Placement: Consent Agenda
Action Requested: Motion / Vote
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Approve Stop Loss Insurance Policy with Symetra Life Insurance Company for FY 2022/2023
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Submitted By: Kimberly Sala, Labor Relations & Benefits Administrator, Human Resources
Strategic Plan Link: The City's Goal of a high-performing city government organization.
Summary Brief (Agreements/Contracts only)
1. Prepared by: Kimberly Sala, J.D., SHRM-CP, Human Resources
2. Parties: City of Port St. Lucie and Symetra Life Insurance Company
3. Purpose: To provide Stop Loss Insurance for medical claims.
4. New/Renewal/Modified: New
5. Duration: 1 year
6. Benefits to Port St. Lucie: To provide protection to the City for medical claims that exceed the threshold of $275,000.00 per claimant.
7. Cost to Port St. Lucie (Annual and Potential): The estimated expenditure for FY 22/23 is $2,112,739.00.
Presentation Information: Staff and Gehring Group are available to answer any questions the Council might have.
Staff Recommendation: Move that the Council approve the stop loss insurance policy with Symetra Life Insurance Company.
Alternate Recommendations:
1. Move that the Council amend the recommendation and approve the stop loss insurance policy with Symetra Life Insurance Company.
2. Move that the Council deny the recommendation and provide staff with direction.
Background: Stop loss insurance is a component of the City’s self-funded health insurance program and it provides protection to the City from the financial risk of unpredictable high costs and/or high volume claims filed under the plan. Stop loss coverage protects against claims that could compromise the City’s financial health. The City first engaged the services of Symetra in 2003 to provide stop loss insurance and retained them through the competitive RFP process in 2011. For Fiscal Year 2020/2021, the Council approved a waiver of bid for good cause shown with respect to the stop loss insurance with Symetra. On July 6, 2022, the City’s insurance broker, the Gehring Group, released an RFP to the market and solicited responses for stop loss insurance proposals. A total of six (6) proposals were received from four (4) carriers. All proposals were vetted by the Gehring Group and the City.
Issues/Analysis: Based upon market factors and the City’s claims data, the City’s actuary assumed a 20% increase in stop loss premiums for FY 22/23. The option before you for consideration proposes an 18.9% increase in annual premium, which remains within budget. The proposed policy coverage is identical to the coverage currently in place: Individual Specific Level (ISL) remains at $275,000.00; the policy is based on when claims are paid and does not consider when the claims were incurred (Paid Contract Basis); there is an unlimited maximum annual reimbursement, which includes medical and prescription claims; and there are no higher deductibles for certain high claimants or exclusion of any claimants from coverage (no lasers).
Financial Information: Funding is appropriated in the Medical Trust Fund / General Government / Stop Loss (#605-1900-549363-ALDEN).
Special Consideration: N/A
Location of Project: N/A
Attachments:
1. Stop Loss Plan Evaluation (comparison of current plan offering versus proposed plan offering);
2. Symetra Stop Loss Policy.
NOTE: All of the listed items in the “Attachment” section above are in the custody of the City Clerk. Any item(s) not provided in City Council packets are available upon request from the City Clerk.
Internal Reference Number: N/A
Legal Sufficiency Review:
N/A