HomeMy WebLinkAboutItem C25BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: October 19, 2011 Division: Employee Services
Bulk Item: Yes X No _ Department: Employee Benefits
Staff Contact Person/Phone#:Maria Gonzalez X4448
AGENDA ITEM WORDING: Approval of contract amendment with Wells Fargo Third Party
Administrators, Inc. to provide medical run -out claim services.
ITEM BACKGROUND: On February 16, 2011, the BOCC approved to advertise a Request for
Proposals for Medical Plan Administration on a Self Funded or Fully Insured Basis, including: Claims
Administration, Utilization Review, Large Case Management, Disease Management, Network
Management, Pharmacy Benefit Management, Wellness Programs and/or Stop Loss Insurance.
PREVIOUS REVELANT BOCC ACTION: On June 15, 2011, the BOCC approved to allow staff
to begin negotiating a contract with Blue Cross Blue Shield of Florida.
CONTRACT/AGREEMENT CHANGES: The per employee per month (PEPM) fee for claims
administration will expire on November 1, 2011 and run -out claims will be processed from November
1, 2011 through October 31, 2012 at a cost of 10% of paid claims.
STAFF RECOMMENDATIONS: Approval.
approx
TOTAL COST: $200,000 INDIRECT COST: BUDGETED: Yes X No
Internal Service Fund
COST TO COUNTY: $200,000 approx SOURCE OF FUNDS: Primarily Ad Valorem
REVENUE PRODUCING: Yes _ No X AMO T PER MONTH Year
04_
APPROVED BY: County Atty `�"` OMB/Pure asing Risk Management6l-
DOCUMENTATION
DISPOSITION:
Revised 2/27/01
Included X To Follow Not Required
AGENDA ITEM #
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS -
CONTRACT SUMMARY
Contract #
Contract with: Wells Fargo TPA, Inc. Effective Date:November 1, 2011
Expiration Date:October 31, 2012
Contract Purpose/Description:Approval to amend contract to provide run -out claim services
Contract Manager:Maria Gonzalez
(Name)
for BOCC meeting on
4448 Employee Benefits/Stop #1
(Ext.) (Department)
Agenda Deadline: October 4, 2011
CONTRACT COSTS
Total Dollar Value of Contract: $207,000 Current Year Portion: $204,026.94
Budgeted? Yes® No ❑ Account Codes: 502-08002-530-310-
Grant: $
County Match: $
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, sz
CONTRACT REVIEW
Changes
Date Out
Date In
Division Director
Needed
Yes[—] No[
viewer
Risk Manage m nth(
Yes[—] No❑"'
O.M.B./Purc asing
Yes[—] No®
County Attorney t 0 - 6' if
Yes[—] No
• /
!c (� - it
Comments:
v,3cu 71 i 117J ivLLr rr/-
THIRD AMENDMENT
SELF-INSUREDTO
WELFARE BENEFIT PLAI
THIS THIRD AMENDMENT TO ADMINISTRATIVE SERVICE AGREEMENT
("Amendment"), made and entered into this 19th day of October, 2011 by and between Monroe County
(hereinafter called "Employer") and WELLS FARGO THIRD PARTY ADMINISTRATORS of Charleston,
West Virginia, (hereinafter called "Wells Fargo Third Party Administrators");
WHEREAS, the Employer presently receives third party administration (TPA) services from Wells
Fargo Third Party Administrators for certain of Employer's employee benefit plans; and
WHEREAS, the services provided by Wells Fargo Third Party Administrators are defined in an
Administrative Service Agreement between the Employer and Wells Fargo Third Party Administrators dated
June 15, 2005, as amended on April 16, 2008 and May 20, 2009 (the "Agreement"); and
WHEREAS, the current Agreement is in force and effect until May 20, 2012, however, paragraph 21
of the Agreement specifies that the Agreement may be terminated by either of the parties on thirty (30) days
written notice; and
WHEREAS, the parties now wish to specify the terms and conditions by which Wells Fargo Third
Party Administrator will continue to handle claims during a runout period following termination of the
Agreement in accordance with paragraph 24 of the Agreement.
NOW, THEREFORE, the parties hereto agree as follows:
The administrative fee for Wells Fargo Third Party Administrators, Inc. service for Medical run -out claims
shall be:
1) Ten percent (10%) of total paid claims for the period starting November 1, 2011
through October 31, 2012, which shall be the runout period. Invoices shall be issued
on the 15'' and 30 of every month. The Employer agrees to pay Wells Fargo Third
Party Administrators within thirty (30) calendar days following receipt of the proper
invoice of the amount due during the previous billing period. If payment in full is
not received by Wells Fargo Third Party Administrators, Inc. by the due date, the
payment will be considered past due and interest equivalent to twelve percent (12%)
per year will be charged and paid on the unpaid balance upon the 46 h day after
receipt of invoice, or the maximum amount permitted by law, whichever is less.
Wells Fargo Third Party Administrators will immediately suspend its services until
payment is received by Wells Fargo Third Party Administrators.
2) This administrativz fee supersedes the stated adm }strative fee -in the Agreemn
between Employer and Wells Fargo Third Party Administrators.
3) The services that will be provided by Wells Fargo Third Party Administrators under
this Amendment during the runout period shall consist of those services specified in
paragraphs I0(f){h) and paragraph 14 of the Agreement.
4) No run -out claims will be processed until this agreement is fully executed. Upon
execution, all requests for payment of claims will continue to be processed in the
same manner in which claim payments were processed during the term of the
Agreement. Run -out claims must be funded each week. If they are not funded
weekly, the run -out agreement will be automatically terminated and services will
cease without Notice by Wells Fargo Third Party Administrators to Employer.
IN WITNESS WHEREOF, the Employer and Wells Fargo Third Party Administrators have caused this
agreement to be executed this _ day of October 2011.
ATTEST: DANNY L. KOLHAGE Board of County Commissioners of Monroe County
Deputy Clerk
Witness
WELLS FARGO THIRD PARTY ADMINISTRATORS
CHIEF OPERATING OFFICER
MONROE COUNTY ATTORNEY
AV?ROYEp , ,SITC)AFORM:
YNTHIAL. MALL
ASSISTANT COUNTY ATTORNEY
Date f a 20_tr