1st Whistle Blown -- County employee health insurance $52.3 Million Dollar Contract on July 6

It didn’t take long for our 1st Brave American Patriat to blow the whistle   -- County Commission to vote on $52.3 Million dollar health insurance contact for all county employees and families … Very quietly this deal got on the agenda for July 6th (while most are out on holiday, no doubt) .  

Below is the item (sent to us with links to all documents -- bear with us it's our 1st effort -- hope all links work).

As you can read there are more questions than answers in the 2 page memo.

So here are the questions --

  1. How much are employees going to pay for this health plan?
  2. Are we keeping our Doctors or will they be changed?
  3. Co-payments going up?
  4. What about our families?
  5. Are retirees covered and for how much?
  6. What about out-of-town folks?
And taxpayers are getting hit with a $52.3 million dollar bill -- how much will they pay?

Finally, looks like that some unions but not all unions had a say in this deal -- “The approved solicitation reflects input from the following labor unions: American Federation of State, County and Municipal Employees 199 General, 1542 Aviation, 3292 Solid Waste and the General Government Supervisors Union. “

Can anyone shed some light on this $52.3 million dollar issue -- send directly or post in comments

Just in case let’s watch on July 6th, for sure

Ps keep the info coming and we’ll be sure to publish and keep everyone informed!!



Miami-Dade Legislative Item File Number: 161237


Legislative Text


TITLE
RESOLUTION APPROVING AWARD OF CONTRACT NO. RFP-00196 TO AVMED, INC. FOR THE PROVISION OF A SELF-FUNDED EMPLOYEE GROUP HEALTHCARE PROGRAM FOR THE HUMAN RESOURCES DEPARTMENT IN A TOTAL AMOUNT NOT TO EXCEED $52,310,000.00 OVER THE INITIAL FIVE-YEAR TERM AND ONE, TWO-YEAR OPTION TO RENEW WITH ESTIMATED CLAIMS COSTS OF $2,100,000,000.00 OVER THE INITIAL FIVE-YEAR TERM; AND AUTHORIZING THE COUNTY MAYOR OR COUNTY MAYOR’S DESIGNEE TO EXECUTE SAME AND EXERCISE ALL PROVISIONS CONTAINED THEREIN, INCLUDING ANY CANCELLATION, RENEWAL AND EXTENSION PROVISIONS, PURSUANT TO SECTION 2-8.1 OF THE COUNTY CODE AND IMPLEMENTING ORDER 3-38

BODY
WHEREAS, this Board desires to accomplish the purposes outlined in the accompanying memorandum, a copy of which is incorporated herein by reference,

NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MIAMI-DADE COUNTY, FLORIDA, that this Board approves the award of Contract No. RFP-00196 to AvMed, Inc. for the provision of a self-funded employee group healthcare program for the Human Resources Department, in substantially the form attached hereto and made a part hereof, as set forth in the incorporated memorandum in a total amount not to exceed $52,310,000.00 over the initial five-year term and one, two-year option to renew with estimated claims costs of $2,100,000,000.00 over the initial five-year term; and authorizes the County Mayor or County Mayor’s designee to execute same for and on behalf of Miami-Dade County and exercise all provisions contained therein, including any cancellation, renewal and extension provisions, pursuant to Section 2-8.1 of the County Code and Implementing Order 3-38.

HEADER
Date:

To: Honorable Chairman Jean Monestime
and Members, Board of County Commissioners

From: Carlos A. Gimenez
Mayor

Subject: Recommendation for Approval to Award Self-Funded Employee Group Healthcare Program

STAFF RECOMMENDATION
Recommendation
It is recommended that the Board of County Commissioners (Board) approve award of Contract No. RFP-00196, Self-Funded Employee Group Healthcare Program, to AvMed, Inc. (AvMed) to provide third-party administrative services for the County’s comprehensive self-funded group healthcare program. Covered groups under the Program include employees and their eligible dependents, retirees and Consolidated Omnibus Budget Reconciliation Act (COBRA) participants. Under the contract, AvMed will deliver the current plan design (Point of Service and High, Select, Jackson First and Low Health Maintenance Organization options, pursuant to collective bargaining agreements) plus Wellness and Disease Management Programs.

Scope
The scope of this item is countywide in nature.

