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File #: 1820   
Type: Consent Status: Adopted
File created: 7/1/2020 In control: Human Resources
On agenda: 7/21/2020 Final action: 7/21/2020
Title: 2021 RFP #P-1-20-11 Comprehensive Health Plan Services Contract Award Recommendations
Attachments: 1. Selection Committee Consolidated Evaluation Scoresheet.pdf



2021 RFP #P-1-20-11 Comprehensive Health Plan Services Contract Award Recommendations



Fiscal Impact:

Minimum -$535,000 Year 1 cost reduction with potential additional savings based on premium and plan design recommendations made by the EBIAC and adopted by the Board.


Office of Human Resources / Employee Benefits


Requested Action:


That the Board approve the recommendation of the Office of Human Resources/Employee Benefits and the County’s Employee Benefits Insurance Advisory Committee (EBIAC) to award contracts to Cigna Healthcare and Health First Health plan pursuant to the above referenced RFP



Summary Explanation and Background:

The Office of Human Resources/Employee Benefits, through a competitive solicitation process managed by Central Services, conducted a Request for Proposals for Comprehensive Health Plan Services to administer the County’s self-funded health plan effective January 1, 2021.  The RFP requested options for self-funded administrative services only, integrated Pharmacy Benefit Manager (PBM) services and fully insured health plan options.  Proposals were received from Aetna, Cigna, Health First Health Plan (HFHP), Trustmark and UMR.  Responses were summarized and presented to the EBIAC on June 4, 2020.  


In a unanimous vote, the EBIAC recommended the continued combination of Cigna and HFHP for contract award with guaranteed administrative fees for three (3) years.  It is further recommended that Cigna continue to provide PBM services to all health plan participants. 


The RFP successfully yielded cost reductions in administrative fees and included enhanced clinical and customer service resources as follows:


1.                     ASO Fee reduction from current based on proposed and negotiated fees:  -$535,000 savings Year 1 (Cigna Year 1 ASO fee holiday of -$426,850 and negotiations with HFHP reducing annual fees by approximately -$108,000.  Cigna ASO holidays in Years 2 and 3 will result in additional savings of $426,850 over the subsequent two plan years). 

2.                     Cigna to provide a 2nd full-time, onsite clinical resource to assist with wellness and health improvement strategies:  $135,000 annual plan benefit at no additional cost

3.                     Cigna and HFHP to provide enhanced concierge level customer service to improve member interaction and health plan support:  $120,000 annual plan benefit at no additional cost

4.                     Cigna will provide the option for enhanced clinical plan management through Health Matters Care Management providing more robust plan oversight and precertification estimated to reduce plan costs by 3.6%:  $119,000 annual plan benefit at no additional cost


Upon the Board’s approval of the Comprehensive Health Plan Services RFP recommendations, the EBIAC will meet to develop premium and plan design recommendations for the Board’s consideration and approval.


The Office of Human Resources/Employee Benefits requests that the Board review and approve the attached recommendations and authorize the Human Resources Director to execute required contracts and plan documents necessary to secure these services. 


Clerk to the Board Instructions: