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HomeMy WebLinkAboutContract 60637CSC No. 60637 PartnerRe Excess Loss Insurance Application PartnerRe America Insurance Company Wilmington, DE NAIC# 11835 Mailing Address: 6900 Wedgwood Road, Suite 120 Maple Grove, MN 55311 612 234 4920 The Applicant hereby applies for the Excess Loss Insurance Policy. 1. POLICYHOLDER: City of Fort Worth Principal Address: 200 Texas Street Fort Worth, TX 76102 Are subsidiary or associated entities to be included? ❑ Yes ® No 2. POLICY PERIOD: Effective Date: January 01, 2024 Termination Date: January 01, 2025 3. POLICYHOLDER INFORMATION: i. Standard Industrial Classification (SIC): 9111 ii. ❑ Corporation ❑ Partnership ❑ Sole Proprietorship ❑ Labor Union ® Other If other, please specify: Government iii. Nature of Policyholder's Business: General Government 4. CLAIM ADMINISTRATOR: Meritain Type of Coverage: Medical Address: 300 Corporate Parkway Amherst, NY 14226 CLAIM ADMINISTRATOR: Type of Coverage: Address: Optum Rx Rx 2300 Main Street Irvine, CA 92614 ❑ MEWA OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX ESL-APP-200-US-2021 Page 1 of 3 Issue Date: 10/25/2023 5. EXCESS LOSS INSURANCE: a. Specific Excess Loss Insurance: ® Yes ❑ No i. Specific Deductible: $1,000,000 per Covered Person Covered Persons subject to an Adjusted Specific Deductible: Member ID#: PRECIT- 0124-01 at $1,800,000 ii. Coverage Period: Eligible Expenses Incurred from January 01, 2022 through January 01, 2025 and Paid from January 01, 2024 through January 01, 2025 b. Aggregate Excess Loss Insurance: ❑ Yes ❑ No 6. The following endorsement(s) are elected: ® Yes ❑ No Specific Advanced Funding Endorsement The coverage afforded by this Application is based upon the Excess Loss Quotation dated October 25, 2023 attached hereto, incorporated herein, and is conditioned upon receipt, review and acceptance by PartnerRe America Insurance Company ("PartnerRe"), on or before November 8, 2023, of all outstanding information as detailed in Special Notations section of the quotation. Additional underwriting adjustments, including changes to terms, premium or specific deductibles on certain individuals, may be required. I, the undersigned, understand and agree that: This Application is based upon claim details, enrollment, eligibility, Benefit Plan and other information provided by Applicant to PartnerRe. Any known material change in such information must be reported to and agreed upon by PartnerRe prior to coverage becoming effective. The coverage afforded by this Application is to be effective from 12:01 A.M. standard time on the Effective Date stated above at the Policyholder's address, provided the first month's premium is paid in full and that the Claim Disclosure Statement and this Application are accepted and approved by PartnerRe. The coverage afforded by this Application is subject to all terms and conditions of the Policy in current use by PartnerRe. This Application and Claim Disclosure Statement will become a part of the Policy when issued. This Application assumes the Producer/Agent of Record is duly licensed as required by law and has been appointed with PartnerRe America Insurance Company in the state in which the Policyholder is located and the Policy is to be delivered. By signing this Application and the Claim Disclosure Statement, the Applicant represents that all statements, answers and information provided to PartnerRe are complete and true to the best of its knowledge. Applicant further acknowledges and agrees (i) that such statements, answers and information provided and in the Claim Disclosure Statement, together with a copy of the Benefit Plan and other information attached to this Application or furnished to PartnerRe, are submitted by the Applicant as an inducement to and will be relied upon by PartnerRe in underwriting this risk ESL-APP-200-US-2021 Page 2 of 3 Issue Date: 10/25/2023 and determining whether to accept this Application and issue the policy being applied for; (ii) if such statements, answers and information is/are incomplete or untrue and such incompleteness or falsity is material to the risk to be insured by PartnerRe, any policy issued by PartnerRe may be rescinded and/or any benefits that might otherwise be payable thereunder may be denied; and (iii) the Applicant has fully read and understands this completed Application and the Claim Disclosure Statement. I hereby agree to the terms as stated above and warrant that I am duly authorized to execute this acceptance: Applicant Signed By: Its Corporate Officer or Authorized Representative Assistant City Manager Title Accepted by PartnerRe