TITLE
Title
APPROVE CONTRACT WITH SYMETRA STOP LOSS COVERAGE FOR 2025 PLAN YEAR
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SPONSOR
Sponsor
Jaime Joyner (Mirna Simaan)
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BACKGROUND
Background
Guilford County Sponsors a self-funded health insurance plan for eligible employees and retirees. This plan covers claims up to $425,000. A separate "stop loss plan" reimburses the County for claims that exceed $425,000 per individual claimant. United Healthcare (UHC) currently provides stop loss services related to the County's specific excess loss insurance at a cost of $75.12 per member per month. For 2025, Symetra will provide these services at a cost of $52.07 per member per month. This is a decrease of $23.05 per member per month or 30.7%.
The final total cost will fluctuate depending on the total number of insured members throughout the year which will change with things like new hires, resignations, retirements, qualifying life events, and open enrollment. We currently have 2,858 members insured with UHC. If that number were to remain approximately constant, it would translate to an estimated total annual cost of $1,785,793 (2,858 members multiplied by $52.07 per member per month for 12 months). This will result in a savings to the County of approximately $790,523.
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BUDGET IMPACT
Budget Impact
NO ADDITIONAL COUNTY DOLLARS
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REQUESTED ACTION
Requested Action
Approve the price proposal, in substantial form, with Symetra for stop loss coverage for the 2025 plan year in the amount of $52.07 per member per month to be effective January 1, 2025, for a term of one (1) year. (The anticipated expense to the County is $1,785,793) and authorize staff to take all necessary steps to effectuate a contract not to exceed $1,785,793.
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