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05-A Health Ins. Consultant DRAFT H:\JANICE\RESWORK\PROF SERVICE CONTRACT CITY HEALTH INSURANCE RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS, PARIS, TEXAS, APPROVING AND AUTHORIZING A PROFESSIONAL SERVICES CONTRACT WITH REGARD TO CITY HEALTH INSURANCE FOR THE PERFORMANCE OF A BENEFITS REVIEW AND TO PROVIDE ADDITIONAL CONSULTING SERVICES RELATING THERETO; PROVIDING FOR AN ANNUAL CONTRACT; STIPULATING A MAXIMUM FEE; MAKING OTHER FINDINGS AND PROVISIONS RELA TED TO THE SUBJECT; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, the City Manager of the City of Paris has solicited informal bids from qualified entities to act as a consultant to assist the City in modifying the City's health insurance plan, including the implementation of an Internal Revenue Code § 125 Premium Conversion Plan; and, WHEREAS, other consulting services will likewise be required with regard to the possible restructuring of the City's health insurance plan; and, WHEREAS, the City is prepared to enter into a professional consulting services agreement payable from current year revenues in an amount not to exceed $25,000.00;NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PARIS, PARIS, TEXAS: Section 1. That the findings set out in the preamble to this resolution are hereby in all things approved. Section 2. That the City Council does hereby authorize the City Manager to execute and the City Clerk to attest to a professional services contract for consulting services associated with the creation of an Internal Revenue Code § 125 Program and for assisting in making other possible changes to the City of Paris health insurance program, as said agreement is attached hereto as Exhibit A and incorporated herein for all purposes. Section 3. That all funds for said contract shall be paid from current year revenues, and that the sum total of all fees paid for said services shall not exceed $25,000.00. Section 4. That this resolution shall be effective from and after its date of passage. PASSED AND APPROVED this 8th day of November, 2004. Curtis Fendley, Mayor ATTEST: Sherian Dixon, Assistant City Clerk APPROVED AS TO FORM: Larry W. Schenk, City Attorney PROPOSALS FOR BENEFITS CONSULTING SERVICES Infonnal proposals were received from Grizzaffi Darby, LLC and Effective Plan Management, Inc. Both proposals offered similar services which are outlined below. Services Offered: 1. Review all aspects of current plan including: a. Third party administrator contract b. PPO contracts c. Prescription benefit manager contract d. Specific / Aggregate stop loss contracts e. HIPP A & Cobra compliance f. Claims and loss data g. Premium adequacy h. Coverage levels 2. Set Up of Section 125 Plan a. Premium conversion b. Flexible spending accounts 3. Recommendations Based on Review. a. Long range planning b. Employee insurance committee 4. Prepare request for proposals, identify vendors, analyze responses, and make recommendations. 5. Aid in administrative procedures caused by vendor changes if necessary. 6. Aid in open enrollment/education meetings. 7. Engage in follow up activities. The costs of services are estimated to be $40,716 for Grizzaffi Darby, LLC and $24,000 for Effective Plan Management. Both finDS advocate a multi-year agreement. ø Effective Plan Managen:ent, Inc. c9Qn Jim C. Mosley President October 11, 2004 Mr. Larry Shaw Interim City Manager City of Paris P.O. Box 9037 Paris, TX 75461-9037 .. . Re: Benefits Review and Consulting Services Proposal Dear Larry: Thank you for the opportunity to meet with you and Mr. Gene Anderson to discuss the prospect of providing our services to you once again. We enjoyed a lengthy and pleasant relationship with you at the City of Duncanville and we are honored that your confidence in our services prompted you to contact us once more. If we are fortunate enough to earn your business we shall be pleased to work with you, Mr. Anderson and the City of Paris. As you and Mr. Anderson have agreed, one of the most immediate changes to the benefit plans sponsored by the City should be the implementation of IRC Section 125 Premium Conversion Plan. The adoption of the Plan will allow eligible employees to pay for their medical and dental premiums pre-tax. Participating employees will realize an increase in net take home pay because of the tax-favored treatment that results from participation. The City will recognize an immediate payroll tax decrease because of the reduction of taxable income to employees. We shall provide the City with the Plan Document for a premium conversion plan that is required