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HomeMy WebLinkAboutResolutions - 1996.12.12 - 24719MISCELLANEOUS RESOLUTION #96290 December 12, 1996 BY: Public Services Committee, Shelley G. Taub, 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 Cross\Blue Shield for hospitalization of inmates; and WHEREAS the Oakland County Board of Commissioners authorized such a program by Miscellaneous Resolution #95317; and WHEREAS the Sheriff's Department wishes to continue with this arrangement for the period December 1, 1996 through November 30, 1997; 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, 1996 through November 30, 1997. Chairperson, on behalf of the Public Services Committee, I move the adoption of the foregoing resolution. PUBLIC SERVICES COMMITTEE .......n••••••nnn••• Blue Owe Blue Shield Macey* Network of Michigan independent licensees of the Blue Cross Blue Shield Association OAKLAND COUNTY CORRECTIONAL DECEMBER 1996 - NOVEMBER 1997 RENEWAL September 24, 1996 AGENDA RENEWAL WORKSHEET HISTORICAL FEES, SAVINGS AND ENROLLMENT RENEWAL COMPARISON EXCESS CLAIMS SCHEDULE A Blue Cross Be Shield Blue.Care Nahvak 'lb 'of Michigan independent licensees of the Blue Cross Blue Shield Association OAKLAND COUNTY CORRECTIONAL RENEWAL PROJECTION FOR 12/96 - 11197 22-Sep-97 CONTRACT EXPOSURES CLAIM CHARGES AND PAYMENTS INC 06/95- 05/96, PD © 07/96 FACTOR: 1BNR AT 07/96 AMOUNT: UNREPORTED AS OF 07/96 INCURRED CHARGES AND PAYMENTS CORPORATE TREND TO 12/96 - 11/97 ANNUAL TREND TRENDED CHARGES AND PAYMENTS FACTOR: HOSPITAL DIFFERENTIAL AMOUNT: HOSPITAL DIFFERENTIAL BENEFIT COSTS AMOUNT: RETENTION PROJECTED TOTAL EXPENSES ANNUAL INCOME AT CURRENT RATES INDEX TO CURRENT RATES HOSPITAL 18,678 $ 2,039,423 0.0710 $ 144.799 $ 2,184,222 1.0836 1.0550 $ 2,366,823 (0.4631) $ (1.096.076) $ 1,270,747 $ 86.599 $ 1,357,346 $ 863,671 1.5716 SURGICAL MEDICAL 18,678 $ 192,706 0.0540 $ 10.406 $ 203,112 1.0301 1.0200 $ 209,226 $ 209,226 $ 41,254 $ 250,480 $ 121,407 2.0631 COMBINED COVERAGE 18,678 $ 2,232,129 $ 155.205 $ 2,387,334 1.0790 1.0520 $ 2,576,049 $ (1.096.076) $ 1,479,973 $ 127.853 $ 1,607,826 $ 985,078 1.6322 ADMINISTRATIVE FEE AS A PERCENT OF CLAIMS ADMINISTRATIVE FEE PER CONTRACT 8.64% 6.84 Blue Cross Blue Shield Blue Cie NetWOlk • or Michigan independent licensees of the Blue Cross Blue Shield Association OAKLAND COUNTY CORRECTIONAL HISTORICAL FEES, SAVINGS AND ENROLLMENT ADMINISTRATIVE FEE PERCENT PROJECTED PLAN YEAR OF CLAIMS ADMIN 12/94 8.15% $ 92,134 * 12/95 8.64% $ 112,172 12/96 8.64% $ 127,853 " Actual HOSPITAL DIFFERENTIAL COMPARISON 12/96 12/95 CHANGE 0.4631 0.4204 10.16% BCBSM SAVINGS 12/91-06/96 Hospital $ 2,650,000 Surgical/Medical $ 478.000 Total Savings $ 3,128,000 ENROLLMENT 06/96 06/95 06/94 1,563 1,515 1,661 Blue Cross Blue Shield Blue Caw Network • o1 Michigan independent licensees of the Blue Cross Blue Shield Association OAKLAND COUNTY CORRECTIONAL RENEWAL COMPARISON 12/96 TO 12/96 12/96 12/95 CHANGE EXPOSURE (12 MONTHS)* 18,678 19,524 -4.33% COMPOSITE TREND (ANNUAL) 5.20% 7.14% -27.17% HOSPITAL SAVINGS 46.31% 42.04% 10.16% CLAIMS (CHARGES/PAYMENTS)** $2,232,129 $ 1,363,399 63.72% BENEFIT COSTS $1,479,973 $ 933,972 58.46% PROJECTED TOTAL EXPENSES $1,598,281 $ 1,014,660 57.52% BLUE CROSS CASES 877 499 75.75% CASES PER CONTRACT 0.56 0.31 80.65% BLUE SHIELD CASES 1,485 790 87.97% CASES PER CONTRACT 0.95 0.49 93.88% CLAIM COST PER CONTRACT $ 85.57 $ 51.97 64.65% * The exposure period for 12/96 was 06/95-05/96. The exposure period for 12/95 was 06/94-05/95. ** The claims experience period for 12/96 was incurred 06/95-05/96, paid through 07/96. The claims experience period for 12/95 was incurred 06/94-05/95, paid through 07/95. 