access to Baptist on an out-of-network basis — Per Humana, they are actively working to re-contract with Baptist but as of now there is no short-term possibility (1 — 3 months) of this occurring GaIIa_ er Benefit Services,Inc. Next Steps el (,aIIaghrr Ikneiit Services Inc. t h i n k i n g a h e a d 1 c X oo.m . 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O !D > N j "1 N N j g _ N P - C Tl f1 7' ? g1 E ' N a) st. 3- R rD c ° o m Q, or o rroo ,0 c c s .c5. , 5 n 6 :► < H m 3 s 3 J n, n T CI g to a n N ' a n * '�.. Z• y r 3 , 3 a < o '�,. -' ^ o m ° ov 0 m 3 > og ° �_ �R c . 3 m •r� f m ? m oo ie m oc x o raD .3 i.• ' N c 3 ° e3o n3' 3--,;" a A .J. . a roo y fD u a w rz 9, � • ? ti C 5.S 6 -0 3 :9 U, m p X d ,D p x m —ry ON N,3 ., D .. " Q (@0 ? st w 7 a' Oo = _.,,e C O Ol Q H d fL in S N S ? (1 n p 'n j. rD /D n N 00•N T d fD • rD • fD N 2 3 in d fD o n 3. o_ o .c^. a L. u � 0 3 d � .JN. �� ro a v � n � � `� f o y fD R c, . 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J .+ n tD o, — 0 3 J .O S - 1 S CU J 7 N J W L9 D o p o n n n a - a m p a, N Qt c w n n c m d o' 0 3 n s '" a * v C1. 3 m ° n� m m n _ o d G m m 6 — 1 J = v3, ° d N O 3 d m O - m c 3 a 00No ° rD s J C ' N E rp n C, T. N N M 4 00 N 2 O 0' -1 7 A 3 rD N A F 3 E C •-�+ n�i =► rt iD X C c a 3, a • a3o ran o n o. X "I O ° m 0' ^ a x C s 3 Se c D, oo r, ,< J- on 5 o- n f+ .�6. d C .c. 3 _ N c 5- = N Dr - H fD N (D n a D? x .. o 01 J m J a �, Cr. Cu = C o _ " v, rp An o ° o o ., ° n D o 3 u o_ o c EC a 0 '" J a o a S O _5. rz a O fD Ol 5' 5. O- C = f9 rC an C d c, x' a fD D, m — a, • J a o y a� - °- rat n S d O st N v 3" Ol A 0 p D °- 0~0 D Oc C c C RI G N d 0J J roC . m m o o ro co,D CU _ v o v 7 rc w• W 3 ,,,1 ..,1 .S o 5 o v " J ^ - G ° o o m s, 3 n N 0a < » W O rD o 3 D, �° rD n v D 0.n n. N m `n ° < d _ R a o, 3 n.x < ° e o a • 0 3 3 o o i c 1A Co a Do, oo' < T c F,- A nu a 5 o - S s D eD n n c o N ` g o• C m a o� . o w a o D! N C C 2 J• C' O N < D N J _ .r s 00 F.. < N 0 O 3 _ 5 u� S .3 X N ON o fn C ° . -. D J J p V J J O v J- O = rx The City of Miami Beach-Cadillac Tax Analysis at 9%Trend (estimate) $23,000,000 45.0% - $22,000,000 40.0% 5 c $21,000,000 Z c - $20,000,000 r w d _ - 25.0% $19,000,000 - 20.0% $18,000,000 15.0% $17,000,000 ' - 10.0% $16,000,000 ' S 1 $15,000,000 0.0% 2015 2016 2017 2018 MN No Changes $17,312,477 $18,870,600 $20,568,953 $22,420,159 mos Changes Necessary to Avoid Tax $16,585,368 $17,388,817 $18,300,477 $19,328,218 ■wwwlncrease with No Benefit Changes 9.0% 18.8% 29.5% 41.2% asiwIncrease with Benefit Changes 4.4% 9.5% 15.2% 21.7% G Gallagher Benefit Services.Inc. Page 2 of 8 Ii The City of Miami Beach-Cadillac Tax Analysis at 6.5%Trend (estimate) $21,000,000 — - 35.0% 1 - 30.0% $20,000,000 v E f, - 25.0% j $19,000,000 ' r d - 20.0% 1 $18,000,000 Ai - 15.0% $17,000,000 — - 10.0%1 $16,000,000 11111 MVP 5.0% , $15,000,000 0.0% 2015 2016 2017 2018 ■No Changes $16,915,401 $18,014,903 $19,185,871 $20,432,953 ■Changes Necessary to Avoid Tax $16,316,225 $16,808,814 $17,363,006 $17,981,263 .nw.lncrease with No Benefit Changes 6.5% 13.4% 20.8% 28.6% .Increase with Benefit Changes 2.7% 5.8% 9.3% 13.2% CO Gallagher Benefit Services,Inc Page 3 of 8 c 7� _ _ bi a a i r E 3 0 N F 3 0 t" 'o i 3 0 c t 3 f i p 3 3 0° O 1 B ifltiv K, 3 d o ; 3 ° -�_ 3 7 I f 3 i n §EC !i" iF c - :i 7 II R E t? 4 is . o t pi n li E..ii o c oa g & —N�y .. f° 3 1 r---- O ^v N-F Z N V N Y a 7 .N F 3 4_ Y r to°;$ ? i9 � 3 o�@ $ft gilt w,"3 3 * . i Vj� .w. i C r ! �m '1 f i `s x 1 t w 6 U g! iiig C V O r g s 1 r • U o°U iilp oS iii' FM Nb� H a p i o v 3 i f e �3 c w v�, f L a° _€ -f! v o>I c SE,—ti LL a D n c W;i t w c D o N 011i P t O y N N O aOaJ f W 7. 'u P ° * M ~ i i r 4.2i tHat iink.Ea at il l xvvig 4 " } N y_e ilia, F ilia f 1 t PHIIIii i ipg .i iiig ! lio i ilu I fill i ii FT EE fe .071 i 01E111 t 1 a f . a. r.' gl -1 ' a 1 ga L i vl -,'o: f .. ..T r . . t : . ! " . A !- " F.. g ..r rr !I 1 , , 1 -- -- F. i I ( F.l E E --- - g g tO? t-29 trgg r; i i 1114 ,.i 5 5 If 1 'Ili .fil ii's lifi 1? ti “ 1 IP t6, • Pgr ' ."..7rit r fE • tti! ;tiiii i! i i' rt P: ti i r Miltal L'it0§11 fiiiiR§11 r:;iiiiti .-.41iiii i 11 iit I ....., 5 i i;t !ltt- i.iitmt ;Ft:film rtrt-H§§t ;;tmt ;MM. tr -, I A 4 . 1 111 Erg,. 48fl. ;211-1 ,..t.:Ei7 f? ts _ 11 iMi 41 LIU l _ . 4..a f t r ii q ! 1 i trAl MLA; 5rP2!1' PEvr1 tzt! MI- 'HU iggi Mk MI ;z-mt ini rviEE 'z; tsluz F-t r1;...li Rsi rvifia i 7 I i 1 nEi vvrEgE -6,-6-silt Trvilt _ -,zi Vo'rwg.. Trvgn . Ing !CIA Mil zAvi --E.....-A.L1 ?AiEi = 44 0.,m- % ., o y z 0., d z n 'g f ~RR a;3 i f t T a 1 G 3 Y 'o t 3._; , £3 R S r i t i i c n z 10o 3 S n 3 1 _ s 3 a 2 ° O > Y 3°l n 7 3 i ` $ g'- E g i., s o m i R 3 3 i t s e S F a n?s ,741 T a l i .'-at;,' R t. m!1 `v,w"3 ^ v e u _ I= a N . $° ST i 1T1 I.- . 5 E F S1 MI Drug .G Y.�t tv.x § r SE Y C w -. 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R sa as Ht *IVA Illi( Wei a" E! 2 m The City of Miami Beach Cadillac Tax Forecast Assuming 9%Annual Increase in Premium Equivalent Rates&the 60%Plan in 2015 Projected 2018 Excise Tax Thresho.ds employee $10,200 1 gamily 527,500 2.70 Assumed Annual Increase it Premium Equivalent Rates 9.0% "Adjusted 2018 Tax"assumes 2014 accrual rates do not go up until 2019,at which point a 3%annual increase is assumed. Enrollmen-counts include pre-65 retirees,COBRA,and all other employees currently enrolled in the health plan. Miami Beach 60%Plan In 2015 Projected 2018 Projected Projected Year Total 2014 Premium Assumed Increases Benefit Premium Equivalents 2019 2019 Tax Tier Enrollees Equivalents 2015 2016 2017 2018 Adjustment Monthly Annual Excess Tax Triggered Employee Only 752 $649.18 0.718 1.090 1.090 1.090 1.000 I 5604.02 57,248 50 50 2025 Family 519 51,609.63 0.718 1.090 1.090 1.090 1.0001 51.497.67 517,972 SO SO 2026 Total 1,271 $11,411,473 512,438,506 $13,557,971 $14,778,189 $0 Total Cost of Health Plan 2014 PEPM 2015 2016 2017 2018 Total All Plans I 1,271 51.041.37 $11,411,473 $12,438,506 $13,557,971 $14,778,189 Excise Tax Analysis Tax Plan Design Enrollees Per Plan Miami Beach 60%Plan in 2015 1,271 SO Total 1,271 50 GL, e.ala;;her Iknon Ocrvices Inc. 8 of 8 Y 8 e-. II ,f . •f Miami Beach , . ... Budget Advisory,.., . ..., , ,. ..„.. ._. . ....., • ••..•. . _ tc c Nleeting 1 FP \ () x`013-08 . , ...,...,:... ••••••__ .,••• . _., _ _!•"� ``i° �... .�.�: ea. an.erv1ces.• ,—+frrty � y-- . s-r�-± ,s .s_ �. v} M_ —i—,• v w �- �. t •May 1 th 2013 f.aab' -.4 7:4'1, ",. ....-•,- --.7.-. .• i •-,ie.,.„1:.;;;---;11?...,--: Al.;,F.:.SS, -. , . ..............t.. ,77-_,... ipe::-......4. , ,....4,,,:--..2 ' - ...,41.• yrio. • t 1' . Via' ••1- a ;, ■■![••f• The information contained herein is subject to the disclosures and disclaimers on the final page of this report. .-.'. jkgenda • 1. Current Health Plan Overview 8. Pharmacy(Self Funded)Marketing 2. Overview of RFP Process Analysis a) RFP Timeline a) Pharmacy Marketing b) Deficiencies Letters Methodology _. s. 3. Responding Vendors b) PBM I PBA Analysis a) Lines of Coverage Quoted per Vendor I. Total Population t. b) A.M Best Financial Ratings ii. Total Excludes Post-65 � � 4. Disruption&Geo Access Retirees r k s. Medicare Advantage Analysis iii. Full Truveris Analysis F). 6. Fully-Insured Marketing Analysis (under separate cover) ' a) Scenario A Plan Designs 9. Overall Financial Summary %•' i. Financial Summary a) Scenario A ` ll i;1 b) Scenario B Plan Designs b) Scenario B �> i. Financial Summary c) Claim Runout Scenarios : 7. Self-Funded Marketing Analysis 10. EAP Marketing Analysis g 7 -- , �_ a) Plan Designs&Methodology a) Premium Rates ,/'I: " °__:1= ., b) Administrative Services Only(ASO) b) Benefits Summary ''.,,, - .,, / !.. Fees 11. Wellness c) Reinsurance Quotes a) Benefits&Cost d) Reinsurance Terms&Caveats 12. Next Steps 13. Appendix a) Contingencies,Exclusions,& �,_n,, Limitations Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. CURRENT HEALTH PLAN OVERVIEW Gallagher Public Entity&Scholastic Group •a Division of Gallagher Benelii Services,Inc. •.... , . _ ______. _____ . 1 . _ Health Plan Self-Funding Analysis - Plan Year Actual I Projected Actual 1 Projected Actual I Projected Fully- Actual Self-Funded Plan Year' Full-Insured Increase Self-Funded Increase Enrollment Insured Premium Exiense Difference 2008 12.3% 12.3% 1;639 $15,586,760 $15,586,760 $0 2009 4.4% 3.3% 1,637 $16,256,857 $15,484,667 $772,190 2010 9.8% -3.6% 1,624 $17,248,591 $16,219,484 $1,029,107 2011 3.0% 9.3% 1,586 $17,351,316 $18,517,167 ($1,165,851) 2012 24.2% 12.4% 1,541 $19,866,823 $19,144,875 $721,948 2013 9.4% 16.7% 1,541 $21,734,304 $20,923,320 $810,984 Totals 12.5% 9:9% 1,59' 5108,044,651 5105,876,272 $2,168,379 '2008 was fully-insured. Projected fully-insured increases in 2009-2013 are estimations based off past experience and projections. Fully-insured increases projected above assume that current plan designs were not changed and insurer factors continued to be used 30.0% 1 25.0% c 24.2/o 20.0% doillibh 12.3% 16.7% 15.0% ►" 12.5% 1Q.0°'o 12.3% 4.4% •.8% 12.4% - 41Tr ""9.9% 3.3%` _ 3.0/0 0.0% -5.0% 2008 2009 i -3.6% 2011 2012 2013 Totals •• •Actual/Projected Fully-Insured Increase Actual I Projected Self-Funded Increase pGallagher Public Entity&Scholastic Group • .. a Division of Gallagher Benefit Services,Inc. 4 . _ _ _ _ . . _ . _ _ I Current Health Plan Benefits , . . Standard HMO Premium HMO PPO Standard PPO Premium POS Employee Monthly Premium Employee Only $134.72 $381.74 $261.70 $763.90 $425.06 Employee+Spouse or 1 Dependent -- -- — — 1 Employee+Child(ren) •- — -- — Employee+Family $472.26 $946.40 $908.00 $1,874.46 $1,054.86 Plan Deductible and Maximum 00P Annual Deducible(Individual!Family) $0 $0 In/Out-$5001$1,500 In/Out-$200!$600 In-$0,Out-$400!$800 Out of Pocket Maximum(Individual!Family) $1,5001 53,000 $1,500/$3,000 In/Out-$3,500/510,500 In/Out-$1,000!$3,000 In-None,Out-$2,500/$5,000 Physician Services-In Network Office Visit PCP $25 $5 $35 $10 $5 Office Visit Specialist _ $40 $0 $35 $10 $5 • Facility Services Hospital Inpatient $30015 days $100 In-20%after ded In-$100/admit,10% In-$100!admit Out-40%after ded Out-$500/admit 30%after ded Out-$500!admit 30%,after ded Outpatient Hospital Surgery $200 $0 In 20%after ded In $100 i admit 10% In-$0 Out-40°k after ded Ou,r $500!admit 30%after ded Out-30%after ded Outpatient Diagnostic Services/Imaging $200 $0 In-20%after ded In-10%after$25 In-$0 p 9 g 9 Out-40%after ded Out-.30%after ded Out-30%aRer ded Emergency Room $200 $25 In/Out-20%after 5200 In/Out-10%after$25 In/Out-$50 In $35 In $10 Urgent Care Facility $4Q $25 Out-30%after ded Out-20%after ded Out-30%$5 %after ded Prescription Drug Coverage-In Network • Generic!Brand/Brand Non-Pref l Specialty $71$40/$60 MO x2 $5/$5155 MO x3 $10 1 540/560 MO x3 $10/$10/$10 MO x3 510/$10/510 MO x3 r" L,j Gallagher Public Entity&Scholastic Group • a Division of Gallagher Benefit Services,Inc. t I ■ .__________ . _ , , , . Current Health Plan Rates and Contributions Active Employee Monthly Rates Standard HMO Premium HMO I POS Standard PPO Premium PPO Employee $134.72 $381.74 $425.06 $261.70 $763.90 Employee Only City $329.84 $381.74 y.25.06 $640.72, $763.90 Total $464.56 $763.48 $850.12 $902.421 $1,527.80 Employee $472.26 $946.40 $1,054.86 $908.001 $1,874.46 Family City $679.60 $946.40 $1,054.86 $1,306.641 $1,874.46 Total 51,151.86 $1,892.80 $2,109.72 $2,214.641 $3,748.92 %Employee/City Cost Share• Standard HMO Premium HMO POS Standard PPO I Premium PPO Employee 29% 50% 50% 29%I 50% Employee Only City 71% 50% 50% 71%I 50% Total 100% 100% 100% 100% 100% Employee 41% 50% 50% 41% 50% Family City 59% 50% 50% 59%1 50% Total 100% 100% 100% 100%1 100% Pre-65 Retirees Monthly Rates Standard HMO Premium HMO POS Standard PPO 1 Premium PPO Retiree $134.72 $381.74, $425.06 $261.701 $763.90 Pre-65 Retiree Only City $329.84 $381.74 $425.06 $540.721 $763.90 Total $464.56 $763.48 $850.12 $902.421 $1,527.80 Retiree $472.26 $946.40 $1,054.86 $908.001 $1,874.46 Family City $679.60 $946.40 $1,054.86 $1.306.641 $1,874.46 'Total S1,151.86 $1,892.80 $2,109.72 52,214.641 $3,748.92 %Pre-65 Retiree/City Cost Share Standard HMO Premium HMO POS Standard PPO 1 Premium PPO (Retiree 29% 50% 50% 29%I 50% Pre-65 Retiree Only City 71% 50% 50% 71%1 50% ' Total 100% 100% 100% 100%I 100% I Retiree 41% 50% 50% 41% 50% Family City 59% 50% 501% 59% 50% Total 100% 100% 100% 100% 100% :",9 Gallagher Public Entity Scholastic Group .• . a Division of Gallagher Benefit Services,Inc. ,. Current Health Plan Rates and Contributions 1..•••■■■■■■■■••■••■••■■■ Standard Standard Premium Post-65 Retirees Monthly Rates 1 POS PPO Premium PPO %Post-65 Retiree/City Cost Share POS PPO PPO Retiree I $327.89 $342.95 5582.11 Retiree 50% 50% 50% Single City $327.89342.95 £582.11 Single City 50% 50% 50% Total 5655.7711W685.89 $1,164.21 Total 100% 100% 100% Retiree $737.75 $771.60 $1,309.76 Retiree 50% 50% 50% Retiree/Spouse(0/U) City $737.75 $771.60 $1,309.76 Retiree/Spouse(0/U) City 50% 50% 50% Total $1,475.50 $1,543.19 $2,619.51 Total 100% 100% 100% Retiree £655.77 $685.86 $1,164.21 Retiree 50% 50% 50% Ret/Spouse(0/0) ga2655.7- 6 $1,164.21 ReVSpouse(0/0) City 50% 50% 50% Total $1,311.54 $1.371.71 $2,328.42 Total 100% 100% 100% Retiree S737.75! $771.60 $1,309.76 Retiree 50% 50% 50% Ret/Child Cit 5737.751 $771.60 $1 309.76 Ret/Child . , 50% 50% 50% Total , $1,475.501 S1,543.19 $2,619.51 Total 100% 100% 100% Retiree $1,085.38 $966.74 $1,640.99 Retiree 50%l 50% 50% Ret/Sp/Child(0/U) City $1,085.38 $966.74 $1,640.99 Ret/Sp/Child(0/U) City 50G/0' 50% 50% Total $2,170.75 £1,933.48 $3,281.97 Total 100%I 100% 100% Retiree $853.01 $881.01 $1,495.48 Retiree 50% 50% 50% Ret/Sp/Child(0/0) City S853,01 S881.01 $1.495.46 Ret/Sp/Child(0/0) City 50% 50% 50% Total $1,706.02 $1,762.01 $2,990.96 Total 100% 100% 100%1 G.., Gallagher Public Entity&Scholastic Group :::.-:::::.- • • • a Division of Gallagher Benefir SeNices,Inc. . ....... . .. . . , ..... .. ....... .. .. . . . • OVERVIEW OF RFP PROCESS ea Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. :•:• --- - • - -- - — • 8 - ---- • - RFP Timeline • GBS to release RFP - February 8, 2013 • Pre-Proposal Submission meeting - February 14, 2013 • Release answers to carrier questions - February 27, 2013 • Vendor proposal due date - March 15, 2013 • Analysis by GBS- March 18 thru March 29, 2013 - GBS identified significant proposal deficiencies • Vendors notified of proposal deficiencies -April 2, 2013 • Vendors provided additional week to rectify proposal deficiencies • Vendor proposal due date -April 10, 2013 • Round 2 of GBS analysis -April 11 thru May 1, 2013 • Analysis of Pharmacy RFP (Truveris) - May 1, 2013 • GBS completes initial analysis abGallagher Public Entity&Scholastic Group a Division of Gallaher Benefit Services Inc. —" --- -- — --- -- — • 9 Deficiencies Letters • Based upon the responses received after the release of the initial RFP, the deficiencies in each vendor's proposal would have disqualified all responses • GBS informed the City of the results and the decision was made to re-open the bidding to RFP No. 2013-08 in order to receive thorough, well thought out responses • Subsequently, deficiencies letters were prepared for each vendor that submitted an initial proposal in order to correct and/or identify issues that required correction or clarification • Vendors that did not submit a second proposal were: - Interactive Health (Wellness) - HM Insurance (Reinsurance) • The vendor deficiencies letters have been brought with this presentation under separate cover for your review t"' Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. .__ _ 1 . . 1 ,. Lai ESP®NDING VENDORS 1 .�� Public G pt Gallagher Public Entity&Scholastic Group ......,.. .... ... ... .... ...,:., ... ... .... .. .... .... ... ... a Division of Gallagher Benefit Services,Inc Lines of Coverage Quoted per Vendor • Aetna • Humana - Fully-Insured - Fully-Insured - Self-Funded - Self-Funded - Stop Loss - Stop Loss - Medicare Advantage - Medicare Advantage - EAP - EAP - Wellness - Wellness • Cigna • Symetra - Fully-Insured • Stop Loss - Self-Funded • Ulliance - Stop Loss • EAP - Medicare Supplement • United Healthcare - EAP - Fully-Insured - Wellness - Self-Funded • Engagement Health - Stop Loss - Wellness - Medicare Advantage - EAP a - Wellness Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Seivices,Inc. __......_.� A.M. Best Financial Ratings A.M.Best Financial Strength Rating Reference Guide-2013 Financial Strength Rating Financial Strength Rating Financial Strength Rating Financial Strength Rating Entity A.M.Best# Month Rating Size Month Rating Size Month Rating Size Month Rating Size 'nine Life 006006 A Excellent XV A(Excellent) A Excellent XV A(Excellent •etna Health Inc 060120 1 A Excellent XV IIII A(Excellent' 11111A Excellent 111 4 i A(Excellent I -tna Health Insurance 007443 111 A Excellent MN A Excellent INA Excellent II 4 ,A(Excellent II iina Healthcare of Florida Inc. 068860 U A Excellent XV 2 A'Excellent XV NA Excellent I 4 A Excellent A- umana Health Insurance Co of FL Inc 009494 U A- Excellent'IN A- Excellent XIV 3 (Excellent 4 A- Excellent)Ill metra Life Insurance Com.an 007017 U A Excellent IN A'Excellent IX 3 A Excellent I 4 A(Excellent' Med Healthcare Insurance Damian 008290 U A Excellent IN A(Excellent XV 3 A Excellent 111 4 A Excellent II G. Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. 13 DISRUPTION & GEOACCESS ANALYSIS GGallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. " 4 Disruption Analysis Aetna Open Top 100 HMO Providers by Aetna Choice POS Aetna Access Managed Aetna Managed Aetna Health United Category Humana II(SI) Select(SI) Choice POS(F)) Choice(Fl) Network Only(FI) Cigna Healthcare HMO Providers In-Network 89 99 96 99 99 96 92 95 %of Total HMO Providers 89% 99% 96% 99% 99% 96% 92% 95% HM05's In-Network $5.938 085 $6.335 086 $6,179,924 $6,335,086 $6,335,086 $6,179.924 $6.118,966 $6.104.133 I %of Total HMO S's 93.5% 99.8% 97.3% 99.8% 1 99.8% 97.3% 96.4% 96.1% Aetna Open Access Top 50 PPO Providers by Aetna Choice POS Aetna Managed Choice Aetna Managed Aetna Health United Category Humana II(SI) Select(SI) POS(FI) Choice(FI) Network Only(FI) Cigna Healthcare PPO Providers In-Netwo 43 48 46.1111k 111.11;t 45 43 45 %of Total PPO Providers 86% 96% 92% 96% 96°. 90% 86% 90% PPO 5's In-Network $1,953 693 $2.032,0421 $2 002 52 $2 032 04 $2 032.044 51 956,284 $1.981,950 51,989 710 %of Total PPO$' 95.3% 99.2%l 97.7% 99.2% 99.2% 95.5% 96.7%1 97.17. G.• Gallagher Public Entity&Scholastic Group ...-...- . a Division of Gallagher Benefit Services,Inc. 1 5 EMIL .J11111111111•11111■1111111■L _All11111111■111■1111111•11 , JII■ Geo Access Analysis Mil Entire Population Including Post-65 Retirees Including Post-5 Retirees Entire Populatin Including 2 Prl . Care Physicians within 10 miles I 1 IIM Entire Populalion In6 2 Pediatricians Within 10 Mlles III tiro Post-65 Retirees 2 Obstetricians I G necolo.ists within 10 Miles . EMIHumana NPPO Aetna Choice UHC Choice 1 NM Humana NPPO Aetna Choice UHC Choice III Humana NM Aetna Choice UHC Choice Ill Choice Care POS II Ci.a oar Plus Choice Care POS 0 Cl.na oar Plus Choke Care POS II CI.na OAP• Plus 1 om„ IMINERWIntr Water-IznI"oerti ,7".1.,.1 rota' 'eon EIRRNEM---i liffIRERIM EffillEASIIMPEINE,=."--'11111 ! MMTIMINIIIKEMEIMIEM. 11.. 593' 1911 10C, 1911 lami-Dade 1911 100. 1911 NM 11211.1211M11102111EM dilarn1-Dade 1911 ElE21EMEMMINIE2 1911 10051110 rovrard 1111111211EMEEINEMZIMMINEEMIEMES TEMEMMEIMMI101111M11117111111111MEINMEMIM ,.,.--111:121WAIIMINIZI111122111MIET1211112 •:dm Beach 1111111MMINEIREEIMEMINIIIIIMIEMEE ZEIMIIMME1211FAIIIIMIIECMINE ,alm Bench •AIM 70 1013%1IMINESEIINIIIIIMINIE 13 raa4rd IMERMIEMORIEMMIEEMEMEMIREIE MEM 100•MINEIMMEME2MEE21 2 Bravard 20111E21111111M=iEM121=1111EZEINE 21112MIMINEEMIRIEEEME1111111WEINIE MIMI 1. 1 00,iEllIMMIMMEIIIIMIllEr 13/102111•11111111211111EIE:211116111FEMEMIMIN MEIZIIIIIIIIIIIEIMEMMEIBEZIMIEMIEIIIIIERLIEME 2111111111111EMEMMEIMEMIE11121MEEIME EZINEMMEEINIE21•711MIIMINIMIIIIMECEMME 'k Wands MMEINIGI=EMS2MIEENIUDiENIMME. IMMENIEBIEDINEM2211111111E111102•11111111110}111111E EIMIIIITIME111131011111X.WIME=EMIMMU MINIIMMICIIIE32 EIMIERINIMIIIIIEINE01111E TI:f■MIIIIEIKM1111113111112211111111E11112:2=61.1121111E ETIMMIE11112111MEMERIAMMIENICEMIIE hfior 111111EIMENIIIIMEMEMIIIIIENEENEff 221W3111•IENIENINE11121WWEI i MIEITINIMMEM1111122•1111MIMMIE11111211111E ',al..Rd,*iE110211111E1E321111l2=EINERME 'than Rive, 11 lo,IMENIEZEIEMIEZNEEMEM 1 21121MTMINE•022=0111:211011EMELI=E 100Y ME ladL NV MIEMEMMEIE:1321111E1E21111111EINEMIE ladt.NV 17 tor 111M.111M11111E1111121111111EIMMIEE SIEEMINNIMEMIEME:2111111EIERIME 101,ME ZEIMINMEEMIE111221=MMENEZNIE RETTIMMIEIMMINICIEEZ111112111312MIECRINIE Sumter 9 WC,. .91 100%=.321=Iffr2= EZIIIIIMIIIKIK211111[1111201EMEIMEME521111116 MIZTMIlittliMiliMIIMIIIIEMEMIIMI 8=1111■11111111EMME521M1•1121111111111121•116 ehtsia 111111•111E2=ENIMMIIIIMINIEINE21111[ MITIIIIIIINKNIMINIEEM11111[1•11211111EINIIIIME folusia 8•111121111111MMIEIMMIEIMMINE •orate IIIMMEMINEW2INIENIENIMERERME ERITNI■10[21=111116112111111E1102211111111E=011111E II1=1•111=111111111211111•01EMIIIMOIMIIMIM IT 0111111111111E clot -.99.389 '9982 M99.70EME799.51Y E 96.3283 26311 99777,1ELEITE2111M11221131E Entire Population Including Post-65 Retirees Entire Population Including Post-65 Retirees Entire Population Including Post-55 Retirees 2 Primary Care Physicians within 10 Mlles 2 Pediatricians within 10 Miles 2 Obstetricians I Gynecologists within 10 Miles Humana NPOS Aetna OA Cigna CAP UHC Choice Humana Aetna OA UHC Choice Humana Aetna OA UHC Choice Choke POS Plus. NPOS Choice POS Cigna OAP. Plus" 14P00 Choice POS Cigna OAP. Plus" County ,Cy mr LI 0, •3,01 0 Of..AAni ,...A.of nu ToId Court, ., .1 1 a d 'id Ad 'Ad *of v, ro,a, Ad lid bol ,cr, Ad V,c1 1,4 %of Lierbor*Hdltel Vauban Atedsoni W.,/LIAntArs Ltentsn limbos Utility ,,,,....hiCrICOS I.Lvern11...*a Marten acql:en MAtTen. LIAr*Ar, Told Miand-Dade 1911 030% 1911 100% 1120 59% N/A WA 1911 Miami-Rode 19111 100% 1911 100% 1120 59% NIA 1I/A 1911 Miami-Dade 1911 100% 19111 105% 1120 59% N/A N/A 1911 Broward 509 100%1 506 100% 231 45% N/A WA 508 Broward sr* um 508 100% 231 45% NIA NIA 508 Broward 509 IOC% 5081 100% 731 45% N/A NIA 508 Palm 69 99% 70 MC% 19 27% N/A WA 70 Palm Beach I 01 99% 7C 10091 19 27% N/A NIA 70 Palm Beach 68 97% 701 100% 19 27% ,JiA NIA 70 Beach 20 10)% 20 100% 10 50% Ni l/A 20 Brevutl 201 100% 2C 100% 10 50% N/A WA 20 3rovard 20 100% 201 100% IC 50% N/A WA 20 Breyard A t Si Lucie 181 109% 16 100% 7 39% N/A N/A 8 St,Lucle 16_1 100% le 100% 7 39% N/A NIA 18 St.Lucia 18 ICC% Al 1 100% 7 39% N/A WA 18 1 Martin 17 T00% 17 TO% 5 35% N/A NM 17 Marti. 