by the Internal Revenue Code and the necessary election fonn for employees. The City will realize immediate cost reductions as you aware of over $3,000 per month based upon projections provided by the Mr. Anderson. We will prepare the Plan Document and the necessary forms for an implementation date of November 1, 2004 with the first year being from November 1, 2004 through December 31, 2004. The first Plan Year will be a short one. Subsequent Plan Years will operate on a calendar/tax-year basis commencing January 1,2005. Meetings must be held to explain the new approach and election forms must be distributed and collected prior to your last payroll period in October if a November 1 date is to be accomplished. 104 Houston Street, Suite B . Roanoke, Texas 76262 (817) 430-7100. Fax (817) 430-7105 Mr. Larry Shaw October 11, 2004 Page 2 Larry, you will find enclosed a description of services in which you have shown particular interest. You will observe that the list of services prepared for your consideration has been separated into three (3) distinct and logical phases. The first phase determines what you have within the context òf what you want. The second phase assumes that a market.$earch is required for some or all of your benefit plans and the third phase allows review and managelnent of the adopted planes). Our proposal provides you with the option of Phase I only or Phases I and II or all three (3) phases of service. If you choose all phases, the annual fee presented will be guaranteed for a second year. Indeed, the services have been priced for two (2) years in order to amortize acquisition costs over a longer term. Annual pricing for each of the options is provided below: PHASE I, including up to two (2) trips to Paris $8,000 PHASE II, including up to two (2) additional trips to Paris $12,000 PHASE III, including up to two (2) additional trips to Paris $4.000 Total $ 24,000 Larry, thank you again for the invitation to us to offer this proposal. The confidence that have shown is us is greatly appreciated. We recognize the significance of the task before us and we look forward to being of service to the City. We shall be pleased to answer any questions that you, Mr. Anderson or your City Council may have regarding the proposed services. Sincerely, ..V11~ t. , ¿, I wv .~ r ", C. Mosley President Enclosures Cc: Mr. Gene Anderson, CPA Mr. Rodney K. Dryden DESCRIPTION OF SERVICES EFFECTIVE PLAN MANAGEMENT, INC. PHASE I SERVICES . Provide information regarding available alternatives to the current funding arrangement; . Evaluate present plan design(s) for medical, dental, vision, prescription drug service, disability and life benefits as they relate to employer objectives; . Study available loss infonnation from and administr~tive performance by providers; .. . Study existing Retention Agreement(s) with emphasis upon reserving requirements, interest payable upon such reserves and provisions for release of unearned reserves, if any, in the event of policy termination; . Study existing administrative and stop loss agreements in order to determine cost effectiveness for services performed and risks accepted including run-off liability if the plan is tenninated and administrative expense associated with processing of run-off claims; . Review adequacy of premium equivalents created to fund a self-funded plan; . Examine present contract(s) and Plan Document to determine conformity to both state and/or federal laws and regulations as well as compliance with the company policies regarding treatment of employees; . Provide recommendation for administrative management of employee benefits including format and content of regularly issued loss reporting; PHASE II SERVICES . If the decision is made to obtain bids on new or alternative plans; provide draft for bid specifications, submit bid requests with complete and accurate information required by underwnters. Act as point of contact for underwriters to obtain information and gain a complete understanding of contract or plan document provisions, approaches to administration, loss or exposure data and other pertinent matters; . If a Request for Proposal (RFP) process occurs, at the conclusion of that process, provide evaluation of conformity to bid specifications, reputation of bidders, pricing for services to be performed, acceptance of risk as reflected in cost, ability to meet administrative management requirements and compatibility of provider's managed care network to all COPdescofsvcslOll04 - 1 - DESCRIPTION OF SERVICES EFFECTIVE PLAN MANAGEMENT, INC. geographical locations of participating employees; . Provide