CITY OF SAN ANTONIO
HUMAN RESOURCES DEPARTMENT
INTERDEPARTMENTAL CORRESPONDENCE
TO: Sheryl Sculley, City Manager
FROM: Lori Steward, Human Resources Director
COPY: Audit Committee; Ben Gorzell, Jr., CPA, Chief Financial Officer; Kevin Barthold, City Auditor; Troy Elliott, CPA, Finance Director
SUBJECT: Pre-Solicitation Briefing for Third Party Administrator for administration and payment of medical claims, pharmacy, flexible spending accounts, health savings accounts and COBRA
DATE: January 19, 2016
The Human Resources Department will present a pre-solicitation briefing on the Third party administrator for administration and adjudication of medical claims, pharmacy, flexible spending accounts, health saving accounts and COBRA which was presented in the Annual High Profile Report. This briefing will allow an opportunity for input and direction from Committee members.
This pre-solicitation briefing will cover estimated contract value, projected timeline, high profile designation, scope of the project, terms of the contract, audited financial statements, proposed scoring criteria, evaluation committee members, project considerations, local preference program applicability, veteran owned small business preference program applicability and SBEDA Program requirements.
The City manages the risk of medical and pharmacy insurance coverage for all full-time civilian and uniformed employees as opposed to buying insurance. An external vendor is contracted to administer and adjudicate medical and pharmacy claims for covered full time employees and non Medicare retirees and their dependents. The City’s health plans are intended to qualify as a cafeteria plan within the meaning of IRS Code Section 125 which permits employees to pay for medical, pharmacy and dependent care services with pre-tax deduction from wages. The administrator will manage associated claims including claims for employees and family members who elect to continue coverage following employee separation as prescribed by Federal and State law. The City implemented an IRS approved Consumer Directed Health Plan that includes a Health Savings Account that is funded by the City. The administrator will be required to set up enrollment of eligible employees. The contract with the existing administrator will expire as of December 31, 2016. Because of the program set up and complexity involved in the management of all programs, the anticipated contract period will extend for a base period of five years with two one year extensions.