Resolution 2023-32624RESOLUTION NO. 2023-32624
A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF
MIAMI BEACH, FLORIDA, ACCEPTING THE RECOMMENDATION OF THE
CITY MANAGER, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO.
2023-259-WG FOR HEALTH, PHARMACY, AND MEDICARE ADVANTAGE
PLANS, AND AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH
CIGNA HEALTH AND LIFE INSURANCE COMPANY, THE TOP -RANKED
PROPOSER FOR PLAN A (HEALTH AND PHARMACY PLANS) AND PLAN C
(MEDICARE ADVANTAGE PLAN); AND, IF UNSUCCESSFUL IN
NEGOTIATING AN AGREEMENT WITH THE TOP -RANKED PROPOSER,
AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH AETNA LIFE
INSURANCE COMPANY, THE SECOND -RANKED PROPOSER FOR PLAN A
(HEALTH AND PHARMACY PLANS), AND HUMANA, INC.; THE SECOND -
RANKED PROPOSER FOR PLAN C (MEDICARE ADVANTAGE PLAN); AND
FURTHER AUTHORIZING THE CITY MANAGER AND CITY CLERK TO
EXECUTE AN AGREEMENT UPON CONCLUSION OF SUCCESSFUL
NEGOTIATIONS BY THE ADMINISTRATION.
WHEREAS, on October 1, 2016, pursuant to Request for Proposals (RFP) No. 2016-
086-WG, the City entered into an Administrative Services Only (ASO) agreement with Cigna
Health and Life Insurance Company ("Cigna") for the administration of its health plan and
pharmacy benefits, which services included, but were not limited to, utilization review, claims
management, case management, disease management, nationwide access to physician
network, concierge services, administration of COBRA benefits, a 24/7 nurse line, and
pharmacy benefits management; and
WHEREAS, the ASO Agreement with Cigna is scheduled to expire on September 30,
2023; and
WHEREAS, on February 22, 2023, the Mayor and City Commission approved the
issuance of RFP No. 2023-259-WG for Health, Pharmacy, and Medicare Advantage Plans (the
"RFP"); and
WHEREAS, the intent of the RFP was to solicit proposals for an ASO agreement, to
administer the City's self -insured health plan covering employees, retirees, and dependents,
effective October 1, 2023, as well as soliciting pharmacy benefit management and a new
offering for Medicare -eligible employees and retirees; and
WHEREAS, on February 23, 2023, the RFP was issued; and
WHEREAS, on April 14, 2023, the City received proposals from the following firms:
Plan A — ASO Health and Pharmacy Services
• Aetna Life Insurance Company
• AvMed Inc.
• Cigna
Plan B — Pharmacy Benefits Only
• Drexi, Inc.
• CerpassRx
• Cigna
• Medlmpact Healthcare Systems, Inc.
Plan C — Medicare Advantage Plans
• Cigna
• Humana, Inc.; and
WHEREAS, the proposal submitted by Drexi, Inc. was determined to be non -responsive
for failure to meet the minimum experience requirement and received no further consideration;
and
WHEREAS, on May 8, 2023, an Evaluation Committee, comprised of Marvin Adams,
Employee Benefits Manager, Human Resources Department; Andrew Bejel, Assistant Human
Resources & Risk Management Director, City of North Miami Beach; Thomas Curitore,
Assistant Director, Code Compliance Department; Jennifer Sanchez, Senior Human Resources
Specialist, Human Resources Department; and Elizabeth Miro, Assistant Director, Facilities and
Fleet Management Department, convened to consider the proposals; and
WHEREAS, the Committee was provided an overview of the project, information relative
to the City's Cone of Silence Ordinance, the Government Sunshine Law, general information on
the scope of services. and a copy of each proposal; and
WHEREAS, the Committee was instructed to score and rank each proposal pursuant to
the evaluation criteria established in the RFP; and
WHEREAS, the evaluation process resulted in the proposers being ranked by the
Evaluation Committee in the following order:
Plan A — ASO Health and Pharmacy Services
1st ranked - Cigna
2nd ranked - Aetna Life Insurance Company
3rd ranked — AvMed Inc.
