| Item Title: | HR - Plan year 2023 Aetna Stop Loss Insurance Renewal Rate (2022-0932) | | Submitted By: | Minnie Holguin, Chief Human Resources Officer, Human Resources Department (915) 546-2218 | | Subject: | Approve and authorize the Stop Loss Renewal Proposal Rate with Aetna Life Insurance Company for Stop Loss Insurance coverage for the County’s Health and Dental Plan for plan year 2023. Funds are available in account: IS-HEALTH-SPECF/AG STP LSS INS. (Contract No. 2022-0932) | | Background: | On December 3, 2018, the County of El Paso awarded a bid to Aetna Life Insurance Company to serve as the County’s Third Party Administrator (TPA) for Health and Dental Benefits. Included in the Aetna’s bid was the ability for the County to obtain Stop Loss Insurance through Aetna Life Insurance Company. The purpose of Stop Loss Insurance is to protect the Risk Pool Fund from catastrophic individual claims over $300,000.
Over the past five years, the County’s Risk Pool Fund has experienced on average between 5 to 6 stop loss claims per year. This year between January and September 2022, the County's Risk Pool Fund has experienced eight Stop Loss Claims in excess of $300,000.
The attached Stop Loss Renewal Proposal Rate from Aetna Life Insurance Company maintains a $300,000 deductible without any members who would require a separate deductible (no lasering). This renewal would increase premiums costs from $2,784,301 to $3,081,244 ($296,943 annual increase).
The County’s Risk Pool Board has recommended approval of the Stop Loss Renewal Proposal Rate during their regular meeting on November 16, 2022.
Approval of this renewal proposal rate will result in the creation of formal insurance policy which will be brought back to the Commissioners Court for final approval.
The Stop Loss Renewal Proposal Rate with Aetna Life Insurance Company for Stop Loss Insurance for the County’s Health and Dental Plan for plan year 2023 has been reviewed by the County Attorney’s Office. (2022-0932) | | Fiscal Impact: | 2019 plan year $57.48 PEPM = $1,751,875
2020 plan year $72.25 PEPM = $2,214,462
2021 plan year $83.81 PEPM = $2,583,695
2022 plan year $92.11 PEPM = $2,784,301
2023 plan year $103.62 PEPM = $3,081,244 (estimated)
Premiums for Stop Loss Insurance Coverage are paid through the County’s Risk Pool Fund.
IS-HEALTH-SPECF/AG STP LSS INS
COIS-5001-0000000-431-10-10000-0001-00000-540003- | | Recommendation: | Approve and authorize the Stop Loss Renewal Proposal Rate with Aetna Life Insurance Company for Stop Loss Insurance coverage for the County’s Health and Dental Plan for plan year 2023. Funds are available in account: IS-HEALTH-SPECF/AG STP LSS INS. (Contract No. 2022-0932) | | Prior Action: | December 3, 2018, Item #18, Commissioners Court awarded RFP#18-030 to Aetna Life Insurance Company to serve as the Third Party Administrator for Health and Dental Benefits for the County of El Paso.
May 20, 2019, Item #16, Commissioners Court approved the Stop Loss Rate Renewal for 2019 with Aetna Life Insurance Company (2019-0206)
December 9, 2019, Item #11, Commissioners Court approved the Stop Loss Rate Renewal for 2020 with Aetna Life Insurance Company (2019-0883)
November 23, 2021, Item #22, Commissioners Court approved the Stop Loss Rate Renewal for 2021 with Aetna Life Insurance Company (2020-0976)
June 28, 2021, Item #4E, Commissioners Court approved the Stop Loss Insurance Application for plan year 2021 with Aetna Life Insurance Company (2021-0432)
October 25, 2022, Item #27, Commissioners Court approved the Stop Loss Rate Renewal for 2022 with Aetna Life Insurance Company (2021-0790) | | Strategic Plan: | .. | | Strategic Plan Information: | |
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