a complete report of bids with recommendations that are calculated in a fair, impartial, objective and reasonably easy to understand manner. Provide logic and criteria used to determine results and conclusions for recommendations. Be prepared to answer questions about the report and information provided. PHASE III SERVICES . Provide adoption pfocess guidelines that includes transition plans for change from current insurer or administrator, compliance with the Texas statutes regarding replacement of coverage where ERISA preemption does not exist, meticulous examination of all documents issued and procedures established to determine that they are in compliance with specifications and agreements; . Following plan adoption and after 3 or 4 months of plan operation, provide audit of exposures, expenses and paid losses to measure accuracy of record keeping and actual charges to the plan are consistent with those quoted; . Provide continued monitoring of plan losses as compared to expected and administrative performance the administrator contractually agreed to provide. Assist in the immediate resolution of problems by providing guidance for instituting corrective action; . Provide year-end review of insurance companies and/or administrator's performance, losses and proposals for renewal for the forthcoming year. Provide guidance for plan modifications, reasonableness of proposed renewal actions, negotiate renewal to ensure acceptable terms are achieved, assist in the drafting or redrafting of plan documents and summary plan descriptions and/or conduct a thorough examination of documents provided by the insurer or administrator; . Provide consulting services throughout the year, on an as needed basis, to answer questions on state and federal compliance related issues. COPdescofsvcslOll04 - 2- Ii f¡ f I: r f r r f I r ~r ~~:ì?7 r~;; 't~E<r;:" ~.t:1fQ'~~ ~!:~. i! ~ ~:;£L:;';J ¡, G~ C R I Z Z.\ F F J D.\ R BY ~ 8.-'1"'-" fl..1i~" .-:'1tJ' .\(0:'111'-"""": ., . . , ,.---:- ..' .".,. '----0 ..511arÍJ1g POH'e¡:!Ìll ]"'o01s to 1,11jJrO1'e .BOttOJìl Lille p e J.~/ò rill (l/1 c e a ~,. ~'N. ~ g .if;;;~....:I~ ~ ~ ~~ .~~.;.;~~~~ ~.::r:: jJ ~ ! j 2 J J I J J J I I Section I: Executive Summary Section II: Consulting Action Plan ¿ ll-. Materials Required ~ A Review and Analyze ~'3.' Analysis and Implementation ~.~ Long Range Strategic Planning fa RFP Process for Renewal ¿:l Open Enrollment ¡4. Implementation and Follow Up Section III: Consulting Fees Section IV: Professional Services ~ ~ Areas of Specialization ~ ~ Vendor Evaluation/Selection Assistance Section V: References & Contact Infonnation or . , , ,...--:-.- "" "... . ....., G~ GRIZZAFFI DARn\' Bol,,{i' DtJit" A"d .\("""g"""'1 ~C £:.: r.F.:it~~1T~~4\'.\"~~!~~~ ~,~'~'1'{.~~~'¿~. :f>iV..£iI':'M... . ~~Ao ~'"£:!I'W~~"rj-.E!,) '::'-;7~'P','~~~r¡~ ~ I I I I . . I I I I I I I I I J I I I I I I 1 I , . ~ ~,' ..". . ... ,,~, Proposal for Employee Benefits Consulting Services Executive Summary , Grizzaffi Darby, LLC provides creative benefit solution and unparalleled customer service to clients who share our commitment to long-term partnerships. Grizzaffi Darby, LLC uses three core principals. We provide professional value-added services based on strategic planning, five-star service, and cutting edge technology. The team of specialists assigned to The City of Paris is dedicated to using their experience and expertise to meet your objectives, and is committed to anticipating and fulfilling your needs. The Grizzaffi Darby, LLC account team includes: ." . .~ Linda S. Hooper - Lead Consultant James R. "Trey" Darby, III - Partner Luke M. Grizzaffi - Partner Steve Gibbs - Human Resources Consultant Amanda Griffin - Account Manager Susan Williams - Customer Service Christine Edwards-Ruggerio - Client Communication Specialist . - ...:... :.~ ::'1. :'l , ,,\ Grizzaffi Darby, LLC is able to offer consulting in a variety of medical plans, voluntary products, retirement planning services, flexible spending (Section 125) accounts and other employee benefits plans from carriers and vendors across the United States. We specialize in evaluating, negotiating with, and recommending insurers and providers to our clients, and we employ rigorous selection criteria and performance objectives when considering a vendor. Grizzaffi Darby, LLC also offers a variety of other Professional Services, claims data analysis services, plan administration and legislative compliance assistance, custom communication services, technology-based human resources tools, and access to specialized pharmacy benefits expertise. y It is our understanding that you wish us to act in the capacity of consultant / broker to The City of Paris and review and advise you on the contracts/vendors The City of Paris is currently working with as well as make recommendations for future changes / enhancements. This .ptop.osal outlines a specific course of action to meet The City of Paris's employee benefits objectives and will provide: . Improved benefit and vendor contracts A better understanding of benefit contracts Reduce or control costs associated with each contract Recommendations for Section 125 Flexible Spending Account G~ . . . (; R I Z Z;\ F F I D..