171 IOC% 17 100% 6 35% NIA NIA 17 Martin 17 10C% 17 100% 6 35% NIA N/A 17 Highlands 15 94% 15 94% 12 75% N/A WA— 16 Highlands I 15 947i 15' 94%! 12 75% NIA WA 16 Highlands 13 81% 12 75% 9, 56% N/A WA 16 Lake 13 WO% 12 100% a 67% ii/A NIA 12 Lake 1 21 10051 11 92%1 7 50% 5/9 NIA 12 Lake 12 108% 12 100% I 67% NIA NIA 12 Marlon 10 83% 12 IOC% 5 67% N/A Mb\ 12 Marion 1 101 839/ 9 75% 6 50% NIA NIA 12 Marlon 6 50% 9 75% E 50% WA N/A 12 Indian 10 100% 10 100% 5 50% NIA i•uA 10 Indian River IN 100% IC 173% 5 50% WA WA /0 indLsn River 10 100% ID 100%1 5 50% WA N/h 10 River Clark,NV 1 17. 100% IC 100% 3 30% N/A N/A 10 Clark,tIV 10 ICC% 10 100%, 3 30% N/A tJA 10 Cluk.NV 10 100% 10 ICC% 3 30Y, N/A WA 10 sum, 31 33% 7 100% 6 67% NIA WA 9 Sumter 9 100% 7 1009/ A 07% WA WA 9 Sumter 9 100% 9 WO% 5 67% NIA N/A 9 Orange 71 100% 8 114% 5 71% NiA N/A I Orange 7 170% 01 114%_ E 11% N/A WA 7 Orange 7 100% 8 114% 5 71% NiA WA 7 ‘'iltsia 81 100% 5 100% 4 50% MA MA 8 Voluala 8 100% 9 100%1 4 50% VA N/A 8 Volusia e sou% 8 la% 4 50% N/A N/A o 1 0% 5 71% 3_ 43% NIA NIA 7 Monroe C% 0% 0% N/A WA T Monroe 0%1 7 WC% 3 .13% N/A WA 7 Mon,. Total 2626 99.66%1 2035100.00% 144 54.91% NIA WA 2830 Total 2617 99-39% 2629 99.77% 1141 51.80% NIA NIA 2635 Total 2619 99.39% 2523156.51% 1439 54.61% NIA NIA 2635 ea Gallagher Public Entity&Scholastic Group •. a Division of Gallagher Benefit Smices,Inc. :: :. :,-.::: .: :-:• ::...... ,...,::: ::...,, i •.,::: :,.•: •,..-.• ..••:•.,• .. .:::: • .__ ----. — i 6 . _ .._. _ _ ,_, _ __ _ _ „ . __ GeoAccess Analysis • ______ _•• . , Entire Population Including Post-65 Retirees Entire Population Including Post-65 Retirees Entire Population Including Post-65 Retirees 2 Prima Care Ph:icians within 10 136es 2 Pediatricians within 10 Miles 2 Obstetricians 1 Gynecel••Ists within 10 Miles Humana Aetna Choice UHC Choice Humana Aetna Choice UHC Choice Aetna Choice Cigna OAP UHC Choice Premier POS CI.no OAP IN' Plus Premier POS CI.ne OAP IN' Plus 11111 Humana Premier POS 111. Plus sd ad ad ae1 as ad ad ad .o Id Leal rd aid Id ad ERIM ERPONr as xa Me' as Court o.-,-, u..,.,- i..r.: un,vn, um....e4.....•molten Tot46 County Y•,Sa,,,,,smm.n°eons.taenea,Ft.ees lmrbmw:,iw, Tots' amnes uem-n r.1-rt;ea eft,enr: Tall rr, r NIA N/A 1911 r r rr 11 r Miami•Dade 1911 if4W%�®� ° Miami•Dade 1911 100% 1911 100% 1120 s4% WA N/A ts91 �®��' E2® Broward 504 100%1 rT. . WA N/A 508 [froward 509 100% 5CR 1D0%1WEEMU 1 3=2:•1_____ IEZNET 1152111EMMEM Palm Beach 69 99%.112 ir'=EIMM 4 Palm Beach 69 99% 70 100%1111KIIMEEMEM 1117 112E111112 11 r� Brevard 3 15%. 2011E1911111131•121122111121 Beevard 2 10% 19 95% 10 50% WA ILIA r © � ®I ' SI.Lucie 18 100% 1009% 7 39% WA NIA 18 St.Lucie 18 100% 18 100% 7 39% WA ti/A 1• MIEMEIMEICOMMILEEMINENGEONEEMIKE Martin ,7 100%..EINI:MMIEM WA NIA 1 Marton 17 100% 17 100% G 35% NIA NiA 1 MIME 11=FAMMIEEEMIMI112111111831 Hi hlands 15 94%® WA N/A 16 Highlands 15 94% 15 94%1 12 75% WA NiA 1; *'a • IIIIMEIIIIIMMEMERNINE 6%WA N/A.. Lake 13 108..® 1110%. 8 57% WA N/A 12, Lake 12 100% 11 92% 7 58% NIA WA r _:I211/11 I'r 6781 WA CPA Marion 10 83% 12 100%I 8 67% WA NIA 12 Marion a 67% 9 75%MINIZIENIMI t2 IIIMMENE ` 50%N/A WA �'s Indian River 10 100% 10 100% 50% WA NIA 10 Indian River 10 100% 2 20% 5 50% NIA NIA 1C IiIMEZIMIE 100' 6 K''IIIIIIa-IENCEI Clair NV 16 100%INECIE133 3096 N/A ! N/A 11 Clark,NV 10 100% 10 100% 3 30% NIA N/A 1C EIMEZNIMEIKENEEMIIIEINEZ under 9 100%.MIE NIA I N/A 9 Sumter 3 33% 9 100'- 6 67% rl:'A 1i/A 9 3=211111111MMEZIMMIBEIIIKICEIZEMEIMIE Oran 7 100%Marl111311510 WA i N/A 7 Oran,o 7 100% 8 114% IMINEVIMIE 'ran e MNIONIE2IIKEECIIIILMIEEEMMINE olusia 8 1.00% WrillE2 N/A I NIA I Valusia 6 100% 6 10096e © °lusts 8 100°.1` IMEIKEEMMEM ' Monroe 0 0%1NMEMEIMEINEMIEMIEMIM Monroe 0% 5 71% 3 43% NIA WA 7 Ef1== I ___ t '' Total 2609 90.01'c/ 100.00Y. 1447 5491'- NIA ILLME Total 2595 98.63% 2620 99.43% 1444 54.80% NIA NIA 263 MEM 2601'98.97% 261 t= l 1ilr>7N7r alcscl:' Entire Population Including Post65 Retirees Entire Population Including Post65 Retirees Entire Population Including Post-135 Retirees 2 Primary Care Physicians within 10 Miles 2 Pediatricians within 10 Miles 2 Obstotrlclans!Gynecologists within 10 Idles Aetna Choice UHC Choice Humana Aetna Choice UHC Choice Humana Aetna Choice UHC Choice Humana Select P05 Cigna OAP IN' Plus Select POS China OAP PP Plus Select POS Cigna OAP IN• Plus County rd s',a as xa ea xd sa ad Tool County • xd as xa Sol ac um 1•d T Leto), ea I ad em ate as xa as sa roe. Ilmhr. .,ol lM,i1,, Nnrbr Nvd, L.%d ka-h•:s N,,t1 Y9,bers:erBr. Y. Ymintc Nanol. ad YaMez Rhrthai NEIOntlkrtCq!Ye*hn dorms woolcro Ye.YSd LM°bme Metue Miam6Dade 1911 100% 19.1 100% 1120 59°%1 N/A N/A 1911 Miami-Dade 1911 100% 1411 100% 1170 59% WA WA 1911 Miam1•Dacte 19111 100% 1911 10096 1120 59% N/A N/A 19111 i froward 509 100% 508 100% 231 45%1 N/A N/A 509 [froward 509 100% 508 100% 231 45% WA N/A 506 Broward 5051 1005E 573 100% 231 45% NrA NIA 5391 Palm Beach 69 99% 70 100% 19 27961 N/A N/A 70 Palm Beach 64 99% 701 100% 19 27% N'A N/A 70 Palm Beach 681 97% 70 100% 19 27% WA WA 701 Brevartt 3 15% 20 100% 10 50%1 N/A NIA 20 Brevard 0% 19 95% 10 50% Id'A NIA 20 3revard • 0% 18 9C% 10 50% NIA NM 7/) Si.Lucie 18 100% 19 100% 71 39%I NIA NIA 18 S1.Lucie 19 100% 18 103% 7 39% 8/A WA 18 St.Lucie 181 100% 15 100% 7 3/5% WA. N/A 18, Martin 17 100% 17 100% 6 35%I WA NIA 17 Marlin 17 100% 17 103% 6 35% WA N/A 17 Martin 17 130°% 17 100% 6 35% N/A N/A 17 Highlands 15 94'6 15 90% 12 75961 N/A NIA 15 Highlands 15 94% 15 94% 12 75% N/A WA 16 Highlands 13 61% 12 75% 9 56% N/A NIA 15 Lake 13 100% 12 92% 8 62% NIA I•//A 13 Lake 12 103% 11 92% 7 5896 NIA N/A 12 Lake 13 190°% 12 92% 8 62% NIA NIA 13 Marion 13; 63% 12 100°% 8 67% NIA IJ/A 12 Marion 6 59% 5 75% 6 50% NIA WA 12 Marion 5 42% 9 75% 6 50% WA N/A 12 Indian River 101 100°% 10 100% 5 50% N/A NIA 10 Indian River 6 60% 2 23% 5 50% N/A NIA 10 Indian River 7 70% 8 80% 5 50% WA NIA 10 Clark,NV I 0°% 10 100% 3 30% 11/9 6/A 13 Clark,NV 0% 10 100% 3 30% WA WA 10 Clark,NV 016 10 100% 3 30% N/A rJ/A /55 ' Sumter 91 100% 9 100% 6 67% N/A WA 91 Sumter 2 22% 9 /30% 6 67%l N/A WA 9 Sumter 9 100% 9 100% 6 67°% N/A WA 9 Orange 71 100% 8 114% 5 71% NIA NIA 71 Orange 7 1004 8 114% 5 71% WA WA 7 Orange 7 100% 8 114% 5 71°% NIA WA 7 Valusia 81 1004 9 109% 4 50% NIA N/A 81 Vokls/a 8 100'% fl 100% 4 50% WA WA 8 Volusia 8 100% 8 100/ 4 50% NIA WA 8 doreen 1 0% 7 100% 3 43% N/A WA 7j Mnnroe 0% 5 i1% 3 43% N/A WA 7 rdoerne D% 0% D91. F00 N/A 7 Total 25991 98.56% 2635 99.92% 1447 54.87% NIA NIA 26371 Total 2580 97.919%1 2620_99.43% 1444154.80% N/A N/A 2635 Total 2585 98.03% 2618 99.28% 1439 54.5794 WA tJ/A 2637 elkl. p 1i, - � Gallagher Public Entity s:Scholastic Group ""'"" " :... f Gallagher l3enefil Services Inc. : ,... .._._._...._ • a Division o G __ • • I I • • MEDICARE ADVANTAGE ANALYSIS Medicare Advantage Disclaimer—carriers submitting Medicare Advantage proposals submitted multiple plans,rates,with/without Rx,and Medicare Supplemental plans with fully-insured PDP's. The RFP instructions to quote benefits as closely as possible to Scenarios A&B were generally followed albeit somewhat loosely. After the dissemination of this analysis,if the City intends to pursue a Medicare Advantage program for the post-65 retirees,GBS recommends that further clarifications be explored before implementation. The decision to implement a Group Medicare Advantage Plan should be made with careful planning and in consultation with the post-65 retirees. 4i°441 Gallagher Public Entity&Scholastic Group a Division of Gallagher 1fenefii:Services,Inc. _____ rVedicare Advantage Benefits Humana Aetna United Healthcare Scenario A Benefits Hh10 PPO HMO PPO PPO Deducible $0 $200 $0 $100 SO Out at Pocket $2,500 $1.000 $6.700 $6,700 $1,500 Office Visit $10 Copay PCP/$25 Copay SPC $10 Copay PCP&SPC S5 Copay PCP&SPC 100% $10 Copay PCP!$15 Copay SPC Inpatient $250 Copay(Days 1-5) $100 CopaylAdmission 100% 100% $50 Copay per Admission Outpatient $200 Copay 5100 Copay 100% 100% $25 Copay $25 Co $50 Copay 107% $65 Copay Emergency Room $65 Copay Copay i PX $10!$201$40!25%from$0 to $10!$10!$10!$10 from$010 $10!$50!575 $101510 $10/$30$40!259° Catastrophic Catastrophic Humana Aetna United Healthcare ' .. ... .,: p:- ._ _-- -. . Benefits HMO PPO _ HMO PPO PPO _ Deducible SO $750 SO 5100 $0 Out of Pocket $2,500 $3,450 $6,700 $6.700 51,500 Office Visit $10 Copay PCP!$25 Copay SPC $35 Copay PCP/$50 Copay $5 Copay PCP&SPC 100% $10 POP!$15 SPC SPC Inpatient $250 Copay(Days 1-5) 5100 Copay/Admission 100% 100% S50 Copay per Admission Outpatient $200 Copay $200 Copay 100% 100% 525 Copay Emergency Room 565 Copay $65 Copay $50 Copay 100% 565 Copay 0104201540/25%from$0 to 51055015751575 from$O to $1015501875 $10/$10 510330540125% Catastrophic Catastrophic • Cigna quoted Medicare Supplemental plans with a fully-insured PDP as they do not currently have a Medicare Advantage plan in S.Florida • Cigna quoted a Medicare Supplemental Plan F and a Custom Plan with either a$7/$401$601$60 or$10!$50/$75/$75 fully-insured PDP • The pricing of these plans are presented in the following slide;if the City wishes to pursue this type of arrangement GBS can prepare a benefit comparison to the Medicare Advantage plans above • It should be noted the Medicare Supplemental plans form a wrapper around traditional Medicare and can be difficult to understand when combining them with Rx coverage =` � Gallagher Public Entity&Scholastic Group .. - a Division of Gallagher Benefit Services,Inc. i' , — — -- -_ 19 r :edicare Advantage Financials .• .. _ . ._ . Scenario A-Current Benefits as close as possible with assumed enrollment) `13.Pro•osed DaGTID(close as•ossibieratth=ON Oct'13-Dec Oct'13- Jan'14- Oct'13-Sept Oct'13- Jan'14- Oct'13-Dec Oct'13- Jan'14- Oct'13-Sept Oct'13-I Jan'14- Date Ranee '13 Dec'13 Sept'14 '14 Dec'13 Se.t'14 Date Ran.e '13 Dec'13 Sept'14 14 Dec'13: Sept'14 Humana" Aetna Cigna"' United Healthcare Humana" Aetna China"' United Healthcare Medicare Medicare Advantage Medicare Advantage Medicare Supp Medicare Advantage Advantage Medicare Advantage Medicare Supp Medicare Advantage Tier Enrollees' HMO HMO Custom+PDP HMO Tier Enrollees' HMO HMO Custom+PDP HMO Retirees PMPM 18 I $0.00 $327.13 $319.67 3341.03 N/A N/A Retirees PMPM 18 50.00 5327.13 $319.67 $341.03 N/A . I-IIA Annual Totals 18 I $9 $17,665 $51,787 r $73,663 NIA N/A Annual Totals 18 $0 $17,665 $51,787 $73,663 NIA ' NIA Medicare Medicare Advantage Medicare Advantage Med Sup Plan F Medicare Advantage Advantage Medicare Advantage Mod Sup Plan Medicare Advantage Tier Enrollees' PPO PPO +PDP PPO Tier Enrollees* PPO PPO F+PDP PPO Retirees PMPM 352 $636.00 $499.43 $44174 5448.78 $405.82 3378.55 3etiree_s PMPM 352 $392.00 $499.43 $443.74 $448.78 $405.82 1 $373.55 Annual Totals ® 52,549,088 $500,429=$1,199,246 Annual Totals 352 51,571,136 $500,429 $1,333,882 $1,895,653 $428,5461 $1,199,246 Annual Premium 352 $2;549,088 $1,903,763 . $1,969,316 $1,627,792 •Atn j i 4 'Post-65 retirees lost choose dependent coverage have been loaded by 1 member each to reach a member count 'Post-65 retirees that choose dependent coverage have been loaded by 1 member each to reach a member count 'Enrollment for canters that quoted a MA HMO has had 5%enrollment placed in this plan and 5%removed from the'Enrolment for carriers that quoted a MA HMO has had 5%enrollment placed in this plan and 5%removed from the MA MA PPO PPO "Humana was unable_to provide MA rates in 2014 so these numbers were annualized for comparison purposes but'"Humana was unable to provide MA rates in 2014 so these numbers were annualized for comparison purposes but may change effective 111/14 may change effective 1/1/14 "Humana quoted a$0 MA HMO with Rx for Miami-Dade but S15O MA HMO with Rx for eroward which is difficult to"Humana quoted a$0 MA HMC with Rx for Miami-Dade but$150 NIA HMO with Rx for Broward which is difficult to price with such low HMO enrolment expected price with such low HMO enmliment expected "Humana quoted benefits closely matching Scenarios A&S while the other carriers generated the same proposal "Humana quoted benefits dosety matching Scenarios A&B while the other canters generated the same proposal for for both scenarios both scenarios "'Cigna quoted Medicare Supplement plans with a fully-insured POP(EGWP)for pharmacy coverage "'Cigna quoted Meciare Supplement plans with a fully-insured POP(EGWP)for pharmacy coverage "'Cigna's administrative fee is on a PEPM basis but the claims factor and PDP premium amount are on a PMPM e'Cigna's administrative tee is on a PEPM basis but the claims factor and POP premium amount am on a PAiPM basis basis G-'7-3-, Gallagher Public Entity&Scholastic Group a Division of Gallaher Benefit Services,Inc. 20.. FULLYINSURED MARKETING ANALYSIS SC :NARIOS A GANGallagher Public Entity&Scholastic Group a Division of Gallagher lienefir Services Inc. 21 • Plan Designs • Scenario A - Al Premium HMO (current) - A2 Premium PPO (current) - A3 POS (current) - A4 Proposed High Deductible Plan • Scenario B - B1 Proposed HMO - B2 Proposed PPO - B3 Proposed High Deductible Plan 61) Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services.Inc. . . . . -„ —- . , • • -- .. , , ,• Plavi Designs - Al Premium HMO (current) . . Current Humana, Aetna ODRA United Healthcare P.m.',N1.10 (Indicate any deviations from Current Pb) (Indicate a,deviations from Current Plan) Unebc.nt any deriations from Current Plan) (Indicate any deviations Nom Current Plan)• Maximum Lifetime Unlit Urkinited Confirmed Confirmed Corfamed Confirmed .nnual DeduclitVe N/A Cortamed Confirmed Confirm. Confirmed Emily Deductible NIA Confined Contacted Confirmed Untamed •ndieiduaI Meanum Co-payments WOO Confirmed Confirmed Confirmed Cordamcd ■am,Maximum Covaymenis 13.000 Confirmed Confirmed Conrened Contrived If hyoid.Office Visit $5 C..ntey I Conlfirned Confirmed Contained Contained eciallst Office Visit 10 Cafe Contained Confirmed Conlon. Preventive Cefe•Anne exam ' • dutt $0 Copay Confamed Confirmed Confirmed Confirmed hild health SU Camay Confirmed Confirmed Cordoned Confined •EUGYN $11Copa) Contrreec Confirmed Confnned Confiner, Member cOst Sharing is based 00 00 type al' r-0,is rroseded as any Oter Oren lor the No Copy for tral S2,000, ,nlertlfily Seryiceartreatment Plans Conlarnee service performed and Ole place of service treatment of an uadertyfogneda.al condition up Confines DA of rcannatheco.after whose it t rendered. to the point.Infertilly condition is diagnosed Physical Therapy No Coyly comm. Confined I Untamed Coo/teed SpeechiThernoy to Copes Confirmed Conhned I Confirmed Confirmed •ccupationai Therapy No Co., Conteined Confirmed Conine., Conlvmed •lien Testing 8'treatment No Copa• Confined Confined Confirmed Confined •:patient Surgery/hospital or surgery canter) No Copav Confined Gonfioned Confrrred Confirmed and Lab Out Went-PI sician's Office S5 Cosj Confirmed Confined PCPor S..-,.fistCo••y Convened rgency RoornPiospital _ %Valved d aratined -Illness S25 Copay Confined Contained $50 Copay Confirmed -Accidents $25 Copay Confirmed Conferred $50 Cope, Confined I Ambulance No Coeds Contorted $500h1eY mac onfirmed $25 Coop I inpatient Hospital 5100/Admission Confirmed 1100/ar000 Confined Confined I Urgent Care 15 Copes Confirmed Confirm. 52500810 Conferred I ,ome Health Care $5 Cope! Confirmed Confirmed No Caney Confined •:retie Medical E ui,ment - No Coom Confirmed Confirmed 00001505*Coin.ance Confirmed Matemhy - • •PhySiClEfl 35 Copav Confirmed Confirm. PCP or 4.1altsi Copav Confined -Hos•hal S100/Admission Confirmed Confirmed Contrrned Confirmed ,0.tient hierhadll mote $1001 Admesion Confirmed Confirmed C.ontarn. Confirmed ••npatient MerrtafiNcorous I S5 Cope, Confirm. $0 Confirmed Confirmed n•Mint Substance Abuse I S100/Admen:nit Confirmed Confrmec I Confined Confirmed •I.ntient Substance Abuse . $5 Cepa, Confirmed 50 I Confirmed_ Confined . . Prescription Nags•Retail Generic 1 $5 Copy Confirmed Confines I Conned Confirmed Brand I $5 Copan Confined ronfinred i Confirmed Confirmed •I etail Maximum Supsity. 30 Clay suppN Confirm. Conferred Confined Confined I ••res..lion Card Yes Confined Confined Confirmed Confirmed I . . prescignIcnOnms•Balt Order :reneric $15 Copy Confined Con/reel Confirmed Confirmed doted £15 Copay Confirmed Contrrned, I Conremed I Confined all-Order Maximum Supplv %deY suPPN Confirmed I C.ontarred Confine° I Contained vA subset ot generic drugs are available through retail vIth a 90 day supply. . Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. •i ::, :,-,:. ,;....-ii• .. .. 1E.. .,:,"--•-.. ::: -:.....-:H,:-. • , - 23 • r • ., . • , . Plan Designs — A2 Premium PPO (current) . • Comm Humane Acme CIGNA United Heencare Premium 170 ffnmete any deviation Porn current wan) pi:nate any devotion Min current pun) On loalle..Y demetfem from mime.,0.) On Merl..arlY ilfMetion from ormicel 01.1. Inineruesrli Om-of4lenrork fe•Hetoork but.cl.fletworfi fn.enceirli. Otn•of•fl nark In•Nenark •Out•of•Nehandt Infie.orA 0.of-lfemork rdarnurn Ulchrne Benefit Unlisted Urinited Confarr. Confined Confer. Confined Corlinned Confirmed Unenvied Urines/ •nnuai Derionble 5200 5200 Cortemed Confirmed Co.red Confirmed Conferred Confirmed 520D 5200 anYly Dc dumible individual faschnum Of-Pocket $300 $LOCO 5600 SIDOD Confrrneo Col.-red Genf.. Calmed Conferee Confine. CarMoned Conferred Confirmed Concerned Ce.mned Carlin. 5600 SLUR $000 S1,CCO LF smily Idayinium Ont-ol-Pochet 53.050 53.000 C..unforte0 Cardin. Confirmed Confirmed Canfemed Confirmed $3.000 S3000 1 PhySlelan Office Visit 510 COO. N/A Creamed Concerned Conferred Dal-Ciro Coins 000/00101 Dee.Cam 310 090-0,,,,000,, S i eciahl Olt ice ViSit 0/000001 MA Conned Cent.. Conferred Deo-MC-aim Corrine, 000.0009 810 O.•TOY.Coins Preventive C are•Annual men •dult 100, +00+0000000 Corrine. Confirmed Cm-dinned Cita-RN Coins Con/0.. Conon. Confirrnd Confinn. 000+0+0+00 loors, tri%-fled WO,. Coin:rimed Confined Confirmed Can.. Conferred Ccrins. Conferred Confiner/ .0001+ 100: Ced-30,Com Cenh-rned C,rifersed Conferred Conferred Confirmed Confined Confirmed 00000+00 Ideal,Scrvicesfireatment Plan Nct Covered I Met Covered Confirmed Confined Varied Vaned Con-me, Confirmed Conlon. Conform boo/cal Them. 090.00% I C.-GO%Coins Caen. Cordlirm Coen. Can.. Cadre. Confined Conned Confirm. perch Therapy Dad-00% I Cal-50%Coins Ceara. Confined Confirmea Confirmed Confirmed Conn. Conftmea C.onfinea e ccupauonai I hcrapy 000+50% C.-5091.Co. Ccermerl Catered 00+0+0+4 Confirmed Confirmed Confined Confined Confarnen Testing OV 310 Covey. •ilergy Testing A Treatment 93 Coney Ced-60%Cairn Conferred Confined 91000909 Conferred nen'Infection-can Ise Confirmed Confirm. Confirmed cover.undre 9$3 Caney Owe-orient Saran,rhosgrat or turn,cental VICO Cap.-00%06ns i Ded.5500 Caosy.70%Coins Confined Confirm. 00+0,0+ Confrm. Confirm. Confirmed WO,cifer Copay :Mtn. i-re and Lab Ou.16900•Ph eiclen's Office 10C%moved Decl*50,Con Conlanee Confined Coen. Confirmed Confirmed Confirmed Confirm. Confirmed Emergency RoonHosoltal • •Illness Conferred Co.. 5100 Copay.90,Con Cea•S500 Com.7 0%00.1 S50 Gcv., S000 Cop. 525 Coda, Ded.7094 Con •Accidents Coins 525 Dopey-Str5 Coins Conferred Confirmed 5100 Cope,.PO%Colas Dea r 5500 Cop.r TO%Coins I 550 Copay .550 Cepa' 02500p0+ Ond.70,00. •'dance Ded.60%Ccin . DO.50%Cans Confirmed Cen.. Conferred Confrmed Confcrnd 000+1 .a 510Cfadmil UIP C$ 25 ED 51 Ded.TO%Cons Inpatient MD CO3. WA Cohs Drd S5.00 Cony.7G•ro Coins Conned Confirmed Conferred Confirmed I Conferred conned TO%alter$100 Cop. 100,341-SSOD C.apny r•chi Care 01004000 1 Cod-80%COW. Confamod Cenfirmed Confined Confnma l 525 Cop. 525 Cspay Confirmed fled.7000C400 Deo ten liCrle. Ded ere 00001 Cao 90 days per cal year 40 days M peen r c60al 9 Sye. sr Conned Conrmed Cofered Co.r. I Confeed Unlined Cortrn. Cotmd orable Medical E i tap. Dad.50%Coes Ded.60%Con Confirmed Certarned Conf.. Confrerd Confrmel Confirmed Conferred Corterned Maternity •Ph sician 510 Caney.ersl,Msa only Not Covered • Confirmed Conferred Conferred Confirmed Confrmerl Cotten. Conferred Confined •Hospital $100 Cop..90%Coes Dcd.3500 Cam.70%Coins Coarrred Corermed Confirmed Conferred Confoned Calms. 1013%the Ccipay Confirm. .npaiiont Mauls lifienews 5100 Camay.SO%Osiris Der/-3500 Coady.70%Cdrs Conned - Confirmed Confirmed Confined Confined Corfirmed 100%after Cop. Confined 9 n atlent MentallNervous 0100 Co,.-90%Ccnris O..5500 C..-7000000+ Confirmed Cenierned Confined Confmmed Confirm. Conf.. 10000 ater Co Cei ..relinied r nen,Substance AP., SI CFO Com-90%Con Deo•5500 Con.-70%Coins Confirmed Confirmed Confirmed Confined Confirmed Confirm. 100%c04 Copay Confinned Dm i alert Suntan.Abuse 5100 Cam-Mains Dee-5500 Can•-0000000 Conn. Confer. SID Coney 4000 004400 Confirrim Confined 1000+1+ • r Comer. Pi esoiption Drupe•ReteM • - . .•Generic MEM 8'0'0' Confined 00n177:. C.GMAMEd Confirmed Conferred Confirmed Confrmed Confirmed Brend i i Hot Covered Confirm! Confirmed Confirmed Conferred Confined Cann. Conf rrned Confirm. 501000 0+0+000+Supply 10000,000700 strA Confirmed Conned Cordmred Costar. Conferred Confined Confrmect Coniernd ••-sere:Mon Card Yes Confirmed Conferred Confined Coln. Confer. Confer. Conferrer/ Conan:lea Prescription 0.59-fif,t,Off* Gene. 530 Copay 0000 0000194 Confer. Conferred Conferred Coainrei Confirmed Conferred Corer:red Careered Brand 53000707 1/00 000004 Cenened C00000901 Caterned Contmed Conferred Corderned Cana. Ccnfirmed 51alh000er Maximum Supple 3.3 day Supply NA Goan. Conferred Confirmed I Conirmei conform connroi caro,red 0a00104 1 'A subset of generic drugs aro available through retell with a 90 day supply. Gigi) Gallagher Public Entity&Scholastic Group •• • • . . •: - • • • i....• a Division of Gallagher Benefit Services,Inc •_• •-• • • ••.• • • •••••• • ••• • ._..... ____.... ._ ,..... 24 . ■ . ._...... Plan iesigns ® A3 POS (current) Cetrent Nemana lima ULNA United Neallhere POS Plan (tndicato any deviations tem current plan) (mac ate any deviations from currentptan(• (Irmcao any deriimna from currert plan) (Indicate any deriativas from currant plan) lo•NCtwmf Dotal Network _ In•+anonA Oumaf Ne mo, le.cmwork CIA.Newer, h.-8 wo is Ousel Network leaf ewers Ooaf NOw% L.-alimony Liteinnn Benefit I lmfineted Uroirnled Continued Cordoned Conine Confimec I Confirmed Confirmed Unfunded Unlrnded Annual Deductible I SO 5400 Confirmed Confirmed Unarmed Confirmed I Conformed Confirmed Conte. 0000 Fondly Drduetlbth I SP SOLO Confirmed Co-armed Con reed .^.:pinned I COnfmned Cadmmd CcnSnmd 5900 ndnidual Nedmm Copeymentsl0o•OI•Pocky 1 NIA 0SO NM/00SOD Confined COnfinmd Ccnfrled Confined I Untried 000*1/ed CeeNns.