Plan B — Pharmacy Benefits Only
1st ranked - Cigna
2nd ranked - Medlmpact Healthcare Systems, Inc.
3rd ranked - CerpassRx
Plan C — Medicare Advantage Plans
1st ranked - Cigna
2nd ranked — Humana, Inc.; and
WHEREAS, Cigna is the top -ranked firm for Plan A ASO Health and Pharmacy
Services, Plan B Pharmacy Benefits Only, and Plan C Medicare Advantage Plans for 65+
Active employees and Retirees; and
WHEREAS, since Cigna is also the top -ranked firm for Plan B Pharmacy Benefits, the
City Manager recommends that the pharmacy benefit plan be awarded alongside the medical
ASO services (Plan A) instead of as a separate Plan B; and
WHEREAS, while all of the proposing firms have sufficient experience to provide
services for the. City, Cigna provides a unique familiarity with the City's employees and retirees
and is able to assist the City in tailoring plan designs; has a robust network of doctors and
medical facilities, where 96% of visits are in -network; is the current ASO services provider and
therefore eliminates the potential for disruption to the City's members; Cigna's proposal
includes a reduction in ASO fees and a flat renewal thereafter through plan year 2026; and
Cigna's proposal includes the on -site Cigna representative at no additional cost; and
WHEREAS, after reviewing the proposals and the results of the evaluation committee,
the, City Manager exercised her due diligence and recommends that the Administration
negotiate an agreement with Cigna, the top -ranked proposer for Plan A (Health and Pharmacy
Plans) and Plan C (Medicare Advantage Plans); and, if unsuccessful in negotiating an
agreement with the top -ranked proposer, authorize the Administration to negotiate with Aetna
Life Insurance Company, the second -ranked proposer, for Plan A (Health and Pharmacy
Plans), and Humana, Inc., the second -ranked proposer for Plan C (Medicare Advantage Plans).
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, pursuant to Request for
Proposals (RFP) No. 2023-259-WG for Health, Pharmacy, and Medicare Advantage Plans, and
authorize the Administration to negotiate with Cigna Health and Life Insurance Company, the
top -ranked proposer for Plan A (Health and Pharmacy Plans) and Plan C (Medicare Advantage
Plans); and, if unsuccessful in negotiating an agreement with the top -ranked proposer, authorize
the Administration to negotiate with Aetna Life Insurance Company, the second -ranked
proposer for Plan A (Health and Pharmacy Plans), and Humana, Inc., the second -ranked
proposer for Plan C (Medicare Advantage Plan); and further authorize the City Manager and
City Clerk to execute an agreement upon conclusion of successful negotiations by the
Administration.
PASSED AND ADOPTED this 4
ATTEST:
JUL - 5 2023
RAFAEL E. GRANADO, CITY CLERK
APPROVED AS TO
FORM & LANGUAGE
& FOR EXECUTION
City Attorney Date
day of ,h 2023.
DAN GELBER, MAYOR
Competitive Bid Reports - C2 E
MIAMI BEACH
COMMISSION MEMORANDUM
TO: Honorable Mayor and Members of the City Commission
FROM: Alina T. Hudak, City Manager
DATE: June 28, 2023
SUBJECT.A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY
OF MIAMI BEACH, FLORIDA, ACCEPTING THE RECOMMENDATION OF
THE CITY MANAGER, PURSUANT TO REQUEST FOR PROPOSAL (RFP)
2023-259-WG FOR HEALTH, PHARMACY, AND MEDICARE ADVANTAGE
PLANS, AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH
CIGNA HEALTH AND LIFE INSURANCE COMPANY, THE TOP -RANKED
PROPOSER, FOR PLAN A (HEALTH AND PHARMACY PLANS) AND PLAN
C (MEDICARE ADVANTAGE PLAN); AND, IF UNSUCCESSFUL,
AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH AETNA
LIFE INSURANCE COMPANY, THE SECOND -RANKED PROPOSER, FOR
PLAN A (HEALTH AND PHARMACY PLANS) AND .HUMANA, INC., THE
SECOND -RANKED PROPOSER, FOR PLAN C (MEDICARE ADVANTAGE
PLAN); FURTHER, AUTHORIZING THE CITY MANAGER AND CITY CLERK
TO EXECUTE AN AGREEMENT UPON CONCLUSION OF SUCCESSFUL
NEGOTIATIONS BYTHE ADMINISTRATION.
