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2000-24195 RESO 1 RESOLUTION NO. 2000-24195 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, REJECTING ALL PROPOSALS RECEIVED, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO. 97-99/00 FOR GROUP MEDICAL INSURANCE, AND FURTHER AUTHORIZING THE ADMINISTRATION TO ISSUE A REQUEST FOR QUALIFICATIONS (RFQ) FOR A BROKER OF RECORD FOR GROUP MEDICAL INSURANCE. WHEREAS, on May 10,2000, the City issued Request for Proposals (RFP) No. 97-99/00 for Group Medical Insurance; and WHEREAS, twenty nine (29) specifications were issued, resulting in three (3) responsive proposals from Humana (Fully Insured), Humana (Self-Funded), and Administrative Services (Self- Funded); and WHEREAS, an Evaluation Committee/Group Insurance Board recommended by the City Manager met on October 12, 2000 to review and discuss the proposals; and WHEREAS, the Evaluation Committee failed to select a number-one ranked or number-two ranked proposer since all proposals were deemed to be less cost effective than the current contract with Humana for Group Medical Insurance; and WHEREAS, the Evaluation Committee recommended rejection of all proposals received; and WHEREAS, the City's Consultant, Siver Insurance Consultants with the concurrence of the Evaluation Committee, recommends that the City utilize a broker of record to conduct a Market Analysis and/or secure proposals; and WHEREAS, the City Manager has reviewed the recommendation of the Evaluation Committee, and concurs with its recommendation. NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND THE CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City Commission hereby authorize the Administration to reject all proposals received, pursuant to Request for Proposals (RFP) No. 97-99/00 for Group Medical Insurance and further authorize the Administration to issue a Request for Qualifications (RFQ) for a Broker of Record for Group Medical Insurance. PASSED AND ADOPTED '000011 this 29th day of November, ~iAS 10 FORM & LANGUAGE & FOR EXECUTION ATTEST:.. .4t( kffIM ~J pcwlv-- VChy~~' /).0;'--011 ity Clerk Mayor / SECTION II -SCOPE OF SERVICES The City requires that all Broker/Agent compensation for the required services be proposed as the standard commission on premium. Neither the selected broker nor any of their business partners or affiliates will receive commission from any insurance companies relative to current/in-force policies purchased by the City. The City requires that the selected Braker/Agent pravide, at a minimum, the fallawing services: 1. Provide assistance to' the City's Risk Manager in determining the City's Group Medical Insurance needs. 2. Prepare reparts infarming the City's Risk Manager regarding insurance market (Market Analysis) canditians that may affect the City's palicies and risk expasures priar to' palicy renewal. 3. Assist/prepare Request far Propasal (RFP) specificatians and underwriting data (subject to' the appraval afthe City's Risk Manager) to' submit to' acceptable insurance markets far the purpase af abtaining propasals far Graup Medical Insurance caverage. 4. Upan directian fram the City, approach all acceptable insurance campanies an behalf afthe City. A camplete list afthe campanies cantacted, alang with their respanse, must be submitted. S. Present to the City all insurance caverage prapasals abtained. This repart must cantain a camprehensive analysis by the braker afthe prapasals abtained with recammendatians far the selectian af ane prapasal far the particular risk to' be cavered. 6. Negatiate, an behalf af , and with directian fram, the City with all insurance carriers to' abtain the best prices, terms and canditians available. 7. Review all insurance palicies and invaices received far palicies purchased by the City to' assure their accuracy and appropriateness. 8. Review and evaluate existing City palicies to' pravide recammendatians far passible impravement af price, terms, and canditians. 10. Pravide an annual repart summarizing Graup Insurance caverage in place, anticipated market canditians, recammendatians and strategies. / EVALUATION/SELECTION PROCESS: CRITERIA FOR EVALUATION The procedure for qualification evaluation and selection is as follows: I. Request for Qualification (RFQ) issued. 2. ReceiptofRFQ. 3. Opening and listing of all RFQs received. 4. An Evaluation Committee, appointed by the City Manager, shall meet to evaluate each response in accordance with the requirements of this RFQ. If further information is desired, proposers may be requested to make additional written submissions or oral presentations to the Evaluation Committee. 