Open Session Item. SUBJECT: Contract Awards (PUR-1303) Group Health Insurance Medical, Prescription, Care Management/Wellness, Dental, Vision Coverage

Transcription

1 Board of County Commissioners of Washington County, Maryland Agenda Report Form Open Session Item SUBJECT: Contract Awards (PUR-1303) Group Health Insurance Medical, Prescription, Care Management/Wellness, Dental, Vision Coverage PRESENTATION DATE: March 1, 2016 PRESENTATION BY: Karen Luther Director of Purchasing; Rebecca Royal, Steve Dillman and Liz Logsdon, Account Executives with the County s consultant, CBIZ Benefits & Insurance Services, Inc. RECOMMENDED MOTION: Move to award County employee health insurance coverage contracts to the responsive, responsible proposers per the proposal of each in response to RFP No. PUR-1303 as follows: Aetna Life Insurance Company Hartford, CT Medical/Care Management/Wellness; Express Scripts, Inc. (incumbent) - St. Louis, MO Prescription Drug Coverage; Delta Dental of Pennsylvania (incumbent) - Mechanicsburg, PA Dental Coverage; and UnitedHealthcare Insurance Company (incumbent) Columbia, MD Vision Coverage, as unanimously recommended by the Coordinating Committee. REPORT-IN-BRIEF: The Request for Proposal (RFP) was advertised on the State s emaryland Marketplace web site, on the County s web site, and in the local newspaper. Twentythree (23) firms executed a Limited Data Set Date Use Agreement in accordance with HIPPA requirements to electronically access the RFP document. Ten (10) firms were represented at the preproposal conference. Proposals were received on December 11, 2015 from sixteen (16) companies to provide one or more of the various coverages outlined herein. The Coordinating Committee met on January 14, 2016 to review each firm s Qualifications & Experience/Technical Proposal. Price Proposals of the companies determined to be responsive were opened. The Committee then met on January 29 to review Price Proposals. The Committee also met on February 10 for providers presentations/ interviews and further evaluation/clarifications of finalists proposals. Subsequently, a teleconference was held on February 16 between the Committee and the consultant to finalize its recommendations. The Coordinating Committee was comprised of the County Administrator (Chairman), Director of Purchasing, Director of Health and Human Services, County Benefits Coordinator and County Attorney. Consultants for the procurement are Steve Dillman, Becky Royal, and Liz Logsdon, from CBIZ Benefits & Insurance Services, Inc. DISCUSSION: N/A

2 FISCAL IMPACT: The preliminary projected amount budgeted in FY 2017 is $15,151,081 based on an 8.91% increase to the FY 2016 Approved Budget amount of $13,911,308. CONCURRENCES: Committee ALTERNATIVES: As recommended by the unanimous decision of the Coordinating N/A ATTACHMENTS: The attached Summary will be reviewed and discussed in detail by the County s consultant at the meeting. AUDIO/VISUAL NEEDS: Power Point Presentation by CBIZ representatives

3 Board of County Commissioners of Washington County Request for Proposal Analysis and Recommendations March 1, 2016 Presented by: CBIZ Employee Services Organization

4 PUR-1303 Request For Proposals A Request for Proposal (RFP) was issued for Group Health Benefits including medical, care management, prescription, dental, and vision. The RFP was advertised: - On the State s emaryland Marketplace website - On the County s website - Local newspaper. 23 firms executed an Agreement in accordance with HIPAA requirements to electronically access the RFP document. 2

5 PUR-1303 Process (Continued) Request for Proposal (RFP) asked for: Duplication of BCC s existing plans and services Web-based employee tools and education Performance guarantees Excellent network access and discounts Competitive self-funded fixed costs (medical, Rx, dental) Competitive fully insured rates (vision) Comprehensive care management and wellness resources 3

6 PUR-1303 Process (continued) The RFP Response was to be submitted in two parts: Technical Proposal (Qualifications & Experience) Coverage Response Form Procurement Forms and Affidavits Response to Questionnaire Proposed Benefits Outline Deviations from Current Plans Geo Access/Network Provider Disruption Results Pharmacy Benefit Management Capabilities Exhibits/Marketing Material Price Proposal Fees and Rates Medical Discounts Dental Discount Performance Guarantees Pharmacy Benefit Pricing / Terms 4

7 RFP Respondents Medical Care Carrier Rx Mgmt. Dental Vision CareFirst Administrators (incumbent) X X X X X Cigna X X X X X Tri-State Health Partners (incumbent) X Delta Dental (incumbent) X Express Scripts (incumbent) X United HealthCare (incumbent for vision) X X X X X Aetna X X X X Magellan Rx X Optum Rx X Dominion Dental X X Liberty Dental X NVA X United Concordia (UCCI) X MetLife X X EyeMed X Avesis X 5

