Explanation
BACKGROUND:
The Human Resources Department requests to modify and increase the existing contract with AON Consulting Inc., the employee benefits consulting services vendor. The most recent modification, legislated via Ord. 2741-2019, authorized a one month extension to allow the consultant firm sufficient time to project the most accurate insurance rates.
This modification provides funding to complete two new projects related to the City’s health care plans. The first project is a pre-implementation audit to be done prior to the beginning of the City’s new medical and prescription drug contract with United Health Care. The pre-implementation audit will cost $30,000 and will verify that United Health Care sets up the PBM correctly for the upcoming new contract period which begins February 1, 2020.
The second project is a claims audit for 2018 design plan changes. The claims audit will cost $35,000 and will audit 2018 United Health Care claims to ensure all claims were processed accurately and in accordance with the provisions of the City’s medical plan and service contract.
These two new projects are now being undertaken as part of the department's effort to standardize the audit process of our healthcare vendors and to ensure look backs at claim management become part of the city's standard operating procedure. Both processes are industry standard. The competitive bid process would not have been conducive to completing these projects accurately and in a timely manner. This firm brings a wealth of institutional knowledge and experience working with the department on matters relating to the city's healthcare vendors.
This modification also authorizes appropriation and funding for these two projects
FISCAL IMPACT:
To modify and increase the contract with Aon Consulting Inc., to establish the maximum obligation liability, and to authorize the additional appropriation and expenditure of $65,000.00 for a healthcare pre-implementation audit ...
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