5. The Evaluation Committee shall recommend to the City Manager the proposal or proposals acceptance of which the Evaluation Committee deems to be in the best interest of the City. The Evaluation Committee shall base its recommendations on the following factors: 1. Specific Expertise regarding the Scope ofthe Project 2. Overall Expertise of the Broker 3. Experience of Broker with Governmental Entities 3. Costs/guarantees 4. Overall response to RFQ. 6. After considering the recommendation(s) of the Evaluation Committee, the City Manager shall recommend to the City Commission the proposal or proposals acceptance of which the City Manager deems to be in the best interest of the City. 7. The City Commission shall consider the City Manager's recommendation(s) in light of the recomme,ndation(s) and evaluation of the Evaluation Committee and, if appropriate, approve the City Manager's recommendation(s). The City Commission may reject City Manager's recommendation(s) and select another proposal or proposals. In any case, City Commission shall select the proposal or proposals acceptance of which the City Commission deems to be in the best interest of the City. The City Commission may also reject all proposals. 8. Negotiations between the selected proposer and the City Manager take place to arrive at a contract. If the City Commission has so directed, the City Manager may proceed to negotiate a contract with a proposer other than the top-ranked proposer if the negotiations with the top-ranked proposer fail to produce a mutually acceptable contract within a reasonable period of time. 9. A proposed contract or contracts are presented to the City Commission for approval, modification and approval, or rejection. 10. If and when a contract or contracts acceptable to the respective parties is approved by the City Commission, the Mayor and City Clerk sign the contract(s) after the selected proposer(s) has (or have) done so. ./ Important Note: By submitting n RFQ, all proposers shall be deemed to understand and agree that no property interest or legal right of any kind shall be created at any point during the aforesaid evaluation/selection process until and unless a contract has been agreed to and signed by both parties. . '-T~:' A*Q~ A. PROPOSAL ANALYSIS SUMMARY for THE CITY OF MIAMI BEACH Prepared by SIVER INSURANCE CONSULT ANTS SIVER RECOMMENDATION It is apparent from the projected annual costs reflected in the two financial exhibits (attached), that Humana's Fully-Insured proposal provides the most cost-effective group medical option for the City of Miami Beach. However, Humana's proposal in response to the RFP does not address certain service components presently provided under the in-force Humana contract, specifically, the provision of an On-Site Representative. Premium rates provided in both the Humana renewal and the Humana proposal are the same. Therefore, it is our recommendation that the City continue under the in-force Humana contract as previously approved by the Board for an October I, 2000 effective date. In effect, this recommendation suggests The City of Miami Beach exercise the option to reject any and all responses received as a result of the RFP process and continue with the original renewal provided by Humana for October I, 2000, through September 30,2001. ANALYSIS PROCESS Copies of all proposals received in response to the Request for Proposal No. 97-99/00 (RFP) were provided to Siver by the Purchasing Department for our review and analysis. We began the proposal analysis by confirming if bids met the minimum requiremettts outlined in the RFP. During the initial analysis phase, we determined that several vendors excluded Retirees entirely, and/or Retirees eligible for Medicare. In each case, the vendor in question was disqualified for failing to meet the eligibility requirements of the RFP, as outlined in Section III, Item D, Participant Eligibility. The disqualifying factors for each vendor is shown in bold print on the Self-Funded Rate Exhibit, under the heading "Notations". - The second stage of our review was the preparation of financial spreadsheets and input of proposed rates based on comparable participant numbers. We completed two rate exhibits. The first exhibit reflects the only Fully-Insured proposal, submitted by Humana, the incumbent carrier. The second exhibit reflects Self-Funded proposals, including one presented by Humana. Of the proposals shown on the Self-Funded Rate Exhibit, only the first two are viable proposals, again, due to Retiree exclusions. However, for comparison purposes only, the rates from two additional vendors (selected at random) were included in this exhibit. We would point out that under a Self-Funded arrangement, only the fixed costs are certain. The I ;:t. SIVER INSURANCE CONSULTANTS claims component, shown on our exhibit as "Aggregate Liability", will VllI)' based on actual claims. "Aggregate Liability" is detennined by the Stop-Loss underwriter. Utilizing past claims history and trend factors, an underwriter first estimates the amount of claims anticipated in the upcoming plan year (expected claims). A margin of 20% to 25% is then added to expected claims, resulting in the maximum annual claims liability. Our exhibit for Self-Funded Options is based on the annual maximum claims liability, in combination with the annual fixed costs. The least expensive Self- Funded option shown is from Acordia, using American and Hartford companies for Stop-Loss coverage. This proposal reflects an annual maximum liability of $10,420,584, an estimated $1,713,519 higher than the Fully-Insured Humana proposal. Further, this proposal is invalid, as it excludes coverage for Retirees. The only valid Self-Funded proposal, other than Humana, is Administrative Services, utilizing John Alden's Stop-Loss quote. This proposal reflects an annual liability of$II,445,352 and is $2,739,287 higher than the Fully-Insured Humana quote. Again, Humana's Fully-Insured proposal provides the most cost-effective group medical plan option for the City of Miami Beach. As stated above, Humana's proposal in response to the RFP does not address certain service components presently provided under the in-force Humana contract. To avoid any negative impact to the City, it is our recommendation that the in-force Humana contract continue as previously approved by the Board for an October I, 2000 effective date. This recommendation suggests The City of Miami Beach exercise the option to reject any and all responses received as a result of the RFP process and continue with the original renewal provided by Humana, in lieu of accepting the Humana proposal response to the RFP. As the incumbent vendor, this option would provide continuation of current benefits and provider networks. We did not pursue contact with other vendor's client references, conduct alternate provider network analysis, or other tasks typically utilized in our review process since accepting Humana (either the renewal or the new proposal) was deemed to be in the best interest of the City of Miami Beach. Based on the vendor responses to the RFP process, it appears savings to the City's Group Medical Plan can currently be generated only by plan revisions and/or changes in the contribution strategy. It is our understanding that there may be constraints on the City's ability to revise current benefits, due to collective bargaining agreements. We might suggest that the City consider union negotiations regarding future plan design changes, and also consider a review of current employer contributions at the Active and Retiree levels. Weare available to meet with the appropriate staff to discuss possible alternatives. Respectfully Submitted by: SIVER INSURANCE CONSULT ANTS ~el~ Brenda Sadler Senior Consultant September 23,2000 ]:IEWBIRFPlMBI EINARRA TlV. WPD 2 " ~ 9- 3: iir 2. CD !l o ;:r ..-. .. :J>3:"''''S'S1,,,,l/l... go~"l.i .~... J: a . ,i!. - il. Ia:r I"C fl,J'" :g-<N....VYi .. ." V V Cll Cll ;,,~~(JH.ll..... ii:s! ::I .. ::I ." ""..; !!!!>!3 <DllS- . . 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"t.JW ~ot ~~ - - ..... .... OtCD "'''' .. .. U '0'0 ...... ...... !:!: ~lti ". ..... gg :> < 1ft Z ~ - 1ft n 1ft ! il' N & " ~ I if ill 1ft 1ft " w i .. . l ~ .. & " .. i g ; if -: ~ 3 Il ~il' I ~ 0 .. f rf ~ if:;=; 0 ~ ;r "T1 o ~a.s: Ifm...~&~ ~.a> - ~:: III c !l ill ,0 ~ : ~ : .~; ~ ~ i;.51 ..!. .. <i cs :! & . - ~ f ! !l ~ " .. ~ 8 ; .... i ;' i 0 ! f f :: s i .~ ! i j i ~ It ~ - w : . .. .. g~ -li~ "'... 4Ilt" "'411" ~~ Gi "II!CO"llI111'l''' :;j-lC!1 ~i5ll:t",,,,J;~...tt5- N (abtCoW.~""'Co"""'N-Ul- N Ii,,)'" f.;) N -""" CD....... VI 1'toJ""" (It... 0 (11 CA to>> 0 ~ ... ~ ~.. ~.. .. 414 ~~ P!D.. P.ID...::.Ita;:.. _.~... ...S!!~~co~:tp.,)~cn....."" ~(JI""'O(6U1~N::j~'5~ n'8~i'8}j~~~~~~ ~ ! j i J :: g !! i 1 i w Insurance SIVEi 6 9400 Fourth SlIcel North, Suite 119 St. Petersburg, Florida 33702-2525 Post Office Box 21343 St. Petersburg, Florida 33742-1343 Telephone: (727) 577-2780 Fax: (727)579-8692 October 31, 2000 I [ii)nn f.-m_- ~ n T~:r::l In} . . l , NOV 2 2000 . . L___._ . ' rw:('~" ;'.":;-"" -J r:",,\ )'" ,I, .::' '! -1.J. ,'or- ..,.~, _,"'" ., .. -.-,.___~.__....:._'_:".l .'