RECOMMENDATION
See Memorandum attached.
SUPPORTING SURVEY DATA
Not Applicable
FINANCIAL INFORMATION
See attached.
Is this a "Residents Right
to Know" item. pursuant to
City Code Section 2-14?
No
Legislative Tracking
Human Resources/Procurement
Does this item utilize G.O.
Bond Funds?
IM
Page 68 of 1808
ATTACHMENTS:
Description
❑ Memorandum
❑ Resolution
Page 69 of 1808
MIAM BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,
www.miamibeachfl.gov
COMMISSION MEMORANDUM
TO: Honorable Mayor Dan Gelber and Me bers of the City Commission
FROM: Alina T. Hudak, City Manag r
DATE: May 17, 2023
SUBJECT: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF
MIAMI BEACH, FLORIDA, ACCEPTING THE RECOMMENDATION OF THE CITY
MANAGER, PURSUANT TO REQUEST FOR PROPOSAL (RFP) 2023-259-WG FOR
HEALTH, PHARMACY, AND MEDICARE ADVANTAGE PLANS, AUTHORIZING THE
ADMINISTRATION TO NEGOTIATE WITH CIGNA HEALTH AND LIFE INSURANCE
COMPANY, THE TOP -RANKED PROPOSER, FOR PLAN A (HEALTH AND PHARMACY
PLANS) AND PLAN C (MEDICARE ADVANTAGE PLAN); AND, IF UNSUCCESSFUL,
AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH AETNA LIFE INSURANCE
COMPANY, THE SECOND -RANKED PROPOSER, FOR PLAN A (HEALTH AND
PHARMACY PLANS) AND HUMANA, INC., THE SECOND -RANKED PROPOSER, FOR
PLAN C (MEDICARE ADVANTAGE PLAN); FURTHER, AUTHORIZING THE CITY
MANAGER AND CITY CLERK TO EXECUTE AN AGREEMENT UPON CONCLUSION OF
SUCCESSFUL NEGOTIATIONS BY THE ADMINISTRATION.
ADMINISTRATION RECOMMENDATION
The Administration recommends that the Mayor and City Commission of the City of Miami
Beach, Florida, approve the Resolution accepting this recommendation, pursuant to Request
for Proposals (RFP) 2023-259-WG for health, pharmacy, and Medicare Advantage plans,
authorizing the Administration to negotiate with Cigna Health and Life Insurance Company, the
top -ranked proposer, for Plan A (health and pharmacy plans) and Plan C (Medicare Advantage
plan). If negotiations with Cigna are not successful, the Resolution authorizes the Administration
to negotiate with Aetna Life Insurance Company, the second -ranked proposer, for Plan A (health
and pharmacy plans) and Humana, Inc., the second -ranked proposer, for Plan C (Medicare
Advantage plan). Finally, the Resolution authorizes the City Manager and City Clerk to execute
an agreement upon the conclusion of successful negotiations by the Administration.
This solicitation is currently under the cone of silence.
BACKGROUND/ HISTORY
Effective January 1, 2009, the City went from a fully -insured health insurance plan to a self -
insured program. The day-to-day administration of the self -insured plan is managed through an
Administrative Services Only ("ASO") agreement. On October 1, 2016, pursuant to RFP 2016-
086-WG, the City entered into an ASO agreement with Cigna Health and Life Insurance
Company ("Cigna") for the administration of its health plan and pharmacy benefits. The ASO
services include but are not limited to, utilization review, claims management, case
management, disease management, nationwide access to physician network, concierge
services, administration of COBRA benefits, a 24/7 nurse line, and pharmacy benefits
management. The existing ASO Agreement with Cigna is scheduled to expire on September 30,
2023.
There are approximately 2,678 members on the plan, including 1,574 employees, 437 retirees,
Page 70 of 1808
Request for Proposals (RFP) No. 2023-259-WG, Health, Pharmacy, and Medicare Advantage Plans
May 17, 2023
Page 2
and dependents. Approximately 50% of the retirees are Medicare -eligible. There are three plan
designs — Open Access Plus ("OAP)/(operates as an HMO), High Deductible Health Plan
("HDHP"), and a Preferred Provider Organization ("PPO"), which was closed for enrollment as
,of October 1, 2019.