\ R BY Bnlt/it [)"il" alld '\("""J(tmtnt l;;;:;;' ;;;;:;:£::.::;: ~:::';j¡~"":" ~""':1" ~ =ï4'~'~::'::::';'7~~'2"'~"~~~~'Z\' ~~..r;-.,< t.. ";-~~~~:""~~~t:.:.:~.~~'¡": -;;- .r,;iC'~:~.:.~7'1~~~t;;':¡¡~i:~:::::::::'.::'..;j I I I I I I I I I I I I I I I . I I I I I I I I I I I I I I I I The City of Paris's employee benefits plan objectives are as follows: . , ,~ Review and evaluate vendor contracts/agreements Identify areas of contractual obligation and liability Determine efficiencies of plan administration Recommend funding limits and alternatives Review loss information and provide recommendations Benchmark claims data against industry and regional information Provide legislative compliance audit and identify areas of non-compliance Provide analysis of benefit plan designs and recommended changes Implement and provide savings analysis for Section 125 Flexible Spending Account Implement Employee Insurance Committee to address employee concerns and issues Provide employee education and group benefit meetings ;J, ; ;\ "",1, , ~, i ,,\ " <.\ ;-... ;;,;¡ ,4 .: ~, To address and fulfill your objectives, we propose the action plan on the following pages. ~ . , -~ '.' . '" - ...~. GI) (; R I Z Z A F F I DA R BY 80,,/il O"ilC" alld '\(( "' Jlrlllenl :"';:'~~~7~::;':;:;-=--:O: ::~~;.7:::Z~ ~- .~::7-::;' ,~:. '. ,.::;-... --:- ;""',':-:: ~<rIl'i.i~'?-:;-~~~'~~=-~ "::'.:::,,;'!:r'.~'T¿~~'.":""~~? ~~:3~~~ :;1'7'~:l;:::i:.; ;;:."';; {:;;:.~;¿;"";;;:. ¡ . . . . . . . I I I I I I I I I I J I I I 1 I I I I I 1 1 I , I '; ," 'Iii!, , '*" . , .,' ,.' . '!":~~=~;;,~~-;o.....! :'. .. "', , Consulting Action Plan Steps 1 - 7 Step 1 - Materials required to perform project ~;).. Current Third Party Administration contract/agreement Current specific stop loss application and contract Current aggregate stop loss application and contract Current contract/agreement with PPO vendor Current contract/agreement with Prescription Benefit Manager Current contract/agreement with dental, disability, ancillary vendors Current summary plan documents and plan designs for all lines of coverage Current and previous benefit summaries (medical) for last 3 years Employer contribution schedule for last 3 years Monthly loss reports (premium vs. claims) for last 3 years on all lines of coverage Monthly funding account summaries on self insured products for last 3 years Large claim reports on self insured products for last 3 years Medical, dental and Rx claims data for last 3 years Current and prior rates for all product lines for last 3 years Renewal rates for all product lines as they become available Business Associate Agreement between City of Paris and Grizzaffi Darby, LLC Letter of Authorization! Agent of Record to all parties ~'l. ~ð. <~ ~~ ,;¡i ~o\. è":' ~.a. ~'å. <.3. ~'.'l ~J. .1 (;.. ,..1. ~"- Step 2 - Review and Analyze " ~ TP A contract/agreement to include, ;;~ Administrative Fees ;'¥. Additional fees charged ,). Per claim < 'l Reporting ~,~ Subrogation ;,l Non-network negotiating :'1 Pharmacy administration il Rebates .1 Ad hoc ;:1 Commissions built into additional contracts (PRM, Network, DR, Stop Loss) .. Online capabilities <" Claims data reporting and data transfer capabilities . ' .1 Regular reporting , I . ...". . ¿~ Ad hoc capabilities . ,~-- . ..-. ,~ Mid year reports £ ~ Actuarial reports ~'~ Co-morbidity reports G~ CRIZZAFFI DARBY B""/il D'Ji/C1I a"d ManaK"""" ~~~"'!t?~~J¡.~~"~:r~~:~~.:~¡:1~2"'i%~~,~~.¡:~~.dl;=,~!r;~~,,,"-'I::.>c~,';~~~~~......" ...-....1i!IðII. ~""~"'!'.~ 3, ¡m ::II ::!I ::!I ;! 3 :I 3 3 :I :1 3 :I J J I I I I I I I I I I 1 1 I I "..., . _:, ,!.v" . .