Agenda Item #38
Employee Benefits Contract Renewals for Calendar 2010
A. Stop-Loss for Benefits Trust (Symetra, Inc.)
This insurance protects our self-funded group health plan from any individual catastrophic loss. Our insurer's loss ratio for the past four years is 111 percent. With the coverage adjustments shown below, Symetra will renew our contract for 2010 with no increase in annual premium:
1. Specific Deductible for Individual
Current: $325,000; 2010 renewal: $350,000
2. Advantage Deductible*:
Current: $310,000; 2010 renewal: $350,000
Current Premium: $928,977; 2010 Renewal: no change
*Additional deductible paid by one or more individuals with paid claims exceeding the specific deductible before any reimbursement is due. If there are no claims that exceed the specific deductible, the amount stays in the self-funded trust.
B. Benefits Enrollment/Member Eligibility Software (Easy HR Web)
This online software package provides Brevard Public Schools with online employee benefits enrollment capability and manages all benefits membership deductions and eligibility data feeds to our benefits vendors and our BPS payroll system. This contract will be renewed for calendar 2010 with no change in cost.
Current Cost: $300,000; 2010 Renewal: no change
C. Behavioral Health/Employee Assistance Program (MHNet, Inc.)
MHNet, Inc. currently serves as a carve-out TPA to provide behavioral health and employee assistance program benefits to our employees and their dependents. MHNet will complete the fifth year of a five-year contract with BPS at the close of 2010.
Effective 1/1/10, BPS will be subject to State of Florida and federal mandates to cover services related to autism disorders. Behavioral health services related to autism disorders currently are excluded from our plan; however, the prevelance of these disorders and their financial impact are unknown.
Additionally, effective 1/1/10, the federal Mental Health Parity Act requires health plans to remove any benefits limitations and caps that do not apply to other conditions covered by the plan. Our current capitated plan limits mental health and substance abuse conditions to 60 visits per year and inpatient days to 30 per year. To date, BPS has never had any member reach these maximum service levels.
Currently, BPS pays $6.08 per employee per month, which annualized is approximately $580,000. Due to the requirement to fund these additional benefits of unknown cost, MHNet requested a 41 percent increase in the PEPM rate to $8.60 PEPM, with an annual impact of approximately $250,000. However, we have reached consensus to continue our final year of our contract with MHNet with no change in the fully insured rate and then self fund claims related to autism and mental health parity, which we anticipate will be less than the $250,000 MHNet requires to fully insure these liabilities.
Current Premium: $580,000; 2010 Renewal: no change
Approve renewal of the Symetra, Inc. (medical trust stop loss), Easy HR Web (enrollment/eligibility software), and MHNet, Inc. (behavioral health/ EAP) contracts for plan year 2010 as described above.
Information - 1/5/2010
Consent after Information1/19/2010
Authority for Action
F.S. 768.28; 1001.42
Involves Expenditure of Funds Directly in the Classroom
Source of Funding
Susan G. Standley, Director, Compensation & Benefits, x216