America Insurance Company: mortt 4p,r►,a a e,n, Signature U Senior Group Underwriter Title Dec 22, 2023 Date 75-6000528 FEIN# 12/18/2023 Date INSURANCE FRAUD WARNING Any person who with intent to defraud or knowing that he/she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement, or conceals information for the purpose of misleading, is guilty of insurance fraud and is subject to criminal and/or civil penalties. ESL-APP-200-US-2021 Page 3 of 3 Issue Date: 10/25/2023 Proposal City of Fort Worth Adam Nelson Stealth Partner Group adam.nelson@partnerre.com, Matthew Janssen Effective: 01 /01 /2024 matthew.janssen@partnerre.com, partnerre.com/risk-solutions/health 10/25/2023, Quotation 4 City of Fort Worth Cornerstones of our ESL Value Proposition "Our team offers a unique customer experience, combining personalized `small town' warmth with `big city' capabilities and expertise." Ease of doing business Smooth customer journey Ongoing education & insights • We believe true partnerships are built on trust and straight -forward communication • We provide direct access to the breadth and depth of our expertise • We ensure a seamless onboarding process by providing active guidance and support • We deliver on our promises, offering an efficient claim handling process • Our PULSE + Plus° team offers complementary services customized to each employer group to achieve the best clinical and financial outcomes 10/25/2023, Quotation 4 City of Fort Worth 2 Financial Quote SPECIFIC STOP LOSS COVERAGE Annual Specific Deductible per Individual $ 1,000,000 Except for PRECIT-0124-01 $ 1,800,000 Plan Benefits Included Medical, Rx Card Coverage Period 36/12 Specific Lifetime Maximum Unlimited Specific Annual Maximum Unlimited Specific Advancement Included Quoted Rate(s) Per Month Enrollment Composite 5,927 $ 11.20 Estimated Annual Premium $ 796,589 Commission % 0.00 % 10/25/2023, Quotation 4 City of Fort Worth 3 PROPOSAL QUALIFICATIONS AND CONTINGENCIES 1. This quote is subject to the completion and signature of the application. 2. For inclusion of prescription drug (Rx) coverage under the Specific and/or Aggregate coverage(s) when there is a separate PBM, PartnerRe requires written documentation for underwriting purposes that all Rx experience reports have been received. Otherwise, Rx will not be a covered expense under the Stop Loss Policy. PartnerRe is not responsible for aggregating medical and Rx claims data during quotation or Policy coverage periods. 3. All claim reporting submitted from the selected Administrator should be provided to PartnerRe in a sortable Microsoft Excel format throughout the Policy and Proof of Loss Periods. Failure to do so could result in a delay of claim reimbursements. 4. Actively at Work is waived with receipt and acceptance of the PartnerRe Claim Disclosure Statement. 5. This quote assumes that the Agent/Broker is operating under the appropriate license in which the risk is domiciled. The Agent/Broker license and appointment with PartnerRe will be required prior to binding coverage. 6. The statements herein may vary from the final Policy wording. The final Policy wording along with the Excess Loss Insurance Application and Claims Disclosure Statement shall govern over any inconsistency with the wording herein. 7. This quote is subject to the verification and approval of the Policyholder by PartnerRe through the economic and trade sanction watch lists enforced by the Office of Foreign Assets and Control (OFAC). 8. TPA: Meritain Network: Aetna PPO. 9. Pre 65 Retiree coverage is included. 10. Indication based on Retirees over 65 are Medicare Primary. 11. Contract:36/12 10/25/2023, Quotation 4 City of Fort Worth OPTIONS SUMMARY PROPOSAL ACCEPTANCE PROCEDURES Please check next to the selected proposal option: ❑ 1 $ 1,000,000 36/12 $ 0 $ 796,589 ❑ 1 $ 0 $ 0 10/25/2023, Quotation 4 City of Fort Worth About Us PartnerRe Key Facts and Figures • Founded in 1993, headquartered in Bermuda • Privately owned by Covea since July 2022 • When engaging with our partners we live by our values: • Integrity • Performance • Straightforward Communication • Collaboration • Respect & Care PartnerRe US Health We are a financially strong leader with a focus on exceptional partner relationships. • Direct writer of Employer Stop Loss business for 25+ years • Broad and deep industry experience across all U.S. Health market segments, including HMO Reinsurance, Medical Excess Reinsurance, and Provider Excess Financial Strength Ratings A+ A+ Al A.M. Best S&P Moody's Total Capital $7.5bn Gross Premium Written in 2021 $8.2bn As at September 30, 2022 Gross Written Premiums $350+ Million Clients 350+ Experience of ESL Underwriters (average) 20+ Years As of December 31. 