.:_~._ .:--'" ~ i ~.L___ j E-mail: siver@siver.com Website: http://www.siver.com Cliff Leonard Risk Management City of Miami Beach 1700 Convention Center Drive, Third Floor Miami Beach, Florida 33139 Subject: Proposal Disqualification Dear Cliff: We understand that Bruce Rishty of Wealth Planning, Inc. has contested our disqualification of the Acordia proposal. This proposal included stop-loss coverage through American United Life Insurance Company (specific stop-loss) and Hartford Life (aggregate stop-loss). During our proposal review, the first Hartford stop-loss quote reviewed was submitted as part of the proposal from Robey-Barber, a local third-party administrator. This Hartford stop-loss proposal included specific and aggregate quotes and listed 11 assumptions, The second assumption shown is "Retirees are excluded". Attached is a copy of this proposal page for your review. Note the date on this proposal (provided to Robey-Barber) is 06/21/2000. Upon reading the assumptions, the Robey-Barber/Hartford proposal was disqualified, as the exclusion is in violation of State Statutes requiring public entities to offer such coverage to retirees. When we reviewed the Acordia proposal and found that Hartford provided the aggregate quote, we immediately called Acordia's contact, and requested copies of the assumption pages from the specific and aggregate stop-loss carriers. Attached is the response from Dave Cook of Acordia. Note item 2 of the Hartford assumption list states, "Retirees are excluded", The Hartford proposal to Acordia is dated 06/13/2000. As with Robey-Barber, upon reading the assumptions, the Acordia! Hartford! American proposal was disqualified. SIVER INSURANCE CONSULTANTS Cliff Leonard October 31, 2000 Page 2 The basis of our disqualification was discussed with The City's staff and later with the Insurance Review Committee. Should you have any questions regarding this issue, please don't hesitate to call. Sincerely, SIVER INSURANCE CONSULTANTS ~/:t.~. Brenda M. Sadler Senior Consultant BMSIky Enclosure 1:\EWB\CORlUOOO\CITYMIAM\MBIE3S.WPD MEMORANDUM TO: Corey York (j/ Siver Insurance Management Consultants FROM: Dave Cook RE: City of Miami Beach DATE: September II, 2000 The following are the assumption pages for the American United Life Insurance Company specific quote and Hartford Life's aggregate quote. Each quote requires that more up-to-date shock claim and monL'1ly paid claim infonnation be provided to finalize the quote. The choice of effective d:::.rc v"ill also have some intluence on final numbers. This also gives us the opportunity to correct a typographical error made on our rate summary. The actual specific rates for the $200,000 deductible should be $15.64 per single (our sheet shows $36.50) and $32.17 (our sheet shows $32.14). The correct rates were shown in our answers to the stop-loss question in the Acordia response to the questiOlUlaire. If you need any other information, pleasc contact mc. DPC Acordi. One Hillcrest Drive EISI P.O. Box 1551 (25326-1551) CharI...,n. WV 2S311.J&91 Vai",: 304.346-0611 Fox: 304.347.0697 SEP 11 '00 11:13 304 347 0746 PAGE.al ,.--............. .................. ...)t:)""t ...)...r t:.Ir...c r.t:.I...J/~..) ~~e~/~DOD 14,Q9 FAX 781 83. 2709 RE 1I0tn.roN '. """DIe- .UrdtallJft I"sruace C.JJlp~ .~. R.E.Moulton, Inc. " " -0- roo FROM : Rll: DATI!: . David C"'alc~~:~f WIT :Er:l.c: '1'U=e en 11. tlrews M1am:i. Beach, c::!.ty Of June 13. 2000 Pollo...u.g is clIe proposa), you have l'equeste.1 on the above g%Oup. This quote it; based on the the accuracy of the s'Ubmitted infO%ll\lltion. We ..Pi',....":!.at:e the c:ozU!:!.d.enc:e ytlU bave sho>rn in our fi:rm and loole fo%W&~ to se~ng ytlu: needs. The featU%es of this pro.posal a:e as fallows: " ..' . Th:l.s proposal assumes t:here are no .ongo:l.ng clai~ in exceos of SQ% of the lowest quoted specific deductible. If such a ClaiM shOUld arise.. !:big P=P08aJ. is coontingeut ~= receipt of detailed information reguding the claiinant and fuxtber underwriting ~y be necessary based on the information provided. . Tltis proposal i.Dclucle. all elig:ible employees and. d.epende:n1:8 an.d. dOBs not requill'e employees to be at work, ailcl d"Pende..es to be pe:::fo::::ll:l.:og the f'lmceious of a l:l.lc.. person of the s""'" age ancl sex. · ~s proposal is su1:lject: to R. E. I'louJ.ton. Inc. '~proving' the Thi:.:d pa.:t,y Adnlinistrator.. '. Thill praposal inc:~udes Specific 1w:l'lrance :Fumting, .. For an ....eu=ed ....d paid (:1.2/12) "o.,t:.:a~e. basis. reduce . specific rates 17% (x .83) and aggregate factors 15\ ex .85). * This propc9al is contingSll.t up= receipt aad review of updat:sd eo<pe:r:i.enc:,. (paid claims. head.counts _Ii shock ic.fo"";;'tion) . \:hru .:ruiy 31. 2000. The aggregat" factors vill be fi:a31ized based 0>> t:his updated iZlt'o=ation.: \ . . )/" c:,c;C QJe- . . . IQ_~_"",,, . II&Olu:.1!tI('?Il)IlI&oJPI,P_('IuJ_"'- _1_'1loI('I1IlJ_IS,~cmi"&ol1u ....._ .Ill.. ~ -- SEP 11 '00 11:14 304 347 0746 TOTAL P.03 PAGE. 03 Z13'3:Jtid 91><'13 <.I>~ l>0~ ~ '" :: o ~ .. :t o :( j ~~ ~ ~ ~o- _~O~~I~. ~~o ~)> '_'!;:" p....;. 'Il; i~}!~~~W~~~:~~~f.!l.i ~jl all~-~:f!1f~,~i~!~i"!~~ ~" .. ~n '" [ -- = g - ." C f .. - ~ iI .. - t!.c:&. 9 ~ ~ 8-0b.3 ~III' J!I" ~~<..~~- Q.~..za~ ~i~~~ 0'l!:!.i!.3~;~&i'-l"!!.rt!~~~ ll.g.c; il~~r~it~t!i~l~j~ittif [~~P:~~ifi~f~~i~id ~r i~~~[~~~~~[i~~"~~~~ fg ~i~~J~~:il~t~~~~~~~ ~~ ~i'- ~"a/J-~-"ll..~li'< i! . 