www.mymanatee.org
Manatee County Government Administrative Center Commission Chambers, First Floor 9:00 a.m. - December 1, 2015
December 1, 2015 - Regular Meeting
Agenda Item #20


Subject
Amendment 4 to Agreement 11-2671FL for Third Party Administration (TPA) Services for Medical, Dental, Flex Spending, and Provider Network

Briefings
None

Contact and/or Presenter Information

Contact:  Frank Lambertson, FCCM, Contracts Negotiator, Purchasing Division, Extension 3042.

Presenter:  Kim Stroud, Employee Health Benefits Manager, Human Resources Department, Extension 6432.



Action Requested

Authorization for the County Administrator, or designee, to execute Amendment 4 to Agreement 11-2671FL Third Party Administration Services for Medical, Dental, Flex Spending, and Provider Network (Master Service Agreement MSA-326425) with Aetna Insurance Company extending the agreement forty two (42) months commencing July 1, 2015, and concluding December 31, 2018, at an estimated annual amount of $2,719,038.



Enabling/Regulating Authority

Manatee County Code of Laws



Background Discussion

On May 22, 2012, the Board of County Commissioners approved Agreement 11-2671FL (MSA-326425) with Aetna Life Insurance Company for Third Party Administration (TPA) Services for Medical, Dental, Flex Spending, and Provider Network.  The shift to a national carrier created significant tax dollar savings and eight (8) million dollars in savings on medical claims processing.

Amendments 1, 2, and 3 refined the agreement authorizing:  Health Care and Dependent Care Flex Spending Account Services; American Health Holdings Utilization Management Services (Aetna subcontract); and further defined Onsite Utilization Management Personnel.

Amendment 4 will allow the County to continue receiving TPA services provided by Aetna and will continue to benefit from Aetna's comprehensive provider network with significant negotiated network discounts.  The extension also brings the term of the agreement in accord with the calendar year.

The estimated annual amount of $2,719,038 is split as follows:

  • Utilization Management, Case Management, and Wellness Staff and Management Fixed Rate:  $1,179,000
  • Administrative Fee Medical, Dental, and Flex Rate:  $1,540,038

The following rates will apply to the management/administrative fee and medical and dental rates applied Per Employee Per Month (PEPM).

Medical Rates are:

  • July 15, 2015 - December 31, 2016 at 4%;
  • January 1, 2017 - December 31, 2017 at 3%; and
  • January 1, 2018 - December 31, 2018 at 3%.

Dental  Rates are:

  • July 15, 2015 - December 31, 2016 at 3%;
  • January 1, 2017 - December 31, 2017 at 2%; and
  • January 1, 2018 - December 31, 2018 at 2%.

The renewal includes a wellness credit of $60,000 over the extended period of the Agreement to be available to the County to assist in continuing the Wellness Program.   Possible suggestions include standup workstations, treadmill workstations, and wearable technology to promote wellness.

All other terms and conditions of the Agreement will remain the same.



County Attorney Review
Not Reviewed (No apparent legal issues)

Explanation of Other


Reviewing Attorney
N/A

Instructions to Board Records

Originals to Board Records and Aetna Life Insurance Company, 151 Farmington Avenue, Hartford, Connecticut 06156.

PDF to: HoweK@aetna.com; kim.stroud@mymanatee.org; and frank.lambertson@mymanatee.org



Cost and Funds Source Account Number and Name
506-0004100-531000 Employee Health Benefits Administration

Amount and Frequency of Recurring Costs
None


Attachment:  AetnaAmend4.pdf
Attachment:  EHBDeptMemo.pdf