Fiscal Impact/Funding Source
The fiscal impact for the five-year term is estimated to be $7,313,464 per year. Should the County choose to exercise the one (1), two-year option to renew term, the contract’s estimated cumulative value will be up to $52,310,000 The contract allocation is based on self-funded group healthcare fees, also known as Administrative Services Only (ASO) fees. The actual ASO fees paid will be based on the number of enrolled members in the plan during each plan year. Through this self-funded program, the County also pays the claim expenses incurred. The estimated claims cost for the initial five-year term is $2.1 billion.

The County’s healthcare program has been provided through the current contract, RFP-559, since plan year 2008. The projected ASO fees for plan year 2016 under the current contract are $10,050,664. The ASO fees under this replacement contract yields an estimated 28 percent savings (over $2.5 million savings per year) compared to the amount the County is paying in ASO fees through the current contract. During the option to renew term, the ASO fees may increase by no more than five (5) percent and will be subject to negotiation. It should be noted that both the old and new contracts were competitively solicited. The reduction in annual fees between the two (2) contract periods can be attributed to technological improvements in processing which have caused a decrease in the costs of these administrative services.

The proposed negotiated contract includes a $300,000 enhancement in plan design features (e.g., a part-time prenatal education advisor, full-time nutritionist, tele-medicine option for physician consultations and enhanced reporting features), and $2.6 million in enhancement funds for the Wellness Program to be funded by AvMed.

Department Allocation Funding Source Contract Manager Human Resources $36,568,000 Internal Service Funds and Employee Contributions Helena Denham-Carter Total $36,568,000
Track Record/Monitor
Celeste S. Walker of the Internal Services Department is the Procurement Contracting Manager.

Delegated Authority
If this item is approved, the County Mayor or County Mayor’s designee will have the authority to exercise all provisions of the contract, including any cancellation, renewal and extension provisions, pursuant to Section 2-8.1 of the County Code and Implementing Order 3-38.

Vendor Recommended for Award
On May 5, 2015, the Board approved advertisement of a solicitation for the Program through Resolution No. R-396-15. The County sought a plan that includes robust wellness and disease management programs that provides cost savings for the County and its employees. All unions were provided with the draft solicitation and invited to provide feedback. The approved solicitation reflects input from the following labor unions: American Federation of State, County and Municipal Employees 199 General, 1542 Aviation, 3292 Solid Waste and the General Government Supervisors Union.

A Request for Proposals (RFP) was issued under full and open competition on May 6, 2015. Four (4) proposals were received in response to the solicitation. An RFP was used to obtain the best value to the County by conducting a qualitative review of proposals, including qualifications, experience, financial stability and project approach. The Competitive Selection Committee concluded that AvMed’s proposal represented the most comprehensive project approach meeting the County’s operational needs as the firm offered a self-funded employee group healthcare program that includes all plan design options/benefits currently available, beneficial plan enhancements, and full transparency to provider discounts, billed charges and pharmacy rebates.

Awardee Principal Address Address of Branch Offices or Headquarters in Miami-Dade or Broward* # of Employee Residents Principal 1)Miami-Dade
2)Broward
3)Percentage* AvMed, Inc. 9400 S Dadeland Boulevard
Suite 701
Miami, FL Same 401 Michael P. Gallagher 43 63% *Provided pursuant to Resolution No. R-1011-15. Percentage of employee residents is the percentage of vendors’ employees who reside in Miami-Dade County or Broward County as compared to the vendor’s total workforce.

Vendors Not Recommended for Award
Vendor Reason for Not Recommending Cigna Health & Life Insurance Company Evaluation Scores/Ranking Aetna Life Insurance Company United Healthcare Services, Inc.

Due Diligence
Pursuant to Resolution No. R-187-12, due diligence was conducted in accordance with the Internal Services Department’s Procurement Guidelines to determine contractor responsibility, including verifying corporate status and that there are no performance or compliance issues. The lists that were referenced include convicted bidders, debarred bidders, delinquent contractors, suspended bidders, and federal excluded parties. There are no adverse findings relating to contractor responsibility.

Applicable Ordinances and Contract Measures
* The two (2) percent User Access Program provision does not apply as the services are exempt.
The Small Business Enterprise Selection Factor was not applicable due to the funding source.*
* Local Preference was applied in accordance with the Ordinance.
* The services being provided are not covered under the Living Wage Ordinance.


__________________________
Edward Marquez
Deputy Mayor










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