5'~-U~"j"oil"""""~-'-< IS. ..il ~~~~ j ~f~[Bg~~~@ i ~~ ~Q.!f~ g. .aa-~l!i"o..9'l!l.,.,. _ i'F1lI ~~"i " a" '" 2~~i'- ~ ~~ ~5~.. ~jli. ~~o..~~~ k ~~ ~~~~ l~'<i~ ~~tg~~ ~ [~ ~~~~~ i;3 ~~~~~~~ ~ ~~ g.e- ~ -$O-'ia-. ~~~- ii~~ ~i~i!~~ i ~~l ~~~~ l[!~~~~ ~ t'IlQ.. 3!:o.- "'ZUiolll! 8- ~i[i~~~ ~~J& ~ ~ iicr~ al~'al tn<a)lo Q, !~~ ~:~l~ !~!~~J ~ I>> ~ 3 tI 0" E la )( ~~~ i'< alf ~ ~ _5' '!ilS': ~..B.Sl "ll ~ 3: ~[~ ~~~~ ~ ~ l~ I~I IIJ~ i ~ aa ~~~ ~~~~ a ~ is' :~; S'~~ ~ ~ 2!. Pi51. lIl"Orl CD i~ ~Nt i~~ 3 ~;;; ;1= ~o~ !. ~~ ~~S' ~~~ ~8 ~ ~~ .D~ ~ D i: ~:~ Z~lt <> ~ ~i ~~~ ~s I ~- ~e. ~?t'~ B ~(It Co ~ ~ ~ ~~~ ~ f m i f-~ I 2 ~ ~ ~ a < a ~ fr~ c: I i '8. " , f i i 1 il .. -. - 0: " .. IE !i !; C ~ :J : ~ $ .. IL~ -< " ~. fl~i" .. 3 ~ < " "" go.!'. :r .. .. - " ~ a. ig,~ ~ "- ~l! ~ Ii e- !l '< i<:i 0 Ii", " .. 0 'H. ~3 " ~ ~ .. ~ !!. ~ c: I f .. ,. ':il " c: ". if ~ ~ a. " ~ .. Ii ! ii ~ 3- 3- 9' ~ '- 2 0 ::! '" '" I " '" f ~ 9' g - ~ W ~ f ~I ~i g~ i ~ f <> ~ !1 a .. or C -< !:I ~ '" 'i 1i OJ I>,:n 00. n d3S .. '.;. .. ., ~ & ~ ~ t~ ~ " 2... . G t- ('. "', ~"... ,. :"'.. ". .- . , .cp. . ~ ~. '?-- -. .- " c~/7~'~ Qn)~ )~C ~~~ R~-^M ~n ~Tn~n~ ~n.TT ~~~_TT_~~ Slop Loss PropnQ~1 Prepared For. /L.. Spence ,,- IEffective 10101/2000 Administrator: ~ Robev BarborJ IDat.: Prospect: Cltv ofM"lamr Beach THE loca~ol"l: Miami Beach. FL /lEES: Med & Rx Single: 833 #EES: Den~ Sin~lfe: HARTFORD Family: 700 Family: To..1: 1~2 Tolal: 0 SPECIFIC COV~RAGE Commission % . :,:,:'Oinlon:1::, ',:::,oiiu",,'i=::::::: ::::,:,:O<;UOil:3:;: .. ::;:Oiliwh:.4:" ::.: D;;U6n:S': ::.'::: Qp~O"ll: 15.0% .. .. .. .. Contract B;asis: 12115 12115 0 0 0 0 Specific Deductible: S100,000 S200.0oo $0 SO SO 50 Specific SinQle: 38.39 17.63 0.00 0.00 0.00 0.00 Rate-s FamHv: 92.14 I 42.31 0.00 0.00 0.00 0,00 Com"",;\<!: 63.10 I 28.97 0.00 0.00 0.00 0.00 Anouat Prem. T o~l: 1.167.677.28 I 536,131.71 0.00 0.00 0.00 0,00 "'> .j'!> AGGREGATE COVERAGE 'L ~ 6'- AGGREGATE COVERS: Mqdical X AX X Commission "It . 15.0% :-::=::-:OD!i6Ii'1::'=:: : ,. :oii~iXi:i-: ... :-:000(;,,3::-: . :: :-:'0i.<ini;-~,=:-.': . :Oi>tibi1:S'" ':ijiiiidIl6:=: Contract Basis: 12115 12115 12112 12112 0 0 Spedfic Deductible: 5100.000 5200.000 5100.000 '200,000 SO SO Aggl<lgal4 Med Sino,.: 291.41 296.96 239.25 2US' I=a~o~ Farrii-lv: 757.67 772.84 622.06 e3A.52 Composite: S505.79 ~515.77 $'15.26 $0123.48 $D.oo $0.00 Den Single: "\I.L.U "l?'l.e.S ~'OZ ,l'>\ ':'1'\0.1\ F::lmily: ; G.:lmpo:si!e: SO.OO I so.OO $0.00 $D.OO #DIV/O! #DIV/O! Projedad Atbd'lmenl PoU'lt: 9.359.190.72 9.543.734.88 7,684.029Ail 7,835.S20.~2 0.00 0.00 Minimum Attad'lrr.en~ Point 8.4.3.271.65 8.589.361.39 6,915.826.5:1 7.052,0~.83 #DIYIO! lfQIVIQ! Run-in Limitation: nI. nI. nI, ola 0.00 0,00 MO. Premium R.ate(ee/mo): 2.16 2.38 2.16 2.38 0.00 0.00 Annu31 Aoo~ta Premium: 338.000.00 I S42,000.00 $38.000,00 $42.000.00 Monthly Accounting: nla I z -j Our ProposaJ is has~ upon the following: Assumptions: 1. Quota is based upon the ur:derlying sctledule of benefits whicl-] produced the experience. Any ch<lnges n'ust be approved in advar.ea. 2. Retirees ara axc1uded. 3 Specifl(: Quote includ$S coverage for medi~11 RA daim~. 4.. Acgregate includes a ccnidor ot 25%. S. Maximums; AQl;regste (POlicy Year); S1,OOO,OOO 6 ~1inimvm attachment pcint calC1Jlated using 90% of Quoted enrollment. 7. Ql.IOte ;Jssume.:l underiyin'J plan complies 'Mth HIPAA regula!ton.s. 8. The :above Adminj~trntof must administer all daims on tl".G Specific and A99r~te cov~aQe and must be on The Hartford's ~jst of approved payors 9. CONVERS10N FEE. $O.75/err.pl<lYe.J/rr'.onth, lnch.;des no oommi.s$lCl'1. not indl.lded ill above rales. (OPfIONAL PROVISION) 10. In the e...~nt a plan ~rticipant roceives health care in the state of New YoM< which a,'! subject to the Ne...... York Healthca~ Reform Act. WljI ....-ill ~vO( :.lo:. S.13% cad debt and d'l;arity 5urct1arge under Ol,;r Step loss AgreementS. 11 A:f HarttCl'd...standal'd colley pt'Ovisions apply. Our Propos~l IC Quali-fiod !or the following ~font covsr3g. will be 3ce.optod: 1. 'ihe StqJ loss Medical Dlsdcsura Statement must:e recei\'ed and 3ppru'Jed by 1M Jnder.vr\ter not e.liiar than 45 days, or later tha."l 15 day" prier lo:he eff!:c:jva ck~!'e_ Uflder....ritir'lg J'Tlay require further detail on certain j,xjlvidu2Js btffON ::l.CCQ?ting thO fi$o/(. _. We l"C:5er..e lh~ light to ~caIQJr.lte the specific ar:d a;~re~ale prerr,ium and ~gcreg.H~ f:lc:orslf tr.a am;1 $Old enrcllment \/aries by"";. 1 0% from the quoled ljlnrcllrr.itnt 3. Wa ~ese""e t~e ri'iht to recalculate the aggre"Jatoa: Jr.act'lmerH POinl 3:103 ~i"err:ium if the I:lverage cf :he l.a~: 2 months cf cldlms in the currer-t ~riey ~-eriod vanes 'Jy mare l~,j]n 10% ~rom :r,e a'.'Qf;ql1l mor'\t.