--.. '. '"':. ' ,. " Consulting Action Plan Steps 1 - 7 Step 2- Revie\v and Analyze (cont.) ê~ Utilization review and Large Claim Management procedures ;.:\ In house or outsourced .:~ Number of nurses on staff and their qualifications ;-'" Maternity specialist on staff ~"J. Hourly rate and billing increments ;~ Review criteria .:,l Integration with claims payment, customer service and eligibility ¿.;\ Cost containment Re-pricing claims completed in-house or sent to PPO Procedure for handling hidden provider claims Claims processors ;-.1 Years of experience ;'." Claim limit authority ;- ~ Designated claims contact Internal communication between departments (ClaimsIUR/LCM/FMLA notification) Disease Management programs Centers of Excellence Medical personnel on staff Audit Procedures ; ;¡. Standard procedures ;!. Dollar triggers ;~ Percentage of large claims audited < ,\ Coding accuracy ;.j}. Procedure for identifying bundled charges ;. ,(\ ; .\ i~ ;' J. ;. ~. .t il. ,;~ PPO contracts to include, < ,." Geo-access reports ; ~ Fees ~'3. Average discounts ;~ Utilization ;'.:L Re-pricing procedures ¡.;. PPO wraps for non-network claims (;\ Prepare summary of current employee provider usage ~ ~ Prepare Betwork evaluation based on utilization data and available networks .. . , "P¡'escription Benefit Manager (PBM) contracts to include, . ~.. . '...., ~1 Cost analysis i.. Discount analysis .'~ Dispensing fee analysis il Drugs on Formulary and Non-Formulary Lists it. Rebate analysis a Mail order utilization benchmarks '~ Detennine costs savings of implementing a direct PBM contract CRIZZAFFI DARBY GI) Btll~/jt D.,i/C" "lid .\[all"/ltllten' ~,;¡-,'~iH~~~.::' .:.;1;;'¡~"",-:"(_~7~ =~~""'i>. ,.,~ :V"~:~4!,.:r'."'¡¡O~~..~..~ ~."""'-"""~J~"~6~.",l!:!r.o,? .æ'~¡'~:"'k£. """""~---"""'ZJIm."" ;:""""';;; ¡ j J I I I I I Step 2- Review and Analyze (cont.) Specific and aggregate stop loss contract noting specifically, ~ ~ Reimbursable or immediate specific claim payment . ~ Maximum amount or specific coverage ;.. Exclusions of specific contract ;;~ Amount of risk retain by named carrier versus reinsured to tertiary markets i~ Financial standing and ratings of reinsurance carrier(s) involved , :l Ability of reinsurance carrier to non-renew or offer a higher specific stop loss on selected individuals based on ongoing claims ;;.t¡; Discounts provided by reinsurer because of current TP A ;.~ Length of contract ;;~ Amount or percentage of commission currently being paid and to whom ¿~ Will reinsurance pay according to Summary Plan Document ...). Renewal guarantee, and # days prior to renewal rates become firm ;; ~ Lasering or raising specific stop loss amounts ;; Ii Aggregating specific amount ¿.; Period of reinsurance contract, run in, run out limitations ;\1 Rx included in the specific and aggregate limits ¿~ Pooling points and philosophy at renewal Ancillary vendor contracts noting specifically, iJ. Contract limitations and requirements ;,1 Period of rate guarantee ,;l Benefit levels ¿ å Analyze cost compared to self insuring benefit i 1. Comparison of plan design to market ;,~ Geo access of network were applicable Cobra, HIP AA, HIPP A Privacy compliance audit, ;; ). Review current policies and procedures and forms ,A Identify areas of non-compliance y Claims and Loss Data noting specifically, i... Areas of high utilization ¿ ~ Actual chrims versus norm for region and industry ~'o. . PPO discounts . , ...,". . .~.. . .~-~ Employee versus dependent claims ,~ Inpatient versus outpatient claims i <l Claims by place of service ;. ~ High cost claimants ;'.&. Paid claim distribution by claimant è'~ Paid claim distribution by dollars ;;... Inpatient analysis by length of stay iâ Inpatient analysis by average paid per day CRIZZAFFI OARßY GI) B~"'/il lJ"i/Cti and M(HluJlt"'~1I1 ::r?""'~~y..~;:.; :'.i,~';;, ~~~'";;t~~%.¡r.~~::,! £:~"!Ä7~ ~";;;Y'ð">?o.~' .J\".ltl'l..;'-&~,~~~'..z,~~";~",'1W;¡ rr--<ù~'~!.x.iU' :l'4':d:~~ ~,~!II'J'lœ'=;"m::-ti I I I I I I I I I I I I 1 I I I I I I 1 I I I I I I I I I I I I Step 2- Review and Analyze (cont.) <)¡. Provider usage in versus out of network Inpatient surgery claims Outpatient surgery claims Emergency room visits Office visits Mental health usage Claims by major diagnostic category Lifestyle related claims Disease management and intervention opportunities Co-morbidity management and intervention opportunities Identify necessary areas for wellness education : 1. ~i\. ::\ <"l C :1. ,J,. ,,;¡. ;.~ , .,. ,ì Section 125 - Flexible Spending Account noting specifically, cè. Identify areas where plan can be utilized <.\. Analysis savings versus expense of implementation ~;~ Identify expected savings for City as well as employees ~ i~ Savings versus exposure to City to open plan to all areas versus premium only Step 3 - Analysis, Recommendations and Implementation ; :!l. Current administrative obligations/liabilities Contractual obligations/liabilities Opportunities for reduction in fixed costs Efficiencies of administration Vendor fees / commissions Compliance violations Claims utilization data report Benchmarking data Implement HR software site and train staff Plan of action to meet long range goals Recommended plan design changes Model plan design changes to provide cost differentials Section 125 recommendations, implementation and employee education Implement employee website and provide education materials and meetings Ongoing wellness and consumerism education to employees c .