•d 52500 Fondly filashown Copaymentsl0nt•ol•POCieI I NIA 150 WA!Si,000 Confirmed Confirmed Confirmed Confined I Cannrned Cordoned Carfimed 55.000 I Physician Office Visit 35 COpay IVA Confirmed Conhm_d Unfurled Cannoned I Conferred Dec•Crns Confined 7016 Coats late;Office Viso SS C•I.;, 19/A Conferred Confined Unfurled Confirmed I Confirmed Dec•Coins Confirmed 70%Coins ovomre Cote-.Anouat corn- - -. Adult 18101: Del-70%Coins Confirmed Conferred Cordoned Unlined I Conferred Cadumed Confer. Cordoned Child health 10056 7C+5 dad waived — Confined Confined Confirmed Conferred T—ConAmed ColCSmed Confirmed Conumod 087050 1004 Ded-704 Coln Confirmed Confirmed Ccrdemed Confined I Conferred Cenlomed Untanned Confirmed inlertifih Cwsiccsffreatmeut Plans Not Covered No:CO'/N/NK Cortmed Combined Wed Vs. Comderncd 0.00/ed Confirmed Unframed Physical Therapy No Copsy Ded-70%Coins Contrive Unrolled Confirmed Confmmod I Conrare Condemn Confirmed CObmrd �h Ma Copa Ded-704 Cob6 Conferred Confined Unfurled Coded Condoned ConMrtmd Confined Confirmed Cov eneul I No Coney Del-7096 Coins Confirmed Corfimcd Cendnned Confirmed I ConNtred Confined Ccranzd Cordnvd Allergy Testing 8 Treatment 10096 Ded-70%Coins Confined ConOrm60 Confirmed Confirmed Based on setfne Calfrmed S5 Coon, Conferred bonattont Soma(hospital or stmgery colter) No Copoy Ded-70%Corns Conferred Unfilled Confirmed Confirmed I Confirmed Confirmed COnfaned Casfrned Co-and Lab Op.aliens•Ph sidar'6 Office No C•a Lied-70%Cons Confined _ Confirmed COnerned Contmm.0 Confirmed Confirmed Confirm. Confirmed Eoomtgen•7'Fnw°.9das°Ital ed.d ad0000 d wait if amt. __ - -Nnns S50 canny _ S.50 assay Confirmed Confirmed Carden. Confirmed Confined Conformed Confined 70%Coins •Acddems 150 coney 350 copay Contrtned Coem.d Cnfirr. COnfirrnod Confined Cadumed Conferred 704 Coin Ammotznce CoCo, No Copay Confirmed Confirmed Ccnfrnise Confirmed Confirmed Confirmed 350 Copsy 70k Cdr °patient Nose., I No SlOO per admission Dad.3500 Cepa7-70?,Cans: Conanned Cnntu ed Confirmed Cordoned I Comymmd COnered Confer. 701/Coop Unborn Cam I S5Copay Dec-704 Coins COmfrled Grfodd Confined Camlmmed I 525 COPay - S25 Cgay Confessed 7016 Coins Nov...ntth Cam No CO(wy. Dec-73'4 Cots Canby. Con.. Confirmed Confirmed Confirmed Confirmed Confirmed 0710, 0 I Durable Medico!E rl. No Cop Deo-7O%Coins I Confined Confirmed Confirmed Codtrned Confoneu Confmned Confirmed Confum:d I -Physician 55 Copy DOC.70%Cana I Confirmed COrdmed Conferrer! Conferred Conferred ConGanad Conferred Confined •Hospital 5100 per adnissior Cr_d•5500(anar.7096 Cara Confirmed Confined Conferred Codumnd Confirmed Cordrmed Confer. Conferred Ca4umcn ton tnpa1i008fenleYN=voea 5108 per atlnfssbn Sod•$500 Capay•70%Cars! Ccnfimed Coombe Confined Conferred Confined Carb�rled VaAarses Co limed Confirmed wall Outpatient LlomaBilmous 35 CoFay Ded•7056 Coca 1 Gummed COnfined Coot-Ted Cordoned I Conferred Cortinned Vfirmeds Confirmed Detainee with f°pa0cm Substance Abuse 5100 per 00olo0lan Dud•1500 Copy.t.70%Cann Cardin-4 Confined Cordcmcd Confirmed Confred Cordoned vananr2s Confined Outpatient Substance Abuse 35 CCpcy fled•70%Coins Confnmd Confined Confirmed Cetrmd Confirmed Ccnfimed Confirmed Nib Confaned , Valances •00000_• SID Coney tool Coveted Confined Conferred Confirmed Confirmed 7 Confirmed Confined Crmfore0 -8r;nd $100073Y NIX CO.. I Confirmed Codamed Confirmed Called 7 Confined Con(rned Confined Nmad Nahum S,monlyv 30 dal supply I fanfrme0 Cor4irrned 7 Curbed Neon• .on Card Yes Con0re Confirmed 7 Confirmed Pres:Apr:e Dregs•Nall Ofdfr - -- - --. -Generic 530Cdbay not line 0 Caromed Confirmed Conned Conferee I Centric. Confined NO Covered •Brand 330 Copef Not Catered Confermd Confirmed Confer. Confirmed 7 Confirmed Confined Nei Cmdmd plailOrder ftaehmn Supply 90 day 6tglpry 90 day supply Confined Confirmed Confirmed Confirmed 7 Conferred Confined 'A subset d gon.ic dregs an avallak through retail allh o 00 Clay supply. • G Gallagher Public Entity Scholastic Group a Division of Gallagher Benefi6 Services,lnc. 1 11:1:'... ......1 ` r • .J•=1111 ,________ •• _ _____ ____ . • _ • Plan Designs - A4 Proposed High Deductible Provo. __ , Hymens Aema CIGNA United Healthcare . PPO ligh Dolan. (inchoate my @indef.from proms.plant (indicate any desist.from proposed plan) fiedloate any deyiati.train proposed plan) findicate my dewier.from proposed plan) - to..... Dv,ofirrrtnork ',Network Om cfirlamcre in.Nereduk Out.afieleteura loran., Our.pf.pettyrt,k tottencork Oa,edit...ore Narimum Lifetime Benefit MGT. UNir. Confirm. Confirm. Confirm. Confirmed Corr.. Confim. Unlimited unieneed Anmar Deductible 551114 I 515000 Confirmed Cordirmed Cornirm. Confirm. Confirmed Confirmed 35.000 $15,000 Parmie Dedurebla 11505$ $30,000 Co.rtn. Confirm. Confirmed Confirmed Confined Confirm. $10.000 $30,000 ...ear Wein.Out of Pocket $10.000 520.000 Confirmed Confrrred Confirmed Confirmed Confirmeo Confirm.: 310.000 $20.000 Family Omen.Out of Pecket 520.000 $50,000 Confirmed Confirmed Confirm. Confirm. Confrrned Confirm. 320.000 500,00o PlerPcian Off.Mail $35 Cop.,-Del den 70% D..50. Confirm. Confirmed D..7015 Confirmed 335 Copey only Confirm.' Eas 5033 Specialist Office Visd 555 Covey-(kJ then 7121, Ded•50% Confirm. Confirmed D.•70, Confine. $55 Corley only Confirmed 555 SO% - omheCare.Amwaleaann Acne IOTA 000.50% 1 Confirmed Confirmed Confirtred Con!Irmed Confirm. Confinn. Confirm. Confirmed Child hearth 100. 50775•c...reived Confirmed Confirmed Confirmea confirmed Confirmed Confirmed Confrrrod Confirm. 00.GYN 101777 004.1077. Confirmed Confirmed Confirmed Confirm. Confirm. Contirmeo Confirmed Confirmed Iot1ohOy0oM55lTt0.tOSlllPIOlSO (101 0050100 1401 003770 Confirined Confirmed Confirmed Confirmed Confirm. Confirmed Confirmed Confined Physical Therapy Dad.7070 0..50. Comdr. Confirmed Confirmed Confirmed Confirmed Confirm. Conlemod Confirmed I Speech Del•70. Ded•50. ConfIrmed Confirmed Confirmed Confirmed Confirmed Confirmed Confirm. Confirmed I r2Lipatonal Ded•70. Ded•50. Confirmed Cornemed Confirmed Confirm. Confirmed Confirm. Confirmed Confirm00 enemy rest.,X Treatment Dod-SO. Dod•EC% Confined Confirmed Confirmed Confirmed Confirm. Confirmed CaNnned Confirmed I i Outpatient Surgery firosnitol or su roe.center) Ded•70% 700-00% Confirmed Confirmed Confirmed Confirm. Confined Confirmed Confirmed Confirrnod X,and fiala Chmatierd-P .dan's Office Ded•70. Ded.50. Confirmed Con'.. Confirmed Confirmed Conf... Confirm. Co.irmed Confirmed ntreency RcionrHospital •Muse Del•70% 700.50% Confirmed Confirmed Cordrrroo Confirmed Cordinn. Dad•70% D.Men 100% Dod Men 100% •Accicents Cod•70% Ded-50% Confirm. Confirmed Confirmed Confirm. Cronfinned Confirmed Ded[non 100% Del Men 100% ambulance Ded-70. Ded-50% Confirmed Confirmed Confined Confirm. I Corrfirm. Confirmed Ded Men 100% Ded thon 100% i preen:Hospital . 1,Immt Care 5E0 Copay-Ded•70. Del•50% Confirm. -Contimed Del 0 7C% Confirmed I O.•70. Dorl•70% 36D comy 50% Homo Heailh Caro D.-70% Ded•50% Confirm. Confirmed Confirmed Confirm. Confined Confirm. Confirmed Confirm. Durable Medical Erna. ---Ded•71. LW i.50% Confirm. Confirmed Confirm. Confirm. Confirmod Confirmed Unfinned '--Ccnfirmed laternity __rercmn Cal•70. 0.•50% Confirmed I Confirmed Conlin.. Confirmed Confirmed Confirmed Confirmed Confirm. •Hospital Col•70. 00.50. Confirm. I Confirm. .._ Confirmed Confirmed Confirm. Confirmed Confined Confirmed inpatient Montalfeenrous _De0•7070 Ded•50% Confirmed Confirmed Confirmed Confirm. Confirmed Confirmed Confirmed Confirmed 007011000 00100115000000 Ded•70. Ded•50. Confirm. Confirmed Confined Confirmed Conferred Confirmed Confirmed _ Ccoonnfi,rozedd npailent Substance Abuse Deo-70% Ded*50, Confirmed Confirm.; Confirmed Confirm. Confimed Confirm. Confirmed Outpatient Substance Abuse I Dee-,70. Ded-50. Confirmad Confirmed Confirmed Confirmed Confirmed Confirmed Confirrneo Confirmed . . -eirdiption Dive,Retell • . . Generic I Ded•70. Not Covered Confirmed Confirmed Confirmed Confirmed Confirm. Confirmed $10 Not Covered Brand Ded•70. flol Covered Confirmed Confirmed Confirm. Confirmed Confirm. Confirmed 5337550 Nor C0,0000 Retail fdaximuM Supply 30 day%triply Confirmed Confirmed Confirm. Conf.. Praserfinion Card Yes Confirmed Confirmed Confirm. Confirmed ••arriptron Drop•Mail Order • Generic Daa.70t. 401 000,81 Confrm. Confirmed Confirmed Co... Confirmed Confirmed 2.5a Retailc$25 Not Cover. Ded•70. Rot Covered Confirmed Confirmed I Confirmed Confirmed Conti.. Confirmed 2.5x Retuil=5755125 Not Cove. r:i1"-Ordder blaximem Soppy 90 day supply C3n10rned i Confirmed CoMm00 Confirm. 10 subset of generic drags ore available through rebid with a 93 day supply. jii.- '41141 Gallagher PublicEntity&Scholastic Group .• ••• . •••• •• .„....... a Division of Gallagher Benefit Services,Inc. ...., . -_ ' . 26 • Scenario A ® Fully-insured & Medicare Advantage No Medicare Advantage Implementation Medicare Advantage Implementation Scenario A-Current Premium Plans+High Deductible Plan Scenario A-Current Premium Plans+High Deductible Plan • United United Healthcare Healthcare Humana Aetna , CIGNA DIG Humana Aetna CIGNA Disqualified* Premium Premium Premium Premium Premium Premium Premium Tier Enrollees HMO HMO HMO HMO 1 Tier Enrollees HMO HMO HMO Premium HMO Employee Only 609 $671.55 $713.11 $1,077.24 $0.00 Employee Only 607 $687.82 $729.04 $954.25 5870.01 Employee+Family 467 $1,664.91 $1,854.09, $2,624.53 $0.00 Employee+Family 460 $1,705.22 $1,895.51 $2,337.91 $2,436.03 Annual Totals 1076 514,237,916 $15,601,728 $22,536.488 $0 Annual Totals 1073 $14,552,162 $15,917,164 $20,033,272 $19.968,481 Premium Premium Premium Premium Tier Enrollees PPo PPO PPO PPo - Premium Premium Premium Tier Enrollees PPO PPO PPO Premium PPO Employee Only 221 $1,343.85 $1,64583 $1,011.631 $0.06 Employee Only 84 51,376.40 $860.07 $903.81 $932.39 Employee+Family 116 $3,297.55 $4279.13 $2.478.491 $0.03 Employee+Family 30 $3,377.40 $2,236.17 $2,214.33 $2,610.69 Annual Totals 337 $8,165,951 $10,336,695 $6,141,8231 $0 Annual Totals 114 $2,586,388 $1,660,791 $1,697,128 $1.866,644 Tier Enrollees POS POS POS I POS Tier Enrollees POS POS POS POS Employee Only 27 $747.77 $1,302.13 $1,078.211 $0.00 Employee Only 12 5765.87 $880.12 $961.18 $1,024.09 Employee+Family 21 $1,855.71 $3,385.53 $2,641.631 $0.0') Employee+Family 10 51.900.65 $2,288.31 $2,354.88 $2,867.45 Annual Totals 48 $709,916 61,275,044 $1,015,0311 $0 Annual Totals 22 3328,491 $389,365 $408,789 $476,406 Tier Enrollees HOP HOP HDP HDP Tler Enrollees HDP HDP HDP HOP Employee Only 24 $561.73 $693.61 6642.741 $0.00 Employee Only 24 5575.33! $662.51 $584.56 $0.00 Employee-Family 191 $1,378.38 $1,803.38 $1,574.71; $0.03 Employee+Family I 19 51,411.75 $1,722.52 $1,432.18 $0.00 ! Annual Totals 43 $476,049 $610 930 $544 1431 $O .nnual Totals 43 $487.574 $583 537 $494 890 SO •eenar o A Annual 1,504 523,589,832 $27,824,397 530,237,485 SO `cenario A Annual 1,252 S17,954,616 $18,550,857 522,634,079 NIA •remium •remium *United Healthcare did not provide HDP rates cr___,.,..,� Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. I I '.....•..:: .' .` ..- 27.. • : 1 . : . Pan Designs - .1•1 Proposed HMO .. _ ___.... . ... , ... .,.„., am mrs .-- .. . _ , ' IMO Open Acta. °62't%'‘uirAraliZ133211' '■ 1122Wifgl ,alThfiewt. ncliceloansedurialioashomPropased . _ 'Venn Illeckno Benefit Mari. Cocarred • Ccallm. Catcrtmed Ceded 'Amnia Oeudble 5200 Conf.,. Confirmed Cu led Cortrrn. pirrE,Dartuctibla $600 Cordrired $OO Canaan. Caldera. Individual MariMUM Copayrrt eMsICoinsuramce E3.00E Cuirrel Gutman Conform Cardared Doers madmum CopaymentaCothsurance Corfirei exitance Crain. Cadman 'physician Mutat i5135800 r..ap‘''''",./ Cores. Ccranned Catarrn. Cortmed . ,a1M3110,,IZar , Conamed Canfimed :man. Ceram. indult En Cap, Calm. Crannind iXelrtned Calmed Mtn health SC CPO Calm. Cut.. Cortire. Caramel 0EUGY0 %Calmar Crafrtrai Unarmed Guam. Can.:len ilfertility Scram rTroarne nt Plain 0311550 Cam Confirmed FIRSPO 011 sent.and SerVICI hot Caumed Ccetrirel physical Therapy(60 Waits cort.Yes with Speech and Occupational The,) S•30 Copy Curameri tee.7.10 Cour, SSO a.pay excearned Speech'Therapy(ati vines con...25th Erhysical and Occupational Therapy) 330 Capay Cartrael Cad-S.10 Capay 350 Omar Cantina. pccupatlortm Therapy(Ge oat ined wee Physical and Spaeth Therapy) SA)CaPaa: Contares 1 Oed*S311CnortY E50 Caaay Carla. r.hiropoctic Services S30 Copay-25 Vats Cortarrel i Cod n Sin Capay SSO examf Cardainad Ialtorrty locum A 1're atment T 130150 Copay Outward Consumed Carligned Cm-tared pulp:Int Surrtcrathoraila or auratell eanfor) Dee nen SP% Classed ConlIrmee Creamed Cm:ranee •ray and Lab Outpatient•Phys.:an,OPice $30+550 Capes Cataract Curran. Con.. Conferned I $106 free stanch.Manly, IA:wanes Imaging(PET,MRS.trui.CAT) 5200 oupaSent faciily rt.tad to a hazard; Catered Ceram. Oedurtiale applies then plan prt7s EC% Caton. SODS ot)5alient hasirt.1 6merrtency Room:Hospital) (way.If arerara) • •We. $700 Com Cactra. Ca.. Cortamee VP, •Accidents $200 Copy 1 Coefued Wane Con.. Catfamee a inhuman t.Capay Cecina. COramet Codeeed Ceara. neglect Hospital Gad wS100(Spay a Says Cortimet Confurtioc Conrad MOAN s 5 Urram Care 1.54 Caper Cedoted Confirmed Cce&med SSOCuay lime Health Caro Ito C3f,a7 Cortmed Contrtmeo cutnrad CC7111. inn CPA, Cur mak=ii.upons come,kif DUE tom Chiral:ire Me dice,Equip. Ccetreal ConfIrmed Deduce.applies Inc plzri pais 5S%%chase of OGGE r,..ciree if Mum'th-la rent, I 5SY.-I00%corteurance. . . - •PhyeicJan S.,JratA PCP,SPC Calm. I Callraller. Cunamed Cut.. , •Hospital Dee•MO Cona,13 ea. Castralei COnfItrITEC ccerred surovra,;1 an...Manta:Mem. Oen•••MO Copay a 3 dar. Codrireci I Conarnee Ca:darted Vara:a ReSoonsc Outpatient Mani:Mem:Is $5D Cap Co.-an. I Centred PO Capra Confirm. npailect Substance Ahuse (led.1I00 Capay 13 dim Cutter. I CanGrtnec Dee-E17% 5332505 a 5 Outpatient Substance Alma S50 Copy Corlmed Conanned 030 Can. ecidemcd • •Generic $7 Copy Crafrterd I Confirmed 7 Curaman •Era. 540 Ccpay Ccantrrn. Corti-meal 7 Calmed •Hon-Preferred SEM CcsaY 3 Cc... I Confirmed y Cotarned Retail Maximum Guinthe 31.pray Ccrt trzed Confirmed 7 Corraned Prescription Cord Yes Confute 1 Carded ? Corlirmel lr=5,114INI.triaffitri • . • • ' •Generic Sid CPAY Carter. Corinned 7 Cortennel •Brand SEP UPI Csthtrel Conferred 7 Cert.. .Nan-Formulary I ,331,20..ic.g.., Oral.. Calmed 7 Cuff:men Mall-Order Maximum Spell, Catian,00 Coffman 7 Ort.13 •A:rasa of Franc truss aro available through real with a 90 day supply. LC-1—r2 Gallagher Public Entity&Scholastic Group -7:Z7 - • . .. . • . a Division of Gallaeer Benefit Servic ,Inc. ,: ----" . "I'••:" :.--','!' i i..'-'':::::::i.:'n':: :, -...:....:.:.-:., : --.:::: . . 28 , , . . , , ____ , _. ?Ilan Designs © B2 Proposed PPO . . GCOGIIID 1 date any careen Nam proposed plan -• - .. ••^ • ,) Indicate airy aev on from•poser:elan) .• • (e:= croc=a3 aDatatrO i Out-o3•Naa:076 ( .'i3 i 02d1=ra UDR= Out•ol•netmlr , • 0510C92.= madrn m Wetimo Benefit Urtnited Unfree. Confirmed Cn`aned Cgrea ed Coffee. Corenned Waned Urliniled Urine. ' Annual Deductible $750 91.000 Confrmed Danlnmd Coffered Co*7od Canned Conn:. $150 51.000 ' =amity Deductible 51.250 93,000 Careened Coffered Con07300 Coffered Confined Confirmed 12.250 53000 Indlvldual Maximumtr0-MFOdtet 55.000 110.001 Conferred Confirmed Caromed Caere. Cm*med 57370 _d 15000 510.000 =amity Maximum Omat-Poc0al 115000 910.000 Confined Confirmed Unfair. Confirmed ConDrred Ccnisn ea 515.050 330,000 Physician Of3c°Veit 535 Caper Ja0-60% Confined Cmirr t•d Conant. Caibneed Coffered Unmet: - 935 UM' 63%Cnrcur..rce Specialist Once Visit 550 Caney Ded-60% Cord.. Confirmed Conran. 0573 red Geffen. Codemed 350 Coney 60%CMnsorr en Adult SO CO»ey s ]ed.60°: Confirmed Concmetl Canlrmaed Con'arrr� Cor9red Caere. Confirmed Conan. Ctdm nat. 50 Copay 1 Dr.].1)0% Confirm. I C*7,70 Confirmed Con5recd Coffered Conned Confirmed I Consumed 00(050 r 50 Cray I Ded-60% Confined Careened Confirmed 50707 d Confirmed Confined Confirmed Conned ,der00h 50rvtcesfrreanenc Plans Not Covered I Not Covered Contrived Caermed Bared on seine and per. Base a on 00373 and.se0F0 05710077 Confirmed ,Confirmed Confirmed Phymai Tnarapy Dec.60sv • D.-00% Conned COKa,ed Corr.. - Confrm. Cahoon Cradrred 0075,300 55070.'0 Search Therapy Dee-80% Jot-60% Conferred Confirmed Confined 00000 d Confirmed Cartneed Conine. Confirm. :keuoa0onal Therny De,•83% I Dad.60% Coafemed Catvmed Conferred Coafeaed Conferred Conferred Cu60,00 Confined! Allergy Testiegb Trea:mam 935950 Copy I Dee•60% Confirmed Coldmved CorSrme0 (:v.0med Corimv:d Conferred Confirmed Conned Chiropractic Coo 935 Coma-255635 ; Ded.50% Conferred Confirmed Corder. Coen. Coffered Conn,. Catered Confined Outpatient Surgery(hcsphal f surgery rained 5200 Copap•Dee.f,0%! Deg-60% Confirmed Confirmed Contrived Gondar. Conferred Confirmed Confirmed Cons.. 0-ray and Lab Outpatient-Physicians 0:hce SJ.S%0 PCP15PC I De0-60% Coen. Confirmed Co00700 - Conferred Confirmed Centred Confirmed Consumed Advance • ET,1011.AMA,CAT) De0.6054 Ded.60% Co ne Cn m. CCadeve Cordoned Cordmmd Codoner Calmed Conmr ... , I .1000 s 1206 C:Pay men 60% Cordoned Cordoned Corfsmee Confer ed Codrm. --Ccrffined 5700 cepay then 100%52'0)copay urea 100°: •006700,s 5200 001oy berm 03%I �•�0 Confmue Confined Can.mec 00,0,ed Confirmed C nferned 5200 cedar Mon 100%SX13 ay:a7 then 1000 Ambulance Ded-63% Ded.60% Coolo,od Comae. Cn6rrec Co*NSed _ 500*ei Unturned Conferred Confirmed 03303001 HOSpi(7I 0°6.60% I Dad.60% Coafinted Confirmed Ca76ntoo Cca&rivd Confined Cer*nuad ...nee Confiner. Urgent Care 950 Coney CeO-00% CoM+me0 Confirmed Ctpenl 0 I Co:dm 0 Confirmed CooO0* Conned Ccnamed Home Heats Cara Od.80% I OM.60% Conned Conran. Confine, I Confirmed Conferred Geffen. Confirmed 5007,0,7 Durable Medical E.in•. Dee.807 i C Jed-60°: Conned Cor9med C_aDmed - CP,Smed Confined Confirmed Confirmed Confirmed iar:6J'- •Physician $35x550 PCPYSPC Ded-f0% Conferred Co e,Confined Confin 1 Gomm. Confined Confirmed Confirmed Cnnnrm0 •Hospile Ded-80% Ded,60% Coni n. Conferred Confirm. Conferee CooGme; Coffered Confined Confirmed neat*.ldanta611ervous Dee-0030 Ded.60% Confirm. Confirmed I Caen. Confirmed Confirmed Ccr1rnd Creamed ConNmsd Dulpatian77ema6Nareoua 550 Copay Ded-60% Confined Car0Smed Confer= Caerxd Confirmed Corder 0 Connect Co,Sln:od npaLpnl Semlerce Abuse Dad.B0% i Dad-60% Conrad. Corder. Contrmec Cnanrv0 Conife 0 Confined Confined C,nfemei UOpdent Substance Abase 950 Coed. I Dad.60% Cunfrm. Confirmed 50+1.0 e, I Coffered Conferred Coffered Confirmed Confirmed 'r'l..:r-1i.L•Dl:s�Tlia' 1-.-- - - _ ..- ` .__. ... _ _ enedc 110 Coady i Nor Covered Conned Confined Conine, I Conferee Confined Con.. Conferred Confine, Brand 350 UM 113 Covered Confirmed Confirmed Confirm°, f Cnfined Confirmed Conned Corhrmed Confirmed Non Preferred 975 Copy Nal Covered Confirmed Confirmed Confdm90 Conned _ Confirmed Conran. Confined Confirmed Reel Maximum Supply' 30 day supply Confirmed _— Confumvc Confirmed Conan. Prescd Up 2n 1er_ Yes 0016+00 - Confirm. Confirmed Conferred 0orumc 337 Crgtay ; Not Covered Conferred Confirmed Colin. Cortsrea Conferred Conk-mad Confined Can:env° Brand 9150 ! Nal Covered Confirmed Confirmed _ Confirm.. Confirmed Conformed Conned Confirmed Confined Nan Formulary 5225 Cuddy I Nol Centred Coined CoPfirMea Cofd:mec Comfe:rad Canfnnod _ CooOPmed 00000ed Corm. Clail.0,dcr Maximum 5u,pn6 50 day su7Cly Confined 065 nnrc Confirmed Conned 'A sues°(of 9en.e drugs aro available through read frith a 90 day auppty. . . .. .. . .. I . . . . ..`'—'---E4-- "a Gallagher Public Entity Scholastic Group a Division of Gallagher Benefit Services,inc. ::-. :i _,••..•.. . . . .. .. . . .. .. . . . . . . . :::. , -- - 11111111l. J111111111M1■111111■11■1111W._.A111111111■11111111■MIIIIII■WA11111111111 . , . ,. ,...... .., -* --, Ian Designs - B3 Proposed High leductible - • . .. . , . . . . . elm, _ _ _ -- -- - -. - . 1-8ncilcats may drottotrornproposed plan)j Mk..arly ileupro_p_cese_d plan) m8..ii.et_stearty devtatieposed pt..m)t (1.1 o any e.t.a from pLopo_s_art• . __- • —"----1Wkrn" '-.CMtft,--F razdia . cr_mat5A . uzz.o.:, --Tara= GA.611Mzfs.5 --Ozamil. i 02c925=a aaidmum Wane Benefit Uneted Ureipi. Confined ' Confirm. Cordoned Conferred Confirmed Confirmed Unfirited Denied 1 Annual Den.. 35.009 515.000 Coen:. Confirmed Cannel Confrn. Con.. , Confirmed 55.000 015.000 Family Deductible 1 sulano 5...,,,,, Conferee Corrilamen Conga. Conferee Cofforned Conferred 510.800 030.080 noisidual reasimum Out of Pocket 510.000 520.000 Confined ConAnneo Coogan. Conferred Coffer. Confined $10000 020500 family Mennen Oct.Peens 1 520.003 910.080 Confirmed Conferee Confrn. Conferred Coffin. Confirmed 090,000 500.000 -Thysioian Office Visit 1 425 Corey•fled then 70% Ded.91% Canfrmee Confirm. Ded•71% Coffered ., S35°vaulty Confirmed 535 50% _ Specialist Office VI. 1 255 Coon-Ded too 70, Dad•51), Condoned Corfamed 0.-03% Congo. S55 Coonoily Confirmed S55 , „..., . Adult 1 100% I 0..50% Cones. Confirmed Conferred Con.. Careened Conferred I Confirmed C551innea Mild health erGyN ',fertility Sersicosfrreatmem Plans .ysical Therm esich L r panne 1 1 100% MO% j Not Covered 1 fled•70% 1 Dee-70% 1 Cleo•70, 543%.ded vetoed Confined Confer. Ded..•5:. _ ,,,,.c.,..,,,Co:orrSzn,mrso,ned,d,d _ Confirm. Not Covered Ded•Sffit D.-50% Confer. Conlin. Conferee Confirm. Cm:Erred Coen. Contemn! Contra. Conferned Coffered Confer. Coffnred Contend Conferred Confer. ConOrred Confirmed Conned Cern. Waned Coffered Carden. Confinr. Conferred Confirmed Confirmed Centime Conn. Confirm. Conim. Conn. Corirmec CxtEmied Confirmed Cod.. Conn. Con.. Cookie. Canned Cnermed ,tri,-resting a Treatment J 000+10% Ded-.PA Cottoned Conlin. Contra. Cordoned Oordined Con.. Calm. Cos.. boaticni Surgery(bonnie or surgery center) 1 000.70% Ded•58% Caen. Confirmec Confer. Conferred Confirmed Confined Cordoned CoMertil X.er,and Lab 0 epabent•Physician's 0111cn 1 Der,70% Oed*50% Confer. Confine° Confirmed Confer. Conned Confined Confirmed Condoned IZIONZ=Mift1 -• • 1 - . . . , • •Illness i Dad 70, 000.70% Confirmed Conferrer: Conned Omen. Coninned DM•78% Del then 100% Dad Men 100% -Accidents 1 010-10% Dad•60% Conferred Confirm. Conn. Connor. Men. Confined Dad Men 100% D.P.in% ambulance i Oed•70, Dad•52% Confirmed Conan. Confer. Confirmed Conirmed Confirmed D.Men 500% Oct Mel loa% 'hr:, -AZzr:II - . - -. 1, , _ : 7 1 . • ursmc.0 l S50 Cony.Den-70% D.•01.% Conferred Confemeo Cod•70% Careen. Ded•70% gee-AY% 250 030% 50% Home Health Caro I Ded•10% D.