~ty :.J3im fer 'J;e nr3t 10 months of ~e c\..'n~f1t pclic'l pQriod .t. ,\ signod :lr:d :ated :;fan document 13 reqUIred .....it;.,I('1 ;.,) ,jays of:1"'Q e~c:i"e ::l~te. 5. Ar.y a.d.cit~Cl"\.3t informaticn _,oted befcw in .SO'lcial Ccr.c(lior.s". I~Conr!jrinrui: lU~aies re stst.;s!prcg:"lcs1s ..,eeead fo: an, OC'\1;OI"'..; c:.lims. Upeated -a,,<;:el1enca r.l3edeoj:t'l~ ;,CO ~ ,:entlrm rectors. IThc 0:0 .jJ)' 7LC am ~e :!:cded to the 1Z'12 ~QGI"Qo;;;Ih) ~C" ..l!:% ~ the fSdcr.:] tfor 00 ddY iuJ ~nodl & ;lftrn41..;r:-:. I SpeciOc (Liretime). Sl,ooO,Coo Thi.3 proposal summJol"'J Ls v.lid for 60 daY$ Irom ths proposal d~te. Dna only fer tho effective d.lte shQ'ollm. H.lrtford l.ife In5urunce Companill3 200 ~CprTle-~w Street, Sim:sbury CT 06u89 1L't'ld~,....,.;!t!r: \Phone: Jc.'1n 600~ (Seo~.e..l' I Pro~l Dafa' --l 0612 :t20CO I lfu: (0&)) a4~-2CS.a ~~, t I' Insuraru:e SIVER Mcz-~ c 9400 Fourth Street North, Suite 119 SI Petersburg, Florida 33702-2525 Post Office Box 21343 SI Petersburg, Florida 33742-1343 Telepbone: (727) 577.2780 Fax: (727) 579-8692 October 27, 2000 r;~-'-' ;.-.--.---..-'... ....-..-..---ffi\l I: ~ ls ~ ~ ~ W ~ Q II d)r-"""-"""-.il 1]1 ! iJJ ' OCT 3 1 2000 J W II ! ~ L ....__.___...._._....,... , [Ir" . ~.., ~ ....,-t" 'tlli.. .,- ,'-!' ,-<1\ li..; l_l\I'."~ ,(.. 1\,. !\I',IL-',Il I . '. j ... ,\ ... t ~'I.1. l 1 ..._--.-- E.mail: siver@siver.com Website: http://www.siver.com Mr. Clifl'Leonard Risk Management City of Miami Beach 1700 Convention Center Drive, Third Floor Miami Beach, Florida 33139 Re: Future Action - Health Plan Dear Mr. Leonard: This letter will serve to confirm our thoughts on various options that have been discussed relative to The City's health plan, subsequent to the Insurance Review meeting of October 12, 2000. Market AnalysislProposal Request In light of the number of vendors disqualified in the recent RFP effort, it has been suggested that a market analysis might be conducted. The scope of this project would entail contacting those vendors which responded to the RFP, and in some cases, vendors which did not respond. It is felt that communication at this time might enhance future proposal activity and eliminate many of the factors that resulted in v~ndor disqualification. Subsequent to the market analysis, the appointed party could, at The City's direction, solicit proposals from the market for the group health plan. The concept of assigning an agent and/or broker of record to conduct a market analysis and/or secure proposals on behalf of The City has some merit. It is our understanding that, under this arrangement, the appointed party would not be subject to the "Cone of Silence" as a formal RFP process would not apply. In this case, the appointed party could negotiate with prospective vendors from the initial phase of the project. -'..1- ~, SIvER INSURANCE CONSULTANTS Cliff Leonard October 27, 2000 Page 2 Humana confirms that no commissions are currently built into the rates. Therefore, if coverage remains with Humana, The City would need to negotiate with the appointed party on a fee for service basis, or advise Humana to adjust rates to include commissions. Proposals obtained from alternate vendors would need to identify the amount of commissions, ifapplicable. In either option, The City will incur additional costs to pay for the services of an appointed agent/broker. Whether marketing (analysis an!llor proposal solicitation) is completed through informal vendor contact or through the formal Request for Proposal (RFP) process, Siver can provide this role, ifpayment of these services is provided on a fee for service basis (as opposed to commissions). Siver's fees would be subject to the current contracted rates for The City of Miami Beach. Our company policy does not allow acceptance of commissions. Contribution Adjustment Employee contributions are frequently utilized as a method of cost-sharing. The ability to pass additional premium contributions to the employee may be limited by prior agreements with bargaining units. In the absence of any such agreement(s), contribution adjustments are a viable method of offsetting current and future rate increases. Plan Design Changes Again, the ability to revise benefits may be subject to prior agreements with the bargaining units. There are several areas that should be reviewed, based on the typical benefits provided by employers today. First, by current industry standards, the prescription drug plan is very rich. Most employers have moved to a three-tiered approach, with emphasis on cost-sharing for the more expensive brand medications. We rarely see a $5 co-payment on prescriptions. Even the $10/$14 prescription co- . payments in the current Point of Service Plan (POS) are quite generous by today's standards. Considering the percentage of claim dollars typically associated with prescription drugs, we feel this is an area that should be addressed. In addition, at $5 per visit, the physician co-payment in both health plans is extremely low. We would recorrunend $10 for the HMO plan, and a higher co-payment of$15 or more for the POS plan. Increases in co-payments for hospitalization are indicated, at minimum on the POS and PPO plans. We recommend $250-$500, or a $100 per day.co-payment with a maximum of $500 per confinement. These plan design changes are designed to shift the cost associated with utilization to impact those participants who actually use the plan most. Before implementing any ./...