\. . , -.' ,~ '"" , '0 ,!.. .. ,... - , ,.... ~..l (~ ~1. ; 1 ;:1. c,:>' ',.. , ... " . . , ..-.-'-, '.ò . -.- -...... G~ (;RIZZAFFI DARny BeMli, Desit" and .\I""agt""'" ~P¿ ': *;i ;"t ~ ~~ Zf:' .:?"'.-iT."" ~ ~~:!~,~:s~~ ~~iã.~ !ë~ ,. ~ ~~~~ ~ ~~ ~ ~':"~'J':!\'!!~~r:r~~ ~~E':;2;.. J ., Step 4 - Long Range Strategic Planning Upon completion of this audit we will be able to provide The City of Paris with an in depth knowledge of their benefits and vendor contracts; a better understanding of the financial liabilities associated with those contracts; as well as areas where costs can be more efficiently reduced or controlled. As well as initiate a long range planning committee and goals for future years. ~ Developing a long range strategic plan will identify and prioritize long-term objectives. It will also establish specific deadlines for meeting those objectives, and will allow for ongoing modification as the need arises. ~ If the City desires to create an Insurance Committee we will strive to work with that Committee and the City Council to understand the needs and wants of the employees and provide the education and benefits that will meet those needs. Step 5 - RFP Process for Renewal ,~ Create RFP's for each line of coverage / service Select vendor's to receive RFP's Collect and organize data received from vendors Analyze data and make recommendations for renewal Develop overview for City Council review Assist City Council as needed in selection process of vendors Facilitate vendor changes and implementation process Review and execute contracts Meet with vendors to set up billing format, etc. ~11 ~:1. ~.. ;!. ,.j. ;1). ,>1 : 1. Step 6 - Open Enrollment ,4 Communicate with selected vendors to organize enrollment process Create open enrollment material Setup employee website with enrollment information Conduct open enrollment meetings Provide open ènrollment data to vendors :~ '.. "..... ~ð. ;.~ . . ., - . ..' .... . "-' G~ CRIZZAFFI DARBY t:=2Ð!~.v...~~Ji:~2.X'~~ìt:t..!~f='~~~~~~"'JI.~T~~;:-"~~'1:iJ;'~~~;"';I~il'_";Y ~.".,& ",p:JJ"'~'m;~.:;o:;t.-:;~~ - ~= ~- . - .-!fL.-'::::'T'~& .~. 11!'f::=;~ B",,/illltJiKtl and Manall""tnl f f f r f r [ r r r r I: [ I: r I: J: I ': !, " I I: I, I' " 1 ~ '. " L ., '~ " 'J ;1 ; I~ I~ I" II I , , . Step 7 - Implementation and Follow Up <~ Develop employee education theme and plan of action Select and customize communication pieces Review billings to ensure accuracy Establish lines of communication with City's HR personnel for claims issues Provide training for websites use and administration Mid Year Review (after 6 months of claims data is available) Pre Renewal Meeting (90 days prior to renewal) Renewal Meeting (upon receipt and review of proposals) Post Implementation and Follow Up (1 month after renewal) Additional review/meetings as necessary Customer service on an as needed basis for billing and claims issues ~'-l. ,1. <-\. ~).. ~a. ~;¡. '" < '... ~~ ~,l <.1. ., . , , ....,- . ,.' ,.~-. . ....., G~ CRIZZAFF( DARBY B",,/it Clt';/CfI a"d .\(,jf\"lltlflt", I7tT!'t;~~~~;1':t',;'1 ~c:~1"l:4~.,.~ ~~.;;;'.~:~~;:~7,'i'B\."'. :£.>',¡;,;:~ï~~~.;' ~""..;p,1~'#~ _.,~~......:~~~~I~~~""~r;-.."'li~~ Il r 11 11 11 11 1"1 11 J1 Ii 11 I ~ IJ 11 L 11 r I: I' L r L L I l- I: ~ L J: I. I r..c.: ~;:'C.~ .! ~~ ~=- ~r::'\"~':o.~$:;:';-;~~~~ g . Ë"!,:~~~ v~~- ~~;:.~q~¡";;E:;'%~1.1:;;&,':~ :r:~ :liiæ.;r-~1:¡};;E!i:;;'.;:;: ;:~: .:¡ Upon completion of the initial scope of work The City of Paris will be prepared to move forward with their benefit plan changes with a better understanding of the contractual obligations and liabilities of each benefit and vendor they are working with throughout the year. Fees for these services are based on a per head/per month charge for each enrolled employee/retiree and include all services listed in this proposal; as well as ongoing customer service for day to day administrative issues and claims. Grizzaffi Darby, LLC proposes a $9.00 per employee-retiree/per month fee for consulting services rendered for the partially self insured medical plan. Grizzaffi Darby, LLC shall request all quotes from vendors regarding the medical plan be provided net of commissions, thus