•ffi, Catered Confirmed Coffer. Corder. Con.. Corder. Conned Conlin. .irrahle raselcal Enip. - Ded.70% Ded•50% _ Ces%ared Confined Contra. Cordrared Confirmed Confirmed Conned Cooffiree •,._ c.. .5 • • J. 1 •Physician i Dart.70% Del,911% Core. Confirmed Contented Cantered Conned I Conferred Confirmed Core.. •Hospital i Ded•10, Dad•R3% Confined C7•11.11ea Confinted Coffin. Confirmed COnfinrod Cor&med Cartono-d naive flentallNervon i 000-10% Dad•50% Conbantod Confined Confr.d Con.md Cowered ‘ Confer. Confirmed Calmed •it..agent Mernalalersous 1 Dad•70% Ded-519% Careened Combiner; Collin. Conerne Confirmed Confirmed Confined Confirmed riming Suntance Abuse i O.*017% 5015-50% Confirmed Con.. Confirmed Conferred Conferred Coon. Confirmed Coin. •titinint Substance Abuso 1 O.•75% Dad-&A Confirred Corifirn. Coen. Conran. Corrim-ed Confine. Conhrned Cont.. . •-.11.80•i t•mte J. .._ .. . lei ic I 000•10, Hot Covered Cor6rmed Condones Conferee Conferred Canine. Confirmed 555 Nat Canral gran I Ded•791: Helens. Cantned Onfrtmoo Coen. CCLIMPO1 Coffin. C0.1110d Catrrr. 57d8558 Intl 0000000 deli MUITIIM Soppy I XI day strop ,, COM,. 0:11,57C4 Cafferned Proscription Card ,t Yes Cenimied °Waned Coffered • scrittl04,13ffi••• t'l OAT - . .. • 'Doren Dee•70, Nal Caned Confined Confirm. Confer. Cordoned i Confined Confirmed ?Sc Reta3.025 100 00501.5 3rand 1 5,4.75% Hot Conrad Confer:Jed Coln. ... Cord:nee Conferred Confined Confined 2.5x RetaPS7S5125 Hot Cove. yail.Order!Annum Sunply I SO day=No Coffered Confined COnOmed Consorts I 1 'A subset of generic drugs are reattablo through retail ffith a 90 stay supply. Gallagher Public Entity&Scholastic Group :-..-.,-: .. ... ... . Division of Galla,r,her Bend:it Services,Inc. ,! -,.1.,..... ,....•., ::.:-• ,.....,•:: -.-:.:•.::•,1::::::: :....•:,...,... .....,:.„„ .- . . . . - -'• 30 Scenark =,'-'- © Fu lly insure , & Medicare Advantkeie � No Medicare Advantage Implementation Medicare Advantage Implementation l O°Proposed Cl3i13 > O'Proposed0, - United 1 United Healthcare Healthcare Humana Aetna CIGNA DTO Humana Aetna CIGNA Disqualified' Tier Enrollees HMO HMO HMO HMO Tier Enrollees HMO HMO HMO HMO Employee Only 609 $491.11 $696.33 $931.81 $0.00 Employee Only 607 $512.63 $716.18 6834.77 $870.01 Employee+Family 467 51,2177.56 $1,810.40 $2,282.92 $0.00 Employee+Family 466 51 270.911 $1,862.06 $2,045.18 $2.436.03 Annual Totals 1076 $10,412,238 $15,234,597 $19,603,151 $0.00 Annual Totals 1073 $10,845,7641 $15,636,313 $17,524,916 519,968,481 Tier Enrollees PPO PPO PPO PPO Tier Enrollees PPO PPO PPO PPO Employee Only 248 $1,040.73 $1,489.22 $826.43 $0.00 Employee Only 95 $1,086.331 $809.17 S741.54 5932.39 Employee+Family 137 $2,553.75 $3,871.98 $2,024.76 $0.00 Employee+Family 39 $2,665.651 62.103.85 $1,816.76 $2,610.69 Annual Totals 385 $7,304,771 $10,811,393 55,795.450 $0.00 Annual Totals 135 $2,503,815 $1.920,488 $1,797,798 $2,300,392 Tler Enrollees HDP HDP HDP HDP Tier Enrollees HDP HDP HDP HDP Employee Only 24 5572.78 $683.07 $644.13 $0.00 Employee Only 24 $597.88 $673.10 $584.14 $0.00 Employee+Family 19 $1,405.49 $1,783.78 $1,578.12 $0.00 Employee+Family 19 $1,467.07 $1,7505 $1,431.15 $0.00 Annual Totals 43 $485,412 $604,290 5545.321 $0.00 Annual Totals 43 $506,681 5592,864 5494,535 $0.00 QG`t t 1 103 j $26,650,280 $25,943,922 $0.00 fl - ;$13,856,260 {�L GM *United Healthcare did not provide HDP rates 6r c ��3 , .'?I' Gallagher Public Entity Scholastic Group ::.-... a Division of Gallagher Benefit --- 3eImiccs,Inc. .=: _ .. ...... .... 31. • • SELF-FUNDED MARKETING ANALYSIS SCENARIOS A & B Gallagher Public Entity&Scholastic Group Division of Gallagher Benefit Services,Inc. • • Plan Designs and Methodoogy • Generally, all carriers can administer the requested plan designs under Scenarios A& B on a self-funded basis - There is no risk transfer and the plans do not have to be registered with the State as there is no insurance component . - Scenario B will produce significant savings as compared to current benefits and Scenario A • Reinsurance quotes were solicited to protect the City in the event of catastrophic large claimants and overall poor aggregate claims experience • Administrative Services Only (ASO) quotes were solicited to ensure competitiveness within the marketplace • Medical claims projections were prepared using GBS proprietary database of carrier discounts based upon geographic area, previous claims experience, plan designs valued (A or B), and enrollment assumptiong • The following slides will present projected financial results with and without Medicare Advantage implementation ti Group 06-2÷-,,,06-2÷-,,, Gallaga her Public Entity&Scholastic G o p a Division of Gallagher Benefit Services Inc. 33 1 Ems_ , , _ . ______ _ . _, gf.Funded Administrative Services Fees , ASO Fee Proposal without Medicare Advantage Implementation I ASO Fee Proposal without Medicare Advantage Implementation 1 Humana 1 Aetna' CIGNA' United Healthcare Humana Aetna' ' CIGNA' United Healthcare 'Enrolled Subscribers: 1504 1,504 1,504 1,504 Enrolled Subscrribers: 1,252 1,252 1,252 1.252 Per Subscriber Per Subscribe' Per Subscriber Per Subscriber Per Per Subscriber Per Subscriber Per Subscriber Per Subscriber Per 'Administrative Fee Administrative Fun Per Month Per Month Per Month Month Per Month Per Month Per Month Month !Core Services I $33.31 S42.98 $13.89 540.45 .Core Services $33.31 $39.09 $15.32 837.99 ;Case Management $0.00 $0.00 $0.00 $0.00 Case Management $0.00 90.02 $0.00 $0.00 Disease Management $0.001 $0.00 $5.25 $2.46 Disease Management $0.00 $0.00 $5.25 $2.46 'Behavioral Health $1211 $0.00 $0.00 $0.00 Eehavioral Health $1.21 $0.05 $0.00 50.00 Network Access $4.621 $0.00 $15.56 $0.00 etwerkAccess $4.62 $0.001 $15.86 50.00• Onsite Representative! $0.00 $0.00 $0.00 $0.00 mite Representative $0.00 $0.00 $0.00 $0.05 1Concieme Services ,_,onerce Services !CBS Consulting Fee $10.00 510.00 $10.00 $10.00 -BS Consulting Fee $11.72 $11.72 $11.72 $11.72 Subtotal AdminIstrative Fees: $49.14 S52.96 $45.00 $52.91 Subtotal Administrative Fees: $50.86 $50.81 $48.15 $52.17 Per Subscribed Per Subscriber Per Subscriber Per Subscriber Per Per Subscriber Per Subscriberl Per Subscriber Per Subscriber Per Optional Services Optional Services i Per Month Per Month Per Month Month Op Per Month Per Mont Per Month Month 'COBRA Administrat'on $0.50 Based on Not Included $0.00 COBRA Adminishaton $0.50 Based oo1 h' Net Included $0.00 Occurrence Occmen HIPA4 Compliance(as $0.25 $0.00 $0.00 $0.00 }IIPA4 Compliance(as $0.25 $0.001 $0.00 50.00 applicable) appficab'e) 2417 Nurse Line $0.45 Included Included . $0.79 24/7 Nurse Line $0.45 Included Irduded $0.79 ■ $20,000 Fee $20,000 fee Conversion Fee $0.00 $250 Per Policy Charged at Time $0.00 Conversion Fee $0.00 $250 Per Policy Charged at time of $0.00 of Conversion I Conversio Subtotal Optional Services $1.201 $0.00 $0.00 $0.79 Subtotal Optional Services $126 $0.00 $0.00 $0.79 Total Per Subscriber $50.34 $52.98 $45.00 $53.70 Total Per Subscriber $52.06 $50.81 $48.15 $52.96 Per Month Per Month Total Annual Total Annual Administrative Cost $908,536 $956,183 $812,160 $969,178 Administrative Cost $781,941 $763,1661 $723,213 $795,459 'It shculd be noted that Aetna and Cigna provided quotes that do not include some optional services which will affect the overall administrative fee when added Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. - -- - -. - -j - -- , , . . , _ . Reinsurance Quotes (Specific & Aggregate Stop Loss) . . .. Stop Loss Fee Proposal without Medicare Advantage Implementation Stop Loss Fee Proposal with Medicare Advantage Implementation $230,000 SSL Deductible,1011113 Effective Date,PAID in 12 Month Contract $230,000 SSL Deductible,1011113 Effective Date,PAID in 12 Month Contract i United United Symetra Aetna Cigna Humana I Healthcare I Symetra Aetna Cigna Humana Healthcare. Individual Stop Loss Enrollees Rate Rate Rate Rate Rate IlndividualStopLoss Enrollees Rate Rate Rate Rate Rate PEPM(subscriber) 1,504 057.73 $53.86 $57.44 $66.72 $39.25 PEPM(subsaiber) 1,252 S62.87 $58.13 $48.45 566.72 S39.25 I Annual Totals 1,5041 $1,041,911 $972,06 $1,036,677 $1,204,163 $708,384 Annual Totals 1,252 $944,307 8673,113 $727,719 $1,002,134 $589535 Aggregate Stop Aggregate Stop Loss Enrollees Rate Rate Rate Rate Rate Loss Enrollees Rate Rate Rate Rate Rate PEPM(subscriber) 1,504 $4.28 $6.55 $7.67 $3.78 $5.43 PEPM(subscriber) 1,252 $4.28 $7.30 $7.97 $3.78 $5.41 Annual Totals I 1,504 $77,245 $118214 $138,428 $68,221 $97,459 Annual Totals 1,252 $64,286 5109,6461 $119,709 $56,776 $81,258 120%Corridor Requested I 120%Corridor Requested Attachment Factor,Enrollees Rate Rate Rate Rate Rate Attachment Factor Enrollees Rate Rate Rate Rate Rate PEPM(subscriaer) 1,504 $1,268.74 $1,245.1 $1,513.61 81,385.36 01,066.29 PEPM(subsciber) 1.252 $1,326.17 $1,125.35 S1,387.86 01.063.82 S1,067.82 Annual Totals ( 1,504 522,898,220 $22,471, $27,317,633 $25,002,977 $19,244,402 Annua,Totals 1252 $19,949,113 $16,902,757 520.845,657 $15978,576 516.038,656 Total Reinsurance Premium $1,119,156 $1,090,280 $1,175,105 $1,272,384 $005,843 Total Reinsurance Premium $1,008,593 S982,759 $847,428 $1,058,910 $670,793 Total Claims Liability$22,898,220 $22,471,926 $27,317,633 $25,002,977 $19,244,402 Total Claims Liability$19,949,113 $16,902,757 $20,845,657 $15,970,576 S16,038,656 GGallagher Public Entity&Scholastic Group a Division or Gallagher Benefit Services,Inc. i Reinsurance Terms & Caveats I Symetra Aetna Cigna Humana United Healthcare Contract Term 24/12 24/12 15/12 24/12 12/12 Deductible $230,000 $225,000 $230,000 $230,000 $230.000 Aggregate Corridor 20% 20% 20% 20% 25% No,pending review of Lasering No No No No the Stop Loss Disclosure Form i Incurred by a covered 1 person who is disabled Actively At Work! Waived Waived Waived on the effective date Waived unless disclosed to us prior to the effective date. Enrollment Change% 15% 15% 10% 10%! 10% Lifetime Maximum Unlimited Unlimited Not Specified Unlimited! Unlimited • Reinsurance terms are just as important as the premium rates to which they are attached • Cigna and United Healthcare were unable to comply with the RFP requested terms and conditions • Humana was the most expensive reinsurance carrier to quote the terms and conditions requested • Symetra and Aetna matched the terms and conditions and are within$25k-$29k in price differential • Symetra is the incumbent reinsurer,understands the risk,and has always paid reinsurance claims promptly • When switching reinsurance carriers,careful consideration should be given to all aspects of reinsurance terms, conditions,rates,and history �'" Gallagher Public Entity&Scholastic Group . a Division of Gallagher Benefit Services,Inc. ` `.::. .... ...,. . ;:. : : i _..• • • PHARMACY (SELFFUNDED MARKETING ANALYSIS • Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. • MIL Pharmacy Marketing Methodology • Gallagher Benefit Services partners with a firm,Truveris, Inc.,to perform many self-funded pharmacy benefit manager('PBM")'/administrator(°PBA")marketing's • Truveris systems incorporates three positive tools that previously had been difficult to obtain through the traditional PBM arrangements - The PBM/PBA vendors must agree to the contractual terms and provisions during the RFP process or explicitly disagree with them-this allows the vendor's response to become the contract if awarded the bid - The PBM/PBA must agree with full transparency which is also called a`Retail Pass Through" arrangement-this ensures that the self-funded health plan will receive the best possible ingredient cost without excess margins built into prescription drug expense - Truveris then scores the PBM/PBA vendors based upon the criteria mentioned above and after selection, monitors the selected vendor on a monthly basis to ensure the contractual terms are being met • Self-funded pharmacy vendors have been.queried for pricing with and without Medicare Advantage implementation(post-65 retiree exclusion) • The following slides are a high level projection over a 3 year period with scoring based on qualitative as well as quantitative analysis pervendor • The full analysis is being provided under separate cover and will be referenced in this discussion as disruption and formulary related to pharmacy expense are also important aspects when selecting a PBM/PBA • The vendor with the highest overall score was PCA Pharmacy based out of Louisville,KY etp, Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. - °_ 38 • P '' I PBA Ana'ysis ® Total Popu'ation . t ea. _ :id Quality Scorn 140 121 97 112 126 : 102 128 ':id Financial Score 481 433 414 361 110 488 388 lo Savings 8.90% 5.97% 6.27% 4.84% 0.79% 9.94% 5.55% ruBid Total Score 621 524 511 473 236 590 516 ,maectal Simms '2) . .-. - _.— !ngredient Cost I $15,740.756 614.491,036 515,572,064 $15,303.361 $15,193.753 615,646.591 014,615,693 ri17,777r iiispensing Fee $259.600 $204,818 $153,237 $146,034 $196,826 5244,281 $168,582 i 5204.290 unrg Spend $16,000,357 $14,695,825 , $15,725,301 $15,449,395 615,390,579 615.890,872 $14,784,275 1 $14,948,477 •dmin Fees 60.00 $278,772 SO $0 $349,740 6203.688 SO 6308.414 !Rebates ($4334,643) ($794,681) (51,088,113) (5860.053) /6927.512) _ ($651,567) I ($765,873) ($555,076) rojected Bid Cost $15,505,713 $14,179,916 $14,637,188 $14,569,342 $14,812,807 $15,442,873 _$14,018,401 $14.701,816 Projected Current Plan Cost NIA, $15.565,713 515,565.713 $15,5555,713 $15.565,713 $15,565,713 $15,565,713 $15.565.713 Savinns 6$ N/A1 $1,385,797 $928,526 $976,372 $752,906 I S122,841 51,547,312 $663,898 5pternentation Allowance N/A $10,030 $144,000 $105,000 $45,000 $5,658 $12,000 $0 °erformance Guarantee Risk N/A $75,000 $150,000 $525,000 $32,000 $50.922 $0 $33,000 Offer made by PBA1 to Plan Sponsor are accepted as contract commitments. Accept Accept Decline Accept Accept Accept ! Accept Claim Adjudication Rate definition. Accept Accept Accept Decline Accept Decline Accept Manufacturer Derived Revenue definition Accept Accept ' • Decline Accept Accept i Decline Accept P6pensed as Written or'DAW definition including DAW impact to Drug t i lassificalion. Accept Decline Decline Accept Decline iAccept Accept •BM shall provide Plan Data to Plan Sponsor or Plan Sponsors vendors upon •nest at no additional charge. Accept Accept Accept Accept Accept Decline Accept n redient Cost Discount Guarantee claim inclusions and exclusions i Accept Accept Accept Decline Accept ! Accept Apt 1 BM shall work in good faith to resolve invoice disputes within thirty(30)days. i Accept Accept Decline Decline Accept Accept Axe_pt I lulti-Source Generics Generic Generic Generic Generic Generic Generic Generic .ingle-Source Generics' Generic 1 Generic Generic Generic Generic I Brand Brand ulli-Source Brands(Non-Innovator) i Brand Brand Brand Brand Brand Brand Brand dulti-Source Brands(Innovator) 1 Brand Brand Brand I Brand Brand Brand Brand .i le-Source Brands Brand Brand Brand 1 Brand Brand Brand Brand inimurn Manufacturers for Multi-Source Generics I I No No No j No : No No Yes/2 �r<T 3° •. -- �; Gallagher Public Entity&Scholastic Group .::.-:::::•: :::• ��_ �� a Division of Gallagher Bona r Services,Inc. • , M / PBA Analysis — Excludes Post-65 Retirees • . . 1,1111111111111111111111111111111111FAtract 11111111NA MEM Aetna 1lMIMP3,Illrqltcarcl UBD 111 1M Bic Quality Score 140 121 97 112 126 102 128 Bid Financial Score 460 380 386 I 290 20 488 310 "Yo Savings . 8.33% 5.35% 5.50% I 2.88% .1.58% 10.06% 3.42% TruBid Total Score 600 501 483 402 146 590 438 M1Ml.surr,a, .vOrtilliii=111111.10.111.11111111111NIMMilliMilliMiinliiiiiiMMENIII Ingredient Cost 1122= 510.586 175 11.330.482 I 611 176 011 $11.138 096 511.577 574 510 585,506 510,843,932 .p.sensinq Fee 6172.542 5137.755 5100.696 I $97,095 $130,806 $163,019 $112,304 $135,059 D09g_S:pend $11,619,618 $10,723,930 $11,431.178 1 911.273,105 $11,268,902 $11,740,594 $10,697,810 510,998.992 "Mimi Fees $C 5185,400 $0 I $0 $279,279 $203,688 SO $308.414 'Rebates 15289.920). ($523,113) (5797,065) I (5566.944) ($615,246) i$435,126) (5507.810) ($365,319) Projected Bid Ccst $11,329,698 $10.386,217 910,724,114 910,706,162 $11,003,396 $11,509,155 $10,190,000 $10,942,087 Projected Current Plan Cost NIA $11,329.698 011,329,698 911.329,698 I $11.329.698 $11.329,698 $11,329,698 $11,329,698 Savii,___Igs$0 N/A. $943,481 5605 584. 5623,536 $326 302 /0179 457 91,139,698 V87 611 motementation Allowance . . , N/A $10,000 S144.000 $105 000 $45 000 $5 658 512 000 SO •erformance Guarantee Risk nib 575,000 $150,000 S525,000 $32,000 $50.922 50 533,000 RIYrT,er".rigr(EMMIIIIIIIIIIIMIIIIIIIIIIIIIIIMMMIIIIIINIIIII.MMIMIOMIIIIIMIIIIIIIIIIIINIMIIIIII otter made bv PBM to Plan Sponsor are accepted as contract commitments. MINIIIIMMIIIIIII=1111 Decline Acce.t Acce.t Acce..t Acce.t !aim Acfudicahon Rate definition. 11111/132=1 Acce t Acce.t Decline Accept Decline Accept vlanufacturer Derived Revenue definition IMIIIMMIIIIIMMINI Decline Acce I Acce. Decline Acce.t I ispensed as Written or"DAW'definition including DAW impact to Drug lassification. Accept Decline Decline Accept Decline Accept Accept l BM shall provide Plan Data to Plan Sponsor or Plan Sponsors vendors upon le nest at no additional cha.e. Acce t Accent Acce.t .Acc•.t Acce.t Decline _help 1 ncredient Cost Discount Guarantee claim inclusions and exclusions I Accept Accept Accept Decline. Accept Accept Accept POM shall work in.00d faith to resolve invoice disiutes within thi 30)de' . Ace:t Acce.t Decline Decline Acc•.1 Acce.t Acce.t 15rrrailifica•on Multi-Source Generics Generic • Generic Generic Generic Generic Generic Generic Single-Source Generics • Generic Generic Generic Generic Generic Brand Brand Multi-Source Brands(Non-Innovator) Brand Brand Brand I Brand Brand Brand Brand ivlultl-Source Brands(Innovator) Brand 8-and Brand I Brand Brand Brand Brand Single-Source Brands i Brand Brand Brand I Brand I Brand Brand Brand Minimum Manufacturers for Multi-Source Generics I No Na No I No I No I Na Yesi2 a"T'A Gallagher Public Entity&Scholastic Group ::::.:::::- , g7 a Division of Gallagher Benefit Services,Inc. ii i H..":. .. :-:• ::•:.:.: i: :::: ;:..:,i.–.,:ii:i,,i: >:--:.: •••:.:.- ,....:::: _ —- 40 - . — PLACEHOLDER TO REVIEW TRUVERSFULLANALYSIS Gallagher Public Entity&Scholastic Group ...-...-.: • a Division of Gallagher Benefit Services,Inc. OVERALL FINANCIAL SUMMARY Ga"•111° Gallagher Public Entity&Scholastic Grou p a Division of Gallagher Benefit Services,Inc. — — — — — 42 , . , " . .. Fina - ci& Summary ® Scenario A • Scenario A _ ull-Insured wlo Medicare Advanta•a Humana Aetna Cigna - United Healthcare Health Plan Premium $23,583832 $27,824,397 $30237,485 Declined to Quote Current Funding $17.581,907 517.531,907 $17,581,307 Not Applicable ;$increase/Decrease 66,007 925 510,242,490 312,555.578 Not Appfx.-cbte %increaselDecrease 34.2% 58.3% 72.0% Not A.rlicable Fully-Insured of Medicare Advantage Humana Aetna Cigna United Healthcare Health Plan Premium $17,954,516 518,550,857 $22,534,079 Disqualified`; Medicare Advantage Premium" $2,549,0 51 903,763 51,959.316 Not Applicable Total Expense 320,503.704 S20,454.620 524,603,394 Not Applicable Expected Funding with MA Implementatlon2 $16,002,4031 315,357,078 615,422,631 Not Applicable N IncreaselDecnease $4 501 300 $5,097 542 SS 180.763 Not A..11cable %increase/Decrease 28.1% 33.2% 59.5% Not A..irable Self•Fundedwlodde dicare Advantage Humana Aetna Cigna United Healthcare Projected Medical Claims, $14,390.011 $14,717,62 $14,720,890 515,371,937 Projected Pharmacy Claims, I $4,877,053 $4,677,a 34,817,693 S4,877,693 Administration(Disease Management, $908,536 5956,18 $812,160 $969,178 .2elnsurance•Specific 4Aggregates $1,119156 $1,119,15 $1,119,156 51,119,15E otal Estimated Self-Funded Ex.-nse S21,295.396 $21.670655 $21.529,4 6- $22 337,964 urrent Funding 517 581,907 517 531 907 '.17.501,90 317 581 907 :Increase/Decrease $3,713,489 54,088,748 $3,947,99 $4,756,0571 '4 Increase/Decrease 21.1% 23.3% 22.5% 27.1% Sell•Fundedvd-Medicare Advantage Humana Aetna Cigna United Healthcare , jero cted Medical Claims, MI111111111111MEM 513,745.5281 513,859,745 $14,472 707 Projected Pharmacy Claims, $3,516,407 $3,516,407 03,516,407 03,516,407 AdministratiovDtsease Management, 5781,941 . $763,1661 572321 5795.450 Reinsurance-Specifiic8Aggregate° $1,008,593 51,008,593111 51,008,593 $1,008,593 Medicare Aovantage Premium' .2 549 088 51 903 7631 01 969 31• S1627,792 Total Estimated Self-Funded Expense $21,201.24 520,940,458 921,077,274 $21,420,959 Expected Funding with MA Implemenrationd $16,002,4031 $15,357,0781 $15,422,631 515081,108 $InaeaselDecrease 35.198,838j $5,583,3791 55,654.643 $6,339,851 %Increase/Decrease 32.5%1 38.4%1 36.7% 42.0% 1385 claims projection based upon a proprietary discount database and adjusted for the proposed plan designs ?Current funding with MA implementation removes post-65 heath plan contributions and adds back in the total cost of IetA premium 'Assumes PCA in awarded pharmacy benefit management 'Assumes Symetra continues to provide reinsurance coverage =United Healthcare did not quote fully-insured without MA and did not submit a HDP plan with MA implementation 'MA premium differs per carrier as each quote has different benefit levels:all carriers quoted varying degrees of different plan type ?Administrative/Disease Management expenses vary per carrier in terms of services proposed:please review the ASO exhibit for the detail Gli&# Gallagher Public Entity&Scholastic Group ...,.....,. a Division of Gallagher Benefit Services,Inc. ,,•::•••- '`''' - -_.. __ ,___• • i I . —-,-- - — --.-----— ... _ _ • _ ______. . . , Rnaiciag Summary ® Scenario !le . _ ... ....._____ . .• . _ _ . . ... _.,.......... .. ........... . .... Full-insuredwL9589trJ'dvanlaga Humana Aetna Cline UnllediHeaithcare Health Plan Pr m',um $18,2024211 526,650,28' 525.9439221 Declined to Quote anent Fundir. '17811.851' $17.811,_8511 $17,811.3511 Not Applicable Increase/Decrease $3905711 $8838,430 $8,132,0721 Not Applicable 1,IncreaselD°Crease 2.2%1: 49.6% 45.7%1 Not Appirable FugvInsured-wfiMledicateAdvatjtam• Humana Aetna Cigna Unked!Heakhcare ealth Plan Premium $13.856,260 518 149,66• 519.727,2481 D:•ualified .edicare Advents a Premium6 '.1 571.135 Si 903 763 $:.969.3151 Not A plp irable eta!Expense 515,427.396 520.053,42 $21,695564 Not Applicable xpe•3ed Funding.vilh fv1A ph 515,254.395 515.808,4901 515.874,0431 Not Applicable Increase/Decrease 5173.0011 $4,244,938 55,822,5211 Not Applicable .Increase'Decrwse 1.1% 26.9%. 