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HomeMy WebLinkAboutMercer Health Benefits, LLCShelli R. Stayner Principal 800 W. Main Street, Suite 1250 Boise, ID 83702 +1 208 338 6477 Shelli.r.stayner@mercer.com www.mercer.com November 28, 2017 Ms. Christena Barney Human Resources City of Meridian 33 E. Broadway Avenue Meridian, ID 83642-2631 Subject:Statement of Work (“SOW”) Dear Christena: The objective of this Statement of Work (”SOW”) is to confirm the scope of our work and the compensation for this engagement, 2018 Scope of Service. This SOW is subject to the terms and conditions contained in our existing engagement letter dated December 10, 2010 .All capitalized terms not defined in this SOW shall have the meanings ascribed to them in our existing engagement letter. 1.Description of Mercer responsibilities: See attached Service Schedule Additional projects requested by you that individually are not expected to exceed $10,000 will be billed (i) at time and expense (based on our hourly billing rate in effect at the time the work is performed), (ii) on a fixed fee basis or (iii) as otherwise mutually agreed in writing and will, in each case, be subject to the terms of this Agreement. 2.Description of client responsibilities: You agree to furnish to Mercer’s representatives all information they may request as it pertains to your insurance contracts, rates, rating schedules, surveys, reserves, retentions and all other financial data they may request for their study of your present and future requirements in connection with the insurance program to which this SOW applies. You understand that the failure to provide, or cause to provide, complete, accurate, up-to- date, and timely documentation and information to us, an insurer, or other service provider, whether intentional or by error, could result in impairment or voiding of coverage or service. You agree to review all policies, endorsements and program agreements delivered to you by us and will advise us of anything which you believe is not in accordance with the negotiated coverage and terms within thirty (30) days following receipt. Page 2 November 28, 2017 Ms. Christena Barney City of Meridian 3.Period of time over which work will be performed: January 1, 2018 through December 31, 2018 The Services under this SOW shall be provided from January 1, 2018 to December 31, 2018 (“Initial Term”) and shall automatically renew for consecutive one (1) year terms thereafter (each a “Renewal Term”). Prior to the start of each Renewal Term, Mercer will send Client a copy of this SOW together with a request to reconfirm that the Services, terms and conditions set forth in this SOW will continue for the following year. The Parties agree that the Services outlined in this SOW reflect the Services Client wants Mercer to perform for the following 12– month period, unless the Client informs Mercer in writing to the contrary within ten (10) business days of Client’s receipt of such confirmation request by Mercer. 4.Compensation/fees: We will be compensated for the services described herein in consideration of your payment of our professional fees of $60,000.We will bill you on a monthly basis. In addition to other compensation listed, we also bill for necessary travel and other expenses related to the services requested. In the event Client terminates this SOW prior to the expiration of the Initial Term or Renewal Term, any unpaid compensation with respect to such Term (or the current year in the event of a multiple year term) shall be accelerated and shall be due and payable to Mercer within 30 days of the effective date of termination. 5.Subcontractors: We may need to utilize various subcontractors (“Subcontractors”) in the course of our provision of the Services to assist us in such tasks as printing and mailing, development of interactive tools, graphic design, etc. You consent to our use of the Subcontractors and further acknowledge and agree that we may provide such Subcontractors with your Confidential Information, including Work, on a confidential and a need to know basis for the purposes contemplated by this SOW. 6.Use of Name and Logo: The parties agree and acknowledge that Mercer may need to use your name, logo, tradename and/or mark in connection with the performance of the Services. You consent to Page 3 November 28, 2017 Ms. Christena Barney City of Meridian such use, and grant to Mercer and its agents, vendors and subcontractors of a non-exclusive, royalty-free, limited license to use your name, logo and any tradename or mark only in connection performance of the Services. The parties further agree that such use will be subject to your instruction, direction or prior written approval as to style, form, context and general content. You will not unreasonably delay or withhold your approval. 