eliminating any outside influence in vendor choice. Grizzaffi Darby does require that they be named as agent for all lines of coverage the City of Paris includes in their benefit package in order to have access to necessary information for analysis and planning. In addition, our Human Resources Consultant Steve Gibbs is available to those clients who do not employ a full service Human Resources Department. His services can be utilized on an hourly, retainer or per project basis and are in addition consulting fees stated above. Services included in the Human Resources consulting practice are employee handbook and policy and procedure review, revision and development; EEOC response consultation; unemployment claims consultation; compliance training on HIP AA, HIP AA Privacy, COBRA, ADA, FLSA, FMLA & Worker's Compensation; Current and former employee reference policies and procedure development and training, Leadership training and development; compensation surveys; performance management, including succession planning; and employee relations consultation. A fonnalletter of agreement and engagement will be provided to the City upon request and will explicitly dictate the parameters of the agreement between The City of Paris and Grizzaffi Darby LLC. . . ..r . '.', . ... . ...~. G~ CRIZZAFFI DARBY B~"'fjl [I,,;t" ø..d Mt"'alC"..~..1 ~ -;';- ~:~ ~ ¿;¡;.. - ; "~"'::1!~: . ~~~::I':;':::;:::" ~ ~ l\ ~"1i: ~~ ":~.?Æ;"E:1t'::~r¡~R "; ;';¡)~,~ J. ;-...7~ v~T-~~ ~.t- ~t~J [ 11 Il 11 r. 11 IJ 11 I I [ [ I I I [ I I I I I I I I I I ., I 1 1 I I 1 Grizzaffi Darby, LLC uses three core principles to service and manage your employee benefits plans. We provide to our client's professional value-added services that are based on strategic planning, five-star service, and cutting-edge technology. Strategic Planning We recommend that our clients make employee benefits management a strategic initiative. By defining objectives and developing an action plan based on meeting those objectives, we ensure an organized, complete approach to fulfilling your benefits needs. Our careful strategic planning services include ongoing evaluation of all your plan's characteristics - such as access, service, and price - to ensure a proper balance is achieved. Strategic planning also shields your plan from becoming obsolete as new trends and market factors emerge. Five-Star Service We pride ourselves on the level of knowledge and service we provide to our clients. ;'2. Contact: We meet with clients regularly to ensure carriers, coverage, and costs are meeting expectations. Education: We conduct employee meetings and provide custom communication materials for employees. Advocacy: We work on your behalf to bring an unbiased perspective to all situations, with no allegiance to any specific carrier or vendor. Personnel: We hire and maintain a professional, experienced staff and ensure that they are up-to-date on all the latest trends and information. Information: We possess the information and expertise that allow us to negotiate comprehensive, competitive benefits programs; we know where to find the answers to any of your insurance, employee benefits, and human resources questions. ..~ it). ;:.'1 .. ). Technology We use leading-edge technology to provide our customers with the latest data analysis, legislative, communication, and human resources administration tools. Using exclusive Internet-driven applications, we provide our agency staff and our clients with unsurpassed efficiency and access to information. '.- . ... . ...-. G~ CRIZZAFFI DARBY Bou/it [lff;!!;'1 alld ,\(""Q/(""e,,' 1::.; "'E.r!í~:~'.""?'~.~~:"JT:i.t" ~~l!!;'.~~J.~~~~.iíZ9;<';.~~:¿~.::.'i,~J1~~~ ~~~"!J."fY';1":;::;¡¡ra~..,. ::!~?rylM". =~~JI!.~'ò:"""""""~ Ii 11 11 11 J: 11 (; r I~ [ r [ I [ [ [ I I I I I 1 I I I I I 1 I I I I Grizzaffi Darby, LLC specializes in a wide variety of plan types and lines of coverage. Medical Plans ;.;1 Self-insured plans :, Insured indemnity plans :~ Point-of-service (POS) plans ¿~ Health Maintenance Organization (HMO) plans ;.;<' Preferred Provider Organization (PPO) plans ,.1 Consumer Driven Health Plans (CDHP) ,.~ Minimum premium plans Other Employee Benefits Plans i Dental D Vision ~.:l Short-term disability : <Ì. Long-term disability ~') Long T enn Care ;..:. Group Life/ AD&D ,.¡ Employee Assistance Programs ;, Section 125 Flexible Spending Accounts -.1 Health Reimbursement Acounts ;.¡ Health Savings Accounts ¿..t Travel accident ,f,' Special risk coverage ~ Voluntary Products ,.1 Dental n\ Vision ,'l Short-tenn Disability ;,~ Long-tenn Disability (3, Individual Life/ AD&D ; l\ Dependent Life/ AD&D i" Long-tenn care ;.... Critical Illness i.