HomeMy WebLinkAboutResolutions - 1995.12.07 - 24409IC SERVICES COMMITTEE
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MISCELLANEOUS RESOLUTION #95317 December 7, 1995
BY: Public Services Committee, Lawrence A. Obrecht, Chairperson
IN RE; Sheriff's Department-Oakland County Corrective Services Medical Program
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Sheriff's Department has had a medical program with Blue
Crose\Blue Shield for hospitalization of inmates; and
WHEREAS the Oakland County Board of Commissioners authorized such a program
by Miscellaneous Resolution #94331; and
WHEREAS the Sheriff's Department wishes to continue with this arrangement for
the period December 1, 1995 through November 30, 1996; and
WHEREAS Blue Cross\Blue Shield will monitor and contain costs, review for
inmates insurance coverage, bill Medicaid and qualify Oakland County for a hospital
discount; and
WHEREAS the administrative fee charged by Blue Cross\Blue Shield is more than
offset by the discount provided by the designated hospital provider; and
WHEREAS the County Executive and Sheriff's Departments have reviewed the
proposed program and are in concurrence; and
WHEREAS the attached contract is in accordance with the County Executive's
Contract Review Process,
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of commissioners
authorizes the Chairperson of the Board to enter into the attached administrative
contract with Blue Cross\Blue Shield for the Oakland County Corrective Services
Medical Program for the period December 1, 1995 through November 3G, 199E.
Chairperson, on behalf of the Public Services Committee, I move the adoption
of the foregoing resolution.
n Blue Cross
Blue Shield
commilickw NIF
KEY ACCOUNTS UNDERWRITING
OAKLAND COUNTY CORRECTIONAL
DECEMBER 1996 - NOVEMBER 1996 RENEWAL
NOVEMBER 3, 1995
AGENDA
— Renewal Worksheet
— Historical Fees, Hospital Savings
and Enrollment
— Renewal Comparison
— Excess Claims
— Schedule A
$62,107 $18,581
$889,790
$1,016,127
0.8757
$124,870
$135,850
0.9192
Blue Cross Blue Shield
OAKLAND COUNTY CORRECTIONAL FACILITY
RENEWAL PROJECTION FOR 12195- 11/96
SURGICAL
HOSPITAL MEDICAL
CONTRACT EXPOSURES 19,524 19,524
CLAIM CHARGES & PAYMENTS,
INC 06/94-05/95, PD @ 07/95 $1,259,263 $104,136
FACTOR: IBNR AS OF 07/95 0.0940 0.0560
AMOUNT: UNREPORTED AS OF 07/95 $118,371 $5,832
INCURRED CHARGES & PAYMENTS $1,377,634 $109,968
CORP FCTR: TRND TO 12/95-11/96 1.1146 1.0393
ANNUAL TREND 1.0750 1.0260
TRENDED CHARGES & PAYMENTS $1,535,511 $114,289
FACTOR: HOSPITAL DIFFERENTIAL (0.4204)
AMOUNT: HOSPITAL DIFFERENTIAL ($645,521
BENEFIT COSTS $889,982 $114,289
EXPOSURE AND BENEFIT ADJUSTMENT* 0.93 0.93 .
ADJUSTED BENEFIT COSTS $827,683 $106,289
AMOUNT: RETENTION
PROJECTED TOTAL EXPENSES
ANNUAL INCOME CURRENT RATES
INDEX TO CURRENT RATES
* ADJUSTS FOR DECREASE IN EXPOSURE AS WELL AS THE CHANGE AT 12/94
TO PPO BENEFITS.
MEJ/sg1296-15Excel
Cr 6439 JAN 91
12/95 12/94 CHANGE
0.4204 0.4014 4.73%
06/95
1,515
06/94
1,661
06/93
1,420
Blue Cross
Blue Shield
lOpargar
•
OAKLAND COUNTY CORRECTIONAL
HISTORICAL FEES,HOSP1TAL SAVINGS AND ENROLLMENT
ADMINISTRATIVE FEE (PER CONTRACT)
PERCENT
OF
PLAN YEAR CLAIMS
12/93 7.56% $73,652
12/94 8.15% * $76 .868 c',4'j
12/95 8.64% * $80,688
* Projected
HOSPITAL DIFFERENTIAL COMPARISON
PROJECTED
ADMIN $
HOSPITAL SAVINGS
12/91-08/95 12/94-11/95*
$1,735,227
* Projected
ENROLLMENT
$671,747
CF 64.39 JAN 51
6.80%
9.99%
40.14%
$1,330,561
$1,086,261
$1,174,808
7.14%
9.10%
42.04%
$1,363,399
$933,972
$1,014,660
Blue Cross Blue Shield
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OAKLAND COUNTY CORRECTIONAL
RENEWAL COMPARISON
12194 TO 12/95
12194 12/95
18,481 19,524 EXPOSURE (12 MONTHS) *
COMPOSITE TREND
COMPOSITE IBNR
HOSPITAL SAVINGS
CLAIMS ** •
BENEFIT COSTS
PROJECTED TOTAL EXPENSES
* The exposure period for 12/94 was 07/93-06/94 and the exposure period for
12/95 was 06/94-05/95.