36.7% Not Applicable $eff-FundednvtoMgedtcargAdvan:•e /jtyf$r] t - n 1 Prcjected Medical Claims, 311,604.2321 511.903,811 $11,9382531 $12,466,236 Fwd Pharmacy Clain-s= $3,636,651j 53.638,651 $3,636,6511 53.636.651 Administration vDiseaseManagemenl' $908,535 $956,183 $612,1601 5969.178 Reinsurance-Spe ffic&Aggregete5 91,119.1561 $1,119156 51.119,156 91,119.156 Tate!Estimated Sell-Funded Expense $17,268570 517,615,802 517506,2231 $18,191,222 Current Funding_ 517,581,9071 317,581,907 $17581,9071 517,581,907 S Increase/Decrease -5313.3311 $33,895 $75.6841 3609,315 %Ircrease!Dersease I -1.8% 0.2% -0.4% 3.5% Self-fu d'd,wt Medicare Advents re ffinaCtip Zan • (its Mtilacfaeso •rolectsd Medical Clainr* $10,826,595 $11,182,423 $11,297,395 $11,797,034 •rcjected Pharmacy Claims, $2,607,1301 52.637,130 32,607,1301 52.607,130 Admin'sbafon/DiseaseManagementr $781.9411 $753,166 $723.2131 $795,4`` Reinsurance-Specific&Aggregate' $1.008.5931 $1,008,593 $1008,5931 $1,008,5931 AledicareAdvantage Premium', $'x,571,135 $1,903,763 31,969,31661 51.627.79 Tot!Estimated Self-Funded Expense $16,795,39i $17,465,075 617,605,647 - $17.836 009 Expected Funding with MA lmpiementation' 615.024.4511 515,357,078 $15,422,631 $15,081,108 $Inaease7Deaease 51.770,9441 $2.107,997 32,183,015 52.754.901 °%Increase/Decrease I 11.8% 13.7% 14.2%1 18.3% 1GBS dams protection based upon a proprietary discount database and adjusted for the proposed plan designs ,Current funding with MA implementation removes post-65 health plan contributions and adds back in the total cost of MA premium ,Assumes PCA is awarded pharmacy benefit management ',Assumes Symetra continues to provide reinsurance coverage `United Heathcere did not quote fully-Insured without MA end did not submit a HDP plan with MA implementation `MA premium differs per carrier as each quote has different benefit levels;all carriers queid varying degrees of different plan type 'Administrative/Disease Management expenses vary per carrier in terms of services proposed;please review the.ASO exhibit for the detail '*.`� Gallagher Public Entity&Scholastic Group .......... a Division of Gallagher Benefit Services,Inc. .•, ; • 44 = — — — — . . . • Claim I''unout Scenarios Runout Ex.enses—All Vendors—Scenarios A or B _ Fully-lnsuredwlo Medicare.Advantage' • _ . .. = Humana. - _ -Aetna' . - . •..Cigna... : United Healthcare If-Funded Runout Claims estimate t $1,295.477 $125,477; $1 295 477 Not Applicable Self-Funded Runout Administration(estimate), $103,638 1103,6381 $103,63. _- Not Applicable alai Runout E••nse $1,399,115 $1,399,11.51 $1,399115 Not A.•licable FullY-lnsured wl-Medicare Advantage- Humana _ Aet na _ .,- Cigna-_ United Healthcare Self-Funded Runout Claims(estimate)' $1 295,477 $1,295,477 $1,295,4771 Not Applicable Self-Funded Runout Administration(estimate)' $103,638 $103 6, $103,638 Not Applicable r otal Runout Ex.ense $1,399,115 $1,399,115 $1399,115 Not A..licable Self-Fundedwlo:Medicare,.Advantage._...->—.__- •i •,_ -,Humana :.; .- Aetna r . . . -Cigna: - United Healthcare, ;Self-Funded Runout Claims(estimate), $0.001 $0.00 50.00 $0,001 (Self-Funded Runout Administration(estimate), $0.00! $0.00 $0.00 $0.00! Total Runoul Ex.ense . $0.00 $0.00 $0.00 $0.001 Self-Funded•WI MedicareAdvantage. -._ ,,_ . _ •Humana - Aetna ;,' :..,Cigna a .United?Healthcare , 1Post-65 Runout Claims&Administration3 $316,305 $316,305 $316,305 $316;3051 'Reserve amounts for self-funded runout claims are estimated to be$1.4 million induding administration in the event a fully-insured and/or MA plan is selected 'It is understood that runout claims would be paid through Reserves already held by the City in a separate account and should not be a significant deterrent to selecting die best option for the City ?If the City continues to self-fund the health plan without MA implementation,there will be no runout claims as the claims projection is mature nlf the City implements MA but continues to self-fund the active and pre-65 population,runout claims are estimated to be$320k et Gallagher Public Entity&Scholastic Group a Division of CallaglIer Benefit Services,Inc. 45 101111111... . , EAP MARKETING ANALYSIS • Gash. Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. E: r: ;:..::• ,:•-: • 4• _ ._ ___ __ ___ ___ ___. . . ._ - ___ 1 EAt' Premium Rates . . EAP Fee Proposals United Humana Aetna Cigna Ulliance Healthcare Total EmployeeslRetirees: 2,209 2,209 2:209 2,209 2,209 EAP Fee(PEPM): , Core Services $1.50; $1.70 $1.68 $1.18 $2.50 Subtotal: . $39,762; $45,064 $44,533 $31,279 $66,270 Optional Services(PEPM): Telephonic Worklile $0.00 $0.25 $0.00 $0.00 $0.00 Enhanced Legal&Financial Services $0.00 $0.00 $0.00 $0.05 $0.00 Enhanced Concierge Planning Services $0.00 $0.00 $0.00 $0.80 $0.00 I Subtotal: $0 $6,627 • $0 $22,532 $0 Total $39,762 $51,691 $44,533 $53,811 $66,270 61) Gallagher Public Entity&Scholastic Group • a Division of Gallagher Benefit Services,Inc. . .. . : :: .. .._..... . — — —— --- 47 • — - ______ • •_•_, _____ , EAP Benefits Summary Humana Aetna CIGNA Ull lance United Healthcare Phone Counseling: r417 access to telephonic services.Unlimited telephonic We offer telephonic Included;Up to 5 assessment or problem resolution Unlimited Tcti-free aorxws to masters-level Employee • ag errant con sulation for referrals into the EAP consultation and refer to an sessions per member per problem Assisrence Spedafsts 365 days a year . .rkplace issues as well as consultation on critical EAP provider. ncidents and any other organizational issues that might . • -rise. Face-to-Face Counseling i natal assessment and snort-term counseling for up to 5 We are offering our 5 session Included;Up to 5 assessment or problem resolution 1 to 5 visits or Resolution Face-to-Fate Counseling-3 sessions per incident, essions per problem per year for employees and their model sessions per member per problem model with flexible number per year.(optional buy up apron of 5,7 and 10 ..ependenM for marital,family,Mk,and other of visits session models) . ounseting issues EAP Resolution% i or the entire book of bushess,resolution within EAP Our resolution rare for a 5 Our EAP resolution rate is 89.04 percent. 94% 50%10 70%depending on session model—are able' tout additional referral nuts 01 63%.Please note that session model is 61%. to corrrpiete meatmentelhin the EA?yahoo!having is includes a large percentage af business where the to use the employers bdImicral health benefit) ! P serves as an assessment and referral hi/lotion Whin Humana's own medical plan book of business. • Rate Guarantee -t.50 PENA.Rates are proposed for 24 months with an 3 years rare have proposed a 24-monor rate guarantee. I I year 1 year .ptional extension for 12 months at the same fees On Site Intervention p lo 8 on-site hours included with acditional hours '/Ve are offering unlimited --ritical Incidents Response services;included in COMgs Includel5 hours annually Proactive preparative services as well as on-site -yailable loran additional fee. CISD's up to 20 hours per annual bank of Employer Service Hours(10 hours per 1,000 for Critical Incident Stress services to support individuals and organizations , incident arnployees of Employer Servioes per year or 22 actual hoursbebriefmg s [through times of disaster.6 hours combined )or 2.209 employees).Should additional hours be needed, ,training/CISM hours ff less than 1000 eu's and 9 pre can make arrangements on a fee-for-service basis hours'1000 ee's if greater than10C0 era's. Utitization Reports ., Provided Annual,/ We are offering quarterly Included;Quarterly Quarterly with on-site blooded ttilltilzatlon tepees rtediew and analysis 1 Promotional Materials Includes brochures.wallet cards,and posters,in We are offering at! Included Brochures,wallet cards. Included lectronic format for production and distribution by the promotional mated&at no posters and work/Gre , .. . stonier,explaining the program and how to access it, extra cost. . materials nd providing guidance on common issues _ Orientation Meetings .Aonthly trakiing webinars and up to 8 hairs onsite Vie are offering orientation Included In COMB's annual bank of Employer Service Hours Include 20 hours on-site Included .rientation,raining,and CISD hours are included. meetings al no exisa cost. (10 hours per 1,000 employees of Employer Services per annually •dcltional hours are available at$250 per hour. year or 22 actual hours for 2.200 employees).Should additional hours be needed,vre can make arrangements on a lee-farservicebesis. Additional Resources ubstance abuse professional referrals are avai-E'tbie for Vie are oftenng our websie Access re community resources Website Free telephonic consultation and&smelted rates for 700 aer case;intemet site with behavioral health loots and telephonic worklife. iway.lifeadvisoreapcom ongoing services by a national netsork of over =.resources;telephonic consultation.resource 22,000 attorneys.Free telephonic consulting end denlificalion,and web access to work-lifu services for . referrals by quatilled and experienced financial •ltd and elder-care counseling,legal and financial consultants.Referrals to community agen aim of ••nsulretion. childcare centers,eldercare fact6ties,schools, summer camps,adoption rescue:es,and pet care • tools.Orientation.health fair,and open enrollment meeting participation to pub:joke the EAP and I encourage utilization Account Management I ocal account management team will support the City in.tiVe will offer a designated Included.Dedicated account management Assigned Account integrated account managemthit solution with onjuriction with CAP sentes and support Account Manager locally, Managers,2407 medical plan administrator consultations Locations I ocal PAP affiliates wit be available. e use a virtual model for the Eden Praire,Minnesota Corp.headquarters in Troy, National Flattest response. efichigan and office in N. Carolina . . . , . .. . • -•, '• 48 ' _ • • WELLNESS ANALYSIS Based upon the numerous and varied responses received for Wellness Plan program administration,GBS would recommend exploring all available options after the selection of funding arrangement,health plan redesign,and any post-65 retiree solution that is chosen for implementation. Many Wellness vendors price their services on a participating basis while others charge a per head amount on the entire population regardless of services utilized. A thorough discussion of what the City can implement,hopes to obtain,and can commit to in regards a Wellness Program should take place. Wellness Program solutions designed to improve the health of an employee population are only as successful as the commitment the organization makes from the top down to manage the Program and mandate participation. st Gallagher Public Entity&Scholastic Group a Division of Gallagher benefit Services,Inc. �......_ _ _........ • f MINK ..a. .Im.E.,... Imi.m.n____A...■••••.I.N .N.L._..Am.I Proposed Wellness Benefits and Cost lfurdadr 7_7-:..Y Aetna 77"""''�''°,. � _ ,_... • em CAe :"'T�. �..0li y."'7 ;2013: .b..2,01 'I7."A T,,_a'2li1 -".'�-:.'- 1o177:7:ai .rar:7n,i.:2014..�r7 '772031 ,..$7M7 ..20fi=Mil,- r o, fir., 0403 0-, Net vep;cade Na amt.. S0.24 $024 , 32.^p.Scable. Not makable NA 3023 40.00 te04•54 Fees Not amicable Not••xade 50.24 50.24 i Neg54030 at Renewal lot apple., NA G A) 5000 M 0".4- ".24 . 005024440450 50.09 $0.00 �t ,..r' -•0- C Not A .e..<. �+++f►mac-a-_• ..,.rsr er.r,:.. _ •>•e Fee 54.40 PEPN RTBD etrenevia 50,25 5025 Not4555043 TBD at renewel 5310)4re4 53100.Yeati 53100ineS, 0022 5022 Per Person saeang cat$42 SandaN Healy He Not Included in •irr�aic Saeeratg9 Nd irca list 50.23 5024 S�PP 560 PP 550 LO 550.00 SaeeOCng;as.Erpaded Heat,Heat,Saerdn0 w.,,ess prC6r3 erarted m Al in W O.m bade -leafs Rtsk Assessm:n s fl-tRA'st a0dldad In Ora fee 50.27 5014 i Included in base medial fee dal Irdcdad I 'rdvtlad 50.50 50.00 ie50.Fairs Not 844.04423 Ka app&ade 50.24 5024 j No Aoolienao. Na asstenb0e .•4750 per043+tm0(0 amen) S220ps env'Yevel(I Feta.) 0000 T0D Inrhdad in cue Clam otters 3r.SS P'u Ma programs Base-51.25 lndecevo Admbusbalas �:v.'W ed In base ko :0.24 f0 23 :PEPSI Value-57.45 PEPSI.and Engage•$1.95 Pent I"-"...in ba;e tee Admin.tttlu'tad N'ldn.kGided 10.24 511,^5 i 516&00 per PFPY a S14P"�Cl 01 $750,00 per PPPY a S14 PEPe.7 Or 100%0 BTS Fees eft Rdk 40044 EH 2000 d EN's Fees el R:4 where EH 7lYt(State d aims PiPki D u a l Not Appdrable. f r o n t s en a asa does pogrom era hails wan amid the august and 50.23 20.00 he program is pad by a pagan is pad tY non-partcy and darn wags.orly 4,e 4s d, and can ea'r 4C.only if reaircd •',4•n •:t e.;lr. _ _ .. ,• .. -.A.. .. -. w_ �y._tF,-}.,s"r •i - - , r '�.s[Y Ni'.w..M:•.•.R�,'s _ • .�-'-a:r s. •jleciede0-Standard oralsmacfi0tg;Also agno Heal" Ind hasa tateps es Weight losCS24=Weigel Maumee.Is one o Yard toss•Nuetaa tee 00 4 in base fee 50.25 50.25 De LOestye Na�ment Pro2aets that ae'olccded (sated in base fee Yes Yes 51.46 PEP00 51.50 PEIRS ( esthOgna 4aacvrel A9r5age wldcb is pat of tee I AS0 and inaaed prosesta. Viking t m ease 4rhded In brio leo SO.23 5025 I See Yladitg FYagam d6.$baba IrS5.9ed m base fee Yes i Yes S0.00 5000 ItrApd -5Sadad ease mar:heig;Alm 5aeng0 a IncilCSd v Dose Resame2:4 u Sus GGaugeamm is one d 203 54 s:Rear.. 'tCWed M base Re $0.25 S0,25 U�gte Rimmed.Prowess Was ate IMWed ai0 0454451 in ham fee Yes Yes I 50.70 W00 fee C;g a 24043408...ago wt.,is pat at Pc ASO ( sad'nasal p+@e... I i C,4te Qd Tarta19=Tohaw Cess8Sml d Indsded as Stroking CessaSon dtd d m oau Included In toe fee 5025 5025 I ore N In Ilesl)ie NataSerlent Pre-rare Ott are Ir�05ied m base fee Yes Yes 50.00 50.00 tee j'v¢0ded v(Y. &h�rva AA..,;,mhci h part 1 d the ASO and holed preposa45. c3.y�ra J'Ys4Y0 l"'od m arse haNbd_M M base 4e 50.25 5025 245434-)35038 ontlbe...hag inc.5 is l ae tee Y. Yes 40A5 S0 c0 fee hrchffid h base Your NeaPt First (5525 PEN/is masted m out 4379;Coating(ore-ana) nCue^_S in hue tee 50.25 50.25 Ip04445*Qgna 0050103 Your 00445 Fill)W(59.32 InCtted in�;e fee 5+440447 West.. Qaalarly.g 40445 50.2) 50.03 I ) Pe person fee ltmsbo5c Syndrome Improver.10• j ueek P.a.-5450 wedna,or USG cane.Seninars 2000(Stale 5 skins PEPSI cost) I are 5432555 in netraar.`orret as ae0 provided c0ent !eluded above mckded abate 00:3) 50.00 Flash vers47n 100 software Rat fee of 5325 per o.- l ham swim Gat,;), Gallagher Public Entity&Scholastic Group .. a Division of Gallagher Benefit Services,Inc. Proposed Wellness Benefits and Cost ..nif',--i-ri--;.--.1.,-.',-.e-.,--. - - - liaprina -- ' -— Aetna - ' - - -.• gm ct•.•...,.._ -_ .,. j.-..2 1 _1 _.}(114.----.-:FQ.V_ ?9j4 :- 01 101- .. .', _ _1o14. . ,. ._,._.:,.,_z-o03.....,.:,...,_f.,.'..-_-__.:......-26-4_,-.2_.:::._:.71:',Af----•'-,. I 05 1W I 1 1,Par person lee-Weigld Management 12-nank I 1 ...fig P.P.-1250 pa pun.,20 parson rriricant 35 person mime Weigle ass•Neten 1.i..i.4 mk,,,,,,,,, ,,,, i so.2, X.a rP-er1"s2,o1n4.210.p4e-4r..1,r1r1i4a.t4n11ia.4,9 35 l''d'.23.. Open toescussion or eiteg.attn nen Onsn to deri.sion cr knew afion sin 20 00 ;mason raeatern .iallae-Scrrilar 51 p.algal.ahr 10 5322525 W one-hour seminar Flat lea-Corne.ne F..,5.26001.5 reek 1 Inclutted in 123e =Oren padatetrs.addilonal.cloned indiii„,in bnze i,n Open to.ussion or'rev..Oh Open to deem-fon Or Migration vale ,,.. .V ykin, InClaclerl In Ease t.e 10.21 , 10.25 cal order fatality end ant.Procaam Is mina tor 3rd p.y 3rd pally steps tatithe b14 p32&1851132 walk onsie P21 person.Snook co....a9 p1051051-2085 Per P.son,20 per.nine...30 poison Waded le Ease ir,„,,,,,int...in Om to discussion or Integra.vat Open.discussion or integra1on ittri aon Stu=Red.lion Incl.d In hie lee SUS VI 21 inarrnam $0,02. lee Sod party Sod parly Rat leo-Sentra teats nobble also b S325 Kir one hca screw PE,perste]lee-5-ateaouchlig program-S105 Sect,.Comalon in''''Inctuied io bac lee 10.21 0025 per person.20 putt=roiriniw,35 person bele.in Case Ice S'''''''' ''''i''''''''''W.'CV"W''' '''''' in.'el.'"'''''' SD 00 ED.OL to 3rd party 3n1 Duty maw. P.-person Ice-4.ett coact.Kowa.1140 per person,20 per...min 35 pers.. Incl.5 in base Open In discussion or ategrafton ant Op..dscirtion or Wear..nib Physical fickle Included En boss leo 10.21 10.25 11-.2f111M; Included.base fee 13 00 .500:: he 3rd party d Pan,' Fla lee-Seminar lo.es a.5able alto for S325 par 0501050 11005 A Cam O...Cm,.Wale.°Coordinator Ind .b.a Dr1-50 Cocain. .. irir.bderi ine stin ,,, can be arced.at a cost ci$124.021114.1.frst Included in b.,ie. Open.discussion Open to discussion 12 00 50.00 fee `-' yeiT rib a.1%esc..3r0r.ke io ris I:,eoth year bared.. 1.Per person le.Prebypin.lson 5-enek 5545159I351-01 per person,22500001 rriakrallTE 35 person rmararrun 2 Per parson leo-Cho.s1.445-vred coacting Mier Sine a Zee PENA co. p.c.,5155 par peSen_2pon ri...h 35 5060 10.00 person inaserern 1 Po per.fee tietabok Syndrome InixoveMerl 10-weel.PrOgrair,5475 onsite 4.One.riene heath coacttng,S535 lal fee per km tota alma reNinni.,, Wormy.dilinlai he.35051355 5144100 uarterly arO Annual PaCicipaton&ROI th'bd" I''' Inctaied in base lee 0224 1024 panitipaos reports vent.. b....$325 513 Included Mcbdod 20.51 3000 .1 lee ROI is not amiable at Iles time Ad noc Report:, S150 per hum 5150 per noir 5024 1124 ''''rePar"'''._$'??°_Ph'$175''''''''add'fi'' $150 per tour Included Inc.. 00.00 00.00 nein 4,MT... G-,- Gallagher Public Entity&Scholastic Group ... n . . . . ... .. . ....... ........ .... .... .... .......... .. . a Division of Gallagher Benefit Services,Inc. . .......... .. .. .... . • .....•:•:: -..-.,:' •...• -••••••• ••, •••• •- •"•:•••'"' • • - 51 1 • • NEXT STEPS? • Gallagher Public Entity&Scholastic Group . a Division of GallaAer Benefit Services Inc ° ' • .2 o Questions / Clarifications / Questions I Scorgs • GBS is prepared to do the following at the BAC's direction: - Clarify any RFP responses that require it - Request any additional information and/or submit additional questions to the RFP respondents as directed - Score the RFP responses based on the parameters in the RFP or parameters set by the SAC - Assist in the presentation of findings and results to City management, an Insurance Committee, etc... - Re-open the bidding if it is determined that other quotes are necessary in order to make a decision - Anything else material to decision making regarding the City's health plan redesign ear. Gallagher Public Entity&Scholastic Group a Division of Gallagher BeneIit Services,Inc. ;" _.._ .�. —.....__._....... ... 53.. • • APPENDIX Gar, Gallagher Public Entity&Scholastic Group 5*. a Division of Gallagher Benefit Services,Inc. 54) „ _ ________ _ Contingencies & Exclusions ® Fully-insured • Humana There were no pricing assumptions,caveats limitations or exclusions included in their proposal. Aetna Underwriting Assumptions and Caveats Participation Requirement-There is a minimum requirement at 250 enrolled employees for administration of the proposed self-funded plan.However,any Performance Guarantee c contingent epergne total number of covered lives (i.e.,the total number of City of Miami Beach employees enrolled for coverage)set out in our proposal. This proposal assumes your plan is not grandfathered. As a non-grandfathered plan,the plan will include Preventive care as defined by regulation without cost sharing on In Network services. Aetna reserves the right to modify its products,services,rates and fees,in response to legislation,regulation or requests of government authorities resulting in changes to plan benefits and to recoup arty material fees,costs,assessmens. or taxes due to changes is the law even it no benefit or plan changes are mandated. Fee Guarantee-We have provided a fee guarantee for each of the first three contract years from October 1,2013 through September 1,2014 for the sell-funded coverages included in the proposal-The mature fees are guaranteed according to the par-employee,per month fees as Illustrated on the financial exhibit(s). 1.11 for any product: There Is a 15%decrease In the number of employees in aggregate horn our enrollment assumptions or from any subsequently reset enrollment assumptions. a.The member-to-employee ratio inaeasan by more than 15%.We have assumed a rnenrber-to- employee ratio of: 1.95 for Aetna Select Open Acs 1.75 for Choice POS II 7.If City Cl Miami Beach places the products and services included in this multi-year fee guarantee cultic bid,then this guarantee will be nullified. Specialty Pharmaceutical Rebates-We will retain(as compensation for our efforts in administering the Preferred Specialty Pharmaceutical Program)at specialty pharmaceutical rebates eamed on drug claims that we administer and pay through the medical benefit rather than the pharmacy'benefiL Pharmacy Prescription Drug Benefits A.service fee of 0.65%was Included on the proposed rates for the active only proposal as well as for the active with retiree proposal. • .�irie°so Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. :. Contingencies & Exclusions o Fully-insured Cigna Proposal Caveats Cigna HealthCare may revise or withdraw this Proposal 1.There is a change to the ellective date of the quote. 7.Less hart 200 employees or less than 70%of total eligible employees enroll in the Plan. 3.Enrollment incr eases or decreases by 10%or more,by product or for the total acceunt,from the enrollment assumptions used in establishing the rates andior fees set forth herein. 15.Administration of the Plan will require mom than the following: Billing lines:80 Billing and Claim Branch Benefit Opines:40 B.Scope and Application of this Proposal 3.Includes capitated charges for behavioral care services arranged by Cigna Behavioral Health,Inc.However,this may not apply in certain stales. 4.Includes copiloted charges for the provision of Hi-Tech Radiology services by MedSolulions,Inc.However,this may not apply in certain states. 10.Includes a maximum reimbursable charge for out-of-network coverage equal b 110%of a fee schedule developed by Cigna HealthCare based upon a methodology sunder to that used by Medicare lo determine the allowable fee for similar services in the geographic market OR 80th percentile of charges made by providers of such service or supply in the geographic area where the service is received. 14.Limits the total amount payable by Cigna HealthCare for raaure to meet tha performance commitments of the Perlsmrance Guarantees to$101,555.53. t Gallagher Public Entity&Scholastic Group • a Division of Gallagher Benefit Services Inc. Co & Exclusions. - ASO •., Humana Humana reserves the right to change the quoted coverage terms,rateslteoltactors or withdraw quote it; Employer contributions for all the Out time employees is less than 50%of the conventional equivalent singly rate Both Administration and Stop Loss coverage(s)are nor awarded to Humana Less than 75%of all etigthte employees are enrolled,excluding employees who have waived cover-4e for another group plan(will aceept down to 50%,assuming the difference between to%and 75%is due Is spousal waivers) A signed Disclosure Statement and Application are not received within 30 days prier to the effective date. In addition to the quoted administration fee,Humana or a designated vendor,will bill the dent group separately for the following services: For printingfmaitstg SPDs,If requested as follows: a.Print and patch mail to client at$4.00 per SPD',or b.Print and mail to an employee's home at$5.00 per SPD'. 