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Regular City Council Meeting <br />March 8, 2004 <br />Page 8 <br />Fendley asked if that included dental and visual coverage and Mr. Anderson <br />said it did include those coverages. <br />Mr. Anderson pointed out that the fully-funded plan would cost $2,116,800 and <br />the employees will pay another $456,855.00 for dependent coverage under the <br />Capps proposal. He said the cost under the Texas Municipal League proposal <br />for the self-funded plan would be $202,630.00 for the administration fee and <br />$309,181.00 to the reinsurance company for both types of stop loss coverage. <br />As TML approves and processes claims, the city pays them. In this case, there <br />would be $2,162,844.00 available to pay claims. <br />Steve Capps with Capps Insurance came forward and introduced Jay Tondrum <br />and Gary Cole, Vice President of Sales, out of Dallas. Mr. Capps stated that <br />Mr. Anderson is probably right about 35% to 40% penetration as far as the <br />physicians go. They recognize the fact that as a public employer in town, the <br />city needs to have a good relationship with the medical community and <br />Humana understands that also. Mr. Capps said Humana has certainly given <br />them the indication that if they are fortunate enough to be selected, they would <br />do a blitz on the city physicians and try to take care of that. <br />Gary Cole, Vice President of Sales with Humana in the DFW Metroplex, <br />appeared before the City Council. Mr. Cole said that one thing that they do in <br />preparation to respond to an RFP is they do a GO Access Report, which is <br />matching their network up with where the city employees live. He said that <br />they have done that and their criterion for physicians is they have two providers <br />within 10 miles of any one of the city employees. Mr. Cole advised that they <br />matched that before they submitted the RFP and they knew they had an 89.6% <br />match which is very high. Mr. Cole said if you expand and go with providers <br />within 15 miles you will have a match that approaches 95%. If you go to 20 <br />miles, you will have six people to fall out of your population and you will have <br />about a 98% average. He said that would not really answer the question of <br />what penetration you have for total physicians. He said that he could not <br />confirm 35% or 40% because he does not know what the city’s network was. <br />Mr. Cole said they would make a diligent effort to work with Mr. Anderson and <br /> <br />