-,- SIVER INSURANCE CONSULTANTS Cliff Leonard October 27; 2000 Page 3 plan design changes, the underwriter should be contacted for verification of the anticipated savings. Premium savings should be weighed against the impact to participants and The City. Cliff, we are available to discuss these and any other options at your convenience. Please let me know if a visit or conference call is indicated. Sincerely, . SIVER INSURANCE CONSULTANTS ~Nl.~V Brenda M. Sadler ~ Senior Consultant ~ Q BMS/ky J:\E.WB\CORR2000\CITYMIAM\MB lE34.WPD C!TY OF MIAMI BEACH cr,( HALL 1700 CONVENTION CENTER DRIVE MIAMI BEACH, FLORIDA 33139 htlp:\\ci.mlami-beach. fl.us ~. COMMISSION MEMORANDUM NO..9.0 1-00 TO: Mayor Neisen O. Kasdin and Members of the City Commission DATE: November 29, 2000 FROM: SUBJECT: Jorge M. Gonzalez \ City Manager Ij~ A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, REJECTING ALL PROPOSALS RECEIVED, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO. 97- 99/00 FOR GROUP MEDICAL INSURANCE, AND FURTHER AUTHORIZING THE ADMINISTRATION TO ISSUE A REQUEST FOR QUALIFICATIONS (RFQ) FOR A BROKER OF RECORD FOR GROUP MEDICAL INSURANCE. ADMINISTRA TION RECOMMENDATION Adopt the Resolution. ANALYSIS On May 10,2000, the Mayor and Commission authorized the Administration to issue a Request for Proposals (RFP) for Group Medical Insurance. Two hundred sixty eight (268) notifications were issued, resulting in twenty nine (29) specifications being issued. Proposals were received from the following eight (8) firms: HUImma Blue Cross and Blue Shield of Florida, Inc. Cigna Health Care Robey Barber Insurance Services AP A Partners, Inc. Administrative Services, Inc. Acordia of WV Ascendia Healthcare An Evaluation Committee/Group Insurance Board consisting of the following persons met on October 12,2000 to review and discuss the proposals: AGENDA ITEM 12.., F DATE 11-'2~-Ou Mary Greenwood, Executive Assistant to the City Manager/Labor Relations and Group Insurance Board member Drew Terpak, Fleet Management Director and Group Insurance Board member T.C. Adderly, Human Resources Director and Group Insurance Board member John Wheeler, CW A President and Group Insurance Board member Robin Garber, GSAF representative and Group Insurance Board member Buddy Dresner, Retired City employee and Group Insurance Board member Roberto Sanchez, Health Care Consultant and resident of Miami- Dade County Richard McKinnon AFSCME President and Group Insurance Board member (not present) Siver Insurance Consultants were present at the Evaluation Committee meeting and provided a Proposal Analysis Summary (Attachment A). The analysis provided the following information regarding annual premium/cost and overall compliance with the scope of services: VENDOR ANNUAL COMMENTS PREMIUM/COST Humana (Fully Insured) $ 8,706,065 Complies with Scope of Services Cigna (Fully Insured) ..***.**. Unable to determine premium as proposed Accordia AdminlWeaUh $10,420,584 Retirees excluded from Planning (Self-Insured) Hartford Stop-Loss Robey Barber Admin. $10,587,364 Retirees excluded from (Self-Insured) Hartford Stop-Loss Administrative Services $11,445,352 Complies with Scope of (Self-Insured) Services Humana (Self-Insured) $14,493,396 Complies with Scope of Services Ascendia (Self-Insured) ********* TPA Only-Unable to determine premium as proposed Blue CrosslBlue Shield ********* TP A Only-Unable to (Self-Insured) determine premium as proposed AP A Partners ********* TP A Only-Unable to determine premium as proposed During the Consultant's proposal review, it was determined that the Hartford stop-loss quote, submitted with the Robey-Barber proposal, for both specific and aggregate insurance excluded retirees. When the Consultant reviewed the AcordialWealth Planning quote, it was found that Hartford also provided the aggregate portion of their stop-loss quote. The Consultant contacted Acordia and has confirmed that retirees are also excluded from the Hartford quote (Attachment B). Analysis of the proposals submitted by Cigna, Blue CrossIBlue Shield, Ascendia, and AP A Partners either excluded Retirees entirely, and/or excluded Retirees eligible for Medicare or did not provide stop loss insurance to cover retiree medical costs. Benefits for "Domestic Partners" (optional benefit in