~ Accident ; ,\ Cancer ., . 'Retitenrent Planning .:-~ -"~'40 1 (k) ~~ 403 (b) ,1> 457 í ,\ Pension/profit sharing ~'.l Employee education G~ CRIZZAFFI DARBY Bfflt/i, CI,.;/C11 "rad .\(tHlUJ!tmell/ ~~.:.~~~~'-:'~r.;2:~'~~~"m"..:,~,~ ':Ö'iz.......~ ;'R~"1o'i:~~.')~ c. """i"~'~",,1f ~~ 5". ..~~~~Z"=. ,...."",.~~...,,;.~'Zj~ I [ I; I: [ I I I: I: I I I I I I I I I I I I I I I 1 , I , 1 I I , Vendor Evaluation/Selection Assistance In addition to general day-to-day services, Grizzaffi Darby, LLC would release a Request for Proposal to the marketplace in order to review your various vendor options at renewal. Evaluating, negotiating with, and recommending insurers and providers to our clients are Grizzaffi Darby's specialties. Our position in the marketplace allows us to enjoy preferred financial arrangements with insurance vendors and third party administrators across the United States. We actively cultivate long-standing relationships with major carriers, and those relationships allow us to negotiate aggressively and obtain cost-efficient proposals for our clients. As we negotiate with vendors, we will also examine your loss history, establish the necessary types of coverage consistent with your risk tolerance, choose carriers that provide superior services, and adopt the optimal funding mechanisms for your specific needs. We have established rigorous selection criteria for potential vendors, and recommend a selection based on the following considerations. Critical Vendor Selection Criteria "-" <- Overall service and quality Experience in administering network-based programs Commitment to continuous quality improvement processes Experience in administering multiple option health programs Quality of communication materials (e.g. booklets, EOBs, etc.) Effective administration procedures (e.g. coordination of benefits, subrogation, etc.) Responsiveness of group representative Cost efficiency Responsiveness to client feedback Professionalism of response to RFP Willingness to adapt to changing needs and circumstances Adequate staffing ratios Superior network coverage in relation to location of The City of Paris employees Evaluation and implementation of Flexible Spending Account (Section 125) a. ~'.A. d. ~-~ -:;;l ;, :¡ ~,1. .3. <1. ; it ~;.l ~:>.. ~~ ., . - , .- -- - - -.' . ... . ....., G~ eRIZZAFFI DARny 8t"'li/ ( ";IC'¿ "",1 .\(tJ,.tI (ttlt,ta' i2r,;~L:-::';;~';';.;'":~"'-" ~';:'~7<. ":.. ¿~,~J:;~ :~""5}:'j~7,. ~ .i;}~~'i'~~":::.:¡:;~~ i~ -:". :;~,~~~~~~?or=~,~~,'1:.:! ~¡;;¡; . II . . . . . I . . . I I . I I I I I I I I J I I I I I I I I J ..-.- - Harrison, Walker & Harper Christy Wendell, VP Staff Services 222 E. Hickory St. Paris, Texas 75460 903- 785-1653 c wen dell (tV, web u i I d - h w h . COIn City of Corinth Phillip Bray, Director of Finance 2003 S. Corinth Comith, Texas 76210 940-498-3220 p b ra y ~~ C i t yo f co nl i t h . com Beal Bank Angela McCleery, Human Resources 6000 Legacy Dallas, Texas 75024 469-467 -514 7 twi ggins(â)beal bank.com HT Ardinger Lance Ouellette 1990 Lakepoint Drive Lewisville, Texas 75057 469-635-0137 lanceouellette(c~mac .com v Wise County Medical Center Kala Walsh, Benefits Coordinator 1001 Eagle Drive Decatur, Texas 76234 940-627 - 7829 ext 13 kala~ù:wisedocs.com .., '..~. Alan Ritchey, Inc. Bill OIT, VP Finance P.o. Box 249 Valley View, Texas 76272 800-877 -0273 borr@,alanri tchey.cOlTI GI) CRIZZAFFI DARBY S""lit [J"i/Ctl ."d Ma".sr"""" ~:~n¡ :~'~"l~~~>?" ~~ . ;¡;. ~ 3.; 'EY;~":~ì~~~~,,"tc\!!!t~;~""~E.20~~~r~.' !,{J.~:!'~~";~~~~~~'::<-~d .r..... ~ """~ii _-t-;;T!:;~~~"'!:,:Z'~" . I . . I I . I . I I . . I . . I I I I I I I I I I I I I I I I Grizzaffi Darby, LLC Linda S. Hooper 101 Lamar Avenue Paris, Texas 75460 Telephone: 800-466-7440 Fax: 903-739-9712 I inda({~gdllc.cOln The City of Paris Primary Contact: Larry Shaw Interim City Manager Telephone: 903-785-7511 The City of Paris Secondary Contact: Gene Anderson Director of Finance Telephone: 903-784-9241 This proposal was prepared and submitted by Linda S. Hooper on November 1,2004. This proposal expires on December 1, 2004. Grizzaffi Darby, LLC is a privately held organization and considers all information contained herein to be. p~ÓPñeta,~ alnd/..ço¿~rntia1. . s¡gnature;#1 {¡Ú,-- . j:frrp(./L LInda S.:Hooper, Consultant Date: Ir-¡,-¿1 f '< . . .'- . ..' . ... . "'-' G~ CRIZZAFFI DARBY Bu,/it lJ"if/(ti ""d ,\ftHlII/lt"'t"l t::.'- ~'! ~~.-,..:r~1:\""1'.t~:........~~~.~.rI'r.:~~~!.~=>..........ooí!";:]P""C5~)cJt:.'lMI~'.:2,",,, ~~~~-~fTi:õA~. u:r.",!M-""1&...;¡'....'"}-..~b "'m. ~"'1-~""'" ?,=.~.. ,.j ....~ -, - ;zl