8 General History/Stability of organization Performance Guarantees Managed Care Network Geographic Access History/Stability of Network Disruption Key Physician Practices Administration Claims Administration Cost Containment Features Evaluation Criteria Compliance with Specifications Requested Plan Design Bidding Instructions Form Submission Data Reporting Capabilities Types of Reports Available Frequency of Claims Reports Online Access to Reporting Enrollment Reports Client References Cost Fees/Rates Provider/Pharmacy Discounts Performance Guarantees 6

9 Coordinating Committee Gregory Murray, Chairman Karen Luther, Director of Purchasing Rick Curry, Buyer (non-voting) Stephanie Stone, Director of Health and Human Services Debbie Peyton, Benefits Administrator John Matirano, County Attorney Sara Greaves, Deputy Director of Budget & Finance (non-voting) Rachael McCarty, Procurement Technician (non-voting) Non-Voting CBIZ Consultants Becky Royal, Steve Dillman and Liz Logsdon Met to review Q & E/Technical responses Determined the Vendors who would advance to pricing portion of review 7

10 Vendors Advanced to Pricing Portion VENDOR Aetna CareFirst Administrators (CFA)* Cigna United HealthCare *for vision Delta Dental* Express Scripts (ESI)* Magellan Rx Optum Rx United Concordia Dominion Dental NVA * Incumbent Carriers PRODUCT Medical & Care Mgmt, Rx and vision Medical & Care Mgmt, Rx, dental and vision Medical & Care Mgmt, Rx and dental Medical & Care Mgmt, Rx and vision Dental Rx Rx Rx Dental Vision Vision 8

11 Pricing Analysis STAGES: Pricing Analysis Review and Meeting Finalist Meetings with Select Carriers CareFirst Administrators/Conifer Aetna The Coordinating Committee determined the final recommendations based on pricing analysis and finalist meetings 9

12 Finalists for Medical/Rx Projected Costs for July 1, June 30, 2017 Current Projected Cost Aetna medical Aetna medical CareFirst medical CareFirst medical Jul Jun 2016 With No Bid ESI phamacy Aetna pharmacy Caremark pharmacy ESI pharmacy Total Costs $13,280,427 $14,258,147 $13,493,319 $13,628,559 $14,297,712 $13,529,487 Projected Costs for July 1, June 30, 2018 Aetna medical Aetna medical CareFirst medical CareFirst medical ESI phamacy Aetna pharmacy Caremark pharmacy ESI pharmacy $14,393,907 $14,532,435 $15,279,257 $14,473,589 Projected Costs for July 1, June 30, 2019 Aetna medical Aetna medical CareFirst medical CareFirst medical ESI phamacy Aetna pharmacy Caremark pharmacy ESI pharmacy $15,361,562 $15,503,380 $16,278,687 $15,435,577 Total Costs for Three Year Contract $43,248,788 $43,664,374 $45,855,656 $43,438,652 Total costs for the self-funded medical and pharmacy plan include projected claims, administrative fees and other fixed costs, stop loss premium (estimate), pharmacy rebates, Affordable Care Act fee, implementation/ wellness credits, incumbent runout processing fee, telemedicine, and health care cost estimator tool. 10

13 Rationale: Final Recommendation for Medical and Care Management Aetna Pricing (fixed costs and provider discounts) Care management program Continuity of benefits Compatible network / minimal disruption Performance guarantees Wellness support Web/mobile tools 11

14 Final Recommendation for Rx Rationale: Express Scripts (incumbent) Overall Pricing (discounts, rebates, fees) Service No Disruption 12

15 Final Considerations for Dental Projected Costs for July 1, June 30, 2017 Current Projected Cost Delta CareFirst Cigna UCCI Jul Jun 2016 With No Bid Dental Administrators Total Costs $476,876 $464,404 $463,866 $582,689 $623,989 $529,523 13

16 Rationale: Final Recommendations for Dental Delta Dental (incumbent) Pricing Satisfaction with network and service No network disruption for current providers Continuity of benefits 14

17 Final Considerations for Vision UHC Current UHC NVA CareFirst Davis Vision Dominion Annual Premium $ 118,383 $ 118,383 $ 127,754 $ 149,539 $ 152,754 % Increase/decrease Over Incumbent 0% 0.0% 7.9% 26.3% 29.0% $ Increase/decrease Over Incumbent $ - $ - $ 9,371 $ 31,156 $ 34,371 Rate Guarantee 3 years 4 years none 2 years 15

18 Final Recommendations for Vision Rationale: United HealthCare Pricing Offers a 3-year rate guarantee Large network/minimal disruption Continuity of benefits 16

19 Summary of Recommendations Medical/Care Management: Aetna Prescription Drug: Express Scripts Dental: Delta Dental Vision: United Health Care 17

20 Questions? 18