** The claims experience period for 12/94 was incurred 07/93-06/94, paid 08/94
and the experience period for 12/95 was incurred 06/94-05/95, paid 07/95.
CF 6439 JAN 91
ACTUARIAL / UNDERWRITING SYSTEMS - RUN: 10/06/95 - TIME: 3:01 AM Blue Cross
Blue Shield
oi Morivgan
PGMNAME: YYAC7204 BLUE CROSS AND BLUE SHIELD OF MICHIGAN - COMBINED COVERAGE EXPERIENCE
EXCESS CLAIMS REPORT
INCURRED 06/94 - 05195, MICH, PAID 04/94 - 07/95
GROUP 52225 - OAKLAND COUNTY CORRECTIVE FACILITY PAID BY: ALL PLANS COMBINED
CONTRACia
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423
SIZE CATEGORY COMBINED PAYMENTS SC PAYMENTS SS PAYMENTS MM PANTS
$ - 0- 4999 292,916.49 244,103.56 48,812.93 0.00
$ 5000.- 9999 186,414.58 158,297.78 28,116.80 0.00
$ 10000 14999 103,995.24 89,939.72 14,055.52 0.00
$ 15000.• 19999 71,641.01 65,279.67 6,361.34 0.00
• 20000.• 24999 24,581.77 24,367.32 214.45 0.00 a $ 25000.. 29999 0.00 0.00 0.00 0.00
$ 30000'. 34999 32,090.35 24,481.25 5,609.10 0.00
$ 35000- 39999 0.00 " 0.00 0.00 0.00
$ 40000- 44999 0.00 0.00 0.00 0,00
$ 45000- 49999 47,722.12 44,754.52 945.40 0.00
t 50000- 54999 0.00 0.00 0,00 0.00
* 55000- 51999 0.00 0.00 0.0* 0.00
$ 60000- 64999 0.00 0.00 0.00 0.00
• 65000- 69999 0.00 0.00 0.00 0.00
$ 70000- 74999 0.00 0.00 0.00 0.00
$ 75000- 79999 0.00 0.00 • 0.00 0.00
• 80000- 84999 0.00 0.00 0.00 0.00
$ 85000- 89999 0.00 0.00 0.00 0.00
O 90000- 94999 0.00 0.00 0.00 0.00
• 95000 99999 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
: :::::: :::::
0.00 0.00 0.00 0.08
$ 10000- 14999 0.00 0.00 0.00 0.00
• 15000- 19999 0.00 0.00 0.00 0.00
• 20000- 24999 0.00 0.00 0.00 0.00
$ 25000.• 29999 0.00 0.00 0.00 0.00
$ 30000• 34999 0.00 0.00 0.00 0.00
$ 35000- 39999 0.00 0.00 0.00 0.00
• 40000- 44999 0.00 0.00 0.00 0.00
• 45000- 41999 0.00 0.00 0.00 0.00
$ 50000- 54999 0.00 0.00 0.00 0.00
4 55000- 59999 0.00 0.00 0.00 0.00
$ 40000- 64999 0.00 .0.00 0.00 0.00 0 65000- 49999 0.00 0.00 0.00 0.00
• 70000- 74999 coo 0.00 coo coo
$ 75000- 79999 0.00 0.00 0.00 0.00
$ 80000- 84999 0.00 0.00 .0.00 0.00
t *5000- 89999 0.00 0.00 0.00 0.00
• 90000- 94999 0.00 0.00 0.00 0.00
• 95000- 99999 0.00 0.00 0.00 0.00
$200000-204999 0.00 0.00 0.00 0.00
$205000-209999 0.00 0,00 0.00 0.00
0210000-214999 0.00 0.00 0.00 0.00
0215000-219999 0.00 0.00 0.00 0.00
4220000-224999 0.00 0.00 0.00 040
6225000-229999 0.00 0.00 0.00 0.00
4230000-234999 0.00 0.00 0.00 0.00
1235000-239999 0.00 0.00 0.00 0.00
$240041+ 0.00 0,00 0,00 0,00
ALL RANGES 4759,341.56 $655,225.82 $204,135.74 40.00
Specific Coverage 1__.
Aggregate Coverage
Total
B.
C.
D.