'The price quoted is for Humana printed SPDs and is subject to change due to increased costs in materials,postagelshgrping special mailing instructions,anti any special printing needs being requested For additional interlace expenses associated with external vendors as follows: a.for any data feed to a non-Humana vendor(s),such as Dental or Vision cerrier(s),or HSAIHRAIFSA Administrators b.if Humana provides COBRA notification arid oiling services c.for any data feed to a non-Humana vendor(s),such as a Stop Loss carrier or Pharmacy Benefit Manager. 11 Humana is chosen to administer RX,an additbra1$3.17 PEPM credit will be applied to the Administration Fee and the 50.15 RX Data fod change will be removed.Total credit will be 53.32 PEPM. External appeal expense incurred by the oendorwiti be billed bade to the group alms!.A 550 administration fee by Humana wig also apply. Humana's administration fee do not include the administration of dairos incurred prior to the effective date of this quote. Humana'sadministrative quote assumes an average number of billing units(separate bits for geographic,employee class,divisions,etc.).Fcrgroups requiring greater than five self-billed units,additional fees may apply. Aetna This proposal assumes your plan is not grandfathered. As a non-grandfatbered plan,the plan wilt Include Preventive care as defined by regulation without cost sharing on In Netvorir services. Aetna reserves the right to modify Its products,service,and rates,and to recoup any costs,taxes.fees,en assessments,in response to legislation,regulation or requosls of government authorities. 3.The member-ta-ernployee ratio increases by more than 15%.We have assumed a member-to-employee ratio of: 1.61 for Managed Choice POS 1.98 for Health PJehoortc Only 1.47 for Managed Choice POS Open Access 1.75 for Health Savings Account Managed Choice Open Access 4.At least 75%of the employees in the United States who are eligible to participate in any of the employers cmprehensive medical plans will participate,or at least 50%cutter.adjusting for those enrolled in a spouse's comprehensive plan. 10.If maximum account structure exceeds 60 units per product Maximum total amount structure includes ERGS,conocls,suffixes,biting ant claim accounts. • Gallagher Public Entity&Scholastic Group • a Division of Gallagher Benefit Services,!nc. ---- —— 57 Contingencies & Exclusions - ASO Cigna A.General Terms of this Proposal Cigna Health Care is pleased to present this Proposal for an Administrative Services Only gmup medical phamteq and behavioral health benefit plan(the'Plan')sponsored by City of Miami Beach.This proposal is vot:d for 120 days from Its original dale of release,0311512013.Any revisions orupdatesto this proposal will not renew this valid timeframe unless expressly communicated by Cigna HealthCare. Proposal Caveas Cigna Healthcare may revise or withdraw this Proposal If: 1.There is a change to the effective date of the quote. 5..Less Than 200 employees or less than 70%cf total eligible employees enroll in the Plan. 6.Enrollment increases or decreases by 10%or more,by product or for the total aoxtrnt from the enmtlment assumptions used in establishing the rates anchor lees set forth herein. 13 Its requested to provide optional services beyond those ruled here as being included in the quote:none specified 14.Administration of the Plan will require more than the following: Bitting tines:80 Billing and Claim Branch Benefit Options:40 19.The number of Covered Persons for Stop Loss coverage,in total or in any covered plan,at the beginning of he policy year or at any time during the policy year differs more than 10%from the original estimated enrollment B.Scope and Application of this Proposal Unless otherwise indicated.this Proposal: • 7.Does not apply to part-time or seasonal employees for arty plan. 8.Indudes the Network Savings Program(NSP)and other Cost Containment programs designed to contain costs with respect to charges for health cam services/supplies that are covered by the Flan.For administering these programs, Cigna retains a portion of the savings or recoveries generated. 10.Includes a maximum reimbursable charge for ou Wf-nehvork coverage equal to 110%of a fee schedule developed by Cigna HealtrCare based upon a methodology similar to that used by Medicare to dofnemine the allowable fee for similar services in the geographic market OR 80th percentile of charges made by providers of such service or supply in the geographic area where the service's received. 13.Guarantees the second and third year ASO fees as outlined on the ASO Fees exhibit. All guarantees are subject to a0 other:errns and cenditions included in this document 15.Limits the total amount payable by Cigna HealthCare for failure to meet he performance commitments of the Performance Guarantees to$101,555.53. United Healthcare The quote is based on the following assumptions.Changes to these assumptions may moult in an adjustment to the rates or revocation of the quote.Please refer to the Financial Commentary for further assumptions. `` Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. 8.8. Contingencies & Exclusions- Stop Loss Symetra Contingencies Plan Document(if plan changes are implemented) Paid and large claim experience Una June 2013. Exclusions and Limitations Have been excluded under the terms described in the Excess Less Alternate Reimbursement Endorsement. 1 Symetra wit rot reimburse the Panic/paring E mployer for Covered Expenses incurred by Covered Units or Covered Parrely tints that qualify as Patens!Large Glares.unless dedased and accepted by Symeta. In the event of nondisclosure by the Partiapating Employer.Symetra reserves the right to: Symetra will net reimburse any loss or expense caused by.or resulting from any of the following: Expenses for occupational acddents or illnesses or expenses that the Employee Benefit Plan covers that are covered or eOgtble for Brae by YverWs Compensation,including any payments made by Workers Compensation carrier as exception or payment with no liability concerting ing Workers Compensation coverage; Symetra will not reimburse any expenses that are: Surcharges made on a per Covered Unit or Covered Family Unit basis;or Penalties or fines assessed by a state against the Participating Employer. Aetna Contract/Policy Period:12 months—10/01/2013 to 09/30/2014 Eligibility—Elgfotity will apply to active,permanent full-time employees working in the U.S.,as well as to theirdependens.It edt also aptly to COBRA continues and those who are entitled to extended benefits under the plan felbwing termination.For Slop Loss,eligibitlty aopies to active,permanent full-time employees who are working at least 20 hours per week on a regular sdieduled bast. Quote options with total lives of 1539 include Retirees under and over age 65. Quote options with total lives of 1279 exclude post 65 Retirees. 24112-Run-in ex claims incurred in the 12 months prior to the effective date and paid during the first Sa1p Loss policy period are included under the Slop Loss coverage.Run-in claims most be reported to Aetna no later than 0 months after the end of the First Policy Year. Underwriting Rules—Our standard AAW/DNC Rules are waived or the effective date. Preexisting Conditions Exclusion-the preexisting conditions rule has been waived for existing particlpanrs and new entrants after the effective date. This proposal is preliminary.In order to provide you a final,firm proposal,we will need the following updatud information no later than 15 days prior to the effective date: Large claim intonation for the last 12 months within 120 days prior to the etf°dive date,including diagnosis for all individuals with claims for the 12-month period in excess o150 percent of the ISL. Additional information may be required to validate this information. Updated monthly claims on a tufting 12-month basis with corresponding exposures up to 120 days prior to the effective date. We reserve the right to amend or withdraw our proposal to reflect the underwriting impact of any additional information we obtain or in the event you are unable to provide on any of the information we need to fully underwrite the risk. We agree to offer a no laser contract.Please be aware that we will need to evaluate large claims though May 2013 tc confirm there are no ongoing large claimants. Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. • [ : t • • • • _ _ _ Contingencies & Exclusions- Stop Loss Cigna Cigna HeallhCare may revise or withdraw this Proposal if: Less than 200 employees or lees than 70%of total eligible employees enroll in the Plan. Enrollment increases or decreases by 10%or more,by product or for the total account,from the enrollment assumptions used in establishing the rates and/or fees set forth herein. Administration of the Plan will require more than the fallowing: lliflurg lines:60 Billing and Claim Branch Benefit Options:30 The number of Covered Persons for Stop Loss coverage,in total or in any covered plan,at the beginning of the policy year or at any time during the policy year differs more than 10%from the original estimated enrollment There are charges in the benefit plan,or the addition or termination of a subsrctiary,operation or class of employees,not otherwise accounted for during the Stop Loss underwriting process. •Scope and Application of this Proposal •Includes capitated charges for behavioral care services arranged.by Cigna Behavioral Health,Inc.However,this may not apply in certain states. •Includes capitated charges for the provision of Hi-Tech Radiology services by h?edSoluions.Inc.However,this may not apply in certain states. •Excludes charges for converting a qualified member of a group plan to an individual plan. •Includes a maximum reimbursable charge for out-of-network coverage equal to 110%of a fee schedule developed by Cigna HealthCare based upon a methodology similar to that used by Medicare to determine the allowable fee for similar services in the geographic market OR 00111 perconble of charges made by providers of such service or supply In the geographic area where the service is received. •Requires you notify us within 30 days if any information set forth In this form changes at any lime while coverage is provided to you by Cigna HeatthCare. •Does no:include administration ol'run our claims incurred priori()the effective date. •Limits the total amount payable by Cigna Healthcare for failure to meet the performance commitments of the Performance Guarantees to$101,555.53. •Contains a stop loss rate that will be adjusted by a savings amount of 50.75 PEPM it both the in2riive-basal Cigna HealthCaro Healthy Pregnancy,Healthy Babies program and Cigna Hea CsCare Comprehensive Onctogy program are elected in conjunction with Cigna HeallhCare Stop L oss. •Includes the provision of HIM Certificates of Creditable Coverage to rrrsrnbers.If you choose to cpt-out of this serrice,$.15 per employee per month will be deducted from your fees and you will be responsible for mis function which s required under federal law. Humana Humana will not waive the actively at work provisions within the step Ices quote. Rendered on received outside_the United Staffs,except as defined by the underlying plan for emergency Treatments Such emergency treatmenrs are boiled to$250.000(U.S.)per individual under the stop loss coverage.) The external stop loss interface is a monthly special bill.The charge is dependent upon whether the external stop loss cornier is preferred or non-preferred vender.For preferred stop loss carrier the monthly fee is 0750,and the non- Preferred Slop;loss carriers the monthly fee is S1,OUL Please contact your sales representative for your stop loss carders classification. • et. Gallagher Public Entity&Scholastic Group ... a Division of Gallaher Benefit Services,Inc. - ; l •g - • Contingencies & Exclusions- Stop Loss United Healthcare Pricing Assumptions—Stop Loss Our quotation is based on new dales of loss and claims with dates of se sites on or after the effective date of 8/1/2013. City of Miami Beach contributes a minimum of 759 toward the employee only costs and 50%toward the dependent costs. Individual Stop Loss The Actively-at-Won;provision may be waived,subject tc disclosure of losses for claims paid by the prior carrier that exceed one hall of the Individual Stop Loss deductible to UoitedHeatthcare.Th's Disclosure Statement may be completed no earlier Than 30 days peon to the effective date and no later than 15 days after the effective date.UnitedHeallhcare reserves the right to set separate individual Stop loss Risk Levels or exclude specific individuals from coverage based upon the Disclosure Statement(a sample of the Disclosure Form is provided as a separate tab). Pre-Existing condition limitations will not apply to employees covered under the current plan. Paid claim accumulations are based on issued claim drafts. Releees are excluded from the Individual Ploy 1-C.5,i Coverage.Medicare eligible retirees are excluded from the Individual Stoo Less Coverage. Monthly Acommodatien is not included in=quote. • Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. :: Contingencies & Exclusions ® Medicare Advantage Humana This proposal assumes at members are retired and enrolled in Medicare Part A and Part B. These rates are based on the assumption there is no secondary plan wrapping around Humana's Medicare Employer Medical or Rx Plan. This proposal is based on a minimum Employer contribution to premium of 26%. The rates are contingent upon the retiree residing in the service areas of the quoted Medicare Advantage(MA)plan. Humana requires a minimum of 10 enrolled members per standard product offering to renew an E mployer. Humana requires a minimum of 100 enrolled members per custom product offering to renew an Employer Sponsored plan. II the enrolled membership differs Imm the pricing census by more than 10%,Humana rsetves the right to review and change the pricing if necessary. GENERAL LIMITATIONS AND EXCLUSIONS OF MEDICAL BENEFITS Your benefits do not indude the following,except as otherwise noted: Abortions,except in cases of rape,incest or for life-endangering medical reasons. Acupuncture Orthopedic and therapeutic shoes,except if they are part of a leg brace or am for individuals with severe diabetic toot disease.Orthotics and custom-fitted inserts in stores are not covered unless they are for individuals with severe diabetic foot disease. Plastic,cosmetic,or reconstructive surgery,except when medically necessary as the result of an injury or tumor.Such surgery will also be covered if an objective physical impairment is present which is defined as a direct measurable reduction of physical performance of an organ or body part The presence of a psychological condition wtl not entitle you to coverage for plastic,cosmetic.or reconstructive surgery unless al other conditions are met Breast reconstruction is only covered following a mastectomy. Surgical real nest of morbid obesity.except when determined medically necessary. Rating Assumptions and Stipulations-HMO In the event that the effective date is Outten 10A112013-12/3112013,the rates are subject to duange. Humana reserves the right to change the rates and benefits 90 calendar days alter 0311112013. This proposal assumes all members am relined and enrolled in Medicare Part A and Pad B. This proposal is based on a minimum Employer contribution to premium of 26%. The quoted rates are based on the Humana fotA plan being the only option for Medicare eligible retirees. If the erected membership differs from the pricing census by more than 10%,Humana reserves the right to review and change the pricing if necessary. Members cannot purchase an individual POP with the use of this product yGallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. _ __ 62 Contingencies & Exclusions ® Medicare Advantage Aetna The rates illustrated are an average of the retiree population and where they currently We. Employer contribution requirements—This offering assumes a minimum empleyercontribution level of 50%of the group premium for the medical and pharmacy plan.If the actual employer contribution differs from this assumed percentage,the medical and/or pharmacy rates are subject to revision. Rate and benefit approval—This proposal is subject to the Centers for Medicare and Medicaid Services(CMS)renewal and approval oldie plans'current or pending Medicare Advantage and Medicare presaipton drug contracts. applications and service areas for calendar year 2013.Filed benefits(including copayment arnounta),value-added services and premiums are subject to CMS and state aplgovat(s),where applicable,and are effective January 1,2013 through December 31,2013. We request that City of Miami Beach provide as with open enmtlrrrent materials including employee contribution rates for all plan options,eligibility definitions for all plans(retiree,part-limo employees),and plan designs for all sites where our insured product is offered. Conclusion Aetna presents This proposal on the condition that it will be accepted in its entirety.Furthermore,Aetna has assumed that all other coverages,products,and services currently purchased by City of Miami Beach will continue to be offered. Should there bee material change in this regard,Aetna reserves the right to review and reprice this proposal If City of Miami Beach is interested in the subset of our proposal,then Aetna will gladly review and reprice,It necessary.Prior to accepting the rates in this proposal,City of Miami Beach shall notify us of any material deviation,current ee expected,Isom these assumptions. • • • eau Eri Gallagher Public Entity&Scholastic Group a Division of Gallagher Eenefir Services,Inc. • Contingencies & Exclusions EAP • Humana General The services start an the first day of October 2013 and rates are proposed for 24 months with an optional extension far 12 months at the same fee. • Fees are net of any commission payable to broker,consultant,or other third party. EAP Services provided in these fees include: 2417 access to telephonic services Substance abuse professional referrals are available for$700 per case. Internet site with behavioral health tools and re sources Aetna Ail employees,dependents and immediate household members are eligible for services 36 month rate guarantee from case effective daze Rates are dependent on employee population within 20%(4)of that quoted Cigna Financial Assumptions Effective January t,2014. Rates guaranteed for24 months. Wellness Seminars or Managament Ttninings:$255 per orate hour. Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. ;s • contingencies & Exclusions ® Wellness Humana The Wellness(Structured Web&Telephonic Health Coaching),integrated Chronic Condition Management and Maternity programs are required with HumanaVilality is purchased. The HumanaVitality rewards payment of$121 P•APM is an estimate.Actual rewards payment will be calculated monthly based on actual results. HumanaVitality is ado avalable for your employees who waive medcal coverage.The Hunonavhality PMPM Administration Fee is the same Ion your waived employees as(was)quoted for your covered employees and wll be billed separately. The waiver population must follow and purchase same program opiiorts as medical population. • The Wellness(Structured Web&Telephonic Health Coaching)program Is required when HumanaVilality is purchased. Aetna The Wellness fee proposal sheet lists'All services to be funded by Aetra Health Designs'.Please help us understand whether each specific service will be provided and xnfirm that this will occur under all funding arrangements(ASO,luily- insured,Medicare Advantage).Also,while it is understood that Agra will fund the Wellness program,we still require our fee sheet in written arm electronic format indicating the cost of the services to be borne by Aetna.Please submit written and electronic documents with this information Included. Aetna has partnered with Health Designs and has agreed to compensate them for the services outlined in our proposaL It d impossible to determine what the exact fees will be for the Health Design portion,as it depends on the actual participation within the programs. For example we have agreed to pay an incentive for participation in HRA and Biomelric screening.Each of these programs has a separate$50 allowance for participation.The estimated cost for these programs is$200,000.00.• These programs are ASO.fully-insured,Medicare. Engagement Health Per-Participant Pricing Option Flexmle Incentive Design:The Per Participant Pricing Option provides complete flexibility when it domes to incentive designs.We work with client management to design program incentives that are best suited to company culture,plan design,and budget Incentive Funding:Any client that elects to use a non-participant surcharge as a program incentive will keep the fug amount of this surcharge,which wit otlset the cost of Inc EngagementHealth program. Screenings:The per participant screening cost includes time and travel Minimum Wong of 30 screening participants per location per screening event Incentive-Funded Pricing Options Non-Participant Funding:Health plan participants who elect not to participate in the wellness program or who fail to comply with the requirements of the program pay a monthly non-participant penally of$40.00 to$60.00.This penally,up to the predetermined Total Fee Limit,is passed along to EngagementHealth on order to fund the wellness program. Total Fee Limt:The Total Fee Limit is calculated by multiplying the initial number of program participants by$315.Based on preliminary intonation.Fee Limit and Cant program components are not determined until after completion of a formal Information Request and receipt of an Eligibility File. Success Fee:The difference between the Fee Limit and Non-Participant Fending may be earned be EngagementHeahh only by delivering actual claims savings.Otherwise.Engagemen',Heal h collects no additional fees.Historically. clients using the model have saved an average of mere than 5600 per covered employee. Minimum Requirements:This funding option is available only to companies that have at least 200 adult medical plan participants and that offer the EngagemevtHealth program to both employees and spouses. Screenings:Time and travel included.Up to 90 participants per screening event Additional screenings for$60 per participant with minimum billing of 30 screening participants per location per screening event. wrr. 1-**, Gallagher Public Entity&Scholastic Group ......... a Division of Gallagher Benefit Services,Inc. - — �...