7.Additional Disclosures: a. We do not act on behalf of any insurer or other service provider, are not bound to utilize any particular insurer or service provider, and do not have the authority to make binding commitments on behalf of any insurer or service provider. In addition, we do not guarantee or make any representation or warranty that coverage or service can be placed on terms acceptable to you. We are not responsible for the solvency or ability to pay claims of any insurance carrier or for the solvency or ability of any service provider to provide service. Insurance carriers or service providers with which your other risk or insurance coverage or other business is placed will be deemed acceptable to you, in the absence of contrary instructions from you. b. Mercer and its Affiliates serve a wide array of clients, including clients who compete with or whose interests may be adverse to one another. In addition, Mercer interacts with insurance carriers and other service providers through numerous business and contractual relationships, including serving as a broker for its clients and receiving commissions from carriers, providing consulting or administration services to carriers, and auditing carriers’ claims data. Mercer is committed to serving each of its clients in an objective manner and maintaining the confidentiality of each of its client’s information. Notwithstanding anything to the contrary in the engagement letter, when providing Services to Client pursuant to this SOW, Mercer may use its Affiliates, from time to time, to assist in the performance of such Services. c. You expressly acknowledge that, with respect to the provision of the Services, we are not, nor are any of our Affiliates or subcontractors, an “administrator” within the meaning under applicable law, including the Employee Retirement Income Security Act of 1974, as amended (“ERISA”), nor, with respect to the provision of the Services, are we or any of our Affiliates or subcontractors a “fiduciary” within the meaning under applicable law or ERISA, unless provided otherwise herein or required by applicable law. d. Title V of the Gramm-Leach-Bliley Act and related state laws and regulations establish limitations on the use and distribution of non-public information collected by financial institutions from their customers and consumers. Our insurance-related work qualifies us as a financial institution under this Act. Our Privacy Policy Notice and additional information regarding other compliance policies at Page 4 November 28, 2017 Ms. Christena Barney City of Meridian Mercer, including our conflicts of interest policy is available at the following web address http://www.mercer.com/insights/point/2014/transparency.html. At this web address you will also find information regarding Marsh & McLennan Companies, Inc. and its subsidiaries’ equity interests in certain insurers and contractual arrangements with certain insurers and wholesale brokers. e. Mercer is unable to provide insurance broking, risk consulting, claims or other services or provide any benefit to the extent that the provision of such services or benefit would violate applicable law or expose Mercer or its Affiliates to any sanction, prohibition or restriction under UN Security Council Resolutions or under other trade or economic sanctions, laws or regulations. [Remainder of this page left blank intentionally] NA E Rk, MAKE TOMORROW, TODAY Page 5 November 28, 2017 Ms. Christena Barney City of Meridian We appreciate your business and look forward to working with you on this engagement. Please acknowledge your agreement to the terms contained herein by signing below. Mercer Health Benefi LLC By: 1. Name: Shelli R. Stayner (Please Print) Title: ACCEPTED AND AGREED City of Meridian By, c Name: TG /" m i Je 1/✓eed (Please Print) Title: 14 -7 4 `/dam Date: November 28, 2017 Date: iia gig MARSH&MCLENNAN COMPANIES city of !'lelidiaa Detailed statement of Revenues and Expenditures - Rev and Exp Report - Keith Report 01 - General Fund 15{0 - EuEarr Resources Fton, la / 7 /2071 Through 9/30/2018 unposted Transactions Included In Budget with Current Yea! Actual Budget Remaining Percent of Budget Remaj.ning 42025 0000 PERSONNEI, COSTS Employee Insurance NON-DEPARTMENTAL Tota] PERSONNEL COSTS 140,145.00 0. 00 0.00 60, 628.85 140,145.00 100.00* 0. 001( 60, 140 145.00 60 628.85 t9 s16.15 56.74t TOTAL EXPEND]TURES l9 516 , 15 56 .14\ Dare: 12/t9/11 t2:55:47 PM 14 o, 145.00 50, 528.85 Ol,f,IDIAN City of Meridian BENEFIT BROKERAGE AND CONSULTING SERVICES SELECTION RFQ NUMBER: DUE DATE & TIME: HR-1747-10769 August 7, 2017 VENDOR SELECTION: (in order)Points 85.18 82.33 76.75 1 Mercer 2 The Murray Group 3 Paynewest lnsurance Date Posted: 9-26-2017 IDAHO MERCER HEALTH & BENEFITS SERVICE SCHEDULE CITY OF MERIDIAN This Service Schedule appends the Statement of Work entered into by and between Mercer Health & Benefits and City of Meridian dated December 4, 2017. Our Services will consist of the following: Client Strategy Development  Conduct strategic planning sessions to review agreed upon performance metrics of Client’s current employee benefit coverages and establish future objectives and strategies to manage Client’s employee benefit coverages to which this agreement applies.  