the RFP) were not proposed by any of the respondents. As a result of the analysis, the following proposals were determined to be responsive to the RFP. Insurance Co.! Administrator Humana (Fully Insured) Humana (Self-Funded) Administrative Services (Self-Funded) Annual Premium $ 8,706,065 $14,493,396 $11,445,352 The Premium rates for both the Humana proposal and the current contract are the same. The Analysis determined that Humana's Fully Insured proposal did not address certain service components presently provided under the current Humana contract, specifically, the provision of an On-Site-Representative. Since the Humana proposed plan provided fewer benefits, the current contract was deemed more cost beneficial. The Evaluation Committee reviewed the Proposal Analysis Summary and concurred with the findings. The Evaluation Committee failed to select a number-one ranked or number-two ranked proposer since all responsive proposals were deemed to be less cost effective than the current contract with Humana for Group Medical Insurance. The Administration was concerned with the low number of responses to the RFP issued for Fiscal Year 99/00. In order to solicit a better response to the current RFP (Fiscal Year 00/01), the following changes were incorporated: I. Self-Insured and Fully Insured Plans were requested. 2. Commissions were allowed to be paid to agentlbrokers. 3. Plan design changes/multiple benefits level submissions were encouraged. 4. Due dates/deadlines were extended for questions and submissions. Even with these changes, there were few responses to the current RFP. The low response to the RFP may be attributed to the current condition of the Group Medical insurance market. After reviewing the current responses to the RFP, studying industry publications and newspaper articles, contacting other municipalities, and after consulting with Siver Insurance Consultants, the Administration finds that the following Group Medical market conditions/ risk factors exist which effect the ability to purchase group medical insurance at a reasonable cost: I. Increasing premium (high cost of medical vs. decreasing profit resulting in premium increases of 10% to 30% nationwide) 2. Limited market participation (many of the major companies have consolidated resulting in a smaller market). 3. High utilization of benefits by plan membership resulting in higher cost/risk (fifty five percent of plan participation involves retirees-higher utilization). Upon completion of the RFP process, the Evaluation Committee has requested that the City's Consultant contact all proposers to review those factors which resulted in vendor disqualification. The Evaluation Committee believes that review with the proposers in conjunction with the recommendations of the Consultant (Attachment C) will enhance future proposal activity. The Consultant has recommended that the City utilize a broker of record to conduct a Market Analysis and/or secure proposals on behalf of the City. Assigning a broker of record to conduct the Market Analysis and/or secure proposals on behalf of the City may further enhance communications and increase market response The Consultant has suggested that in addition to the Marketing Analysis and the services provided by a broker of record, that the City may need to consider changes in either premium contribution and/or plan design. The City will be required to issue a Request for Qualifications (RFQ) in order to assign a broker of record. The broker of record will be paid compensation in the form of commissions on insurance purchased. The City will not allow commissions to be paid on the current Humana contract. The broker of record will provide services as required by the City. The Health Advisory Committee met on November 6, 2000 to review the recommendation of the Evaluation Committee. It is the recommendation of the HAC that all proposals be rejected and the City reissue the RFP for Group Medical Insurance at the discretion of the City Manager. In addition, the HAC expressed concerns that the "Cone of Silence" may have discouraged market response to the RFP by hindering communication. It is the recommendation of the HAC, that the Mayor and Commission lift the "Cone of Silence" regarding any future RFP's for Group Medical Insurance. The HAC plans to speak to the Mayor and Commission at the Commission meeting of November 29, 2000. The City Administration recommends that the Mayor and City Commission authorize the Administration to reject all proposals received pursuant to Request for Proposals (RFP) No. 97-99/00 for Group Medical Insurance, and further authorizing the Administration to issue a Request for Qualifications (RFQ) for a broker of record for Group Medical Insurance. JMG:MG:cP/~ Attachment~ '0"" f:\RISK\$ALL\Cliff\Bcnefill\rfp-com\::m4.rfp