In light of the expiring contract with Cigna, the Administration prepared RFP 2023-259-WG
seeking proposals from qualified firm(s) with whom a replacement agreement could be
negotiated. The intent of the RFP was to solicit proposals for ASO services for the City's health
plan covering employees, retirees, and dependents, effective October 1, 2023. The issuance
also solicited pharmacy benefit management and a new offering for Medicare -eligible
employees and retirees. Standalone Pharmacy Benefit Managers ("PBM") and Pharmacy
Benefit Administrators ("PBA") were encouraged to respond to the pharmacy services portion of
the RFP.
The RFP was structured to receive proposals in the following manner:
• Plan A — ASO and Pharmacy Services
• Plan B — Pharmacy Benefits Only
• Plan C — Medicare Advantage Plans
ANALYSIS
On February 22, 2023, the Mayor and City Commission approved the issuance of RFP 2023-
259-WG for Health, Pharmacy, and Medicare Advantage Plans. On February 23, 2023, the RFP
was issued. A voluntary pre -proposal conference to provide information to proposers submitting
a response was held on March 9, 2023. Two (2) addenda were issued. The Procurement
Department issued bid notices to 13,615 companies utilizing the City's e-procurement system,
with 53 prospective bidders accessing the solicitation. RFP responses were due and received
on April 14, 2023. The City received proposals from the following firms:
Plan A — ASO and Pharmacy Services
• Aetna Life Insurance Company
• AvMed
• Cigna Health and Life Insurance Company
Plan B — Pharmacy Benefits Only
• Drexi, Inc.
• CerpassRx
• Cigna Health and Life Insurance Company
• Medimpact Healthcare Systems, Inc.
Plan C — Medicare Advantage Plans
• Cigna Health and Life Insurance Company
• Humana
The proposal submitted by Drexi, Inc., was determined to be non -responsive for failure to meet
the minimum experience requirement and received no further consideration.
On May 8, 2023, the Evaluation Committee convened to consider the proposals received. The
Committee was comprised of Marvin Adams, Employee Benefits Manager, Human Resources
Department, Andrew Bejel, Assistant Human Resources & Risk Management Director, City of
North Miami Beach, Thomas Curitore, Assistant Director, Code Compliance Department,
Jennifer Sanchez, Senior Human Resources Specialist, Human Resources Department, and
Elizabeth Miro, Assistant Director, Facilities and Fleet Management Department.
Page 71 of 1808
Request for Proposals (RFP) No. 2023-259-WG, Health, Pharmacy, and Medicare Advantage Plans
May 17, 2023
Page 3
The Committee was provided an overview of the project, and information relative to the City's
Cone of Silence Ordinance and the Government Sunshine Law. The Committee was also
provided with general information on the scope of services and a copy of each proposal. The
Committee was instructed to score and rank each proposal pursuant to the evaluation criteria
established in the RFP.
The evaluation process resulted in the proposers being ranked by the Evaluation Committee in
the following order (See Attachment A):
Plan A — ASO and Pharmacy Services
1st ranked - Cigna Health and Life Insurance Company
2nd ranked - Aetna Life Insurance Company
3rd ranked - AvMed
Plan B — Pharmacy Benefits Only
1st ranked - Cigna Health and Life Insurance Company
2"d ranked - Medlmpact Healthcare Systems, Inc.
3rd ranked - CerpassRx
Plan C — Medicare Advantage Plans
1st ranked - Cigna Health and Life Insurance Company
2nd ranked - Humana
The following is a summary of the recommended firms for Plans A and C (Attachment B
describes in detail the benefits and cost -savings from each proposer relating to Plan A — ASO
and Pharmacy):
Cigna Health and Life Insurance Company (top -ranked firm for Plans A and C):
Cigna has been providing benefits to the government and education sector for over fifty years.
Today, they have over 1.6 million covered lives in this sector and also currently provide
integrated benefits to many of our neighboring government and education districts, including the
City of Miami, the City of Fort Lauderdale, and Miami -Dade County Public Schools.