4. Estimated Participants: 1,563 SCHEDULE A - Renewal' Term (12/96 - 11/97) Administrative Services Contract - Weekly Wire Between Blue Cross and Blue Shield of Michigan and Oakland County Corrective Facility 1. Contract Effective Date: December 1, 1991 2. Renewal Term: December 1, 1996 - November 30, 1997 3. Line(s) of Business: X Blue Cross Prescription Drugs Domestic*___ Dental Foreign Vision X Blue Shield Hearing Master Medical Other Domestic Facility Code(s) (Hospital Groups Only) If the participants total changes by more than 10%, the renewal will be subject to change. 5. Administrative Charges: Employees Fee (Estimate) 8.64% A. Percent of Amounts Billed B. Predetermination - Foot Surgery C. Mandatory Second Opinion D. Case Management E. Agent Administration 6. Excess Loss Coverage(s): A. Coverage(s) Effective ___ Specific Only Specific and Aggregate ___ None Aggregate Only Fee B. Specific Coverage C. Aggregate Coverage D. Total Monthly Attachment 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 MINg1297-15WIN 12% Simple Interest 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. 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: (Signature) (Print) (Signature) (Print) THE GROUP: BY: (Signature) NAME: -1;///, elid/OC, (Print) TITLE: CAM, Pa 5") DATE: 2 M13/ss1297.15 WIN FISCAL NOTE (Misc. #96290) BY: FINANCE AND PERSONNEL COMMITTEE, SUE ANN DOUGLAS, CHAIRPERSON IN RE: SHERIFF'S DEPARTMENT-OAKLAND COUNTY CORRECTIVE SERVICES MEDICAL PROGRAM TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: Pursuant to Rule XII-F of this Board, the Finance and Personnel Committee has reviewed the above referenced resolution and finds: 1. Blue Cross projections for December 1996 through November 1997 for hospital and surgical benefit costs are $1,479,973. 2. The Finance and Personnel Committee Recommended Budget for FY 97 (nine months) is $900,018 and FY 97/96 is $1,300,865. 3. Although the recommended budget does not match the Blue Cross projections, no amendment is recommended at this time. It is recommended that the issue of prisoner health costs be analyzed during the first quarter of 1997, with a report given to the Public Services Committee and the Finance and Personnel Committee by May 1997. FINANCE AND PERSONNEL COMMITTEE Resolution 496290 December 12, 1996 Moved by Taub supported by Pernick the resolution be adopted. AYES: Garfield, Holbert, Huntoon, Jacobs, Jensen, Johnson, Kaczmar, Kingzett, Law, McCulloch, Moffitt, Obrecht, Palmer, Pernick, Powers, Quarles, Schmid, Taub, Wolf, Amos, Crake, Devine, Dingeldey, Douglas. (24) NAYS: None. (0) A sufficient majority having voted therefor, the resolution was adopted. STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Lynn D. Allen, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on December 12, 1996 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 County of Oakland at Pontiac, Michigan this 12th day. of Decerg4ex 1996. Lyfin D. Allen, County Clerk