HomeMy WebLinkAboutResolutions - 1999.12.16 - 25650MISCELLANEOUS RESOLUTION #99300 November 18, 1999
BY: Public Services Committee, Frank H. Millard, 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 #97254; and
WHEREAS the Sheriff's Department wishes to continue with this arrangement
for the period December 1, 1999 through November 30, 2000; 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, 1999 through November 30, 2000.
Chairperson, on behalf of the Public Services Committee, I move the
adoption of the foregoing resolution.
PUBLIC SERVICES COMMITTEE
PUBLIC SERVICES COMMITTEE VOTE:
Motion carried unanimously on a roll call vote with Galloway absent.
EXHIBIT 1
GROUP: 52225
DEVELOPMENT OF FORECASTED EXPERIENCE
FOR THE PERIOD: Dec 1999 - Nov 2000
1. The average number of contracts covered in the experience period
May 1997 - Apr 1999: 1572
2. Total claims reported for your group in the experience period
May 1997 Apr 1999: $4,990,949
3. Removal of large claims from experience period: $0
4. Addition of expected Incurred But Not Reported claims: $182,784
5. Benefits used to project expected utilization: $5,173,733
6. Annualized charges and payments: $2,586,867
7. The trended increase in claims expected for Dec 1999 - Nov 2000: $244,976
8. Addition of annualized large claims up to the Specific stop-loss limit: $0
9. Total charges and payments projected for your group during the
period Dec 1999 - Nov 2000: $2,831,843
10. A credibility factor of 100% has been applied resulting in an adjustment
to projected claims of: $0
11. The projected charges and payments for the new contract year
Dec 1999- Nov 2000: $2,831,843
12. Less: Hospital Discount $1,508,619
13. Total projected amounts billed for new contract year: $1,323,224
14. Your new administrative fee, percent of billed amount: 8.83%
[ ] Prescription Drugs
[ ] Dental
[ ] Vision
[ ] Hearing
Billed
Fees
8.83%
$0.00
$0.00
.0.00%
Monthly
Contracts
1572
Monthly
Premium
[ ] Specific Only
[ ] Aggregate Only
[ ] Specific and Aggregate
[ ] Master Medical
t] Other
[I All Lines of Business
(Aggregate Only)
Aggregate:
Cost Per
Contract
$0.00
$0
Monthly
Contracts
1,572
Monthly
Premium
$0
SCHEDULE A - Renewal Term (Dec 1999 - Nov 2000)
Administrative Servicei Contract (ASC)
1. Group Name: Oakland County Corrective
• 2. Group Number/Cluster: 52225
3. Contract Effective Date: December 1, 1991
4. ASC Funding Arrangement: Monthly Wire
5. Line(s) of Business:
[X] Blue Cross
[X] Blue Shield
[ ] Master Medical
6. Administrative Charge:
A. Base Administration
B. Predetermination-Foot Surgery
C. Mandatory Second Opinion
D. Additional Agent Fee
TOTAL
7. Stoploss Coverage(s):
A. Stoploss Coverage Purchased
[ ] Standard
[ ] Outlier Protection
[X] None
B. Covered Lines of Business
[3 Blue Cross
[ ] Blue Shield
C. Attachment Point(s) (per contract)
Specific: $0
D. Total Stoploss Premium
Blue Cross Blue Shield of Michigan is an independent licensee of the Blue Cross and Blue Shield Association.
2%
12%
8. Late Payment Charges/Interest:
A. Weekly Late Payment Charge .
B. Yearly Statutory Interest Charge (Simple Interest)
C. Provider Contractual Interest
9. BCBSM Account: 1840-09397-3 Comerica 0720-00096
Wire Number Bank American Bank Assoc.
Your hospital claims cost reflects certain charges for provider network access, contingency,
and other subsidies as appropriate.
BCBSM: THE GROUP:
BY: BY:
(Signature) (Signature)
NAME: NAME:
(Print) (Print)
TITLE: TITLE:
DATE: DATE:
• BY:
. (Signature) (j . (Sigriature)
NAME: P4-01.11 .fiti;-1\100 dal NAME: .
(Print) (Print)
TITLE: V\.-\61 _ii\.A.1%c TITLE:
DATE: qi.8.qci DATE:
BY:
7,919,409
180,259
4,990,949
1,500,851
58.394
GROUP 52225 - OAKLAND COUNTY CORRECTIVE
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BENEFIT AND SAVINGS REVIEW SUMMARY •
Based upon the Experience period Incurred 05/1997 - 04/1999 Paid 05/1997 - 06/1999
I. Total Submitted Charges
Claims Returned To Provider
A. Savings From Non-Eligible Charges
1. Ineligible Members. 1,427,037
2. Benefit Exclusions 260,431
3. Duplicate Bills 334,697
4. Excess Over Maximums 12,953
5. After Filing Limitation 3.097
Sub-Total 2,038,215
B. Savings From Eligible Charges
1. Non-Participating Providers
Charges Over Fee Schedule 23,159
2. Participating Provider Contracts
(Hospital Not Included) 446,612
3. Coordination Of Benefits
a. Benefits Covered By Medicare 3,136
b. Blue On Blue 1,436
c. Other Carriers 0
Sub-Total 474,343
C. Adjustment For Cost Sharing
1. Deductibles And Co-Payments 6,388
2. Sanctions 15.547
Sub-Total 21,935
D. Other 213,501
II. Approved Charges And Payments
III. Hospital Savings
IV. Customer Savings Refund
V. TOTAL SAVINGS & ADJUSMENTS FOR YOUR GROUP 4,307,238
Resolution #99300 November 18, 1999
The Chairperson referred the resolution to the Finance Committee. There
were no objections.
FISCAL NOTE (M.R. #99300) December 16, 1999
BY FINANCE 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-C of this Board, the Finance Committee has
reviewed the above referenced resolution and finds:
1. Blue Cross projections for the cost of prisoner hospitalization and
surgical benefits, from December 1999 through November 2000 equals
$1,440,065;
2. The County expended $2,427,390 for FY 1998 and $1,295,260 for FY
1999. The recommended budget for both FY 2000 and FY 2001 is
$2,422,824.
3. Should the Blue Cross projects hold true, the budget will be
reviewed and amended during the quarterly forecast.
FINANCE COMMITTEE
FINANCE COMMITTEE VOTE:
Motion carried unanimously on a roll call vote.
I HEREBY OPROVUHE FOREGOING Fr! •
Date
's/e4
William Caddell, County Clerk
Resolution #99300 December 16, 1999
Moved by Taub supported by Patterson the resolutions on the Consent Agenda
be adopted (with accompanying reports being accepted). The Chairperson stated
that General Government Committee, item a and Public Services Committee, item f
were being moved to the Regular Agenda.
AYES: Appel, Causey-Mitchell, Colasanti, Coleman, Dingeldey, Douglas,
Galloway, Garfield, Gregory, Jensen, McCulloch, McPherson, Melton, Millard,
Moffitt, Obrecht, Palmer, Patterson, Schmid, Sever, Suarez, Taub, Amos. (23)
NAYS: None. (0)
A sufficient majority having voted therefor, the resolutions on the
Consent Agenda were adopted (with accompanying reports accepted).
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STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, G. William Caddell, 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 16, 1999 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 16th day,pf December, 1999.