Cigna has been the ASO administrator for Health, Pharmacy, Dental, and EAP since the plan
year beginning October 1, 2016. Some of the benefits and cost savings experienced with Cigna
during the contract period of October 2016 to the present are:
• Employees and retirees have great access to healthcare providers under the Cigna
Open Access Plus ("OAP") network. Currently, 96% of utilized providers are in -network.
• During plan year 2021 the City was provided a month fee holiday which resulted in
$96,000 in savings
• On -site Cigna representative assisting employees with plan navigation and claims
management
• In 2022 the City re -negotiated its pharmacy contract terms and conditions with Cigna
with projected cost impact improvements in excess of $500k for the 1 st year
• During this period, a high -deductible health plan was implemented. The plan now has
about 17% of the City's healthcare population enrolled
• Cigna reduced administrative fees in the plan year 2019 and held flat thereafter
• Cigna increased the City's annual Weilness credit from $50,000 to $100,000 in 2019
Page 72 of 1808
Request for Proposals (RFP) No. 2023-259-WG, Health, Pharmacy, and Medicare Advantage Plans
May 17, 2023
Page 4
Aetna Life Insurance Company (211 ranked firm for Plan A):
Aetna offers a broad network, of high-performance, and accountable care arrangements that
connect members with high -quality, cost-effective care. They go beyond the traditional network
with local options that provide greater convenience and savings. As part of CVS Health,
convenient MinuteClinic, and CVS HealthHUB, locations offer care that's affordable and readily
accessible.
They have over 299K national employees, including more than 5,000 in Florida with local offices
in Orlando, Ft. Lauderdale, Miami, Jacksonville, and Tampa. Over 40 of their Florida employees
work exclusively with Public Sector entities like the City of Miami Beach.
Some of their references include Sarasota County Government, Manatee County, and Lee
County Board of County Commissioners.
Humana (2"d ranked firm for Plan C):
Humana Inc., headquartered in Louisville, Kentucky, offers a wide range of insurance products
and health and wellness services that incorporate an integrated approach to lifelong well-being.
Medicare is a significant part of Humana's business and a major contributor to their success.
They offered their first private Medicare plans in 1985 and their first Medicare plans for
employers in 1990, giving them more than 32 years of experience offering group Medicare plans.
Humana services over 630 Group Medicare clients today representing 560,000 group members,
with 28 public sector clients in Louisiana. In addition, Humana agrees to provide the City with
the requested retiree concierge advocacy model for its Medicare -eligible retirees through their
partnership and seamless integration with RetireeFirst. RetireeFirst complements its high -touch
member service model by providing an engaging personalized concierge solution with Retiree
Healthcare Advocates available to guide retirees through every phase of their healthcare benefit.
Today, Humana is licensed to offer employee -sponsored, network -based Medicare Advantage
solutions in all 50 states plus the District of Columbia and Puerto Rico. Humana is also licensed
to cover retirees residing in USVI, Guam, Marianas Islands, and American Samoa.
Some of their references include El Paso County, Colorado, the City of Lynn Massachusetts,
and the City of Dento, Texas.
Plan B — Pharmacy Benefits Only
Of the three proposers in this category, Cig'na ranked number one and thus is being
recommended to provide the pharmacy benefit plan along with the medical ASO services (Plan
A).
Plan C — Medicare Advantage Plan for 65+ Active and Retirees
The City sought proposals for Medicare -eligible employees and retirees and received two
responses. The Administration is recommending the proposal received from Cigna, which
provides the following benefits:
• Implementation flexibility allowing for a 10/1/2023 or 01/01/2024 plan start date
• 0% rate increase through 2025; 5% rate'cap for 2026
• In -home support for members
• Pro -active outreach to all new members
• Concierge and Administration services provided by Retiree First
Page 73 of 1808
Request for Proposals (RFP) No. 2023-259-WG, Health, Pharmacy, and Medicare Advantage Plans
May 17, 2023
Page 5
FINANCIAL INFORMATION
ASO Services for this contract are processed through the internal service fund accounts,
managed by the Human Resources Department, Employee -Benefits Division. The funding for
the medical and pharmacy plans is analyzed and projected through actuarial services and
approved in the budget process each year. Currently, the annual ASO fee for the plan year 2023
is $711,948, and the per -script fee is $2.50 this does not include the claims costs associated
with each plan). Cigna is proposing an annual ASO fee of $692,988, and a per -script fee of
$2.25 for the plan year 2024. This results in annual savings in ASO fees of $18,958.