—__...._..._..._..—_ -- - ..-. —...... 65 • r! P iI 11 _ . Disclaimer This proposal analysis is an outline of the coverages proposed by the carriers based upon the information provided by your company. It does not include all the terms, coverages, exclusions, limitations, and conditions of the actual contract language, and does not include all of the details in the RFPs. See the policies, contract and RFPs for the actual language. This proposal analysis is not a contract and offers no contractual obligation on behalf of GBS. Policy forms for your reference will be made available upon request. 4110 Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. __...._.._....._ ... ..... • Thank you Gallagher Benefit Services, Inc. 2255 Glades Road, Suite 400E Boca Raton, FL 33445 (561) 995-6706 (Direct) (561) 995-6708 (Fax) k Gallagher Public Entity&Scholastic Group :. a Division of Gallagher Benefit Services,Inc. .. Cit.i of Miami Beach . ,-_, , 7,...,..,„.,:.. .,, . , _ i X11 o o\:\ - -J p Analysis to ,-,.:-.-.,---- -,,,,, L' tr �_ _, BAC i\Ieeting' Jic ---- ---- ,,. , � FPNo. 2013-08 ., :, _ 2'‘.c-. _ ~ -- , ..'. . eaIl i P1an-Shervices• ` r._ ; s' " .., -- T. . . . ' ' ' ' June 14th, 2013• -. !yy �M_ �,:. •.. �. , .. •- ' � -yam 'rs f:x,• •a..-.- ! ~ �"• �f11` - The information contained herein is subject to the disclosures and disclaimers on the final page of this report. •4 A a Agenda 1. Plan Designs Recommended by the BAC 2. Scenario B — Plan Designs Detail 3. Financial Results a) Assumptions / Vendor Selections b) Financial Summary c) Financial — Funding Rates d) Financial — Contribution Modeling 4. Pharmacy Cost Containment Programs 5. Wellness Program 6. Next Steps 7. Appendix �6 Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. —_.. . m- �.._ 2 ENDED BY . PLAN .DESIGNS RECaMM , • • • • • • • THE: BUDGET ADVISORY COMMITTEE • • • • •. . • .• �� Gallaghe'r Public:Enfity Scholastic Group. a Division of Gallagher"Benefit Services,Inc. t _ • • • • • Di r, . -, a. fa 1',�1•,• • • , _____ _. _ „ ._, . .___ Scenario B ® Plan Designs (HMO, PPO, HDP) Proposed Proposed Proposed . HMO Open Access PPO Plan High Deductible Plan In•Nenvork In-Network Out.of-letoork 1n-Network Out of•Network. . Maximum Lifetime Benefit UM,nuted Unlimited Uniars%0 Unlimited Unlimited Annual Deductible $100 $750 51,000 55,000 $15,000 Family Deductible $301 $2.250 53.10 510.000 $30,000 ! 1 Individual Maximum CopaymenlslCotnsurance $3,000 $5.000 510000 510,000 520.000 Family Maximum Copayntents.'Coinsurance $5,000 $15,000 530.030 $20,000 $40.000 Physician Office Visit 530 Copay $35 Copay Ceti 60% S35 Copay-Dad then 70% Ded•50% S.ecialist Office Visit $50 Co•ea $50 Cap. I Ded•60% $55 Co,- -Dee Chen 70% Del+50% •reventive.Caro•Annual exam - - - Adult $0 Copay $0 Copay ; Ded•60% 100% Ded•50% Child health $0 Copay $0 Copay Ded•60% 100% 50%-Dad Waved 080555 $0 Copay $0 Copay Ded•60% 100% Ded•50% lertillty Servoes/Treatment Plans $30$50 Copay Not Covered Not Covered Not Covered Idol Covered Physical Therapy(60 visits combined with Speech and Occupational Therapy) $30 Copay Ded•80% Dodd•60% Dod•70% Ced•50% !speech Therapy 160 visits combined with(Physical and Occupational Therapy) $30 Cupay Ded•80% Ded+60% Ded•70% Del.50% 1 ;Occupational Therapy(60 visits combined with Physical and Speech Therapy) 530 Copan Ded•80% ': Dad+60% Dad+70% Ded•50"i% hiroprac8c Services $30 Cepav-25 visit 535450 Copay i Den.60% Dud•70% Del•50% •ergy Testing 8 Treatment $30.350 Copes $35 Copay-25 Vls% Dad•60% Ded•70% ON•50% •(patient Surgery(hospital or surgery center) Ded-130% $.200 Coney•Den•80% Ded•60% lhd+70% Ded+50% •-ray and Lab Outpatient-Physician's office $30450 Copay 535450 PCPISPC Ded+60% Ded•70% Ded•50% dvance limb in• PET,MR6.•''CA $100 free Standen 15200 OP fedi,-0 8300 00n 101 Ded•80% Ded•60% Deb•70% Dod•50% Eirrcrgency Room/Hospital - - - •Illness - $200 Copay $200 Copay Nen 80% I Ded•60% Dod•70% Ded•50% •Accidents 5200 Copay $200 Copay there AO% I Ded•60% Ded•70% Ded•50% mbulance by Copay Ded•80% I Ded+60% Ded•70% Dud•50% npalierd Hospital Ded•$300 Coney x 3 days Ded+60% Ded*60% Dad•70% Ded-50% rgent Care 550 Copay 550 Copay Ded•60% 663 Copay-Ded•70% Ded•.00% tome Health Care No Copay Ceti-80% Dad•605: Ded•70% Dod•.50% x urable Medical E,ui 530 Co.,-Muol bu if chew,-r than rent,/ Dad•80% Ded•60% Dad•70% Dad-50% Maternity •Physician $30450 PCPISPC $35450 PCPISPC Ded•60% Dud•70% _- Ded•50% -Hospital Ded•$300 Copan x 3 days Ded•80% Ded+60% Dad•70% Dad•50% patient MentallNervous Ded-$30i'Copay x 3 days Ded•80% Dad•60% Ded•70% Ded•50% •utpa Bent Mental/Nervous $50 Copay $50 Corey Ded•60% Ded•7000 Ded•50"/0 1 patient Substance Abuse Ded-$300 Copay x 3 days Ded•AO% Ded+60% Ded•75% Ded•50% •u'bleat Substance Abuse $50 Co,..j $50 Den•60% Ded•70% Dad+50% Prescription:Drugs-Retail Generic $7 Copay $10 Copay Not Coveted Ded•70% Not Covered Brand $40 Cope. $53 Copay Not Covered Ded+70% Not Conned Non-Prelerred 560 Copay $75 Copy Not Covered Doti+70% Not Covered retail Maximum Supply' 30 day supply 30 day supply 30 day supply •escri,lion Card One Yes Yes Prescription Drugs.-Mail rder Generic $14 Copay $35 Copay Nod Covered Dad•70% Not Covered Brand S80 Copan 5150 Copay Not Covered Dod•70% Not Covered -Non-Formulary $120 Copay 2225 Copse Not Covered Ded•7U% Not Covered ;4Aai40rder Maximum Supply HO day supply 90 day sutph' 50 day supply 'A subset al goner,drugs are available through retail with a 90 day supply. Please note that it you do not indicate a deviation,your proposal will be considered as matching the listed benefit levels above. • FINANCIAL RESULTS et) Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. 6 Assumpflons / Vendor Selections • In order to produce the following financial projections,the following assumptions and/or vendor selections have been made effective October 1, 2013: - Scenario B is implemented with the requested changes to the HMO plan - The incumbent, Humana, continues to the administer the medical plan under a self-funded arrangement and the EAP program - A new vendor, Pharmacy Corporation of America("PCA"),will begin administering the pharmacy plan under a self-funded arrangement effective October 1, 2013 - The incumbent, Symetra,continues to provide reinsurance coverage under a self-funded arrangement • GBS has negotiated attachment factor reductions on the City's behalf due to the implementation of Scenario B • GBS has negotiated a slight rate reduction to the specific stop loss premium for any enrollment in the High Deductible plan - No Medicare Advantage implementation _ - The eligibility census provided by Humana has 1,477 subscribers enrolled as of May 2013 and this data was used for projection purposes 6---;,,4;17 Gallagher Public Entity&Scholastic Group a Division of Gallagher l3enefic Services,Inc. • Financial Summary Fiscal Year 2014 Projections elf-Funded wlo Medicare Advantage Current-No Changes Scenario B with Humana Difference(Savings) Projected Medical Claims1 $12,496,989 $10,777,714 $1,719,254 Projected Pharmacy Claims2 $4,230,904 $3.368,614 $862,291 Administration/Disease Management3 $714,454 $894,885 -$177,772 Reinsurance-Specific&Aggregate' $1,099,065 $1,098,092 $973 Total Estimated Self-Funded Expense $18,541,393 $16,139,305 $2,404,747 Current Funding $16,858,099 $16,858,099 $0 $Increase/Decrease $1,683,294 -$718,794 $2,404,747i Increase/Decrease 10.0% -4.3% 14.3% 1GBS claims projection based upon a proprietary discount database and adjusted for the proposed plan designs 2PCA is implemented as the pharmacy benefit administrator under Scenario B under a transparent pass through arrangement of pharmacy rebates and ingredient cost without margins 3Humana continues to be the medical benefit administrator under Scenario B but with no rebate offsets producing a slightly higher administrative fee 4Symetra continues to provide reinsurance coverage in both the no plan changes option and Scenario B 6,6, Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services Inc. . .... ___________ _ _ _ _ _ __, _ Financial ® Funding Rates NEW FUNDING RATES EFFECTIVE OCTOBER 1,2013 Active Employees/Pre-65 Retirees Enrll HMO Enrll PPO Enrll _ HDP; EE 619 $620.83 86 $543.70 26 $361.08 FAM 457 $1 539.32 33 $1,347.94 18 $895.28 Annual Totals 1,076 $13,053 163 119 $1,094,886 44 $306,038 Post-65 Retrees Enril HMO Enrll PPO Enrll _ HOP: Single(0) 0 $474.62 138 $415.65 5 $276.04 Ret/Spouse(0/U) 0 $1,074.93 18 $941.39 1 $625.19 Ret/Spouse(0/0) 0 $955.48 69 $836.78 3 $555.71 Ref/Child(0/U) 0 $1,074.93 0 $941.39 0 $625.19 Ret/Sp/Child(0/U/U) 0 $1,345.62. 4 $1,178.46 0 $782.62 • Ret/Sp/Child(010/U) 0 $1,232.53; 0_______11 0 $716.85 Annual Totals 0, $0.00 229 $1,641,0841 9 $44,070 et Gallagher Public Entity&Scholastic Group a Division of Gallagher Benelic Services,Inc. •• _.. �- _.- -•::- :: • Ammo - _ . _ . , Financial — Contribution Modeling • • NEW EMPLOYEE/RETIREE CONTRIBUTIONS Active Employees Enrll HMO Enrll PPO Enrll HOP EE 498 $186.25 32 $163.11 20 $108.32 FAM 385 ',553.65 15 '484.80 15 ',322.01 Annual Totals 883 1 $3,670 868 47 $149,900 35 $83,959 Pre-65 Retirees EnrIt HMO Enrll PPO Enrll HDP. EE 121 $310.41 54 $271.85 6 $180.54 FAM 72 $769.661 18 $673.97 3 $447.64 Annual Totals 193 $1,115,7091 72 $321.737- 9 $29,114, Post-65 Retirees Enrll HMO Enrll PPO Enrll HDP Single(0) 0 $237.31 138 $207.83 5 $138.02 Re+JSpouse(0/U) 0 8537.46 18 $470.69 1 $312.59 Ret/Spouse(0/0) 0 S477.74 69 $418.39 3 $277.86 Ret/Child(0/U) 0 $537.46 0 $470.69 0 $312.59 Ret/SpiChild(0/U/U) 0 $672.81 4 $589.23 0 $391.31 Ret/Sp/Child(0/0/U) 0 $616.26 0 $539.71, 0 $358.43 Annual Totals . 01 $0.00 229 $820.542 9 $22,035, • The employee/retiree contributions shown above assume the following: - Active employees pay 30%of the funding rate for employee only coverage and 40%of the difference between the employee and family funding rates for dependent coverage - Pre/Post-65 retirees pay 50%of the funding rate for retiree only coverage and 50%of the funding rate for dependent coverage '"`°' Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. _ _ __— -_ __.y._•._-_,__ . . Financial ® Contribution Modeling NEW EMPLOYEE/RETIREE CONTRIBUTIONS Active Employees Endf HMO Enrll PPO Enr l HDP EE 498 $310.41 32 $271.85 20 $180.54 FAM 385 .769.661 15 '.673.97 15 '447.64 nnual Totals 883 $5,410,8721 47 $225,706 35 $123,905 Pre-65 Retirees Enrll HMO Enrll PPO Enrll HDP, EE 121 $310.411 54 $271.85 6 $180.54 FAM 72 $769.661 18 $673.97 J $447.64 Annual Totals 193 $1,115,7091 72 S321,737 91 $29,114 Post-65 Retirees Enrll HMO Enrll PPO Enrll HDP Single(0) 0 $237.31 138 $207.83 5 $138.02 Ret/Spouse(0/U) 1 0 $537.46 18 $470.69 1 $312.59 Ret/Spouse(0/0) l 0 $477.74 69 $418.39 3 $277.86 Ret/Child(0/U) 0 $537.46 0 $470.69 0 $312.59 Ret/Sp/Child(0/U/U) 0 $672.81 4 $589.23 0 $391.31 Ret/Sp/Child(0/0/U) 1 0 $616.26 0 $539.71 0 $358.43 Annual Totals , 0 $0.00 229 $820,5421 9 $22,035 • The employee/retiree contributions shown above assume the following: - Active employees pay 50%of the funding rate for employee only coverage and 50%of the difference between the employee and family funding rates for dependent coverage - Pre/Post-65 retirees pay 50%of the funding rate for retiree only coverage and 50%of the funding rate for dependent coverage ' Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc °' MINE • PHARMACY COST CONTAINMENT PROGRAMS GBS recommends having further discussions with the chosen pharmacy administrator,Pharmacy Corporation of America,to determine which cost containment programs to implement October 1,2013. The following slide details some of the recommended and available programs the City could choose to implement. PCA has estimated savings amounts for some of the available programs based upon the City's claims experience. • 4r1;G"Ir Gallagher Public Entity&Scholastic Group • a Division of Gallagher Benefit Services,Inc. • Pharmacy Cost Containment Programs During implementation to be effective 10/1113,the following cost containment programs not included in the projections vet can be selected by the City and administered by Pharmacy Corporation of America("PCA"): • Mandatory Generic Substitution • National Drug Code Lockout - Estimated savings of$153,098 in the first - PCA's system can accommodate this if the City year wishes to implement • Mandatory Mail-Order for Maintenance Drugs ▪ Prior Authorization - Estimated savings of$183,444 in the first - PCA's system can accommodate this if the City year wishes to implement • Step Therapy - Rx claims over$1,500 automatically require prior - Savings estimate of$60,553 in the first year authorization before adjudication • Over-the-Counter Solutions • Diabetic Supply Programs - PCA's system can accommodate this if the - PCA would need the City's assistance in City wishes to implement customizing this program but has several clinical • Confirm No Out-of-Network Benefit initiatives focused on this disease state - PCA's system can accommodate this • Compound Pharmaceutical Review • Quantity Limit Management - Exact make-up of compound pharmaceutical is - Recommended by PCA and can be reviewed to ensure the compound is appropriate implemented at the City's direction otherwise the claim is denied • Mail-Order-3 copays for 3 months supply €1111„,ri, - PC A can support this plan design element Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. 13 IMMO WELLNESS PROGRAM Based upon the selection of Humana as the continued medical administrator on a self-funded basis,GBS would recommend exploring all available options under Humana's and Engagement Health's Wellness responses.A thorough discussion of what the City can implement,hopes to achieve,and the resources available for commitment to a Wellness Program is the next step. Wellness Program solutions designed to improve the health of an employee population are only as successful as the commitment the organization makes to manage the Program and mandate participation. Gallagher Public Entity&Scholastic Group a Division of Gallaher Benefit Services,Inc. Proposed Wellness Benefits & Expense ...-s-„„toGRAms. , Humana Engagement Health__ _ ,_ , ...,.„,... •". tiganWiteApetion 2013 2014 _ 2013 .:_,,2.P1A..„,_ •-• ..• .. . . . .... _.—......_-- . 6 et-Up Fees Not applicable Not applicable NA 1 NA enewal Fees Not applicable Not applimble ! NA j NA 1 •ther State&show PEPM cost 1 i . _ Base Fee S446 PEPM TED at renewal 1 $3100/month $3100imonth Biometric Screenings Ncl included Not Included 1 $60 PP $60 PP liealth Risk Assessments(HRA's) Included it base fee included in base lee Ircluded Irclueed 1Heafth Fairs Not applicable Not applicable $750 per day+Panel(1 person) 5750 per day+travel(1 person) !Incentive Adm.nistration Included in Da.fee Included in base fee Admin.included Admin.included S168.00 per PPPY or$14 PEPM Or 103%of EH's$168.00 per PPPY or$14 PEPM Or 100%of El-Is Fees Fees at Risk where EH fronts entire=t of the at Risk where EH fronts entire cast of the program and • er(State&show PEPM mg) program and the Ingram is paid by non- the program is paid by non-participants and claim partidpants and claim savings,only if realized savings,only It realized - - eight loss-Nutrition Included in base fee Included in base fee Yes Yes Walking Included in base fee Included insane fee Yes Yes tress Reduction Included in base fee Included in Dane fee Yes Yes moir1ng Cessation Included in base fee included in sane fee Yes Yes •hysical Activity Included in base fee Included in sane fee Yes Yes ealth Coaching(one-one) 'that Slate&show PEPM cost) Included in base fee Included in case fee Quarterly telephonic Included above 0Jarterly telephonic Included above _- .„ . 12=5_arlatiOtrelatt.-_,:-.,'...-.•,-:.-.1..;..,--;...-. -.-_..-:-....- ,...- ' ..11:......-....J.....1.41'...i.,.....,....1.Z...•.--.......1.1"-_, I eight loss-Nutrition Included in base fee Included in base tea Open to discussion or integration with 3rd party Open to discussion or integration with 3rd paly diking Included in base fee included in oase fee Open to discussion or integral on with 3rd party Open to discussion or integration with 3rd party 6 tress Reduction Included A base fee Included in sane fee Open to dismission or integrat on with 3rd party Open to discussion or integration with 0/d pany 6 moiung Cessation Included in base fee Included in sane fee Open to discussion or integration with 3rd party Open to discussion or integration with 3rd parry i•hysica Activity Included in base fee Included in base fee Open to discussion or integration with 3rd party Open to discussion or integration with 3rd party •-Site Coordinator lnouded A base fee Included in base fee Open to discussion Open to discussion • • State&show PEPM ccst Id!i:lifer ..... '7"V'..- ' -2...a'•....1...... .. _— -....L.L....'': __:......_._..___;—__----....,:i.:: ,-1 .. 421111A111111 •uarterly and Annual Participation&ROI Included in base fee Included in base fee Included Included •d hoc Reports $150 per hour $150 per nest Included •ncluded •"1"1", Gallagher Public Entity&Scholastic Group • a Division of Gallagher Benefit Services,Inc. -- - .-..' 15 1 • Wefiness Vendor Capabilities • Humana • Engagement Health - Biometric Screenings - Biometric Screenings - Health Assessment - Health Assessment - Health Fairs - Health Fairs - Humana Vitality Program - Onsite Capabilities - Flu Shot Clinic - Performance Guarantees - Web/Phone Based Wellness Program' - Web/Phone based Wellness Program if the City wishes to enhance the existing Wellness program, GBS recommends inviting Humana and Engagement Health to give presentations on their capabilities, cost of their programs, the expected return on investment, and any available performance guarantees 67") Gallagher Public Entity&Scholastic Group .......:::: : a Division of Gallagher Benefit Services,Inc. `[' _ . _ _ T STEPS ® TBD By THE CITY Go Gallagher Public Entity&Scholastic Group . ..... ... .. a Division of Gallagher Benefit Services,Inc. • • APPENDIX Gallagher Public Entity&Scholastic Group ,• • • • 5e" a Division of Gallagher Benefit Services,Inc. g . ••• -•- 18 „ . _ _ Contingencies & Exclusions ® ASO & Stop Loss Humana-Medical ASO Services Humana reserves the right to change the quoted coverage terms,rates/fees/factors or withdraw quote if. Employer contributions for all the full time employees is less than 50%of the conventional equivalent single rate Both Administration and Stop Loss coverage(s)are not awarded to Humana Less than 75%of a0 eligible employees are enrol led,scalding employees who have waived coverage for another group plan(wit accept down to 50%,assuming the difference between 50%and 75%is due to spousal waivers) A signed Disclosure Statement and Application are not tecvad within 30 days prior to the effective date. In addition to the quoted administration fee,Humana or a dosignaled vendor,will till the client group separately for the following services: For printing/mailing SPDs,if requested as follows: • a.Print and patch mail to client at$4.00 per SPD',or b.Print and mail to an employee's home of$5.00 per SPD'. 'The price quoted is for Humana printed SPDs and is subject to change due to increased costs in materials,postugelshipping special mailing instructions,and any special printing needs being requested. For additional interface expenses associated with external vendors as follows: a.for any data feed to a non-Humana vendor(s),such as Dental or Vision carrier(s),or HSAfHRAJFSA P.dministrators b.if Humana provides COBRA notification and baling services c.for any data feed to a non-hlumana vendor(s),such as a Stop Loss carrier or Pharmacy Benefit Manager. If Humana is chosen to administer RYX,an additional$3.17 PEPM credit will be applied to the Administration Fee and the$0.15 RX Data feed charge will be removed.Total credit will be$3.32 PEPM. External appeal expense incurred by the vendor will be billed bade to the group at cast.A$50 administration fee by Humana will also apply. Humana s administration fee do not include the administration of claims incurred prior to the effective date of this quote. Humana's administrative quote assumes an average number of billing units(serrate bills for geographic,employee class,divisions,etc.).For groups requiring greater than five self-billed units,additional fees may apply. Symetra-Stop Loss Reinsurance Contingencies: Plan Document(it plan changes are implemented) Paid and large claim experience thru June 2013. Exclusions and Limitations: Have been excluded under the terms described in the Excess Loss Attemate Reimbursement Endorsement. Symetra will not reimburse the Participating Employer for Covered Expenses incurred by Covered Units or Covered Family Units that qualify as Potential Large Claims,unless disclosed and accepted by Symetra. In the event of nondisclosure by the Participating Employer,Symetra reserves the right to: Symetra will not reimburse any loss or expense caused by,or resulting from any of the following: Expenses for occupational accidents or illnesses or expenses that the Employee Benefit Plan covers that are covered or eligible for coverage by Worker's Compensation,including any payments made by Worker's Compensation carrier as exception or payment with no liability concerning Worker's Compensation average; Symetra will not reimburse any expenses that ere: Surcharges made on a per Covered Unit or Covered Family Unit basis;or Penalties or fines assessed by a State against the Participating Employer. •""�1° Gallagher Public Entity&Scholastic Group Gyp b ........:, ..... ... .. • a Division of Gallagher Benefit Services,Inc. ”" 19 111. .111■1111111■11111111.11■11■111 Contingencies & Exclusions - Wellness Humana•Wellness The Wellness(Structured Web&Telephonic Health Coaching),integrated Chronic Condition Management and Maternity programs are required when HumanaVitality is purchased. The HumanaVitality rewards payment of$1.21 PMPM is an estimate.Actual rewards payment will be calculated monthly based on actual results. Humana Vitality is also available for your employees who waive medical coverage.The HumanaVitality PMPM Administration Fee is the same for your waived employees as(was) quoted for your covered employees and will be billed separately.The waiver population must follow and purchase the same program options as medical population. The Wellness(Structured Web&Telephonic Health Coaching)program is required when HumanaVitality is purchased. Engagement Health•Wellness Per-Participant Pricing Option Flexible Incentive Design:The Per Participant Pricing Option provides complete flexibility when it comes to incentive designs.We work with client management to design program incentives that are best suited to company,culture,plan design,and budget. Incentive Funding:Any client that elects to use a non-participant surcharge as a program incentive will keep the full amount of this surcharge,which will offset the cost of the EngagementHealth program. Screenings:The per participant screening cost includes time and travel.Minimum billing of 30 screening participants per location per screening event. Incentive-Funded Pricing Options Non-Participant Funding:Health plan participants who elect not to participate in the wellness program or who fail to comply with the requirements of the program pay a monthly non- participant penalty of$40.00 to$60.00.This penalty,up to the predetermined Total Fee Limit,is passed along to Engagement Health in order to fund the wellness program. Total Fee Limit:The Total Fee Limit is calculated by multiplying the initial number of program participants by$315.Based on preliminary information.Fee Limit and final program components are not determined until after completion of a formal Information Request and receipt of an Eligibility File. Success Fee:The difference between the Fee Limit and Non-Participant Funding may be earned be EngagementHealth only by delivering actual claims savings. Otherwise, EngagementHealth collects no additional fees. Historically,clients using this model have saved an average of more than$600 per covered employee. Minimum Requirements:This funding option is available only to companies that have at least 200 adult medical plan participants and that offer the EngagementHealth program to both employees anti spouses. Screenings:Time and travel included.Up to 90 participants per screening event.Additional screenings for 560 per participant with minimum billing of 30 screening participants per location per screening event. Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. -- -- 20 Contingencies & Exclusions ® EAP Humana•EAP General The services start on the first day of October 2013 and rates are proposed for 24 months with an optional extension for 12 months at the same fee. Fees are net of any commission payable to broker,consultant,or other third party. EAP Services provided in these fees include: 24/7 access to telephonic services Substance abuse professional referrals are available for$700 per case Internet site with behavioral health tools and resources • Gil Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. • A.M. Best Financial Ratings A.M.Best Financial Strength Rating Reference Guide 2013 Financial Strength Rating Financial Strength Rating Financial Strength Rating Financial Strength Rating Entity A.M.Best# Month Rating Size Month Rating Size Month Rating Size Month Rating Size Aetna Life 006006 1 A(Excellent) XV 2 A(Excellent) XV 3 A(Excellent) XV 4 A(Excellent) XV Aetna Health Inc 060120 1 A(Excellent) XV 2 A(Excellent) XV 3 A(Excellent) XV. 4 A(Excellent)I XV Aetna Health Insurance 007443 1 A(ExcellentL XV 2 A(Excellent) XV 3 A(Excellent) XV 4 A(Excellent)i XV Cigna Healthcare of Florida Inc. 068860 1 A(Excellent) XV 2 A(Excellent) XV 3 A(Excellent)1 XV i 4 A(Excellent) XV A- -Iumana Health Insurance Co of FL Inc 009494 1 IA-(Excellent) XIV i 2 A-(Excellent) XIV 3 (Excellent) XIV 4 A-(Excellent) XIV Symetra Life Insurance Company 007017 1 A(Excellent) IX 2 A(Excellent) IX 3 IA(Excellent) IX 4 A(Excellent) XV Jnited Healthcare Insurance Company I 003290 1 A(Excellent) XV_ 2 A(Excellent) XV 3 IA(Excellent) XV 4 A(Excellent) XV ;0"alt, Gallagher Public Entity&Scholastic Group .•.••. i .•..: a Division of Gallagher Benefit Services,Inc. „ _ _ ____. __ _ ____ ___ __ ___ : Health Plan Self-Fundin g Analysis - Plan Year Actual,/Projected Actual I Projected Actual/Projected Fully- Actual Self-Funded Plan Year' Full Insured Increase Self-Funded Increase Enrollment Insured Premium' Expense Difference 2008 12.3% 12.3% 1,639 $15,586,760 $15,586,760 $0 2009 4.4% 3.3% 1,637 $16,256,857 $15,484,667 $772,190 2010 9.8% -3.6% 1,624 $17,248,591 $16,219,484 $1,029,107 2011 3.0% 9.3% 1,586 $17,351,316 $18,517,167 ($1,165,851) 2012 24.2% 12.4% 1,541 $19,866,823 $19,144,875 $721,948 2013 9.4% 16.7% 1,541 $21,734,304 $20,923,320 $810,984 Totals 12.5% 9.9% 1,595 $108,044,651 $105,876,2721 $2,168,379 12008 was fully-insured.Projected fully-insured increases in 2009-2013 are estimations based off past experience and projections. 2Fully-insured increases projected above assume that current plan designs were not changed and insurer factors continued to be used 30.0% 25.0% 24.2% 20.0% 16.7% 15.0% 12.3% 12.5% 9.3% - 10.0% ao •8% 124% 12. /° 4.4% . 9.4% 9.9% , 5.0% •w Air 3 00/0 3.3%- , 2008 2009 ' _3.6% 2011 2012 2013 Totals -5.0% -Actual I Projected Fully-Insured Increase -�-Actual 1 Projected Self-Funded Increase G.--i---1 Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. • • r • Current Health Plan Benefits Standard HMO Premium HMO PPO Standard PPO Premium P0S Employee Monthly Premium . Employee Only $134.72 $381.74 $261.70 $763.90 $425.06 Employee+Spouse or 1 Dependent -- .. -- — Employee+Child(ren) — — — — Employee+Family $472.26 $946.40 $908.00 $1,874.46 $1,054.86 Plan Deductible and Maximum 00P Annual Deductible(Individual/Family) _ $0 $0 In/Out-$500/$1,500 In/Out-5200/$600 In-$0,Out-$4001$800 Out of Pocket Maximum(Individual!Family) $1,5001$3,000 $1,500/$3,000 In/Out-$3,500 i$10,500 In/Out-$1,0001$3,000 In-None,Out-$2,500!$5,000 Physician Services-In Network Office Visit PCP $25 $5 $35 $10 $5 Office Visit Specialist $40 $0 $35 $10 $5 Facility Services Hospital Inpatient $30015 days $100 In-20%after ded. In-$1001 admit,10% In-$1001 admit. Out-40%after ded Out-$500!admit 30%after ded Out-$500/admit 30%,after ded Outpatient Hospital Surgery $200 $0 In-20%after ded In-$1001 admit,10% In-$0 Out-40%after ded Out-$5001 admit 30%after ded Cut-30%after ded Outpatient Diagnostic Services!Imaging $200 $U In-20%after ded In-10%after$25 Ina$0 Out-40%after ded Out-30%after ded Out-30%after ded Emergency Room $200 $25 In/Out-20%after$200 In/Out-10%after$25 In/Out-$50 Urgent Care Facility $40 $25 In-$35 In $10 Ins $5 Out-30 io after ded Out-20%after ded Out-30%after ded Prescription Drug Coverage•In Network Generic!Brand/Brand Non-Fret/Specialty 57/5401$60 MO x2 $5/55155 MO x3 510/$40/$60 MO x3 $10/$10 i$10 MO x3 $10/5101$10 MO x3 05"*. Gallagher Public Entity&Scholastic Group . a Division of Gallagher Benefit Services,Inc. .. .... : : I • , Current Health Plan Rates and Contributions Active Employee Monthly Rates Standard HMO Premium HMO POS Standard PPO Premium PPO 'Employee $134.72 $381.74 $425.06 $261.70 $763.90 Employee Only City $329.84 $381.74 ' $425.06 - $640.72 $763.90 Total $464.56 $763.48 $850.12 $902.42 $1.527.80 Employee $472.26 $946.40 S1,054.86 $908.00 51.874.46 Family Cit '679.60 '.946.40 S1 054.86 $1.306.64 '.1.874.46 Total $1,151.86 $1,892.80 52,109.72 $2,214.64 $3,748.92 Employee/City Cost Share Standard HMO Premium HMO POS Standard PPO Premium PPO Employee 29% 50% 50% 29% 50% Employee Only City 71% 50% 50% 71%, 50% Total 100% 100% 100% 100% 100% Employee 41% 50% 50% 41% 50% Family City 59% 50% 50% 59% 50% Total 100% 100% 100% 100% 100% Pre-65 Retirees Monthly Rates Standard HMO Premium HMO POS Standard PPO Premium PPO Retiree $232.28 $381.74 $425.06 $451.21 $763.90 Pre-65 Retiree Only City $232.28 $381.74 $425.06 $451.21 $763.90 Total $464.56 $763.48 $850.12 $902.42 $1.527.80 Retiree $575.93 $946.40 $1.054.86 $1,107.32 $1.874.46 Family City $575.93 $946-40 $1,054.86 $1,107.32 $1,874.46 'Total $1,151.86 $1.892.80 $2,109.72 $2,214.64 $3,748.92 %Pre-65 Retiree/City Cost Share Standard HMO Premium HMO POS Standard PPO Premium PPO (Retiree 50% 50% 50% 50% 50% Pre-65 Retiree Only Ci 50% 50% 50% 50% 50% Total 100% 100% 100% 100% 100% Retiree 50% 50% 50% 50% 50% Family Ci 50% 50% 50% 50% 50% Total 100% 100% 100% 100% 100% y Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,inc. i? [ Current Health Plan Rates and Contributions Standard Standard Premium Post-65 Retirees Monthly Rates POS PPO Premium PPO %Post-65 Retiree/City Cost Share POS PPO PPO Retiree $327.89 $342.95 S582.11 Retiree 50% 50% 50% Single City $327.89, $342.95 S582.11 Single City 50% 50% 50% Total $655.77 $685.89 $1,164.21 Total 100% 100% 100% Retiree $737.75 $771.60 $1,309.76 Retiree 50% 50% 50% Retiree/Spouse(0/U) City $737.75 $771.60 $1,309.76 Retiree/Spouse(0/U) City 50% 50% 50% Total $1,475.50 $1,543.19 . $2,619.51 Total 100% 100% 100% Retiree $655.77 $685.86 $1,164.21 Retiree 50% 50% 50% Ret/Spouse(O/O) City $655.77 $685.86 $1.164.21 Ret/Spouse(O/O) City 50% 50% 50% Total $1,311.54 $1,371.71 $2,328.42 . Total 100% 100% 100% Retiree $737.75 $771.60 $1,309.76 Retiree 50% 50% 50% Ret/Child City $737.75 $771.60 1,309.76 Ret/Child City !50%i 50% 50% 1 Total $1,475.50 $1.543.19 $2,619.51 Total 100% 100% 100% Retiree $1,085.38 $966.7. $1,640.99 Retiree 50%1 50% 50% ReUSp/Child(0/U) City I $1,085.38 $966.74 $1,640.99 Ret/Sp/Child(0/U) City 50%, 50% 50% I Total 1 $2,170.75 $1,933.48 $3,281.97 Total 100%' 100% 100% Retiree 1 $853.01 $881.01 $1,495.48 Retiree 50%1 50% 50% ReUSp/Child(0/0) $853.01_$881.01 '.1.495.48 Ret/Sp/Child(0/0) City 50%I 50% 50% Total R1,706.02 $1.762.01 $2.990.96 Total 100%I 100% 100% 1.14,4 Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc. 26 Dscamer of the coverages proposed b This proposal analysis is an outline o es osed g p p by the carriers based upon the information provided by your company. It does not include all the terms, coverages, exclusions, limitations, and conditions of the actual contract language, and does not include all of the details in the RFPs. See the policies, contract and RFPs for the actual language. This proposal analysis is not a contract and offers no contractual obligation on behalf of GBS. Policy forms for your reference will be made available upon request. GidP�J" Gallagher Public Entity&Scholastic Group .-.. a Division of Gallagher Benefit Services,Inc. `` —..............._.......... _ ...._........_....._........... • 27 • Thank you Gallagher Benefit Services, Inc. 2255 Glades Road, Suite 400E Boca Raton, FL 33445 (561) 995-6706 (Direct) (561) 995-6708 (Fax) Gallagher Public Entity&Scholastic Group a Division of Gallagher Benefit Services,Inc . . . 'I • i i _ z:-1z v, zz -z y za-lz r" z IIE y'o = 6o SS 2 d FG ii m I/ � C(� 'b A 7 R S R C 10 ^ _.,�w n n - - a. 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G II _v�'.-l ,y N'O`�4 P N A ry R O^ W r W Scenario 1(2013 thru Oct) $3,500,000 -- $260,944 $200,944 $150,009 $109,073 $3,000,000 $2,500,000 51,863,624 $2,000,000 $1,923,624 $1,974,559 52,015,495 $1,500,000 $1,000,000 $1,187,469 $1,080,165 $500,000 $0 $230,000 ISL $250,000 ISL $275,000151 $300,000 ISL •Reinsurance Premium •2013 thru Oct Net Claimant Claims •Reimbursements Scenario 2(2012) $4,500,000 $4,000,000 $626,835 $41,559 $.311,55_ $3,500,000 $3,000,000 $2,500,000 $2,219,927 $2,305,103 $2,405,103 S, $2,000,000 -- $1,500,000 $1,000,000 -: $1,080,165 $soa,000 $0 $230,000 ISL $250,000 ISL $275,000 ISL $300,000 ISL ■Reinsurance Premium •2012 Net Claimant Claims •Reimbursements Scenario 3(2011) $5,000,000 $4,500,000 $4 000 000 $:,l65,294 51,025,294 $874,408 — $747,244 $3,500,000 - $3,000,000 $2,500,000 $2,312,920 $2,452,920 $2,603,806 $2,730,970 $2,000,000 $1,500,000 $1,000,000 -- _ $1,187,469 $1,080,165 $500,000 $967,560 $876,160 $0 $230,000 ISL $250,000 ISL $275,0001SL $300,000 ISL •Reinsurance Premium •2011 Net Claimant Claims •Reimbursements Scenario 4(2010) $3,500,000 $3,000,000 S28.3,u2? 5208,622 _. $2,500,000 • $2,000,000 $1,777,849 $1,852,849 51 977 R4_, $1,500,000 $1,000,000 $500,000 $0 $230,000 ISL $250,000 ISL $275,000 ISL $300,000 ISL •Reinsurance Premium •2010 Net Claimant Claims •Reimbursements Overall Savings Potential-All Scenarios $180,000 $350,000 $160,000 $300,000 $300,000 - $300,000 $140,000 275poo - $250,000 $120,000 $230,000 $100,000 - $200,000 X a $80,000 - $150,000 $60,000 - $100,000 $40,000 $50,000 $20,000 $0 $0 2013 thru Oct 2012 j 2011 2010 EST.SAVINGS $159,437 $38,149 $0 $104,825 .Stop Loss Deductible $300,000 $275,000 $230,000 $300,000 I a -0 A l7 N --1 p N N N - w O Or O N O O O ..< 24 SI. a ci , F+ u , * W N N Z 3 N N d n O 3 < to W CD W W N D▪ +V CO r a S n O t0 A v CO - m p v N A A l0 c n O A N A O -. 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O w m UQ �o w A OP v O f0 v,0000 Om N 6A Hi 69 EA)EA(f3 V co co w CM th O n 0 o0 0 0 0 1,4 o A o .. n X 9 0• z H w ?,0 3 00 i� oocooc00AO”. City of Miami Bench $230,000 Specific Deductible-Large Claims January 1,2009-March 31,2015 2009-$200,000 Deductible 2010-5230.000 Deductible 2011-$230,000 Deductible 2012-$230,000 Deductible 2013-0230,000 Deductible P}'2014-$230,000 Deductible 2014/15-5230.000 Deductible Amount ' Amount • Amount Amount Claimant AmOnat Paid Recover Poid Recovery • Paid Recovery Paid Recovery. AmouniPaid Recover'• Amount Paid Recovery paid Recovery •I 5386.762 5186.762 5392.643 5162,643 $542.412 $312,412 5446,175 $216.175 $417,632 0187,632 $299.602 569.602 5278,930 $48.930 2 5244.614 544,614 5331.169 $101,169 $532,434 5 302.434 $445,786 5215.786 $290,936 560,936 $215,437 5234.884 $4,8134 3 5232.236 $32,236 5309,810 $79.810 5442,120 $212,120 $326,190 596,190 $282.310 $52310 5196.720 $153.080 4 5222.803 522,803 $247,107 $17.107 5424.129 5194.129 5323.508 $93,508 5216.070 $165,932 5118.572 5 I 5189.743 5217,454 5306,149 $76,149 5235.176 55.176 8210,460 5162,157 6 $142,281 5185,855 5277,164 $47,164 $219,015 $157,670 $153,516 7 $133.782 S163.615 5250.886 $20,886 $193561 5135.460 8 $132,605 5150,795 $222,431 $176,642 5130.005 9 I 5134.690 $144,655 $178.948 5174.643 $125,574 10 $122.951 $144.085 $152,762 5174586 5117,615 I I $116,655 5141.925 $148,779 $160.729 12 $135.331 $141.939 $145,337 13 I 5125,808 $140,764 5125.933 14 5124.441 5132.351 $125,784 15 5126.088 16 $122,108 17 $117582 I , I Total 1 52.059.1221 5286,4151 52.814.6941 S360,7291 54.259,0471 51.165,2941 S3,273,0651 5626,8351 82,083,7321 5300.8781 51,193,3631 569.6021 5785.4671 $53.814 Inception to Date Recoveries $2,863,567 Financial Fiscal Year Recovcry S}meea Total FY Reconenen per City: 2008/09 565,319 $0 $65.319 2009/10 $387,793 $364,562 $752,355 2010/11 $316,670 $860,363 $1,177,033 2011/12 5460268 $901,262 51.361,530 2012/13 51,003,887 $283,369 $1,287,256 2013/14 $335,365 5951891 51.287,256 Total $2,569.301 $3.361.448 55,930,749 Page 5 0 d co m 0) g N N N N N N to O O A O W N_N O O O O O 00 ry A C C)�Da C m 3 A W N- 0(O-mss N CD O co a 7 0 CD O. d aafD O m -1R_m y D c C m CO 6 ? 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M N �< W E N N t O W U tOD fD N j W N b N a!O N V V W 66 W 0 U 0000 uaN W U V O W b O O 10 A A N O 9 m OEE W V O� W,ON W NN �! se-g O O 1 D N N A T a D T u� �� W O A W V� O N {T N I N U a G U V V +=O A V O W- W U W O 8 t(r t(� L1 V W W °' V W O A W A P A a V m N m V W m O V N a a vO VT am ai awv+a mrn mn W O W O WW Ql O N A W Q1 T fp V W A 82.. 4,8 3 G City of Miami Beach Health Plan Surplus Analysis FY 2014 Closing Health Plan Surplus $4,546,014 From State Filing Projected FY 2015 Gains/(Losses) FY 2015 Medical $3,066,421 Dental $123,137 Total $3,189,558 Current Forecast Projected FY 2015 Closing Health Plan Surplus $7,735,572 Projected FY 2015 Claims Medical $14,409,748 Dental $997,344 Total $15,407,092 Current Forecast OIR 60-Day Surplus Threshold @ September 30,2015 $2,532,673 Annual Claims x(60/365) Projected FY 2015 Closing Surplus in Days of Claims 183 Projected FY 2016 Gainsl(Losses)@ Current Funding FY 2016 Medical $1,317,207 Forecast assumed no increase Dental $46,593 Forecast assumed 5%increase Total $1,363,800 Projected FY 2016 Closing Health Plan Surplus $9,099,372 Projected FY 2016 Claims Medical $16,974,898 Dental $ 1,077,341 Total $18,052,239 OIR 60-Day Surplus Threshold @ September 30,2016 $2,967,491 Projected FY 2016 Closing Surplus in Days of Claims 184 Page 17 • • • • • • • 1 `�i j H r=.•-o ff c r '8 H b '2 .2 b c a.° D nn P R P ° `d c o CD E r, u a R 5 % tri 2.ti c c, R. ,=<< c cn t•..y CD "�^ y < fix• < O G- L`. y, n O w N '' M v � V- , r• ,. ag c a 8 Et' O n g A /_ o ' 0O • w ti d H E. • ,C N � O O C C tn^• Cv'y K T W'y CD Er j� r S ° PC n v �f." 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II I! 1 III Oc J J O�C1 1h V1 A L' N �/' Z O 1r O&O [r O U1 O F 'I: 5j CD p 2 y � co N 33 2:`� C I m I - O O O IJ N —w A V, .='. V. N OC OC VI W ,A 17.5 > n 7D VI, o 'G s n _� m Y, I`, f9 ^ g O O^ — t' 1..1 Ch N N V.U J v !n I i V� to G1—�V' In V� V: N 5 ry y _ N G Co CJI 0 0 0 A O•..a N O VCi w O A C ic t v V C N.. J OA Oc O —N w J N A V V �.. (J v J A V O ■.. N 4' lD Vi 1c. • N CD oo O O O r O N N J u p 0 N:. O O .1 O N 1,4 N V 0 0 0 0 0 1J N pj J 0 0 N' i`. C y O rc, re _ c, O O O — O N�1 t. 1J O O m +. z1 o- N O W N D N bV r N J IJ W N Oc�.5{ d o A p""' A r V1 W. Gs 0 O as:y 3 1 I I i I 1 I IL' Detail by Entity Name Page 1 of 2 ((� 7 J, FLORIDA DEPARTMENT OF STATE 4 OA- DIVISION OF CORPoRAII'ON'S 1n,41Z r _ _ Detail by Entity Name Foreign Profit Corporation GALLAGHER BENEFIT SERVICES, INC. Filing Information Document Number F99000006362 FEI/EIN Number 36-4291971 Date Filed 12/09/1999 State DE Status ACTIVE Principal Address TWO PIERCE PLACE ITASCA, IL 60143 Mailing Address TWO PIERCE PLACE ITASCA, IL 60143 Registered Agent Name &Address CORPORATION SERVICE COMPANY 1201 HAYS STREET TALLAHASSEE, FL 32301 Address Changed: 04/27/2012 Officer/Director Detail Name &Address Title D CARAHER, JOHN J TWO PIERCE PLACE ITASCA, IL 60143 Title PD DURKIN JR, JAMES W TWO PIERCE PLACE ITASCA, IL 60143 Title T LAZZARO, JACK H http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 2/17/2016 Detail by Entity Name Page 1 of 3 FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORAI [0\S 1.� .z Detail by Entity Name Foreign Profit Corporation AON BENEFITS & INSURANCE SERVICES, INC. Cross Reference Name AON CONSULTING, INC. Filing Information Document Number F06000003266 FEI/EIN Number 22-2232264 Date Filed 05/04/2006 State NJ Status ACTIVE Last Event CORPORATE MERGER Event Date Filed 05/20/2008 Event Effective Date NONE Principal Address 200 E RANDOLPH STREET CHICAGO, IL 60601 Changed: 03/14/2011 Mailing Address 200 E RANDOLPH STREET CHICAGO, IL 60601 Changed: 03/14/2011 Registered Agent Name &Address CORPORATION SERVICE COMPANY 1201 HAYS STREET TALLAHASSEE, FL 32301 Officer/Director Detail Name &Address Title Secretary, VP, Director RICE, MATTHEW M 200 E RANDOLPH STREET CHICAGO, IL 60601 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 2/17/2016 Detail by Entity Name Page 2 of 3 Title Treasurer HAGY, PAUL A 200 E RANDOLPH STREET CHICAGO, IL 60601 Title AVP, Director LEY, MICHELLE S 200 E RANDOLPH STREET CHICAGO, IL 60601 Title President, Chairman, CEO SAVACOOL, KRISTI A 200 E RANDOLPH STREET CHICAGO, IL 60601 Title Director ZEIDEL, DARREN 200 E RANDOLPH STREET CHICAGO, IL 60601 Annual Reports Report Year Filed Date 2013 04/16/2013 2014 05/01/2014 2015 04/21/2015 Document Images 04/21/2015 --ANNUAL REPORT View image in PDF format 05/01/2014 --ANNUAL REPORT View image in PDF format 04/16/2013 --ANNUAL REPORT View image in PDF format 04/17/2012 --ANNUAL REPORT View image in PDF format 03/14/2011 --ANNUAL REPORT View image in PDF format 04/19/2010 --ANNUAL REPORT View image in PDF format 04/27/2009 --ANNUAL REPORT View image in PDF format 05/20/2008 -- Merger View image in PDF format 04/11/2008 --ANNUAL REPORT View image in PDF format 04/19/2007 --ANNUAL REPORT View image in PDF format 05/04/2006 -- Foreign Profit View image in PDF format • Coovriaht©and privacy Policies http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 2/17/2016 Detail by Entity Name Page 1 of 3 FLORIDA DEPARTMENT OF STATE 441t, DIVISION 01 CORPORATIONS fil11bZ - Detail by. Entity Name Foreign Profit Corporation WELLS FARGO INSURANCE SERVICES USA, INC. Filing Information Document Number F98000003178 FEI/EIN Number 56-1882208 Date Filed 06/05/1998 State NC Status ACTIVE Last Event CORPORATE MERGER Event Date Filed 09/27/2010 Event Effective Date 10/01/2010 Principal Address 301 SOUTH COLLEGE ST CHARLOTTE, NC 28202 Changed: 04/23/2010 Mailing Address 301 SOUTH COLLEGE ST CHARLOTTE, NC 28202 Changed: 04/23/2010 Registered Agent Name &Address, CORPORATION SERVICE COMPANY 1201 HAYS STREET TALLAHASSEE, FL 32301 Name Changed: 05/23/2001 Address Changed: 05/23/2001 Officer/Director Detail Name &Address Title PD BROGAN, KEVIN M 301 SOUTH COLLEGE ST CHARLOTTE, NC 28202 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 2/17/2016 r ATTACHMENT D INSURANCE REQUIRMENTS fia MIAMIBEACH INSURANCE REQUIREMENTS The vendor shall furnish to the Department of Procurement, City of Miami Beach, 1700 Convention Center Drive, 3rd Floor, Miami Beach, Florida 33139, Certificate(s) of Insurance which indicate that insurance coverage has been obtained which meets the requirements as outlined below: A. Worker's Compensation Insurance for all employees of the vendor as required by Florida Statute 440. B. Commercial General Liability Insurance on a comprehensive basis, to include Contractual Liability, and Products/Completed Operations, in an amount not less than $1,000,000 combined single limit per occurrence for bodily injury and property damage. City of Miami Beach must be included as an additional insured with respect to this coverage. C. Automobile Liability Insurance covering all owned, non-owned and hired vehicles used in connection with the work, in an amount not less than $1,000,000 combined single limit per occurrence for bodily injury and property damage. A waiver of subrogation in favor of the City must be provided for the insurance required above. All insurance policies required above shall be issued by companies authorized to do business under the laws of the State of Florida, with the following qualifications: The company must be rated no less than "B+" as to management, and no less than "Class VII" as to financial strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent, subject to the approval of the City Risk Management Division. or The company must hold a valid Florida Certificate of Authority as shown in the latest "List of All Insurance Companies Authorized or Approved to Do Business in Florida" issued by the State of Florida Department of Insurance and are members of the Florida Guaranty Fund. Certificates will indicate no modification or change in insurance shall be made without thirty (30) days in advance notice to the certificate holder. CERTIFICATE HOLDER MUST READ: CITY OF MIAMI BEACH 1700 CONVENTION CENTER DRIVE 3rd FLOOR MIAMI BEACH, FL 33139 Compliance with the foregoing requirements shall not relieve the vendor of his liability and obligation under this section or under any other section of this agreement. A