Planning session – 1 per year  Pre-Renewal - 1 per year  Renewal meeting - 1 per year  Benefit Committee Meetings – 1 per month  Council Meetings – As requested by client  Wellness Committee Meetings – Participate as necessary  Meet with the Client’s key designated representatives quarterly or 4 times per year to discuss strategy, healthcare trends and changes, and open items.  Benchmark health plan costs and employee contributions to industry, size and regional standards on an annual basis. Renewal/Marketing  Develop a mutually agreeable renewal action plan and timeline that meets the Client’s stated objectives.  Upon the request of Client, we will assist Client in the preparation of a RFP for purposes of obtaining competitive quotes from the marketplace, based on the timeline below. We will be the primary point of contact during the bidding process.  Medical, Rx - every 3-5 years  Dental - every 3-5 years  Life, STD, LTD - every 3-5 years  Stop Loss, if applicable – every 1 or 2 years based on renewal and client’s direction  When marketing your coverages, we will prepare an analysis comparing proposals to current costs, plan designs, administrative capabilities, network discounts and network accessibility as applicable.  With respect to the Client’s annual renewal process, we will conduct a benefits program review of the benefits coverages for which Mercer is named Broker of Record to include negotiations, on Clients’ behalf, with current vendors/carriers, as per Clients’ request.  At client’s request, conduct review of vendor-produced communication and open enrollment pieces for plan rate and accuracy. 2018 Mercer Health & Benefits Service Schedule City of Meridian 2 Negotiation/Placement  Identify and negotiate on the Client’s behalf with insurers and other benefit program providers and keep the Client informed of significant developments as we understand them to be. We shall be authorized for purposes of this Agreement to represent and assist the Client in all discussions and transactions with all insurers/providers, provided that we shall not place any insurance or vendor programs on behalf of the Client unless so authorized by the Client.  Assist with documentation and other steps to obtain commitments for and implement insurance policies and other services selected by the Client regarding its employee benefits program upon the Client’s instructions, it being understood that we will not independently verify or authenticate information not originating from us necessary to prepare proposals or underwriting submissions and other documents relied upon by insurers/providers, and the Client shall be solely responsible for the accuracy and completeness of such information and other documents furnished to us and/or insurers/providers and shall sign any application for coverage. The Client understands that the failure to provide all necessary information to an insurer, employee benefit provider or third party vendor whether intentional or by error, could result in the impairment or voiding of coverage or service.  Provide Client access to insurers with whom Mercer is appointed and other service providers as agreed with the Client and use our commercially reasonable efforts to place insurance policies and other services selected by the Client regarding its employee benefit program on behalf of the Client, if so instructed by the Client.  Review policies and contracts for accuracy and conformity to specifications provided by Client and the related negotiated coverages. Ongoing Analysis/Projections  Analyze factors driving Client’s plan costs if experience data is available. In connection with such analysis, we will review carrier/vendor utilization reports to determine possible causes of identified cost increases. Assist Client in managing these risks and costs.  Establish claims reports for identified coverages Medical, Rx and Dental, detailing paid claims (and reimbursements if applicable), premium/funding and enrollment summaries. We will review these reports with Client on a quarterly basis and will identify and discuss trends and potential problems.  Provide agreed upon cost projections on an annual basis to determine gross cost scenarios that meet Client objectives.  If applicable, review funding methodology on annual basis to determine if benefits funding structure meets Client objectives. Vendor Management  Act as a liaison between the Client and insurers/ providers for the lines of coverage and services that we have placed or obtained on behalf of Client or for which Mercer is named as the broker of record. 