CONCLUSION
After reviewing the proposals and the results of the evaluation committee, it is recommended
that the Administration negotiate with Cigna Health and Life Insurance Company, the top -ranked
proposerwho is most qualified to provide ASO services for the City's health and pharmacy plan
covering employees, retirees, and dependents. While all of the proposing firms have sufficient
experience to provide services for the City of Miami Beach,, Cigna Health and Life Insurance
Company, provides a unique familiarity with the City's employees and retirees and is able to
assist the City in tailoring plan designs. Cigna has a robust network of doctors and medical
facilities, where 96% of visits are in -network. In selecting Cigna, the City eliminates the potential
for disruption to our members. The proposal includes a reduction in ASO fees and a flat renewal
thereafter through plan year 2026. Additionally, Cigna is including the on -site Cigna
representative at no additional cost.
For the reasons stated herein, it is recommended that the Mayor and City Commission approve
the Resolution authorizing the Administration to enter into negotiations with Cigna Health and
Life Insurance Company, as the top -ranked proposer, for Plan A (health and pharmacy plans)
and Plan C (Medicare Advantage plans), and, if unsuccessful, authorizing negotiations with
Aetna Life Insurance Company, the second -ranked proposer, for Plan A (health and pharmacy
plans) and Humana, Inc., the second -ranked proposer, for Plan C (Medicare Advantage plan);
further authorizing the City Manager and City Clerk to execute an agreement upon the
conclusion of successful negotiations by the Administration.
MT/MA/ /I<%
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Page 74 of 1808
Attachment A
RFP t 23.2H-D
HEALTH, PNARYACYRU). JUID-
IEDICAREAD ADVANTAGE
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FOR DISPLAY PURPOSES ONLY. FINAL RANIONO DOES NOT CONSTITUTE AN AWARD RECOMMENDATION.
Page 75 of 1808
RFP 2023.259-WG
HEALTH, PHARMACY(R1l),
AND MEDICARE
LOW
ADVANTAGE PLANS
Mo. InAdams
Andrsw®a)d
g
TAamko asCurn
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Jennifer panchm
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Totals
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amrdMa1M
I Sumew
I Qmvtot*o
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I Subtsaal
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Subtotal
omstouw
I otormi tNs
I SWrotal
a
71
0
71
3
85
0
65
3
70
0
70
2
73
0
73
3
80
0
GO
3
14
3
pna as an insurance
Company
93
0
03
1
93
0
93
1
85
0
85
1
90
0
90
1
85
0
85
1
5
1
Madimpact. ears ysfema,
1
1
Ins.
76
0
78
2
80
1 0
1 80
2
70
1 0
1 70
1 2
82
1 0
1 82
2
75
0
75
2
10
i
avo
Him"�
Toll
Ystsnn*a
ONnnkoL.w
(Cost•
Proposer
Points
Votm ,$)
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5
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5
0
Cigna HoaMh and Life insurance
5
0
Company
Msdlmpact 1lsahhcaro Systems,
5
0
Inc.
FOR DIM -LAY PURPOSES ONLY. FINAL RANIONO DOES NOT CONSTITUTE AN AWARD RECOMMENDATION.
Page 76 of 1808
RFP 2023-259-WG
HEALTH, PHARMACY(Rx),
AND MEDICARE
g
LOW
ADVANTAGE PLANS
Marvin Adams
Andrew 8*1
Thomas Cueltm
Eltrabedr two
Jamtler eendrsa
AqW"s1m
Plan C Medicine Advantage
Plan
omu ur.
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matntitative
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Cigna HasiM and Life
i
Insurance commarry
91
0
91
1
9a
0
9e
1
95
I 0
95
1
59
0
119
1
go
0
a0
2
6
1
uruna
e3
0
93
2
93
0
93
2
95
0
95
1
66
0
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2
95
0
95
1
8
2
Total
l>!usntlWMe
vateran'e
(Cost4.
