| Item Title: | HR - 2024 Aetna Stop Loss Renewal Rate (2023-0874) | | Submitted By: | Sam Trujillo, Interim 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 2024. Funds are available in IS-HEALTH-SPECF/AG STP LSS INS. (Contract No. 2023-0874) | | 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 six years, the County’s Risk Pool Fund has experienced on average between 5 to 6 stop loss claims. This year between January and September 2023, the County's Risk Pool Fund has experienced four 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 $3,081,245 to $3,379,765 ($298,520 estimated annual increase).
The County’s Risk Pool Board has recommended approval of the Stop Loss Renewal Proposal Rate during their regular meeting on November 15, 2023.
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 2024 has been reviewed by the County Attorney’s Office. (2023-0874) | | Fiscal Impact: | 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 = $3,081,245
2024 plan year $112.21 PEPM = $3,379,765 (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 2024. Funds are available in IS-HEALTH-SPECF/AG STP LSS INS. (Contract No. 2023-0874) | | 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)
December 12, 2022, Item #4P, Commissioners Court approved the Stop Loss Rate Renewal for 2023 with Aetna Life Insurance Company (2022-0932) | | Strategic Plan: | .. | | Strategic Plan Information: | |
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