2018 Mercer Health & Benefits Service Schedule City of Meridian 3  Follow up with insurance carriers/providers for timely issuance of policies and contracts.  Follow up with insurance carriers/providers with respect to the payment or return premiums.  Assist the Client in connection with issues relating to interpretation of insurance policies/contracts placed by us.  Provide information/coverage summaries for all new coverages and updates on changes to existing coverages.  Assist Client in the implementation of the benefit program by dealing with vendor/carriers and performing contract and SPD review for purposes of determining conformity to agreed upon plan provisions and costs. Stop Loss Services – If Partially Self-funded By retaining Mercer, Client hereby authorizes Mercer to perform the following services on Client’s behalf with respect to its Stop Loss insurance coverage placement:  Meet with Client to develop a stop loss placement strategy that meets Client’s stated objectives.  Request and negotiate the terms and conditions of the stop loss insurance renewal from the current insurer and present the insurer’s proposed renewal package to Client.  Conduct a stop loss marketing as agreed based on a list of stop loss carriers selected by Client and its desired terms of coverage.  If necessary, facilitate communication between Clients’ medical and prescription drug vendors and stop loss insurer to establish reporting responsibilities and timing of data required for the purpose of securing stop loss coverage.  Follow up with insurance carrier for timely issuance of policies and contracts.  Review policies and contracts for accuracy and conformity to specifications provided by Client in the placement strategy meeting.  We will assist Client with access to the stop loss insurance marketplace and use our commercially reasonable efforts to place stop loss policies selected by Client on its behalf, if so instructed.  If requested, we shall transmit information and data supplied by Client or on its behalf without independently verifying the accuracy, completeness or timeliness of the data to the stop loss insurer. Important Limitations on Mercer’s Marketing of Client’s Stop Loss Policy We do not make any representations about an insurer's or MGU's payment or claims denial practices. We do not warrant in any way that all claims submitted to the stop loss carrier will be approved and ultimately reimbursed. Also, the terms and conditions of covered claims for the stop loss insurance policy may not fully correlate with the benefits covered under Client’s benefits program. With respect to Client’s Stop Loss insurance coverage placement, Client is responsible for the following:  Client will name Mercer as the broker-of-record for your stop loss coverage. 2018 Mercer Health & Benefits Service Schedule City of Meridian 4  Client will provide all data/information as required by the stop loss insurer in a timely manner. Client is responsible for the accuracy and completeness of such data and information.  Client is responsible for timely submission of claims requests and confirmation that appropriate reimbursements have been issued by the stop loss insurer.  Client is responsible for disclosing all potentially high exposure claims as defined by the stop loss insurer.  Client is responsible for reviewing and executing a confirmation of coverage letter before binding of coverage. Wellness Mercer will help the City of Meridian deploy strategies and tactics that improve the health, wellbeing and productivity of the workforce. We recommend that the City develop “guiding principles” to establish best-practice wellness or well-being programs. We will leverage our HERO Scorecard, to better understand the City’s approach. The use of the on-line survey will help us determine gaps and opportunities for improvement. We will share our HERO Scorecard best practices with the City. We will work with you to determine the best measures for the evaluation of your program(s). All wellness or well-being programs should help increase ownership and health awareness, promote health behaviors, increase engagement, as well potentially leading to better financial outcomes. The goal for the City is to foster a culture of well-being. Other Services  Provide the following health and welfare plan legislative and regulatory compliance support as mutually agreed:  Updates on pertinent federal benefits legislation and their potential impact to employers’ health and welfare benefit plans  Consultative and strategic guidance related to compliance with IRS, DOL and HHS regulations as mutually agreed from time-to-time  Assist Client in responding to inquiries related to federal laws and regulations including ERISA, COBRA, HIPAA and the Affordable Care Act (ACA).  