Proposer
Pointe
vaterwal
Cigna Heeeh and Ltie
5
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inwnnoe C
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5
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Page 77 of 1808
Attachment B
The following chart displays the benefits and cost -savings from each proposer for Plan A — ASO and Pharmacy:
Administrat"
Cigna urro
its nWO0Aetna
AVMGd
Enrollment HMO PPO HOW
Employee 753 94 144
Employee * 1 240 21 59
Faesly 194 1 74
Total Enrollmen 1,107 11e 277
Total Account 1.S60
minfillMon Fees IFlaed)
Medical Administration
$10.25
$9.25
$33.29
$47.51
$40.77
Case Management
Included
Included
Included
Included
Included
Disease Management
Included
Included
Included (Aetna One Flex)
See ASO Proposal. Fee/Panicipant
See ASO Proposal, Fee/Participant
Behavioral Health
Included
Included
Included
Included
Included
Network Access
$17.25
$17.25
Included
Included
Included
Concierge Services
Included
Included
Included
Included
Included
Reinsurer Interface Fee (if any)
$0.69
$D.69
Included
Included
Included
Wesness.Vendor Interface Fee (d any)
Included
Included
Included
Included
Included
CSG Consulting F
1A
eo.ya
Monthly Medical Adminlstrallon (Per Submwfbsr Par Month)
S37.55
1136.55
642.65
SSe.67
$50.13
Total Administration Fen (Annualized)
$711.948
$692,9e6
$60e,844
61,076,255
$950,465
Phartnacy Administration
Clans
Clans
AeMa
AvMed
ArMed
Contract
Traditional
Traditional
Traditional
Pass Through
Pass Through
Per Script Fee
$2.50
$2.25
$0.00
$1.10
$1.10
Miscellaneous Notes
Onsse Claims and EligitA fy Representative (Full -Time Annual)
----'-'`-'------'------•-.—'--------------------..--'---------
— Included
----------------
Included
---------•----•-------___------------
$128.000
-------------------- -------------- ---
S72,133
•-•-------'------"---'-'------____.-
Not Included
—'------------------------------------
MedicalCarrier
Included
I
—------------------
---•-----•-•--•-----•------------•----
--------------------- ---•------•-----
----------------------------------
FSA vendor
Included
---------------------
Included
--------- —---------
TBD
-•---------------------------------'
$9.930
----------------------------------
$9.930
'----------------------•-----•-------
•._.---'-------------.---•—_—•------'------------
anal tcs
---•------------------------•-------
-------------- Included -_
---------------------------------•-'
-------Included
----TBD----------
65-DDD
Not Included
-Rx
Fee Renewal Guarantee
Flat Thru 9130/2026
Flat Thru 9=12026
----•----------------------------•
Flat Thru 9r30/2I
------------------- —'-•"------"---
Not Included
-------......'---"......--"......•.
Not Included
----------------------------------- ----
-----'---------------------••---------------------------•----••---
Fee Hdtday
------------------------------------- ---
-------------•---••-'------------
_ Not Included
---------- --------------------•-
_ 3 Mo Yr 1 6 2 Mo Yr 2
-----------------------•
2 MI ntrLs
------------------- ------"_.--'---
Not Included
'------------------•------------•---••
Not Included
------------- -
Fund
WA
$100.000
Not Included
Not Included
---'--••-•-•----------------•---------
Not Included
----•--------------•-------------------
-----_^._----_._---------------"-----'----'---'-'-------------
Implememetion Fund
-------------'-.._'--'•------._---••---•-----------------•—'-
.—...._..----'----------'------------
_Not Included
•-------- -----'----'-
------------------•--•••-----•---------
-"----' ---------
-----Not Included --.
-----------•--•----•!----------•'--'-
$10.
-------- --_ ----------------_--___
5 ------
--"'-'---^__--"------'-•-'-----'--
Not Incudetl
----- —'----------_."'-'-----'----__-'
Annual Wesnaas Fund
$100,000
$100.000
$100,000
$100.000
$100.000
Page 78 of 1808