Explanation
BACKGROUND:
Funding for runout of medical and prescription drug (Rx) claims and administrative fees is necessary to complete the contract requirements of the city’s medical and Rx insurance program under United HealthCare Services, Inc. Included within the medical program are COBRA services. The Department of Human Resources requests to contract with United HealthCare Services, Inc. and to provide funding from February 1, 2026 through January 31, 2027 for this program. Funding is requested for runout claims and administrative fees continuing through January 31, 2027. This contract was initiated on February 1, 2020.
In April of 2025, the Department of Human Resources, with assistance from Marsh & McLennan Agency, the City’s employee benefits and wellness consultant, went out to bid for a medical and pharmacy third party administrator via RFP030095.
The RFP team interviewed 3 medical program finalists. After careful consideration and evaluation, Community Insurance Company dba Anthem Blue Cross and Blue Shield was selected as being the lowest and best bid for medical third-party administrator services for the City. Due to this vendor change, runout claims and administrative fees need to be paid under existing contractual obligations.
The maximum obligation liability for medical, Rx, and COBRA services for run out claims and administration fees under United HealthCare Services, Inc. is $44,235,000.00.
This ordinance is contingent on the passage of the 2026 insurance appropriation ordinance 3195-2025.
Emergency action is requested to ensure the programs for city employees and eligible terminated participants are able to commence as soon as contractually possible, thereby maintaining continuity of service.
FISCAL IMPACT: Funding is available in the 2026 Employee Benefits Fund for this contract.
Title
To authorize the Director of the Department of Human Resources to enter into a contract with United HealthCare Services, Inc. and to provide all runout clai...
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