SCHEDULE A - Renewal Term (12/95
Administrative Services Contract - Weekly Wire
Between
Blue Cross and Blue Shield of Michigan
and
Oakland County Corrective Facility
1. Contract Effective Date: December_2.-1221
2. Renewal Term;
3. Line(s) of Business:
X Blue Cross
Domestic*
Foreign
X Blue Shield
Master Medical
December 1. 1995 - November ln_ igaa
Prescription Drugs
Dental
Vision
Hearing
Other
Domestic Facility Code(s) (Hospital Groups Only)
4. Estimated Participants: 1.515
If the participants total changes by more than 10%, the renewal will
be subject to change.
5. Administrative Charges:
Employees
(Estimate) Fee
Percent of Amounts Billed
Predetermination - Foot Surgery
Mandatory Second Opinion
Case Management
Agent Administration
6. Excess Loss Coverage(s):
A.
B.
C.
D.
E.
8.64%
A. Coverage(s) Effective
Specific Only Specific and Aggregate
Aggregate Only None
Monthly Attachment
Fee Employees Premium Point
E. Covered Lines of Business
X Blue Cross
Domestic Charges)
Foreign Payments) Applicable for Hospital Groups Only
X Blue Shield
Master Medical
Other
1
Matsg 1297- WEY
12% Simple Interest
DATE:
BY:
NAME:
TITLE:
DATE:
(Signature)
(Print)
7. Late Payment Charges/Interest:
A. Monthly Late Payment Charge
B. Yearly Statutory Interest Charge
C. Provider Contractual Interest
8. BCBSM Account: 1840-09397-3 Comerica 211 W. Fort, Detroit
Wire Number Bank Address
9. Effective with your current renewal, your hospital claims cost will
reflect certain charges for provider network access, and other
subsidies as appropriate.
BCBSM:
BY:
NAME:
TITLE:
DATE:
BY:
NAME:
TITLE:
DATE:
THE GROUP:
BY:
(Signature) 717=1
NAME:
(Print) 17/17117
TITLE:
(Signature)
(Print)
2
MB/41297-1 5 WEN
12/94 Renewal
INC 07/93 - 06/94
PD 07/93 - 08/94
12/95 Renewal
INC 06/94 - 05/95
PD 06/94 - 07/95
$ 33.56
$ 5.33
$ 38.89
0.066
$ 589.11
Blue Cross
Blue Shield
ANALYSIS
OAKLAND CORRECTIONAL, GROUP #52225
Paid Cases Contracts Paid Cases Contracts
Blue Cross $623,259 439 18,481 $ 655,226 . 499 19,524
Blue Shield $100,578 742 18,481 $ 104,135 790 19,524
TOTAL $ 723,837 1,181 18,481 $ 759,361 1,289 19,524
12/94 12/95
Claims Claims
Per Per
Contract Contract
Blue Cross Paid Per Contract $ 33.72
Blue Shield Paid Per Contract $ 5.44
TOTAL AMOUNT $ 39,16
Cases Per Contract 0.064
Amount Per Case $ 612.90
M1380299-15Expe1
CF 6439 JAN 91
December 7, 1995
FISCAL NOTE 1115C. #95317)
BY FINANCE AND PERSONNEL COMMITTEE, JOHN P. McCULLOCH, CHAIRPERSON
IN RE: SHERIFF'S DEPARTMENT - OAKLAND COUNTY CORRECTIVE SERVICES MEDICAL PROGRAM
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies and Gen:
Pursuant to Rule XII-G of this Board, the Finance and Personnel Committee
has reviewed Miscellaneous Resoiution #95317and finds:
1. The resolution continues the contrautual relationship between the
County and Blue Cross/Blue Shield to administer the Corrective
Services Medical Program for the period December 1, 1995 through
November 3:3, 1996.
2, Sufficient funds have been budgeted in the 1996/1997 Biennial Budget
to cover program expenses, no additional appropriation is required.
FINANCE AND PERSONNEL COMMITTEE
I 14EREB
I. Inas Pa
FOREGOING RESOLUTION
/2//1/5.)
on, County Executive Date
Resolution 495317 December 7, 1995
Moved by Obrecht supported by Jacobs the resolution be adopted.
AYES: Garfield, Holbert, Huntoon, Jacobs, Jensen, Johnson, Kaczmar,
Kingzett, Law, McCulloch, McPherson, Moffitt, Obrecht, Palmer, Pernick, Powers,
Quarles, Schmid, Taub, Wolf, Amos, Crake, Devine, Dingeldey, Douglas. (25)
NAYS: None.
A sufficient majority having voted therefor, the resolution was adopted.
STATE OF MICHIGAN)
COZINTY OF OAKLAND)
1, Lynn D. Allen, Clerk of the County of Oakland, do hereby certify that the
foregoing resolut.ton is a true and accurate copy of a resolution adopted by the
Oakland County Board of Commissioners on December 7, 1995 with the original record thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the
Ci tS:5)
County of Oakland at Pontiac, Michigan this 7th day of D ember 95.
-a
Lynn/D=-7Talen, County Clerk