2021 10/25/2023, Quotation 4 City of Fort Worth 6 partnerre.com ACCEPTED AND AGREED: CITY: City of Fort Worth By �t Name: Jesica McEachern Title: Assistant City Manager Date: Dec 22, 2023 Approval Recommended: lfoGG� if MoTT� e�� ByH.11y H Moyer (AS 202315 23 CST) Name: Holly H Moyer Title: Assistant Human Resources Director Attest: By: A Name: Jannette S. Goodall Title: City Secretary VENDOR: By: Name: Title: Date: nn�n a FpORr.. od �o Pvo °=0 P°o nn6�z6s64ad Contract Compliance Manager: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. By: 9'—'"w Name: Joanne Hinton Title: Benefits Manager Approved as to Form and Legality: uL By: / Name: Jessika J. Williams Title: Assistant City Attorney Contract Authorization: M&C: 23-1047 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX 12/18/23, 2:38 PM M&C Review Official site of the City of Fort Worth, Texas CITY COUNCIL AGENDA FflR Create New From This M&C DATE: 12/12/2023 REFERENCE **M&C 23- LOG NAME: 14STOPLOSS2024 NO.: 1047 CODE: C TYPE: CONSENT PUBLIC NO HEARING: SUBJECT: (ALL) Authorize Execution of Agreement with PartnerRe America Insurance Company in an Amount Not to Exceed $850,000.00 for Stop Loss Insurance for the City of Fort Worth's Health Benefits Plan with an Effective Date of January 1, 2024 for a One Year Term RECOMMENDATION: It is recommended that the City Council authorize the execution of an agreement with PartnerRe America Insurance Company in an amount not to exceed $850,000.00 for Stop Loss Insurance for the City of Fort Worth's Health Benefits Plan with an effective date of January 1, 2024 for a one year term. DISCUSSION: The purpose of this Mayor and Council Communication (M&C) is to seek authorization from the City Council to enter into an agreement with PartnerRe America Insurance Company, for Stop Loss Insurance for the City of Fort Worth's (City) Health Benefits Plan for 2024. If approved, effective January 1, 2024, PartnerRe America Insurance Company would provide specific stop loss coverage for the City's self -insured health plan. The specific stop loss coverage caps the City's liability for annual claims on a per member basis. The City pays for all claims for each participant up to a specified dollar amount with the Stop Loss Insurance coverage paying for any claims beyond the $1 million per -participant threshold at a cost of $11.20 per employee per month (PEPM) for each active employee and non -Medicare retiree who is a member of the City's self -funded health plan. In 2023, the City's Healthcare Plan had three members exceed the $1 million in claims cost and will be receiving stop -loss payments which will help offset the increased stop -loss cost for Fiscal Year 2024. The City's benefits consultant, IMA, conducted a Request for Proposal and PartnerRe America Insurance Company was selected due to cost and experience in the stop loss industry. DVIN: Insurance is an exception to bidding per the Law Department, therefore the business equity goal requirement is not applicable. Funding is budgeted in the HR Retired Employee Insurance and HR Active Employee Insurance Departments within the Group Health Insurance and Retiree Healthcare Trust Funds, as appropriated. Funding for the balance of terms of these contracts will be requested as part of the Fiscal Year 2025 budget process. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that upon approval of the recommendation, funds are available in the current operating budget, as previously appropriated, in the Group Health Insurance and Retiree Healthcare Trust Funds. Prior to an expenditure being incurred, the Human Resources Department has the responsibility to validate the availability of funds. TO Fund Department Account Project Program Activity Budget Reference # Amount ID ID Year (Chartfield 2) apps.cfwnet.org/counci I_packet/mc_review.asp? I D=31672&counci ldate=12/12/2023 1 /2 12/18/23, 2:38 PM M&C Review FROM Fund Department Account Project Program Activity Budget Reference # Amount ID ID I Year (Chartfield 2) Submitted for City Manager's Office by_ Jesica L. McEachern (5804) Originating Department Head: Dianna Giordano (7783) Additional Information Contact: ATTACHMENTS ,(Dept.) Request for Waiver of Business Equity Goal -2021 Ston Loss Request 11.13.2023 signed byDVIN.p. f (CFW Internal) 14Stop Loss 2024.docx (CFW Internal) PartnerRe Form 1295 Certificate 101129335 - City of Fort Worth 2023.pdf (CFW Internal) Stop Loss PartnerRe America Insurance Company FID Table 2024.pdf (CFW Internal) apps.cfwnet.org/counci I_packet/mc_review.asp? I D=31672&counci ddate=12/12/2023 2/2