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File #: RS-24-168    Version: 1 Name: Stop Loss Insurance for Medical and Pharmacy Claims
Type: Resolution Status: Passed
File created: 8/19/2024 In control: City Council
On agenda: 9/17/2024 Final action: 9/17/2024
Title: Consider a memorandum/resolution awarding RFP 25-02 to Blue Cross and Blue Shield of Texas (BCBSTX) for an excess risk policy (stop loss insurance) for medical and pharmacy claims under the City health insurance plan, effective October 1, 2024, in the amount of $902,819.
Sponsors: Human Resources Department
Attachments: 1. Bid, 2. Presentation
Title

Consider a memorandum/resolution awarding RFP 25-02 to Blue Cross and Blue Shield of Texas (BCBSTX) for an excess risk policy (stop loss insurance) for medical and pharmacy claims under the City health insurance plan, effective October 1, 2024, in the amount of $902,819.

Body

DATE: September 17, 2024

TO: Kent Cagle, City Manager

FROM: Eva Bark, Executive Director of Human Resources

SUBJECT: AWARD RFP 25-02 FOR AN EXCESS RISK POLICY (STOP LOSS INSURANCE) FOR MEDICAL AND PHARMACY CLAIMS UNDER THE CITY HEALTH INSURANCE PLAN WITH BLUE CROSS AND BLUE SHIELD OF TEXAS IN THE AMOUNT OF $902,819.

BACKGROUND AND FINDINGS:

On June 11, 2024, Council approved Blue Cross Blue Shield of Texas (BCBSTX) as the City's Group Employee Medical and Pharmaceutical benefit provider, effective October 1, 2024. The City will need to purchase stop-loss insurance in the event of high claims to support the self-insured health care and pharmaceutical plan in FY 2025.
Stop-loss insurance protects the City against catastrophic or unpredictable losses. The City of Killeen will protect its plan with both specific and aggregate stop-loss coverage. Specific Stop-loss protects the City against a high claim on any one individual. Aggregate stop-loss provides a ceiling on the dollar amount of expenses that the City would pay, in total, during a contract period.
In partnership with the City's Employee Benefits Consultant, Lockton Dunning, on July 8, 2024, the City initiated a Request for Proposal (RFP) for firms experienced in stop-loss insurance coverage for the City of Killeen employees and retirees. Staff received and reviewed a proposal from BCBSTX, ($902,819), the sole bidder. The review and evaluation of the proposal were based on product offerings, the reputation of the vendor, and cost savings for the City and the employees.
After a thorough analysis of the stop-loss insurance proposal and option, staff recommends entering into an agreement with BCBSTX for the plan ...

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