Assist in reviewing of health and welfare plan SPDs, SMMs, and mutually agreed plan documents for Medical, Rx, Dental and Vision.  Advise Client with respect to available technology platforms to support delivery and administration of its employee benefit plan. While our team of ERISA attorneys are available to review documents and advise on issues, since we are not a law firm , we cannot practice law or render legal opinions 2018 Mercer Health & Benefits Service Schedule City of Meridian 5 Communication Services  Assist Client with the preparation of communication materials relating to the health and benefit program to which this Letter applies. Core Communication Services  Benefits Brochure  Cover Letter  Rate Sheet  Poster  Postcard  Envelope  Healthy Habits Newsletter (4 issues a year) OR Enhanced Communication Services  Open Enrollment Presentation  Enrollment Form  Expanded Medical Spread  Benefits Wallet Card  HSA Checklist  HSA Pre-Enrollment Postcard  HSA Post-Enrollment Postcard  Required Notices Booklet Printing, fulfillment, courier and shipping costs are not included as part of these communications services. Client is responsible for:  If applicable, providing any photography or other artwork to be used in design  Providing all information required by Mercer to complete the services as outlined above in a timely manner  Reviewing and providing comments on all communication drafts in a timely manner  Approving drafts for distribution to employees ACA Compliance Resources Affordable Care Act Consulting Services Note that any ACA compliance consulting is based on Mercer’s current general understanding of the law and regulations as of the date hereof, which can change from time to time, and should not be construed as, nor is it intended to be, legal advice. Complying with Employer Shared Responsibility Rules  For purposes of complying with the employer shared responsibility rules Mercer will: o Help Client understand which employers are subject to the employer shared responsibility rules per Mercer’s general understanding at the time the work is performed. 2018 Mercer Health & Benefits Service Schedule City of Meridian 6 o Provide the general Mercer understanding of the definition of “employee.” o Help Client understand the definition of “reasonably expected to work 30 hours,” variable hours employees, new hire versus re-hire, seasonal, etc. and how that may apply to certain employee classes (interns, seasonal, temporary, others). o Help Client understand, per Mercer’s general understanding, which hours to count when determining “full-time” employees, including specific administrative issues related to: salaried/hourly; leaves of absence; disability pay; rehires; difficult job classes (e.g. commissioned salespeople). o Assist Client with determining the appropriate method to count hours – monthly measurement or lookback measurement and stability period approaches (ongoing and new hire). We will also consider alternatives to counting hours. o Provide guidance on how to track hours, focused specifically on how hours data translates into measurement approach; for lookback measurement period, monthly cycle for “full time” new hires; typically an annual cycle for “variable hour” new hires and ongoing employees. o Help Client understand the rules requiring employers to provide minimum essential coverage (MEC) to “substantially all” full-time employees and their dependent children.  We will review the current employer shared responsibility rules, and the minimum essential coverage and employer shared responsibility reporting requirements, forms and instructions through Mercer’s ACA Readiness Review process.  Help Client understand how penalties are determined, estimate the potential financial impact and consider strategic approaches to remediate/mitigate the risk. Complying with ACA Requirements  Background and considerations on the Patient-Centered Outcomes Research Institute (PCORI) fee and an illustration of the various methods permitted to count covered lives and a table of PCORI fee rates for various time periods  Provide Client with background and considerations on the Transitional Reinsurance Fee and an illustration of the various methods permitted to calculate covered lives.  Review the ACA plan design requirements to determine which requirements apply (i.e., preventive care, OOP maximums, annual/lifetime dollar limits, etc)  Review the ACA group health plan employer reporting and disclosure requirements to determine which requirements apply, and the applicable effective dates.  Help Client understand the ACA requirements for wellness programs.  Provide an overview of the 40% excise tax on high cost coverage that goes into effect in 2020 including what coverages are included/excluded from the tax based on information currently available.  Review the impact of losing grandfathered status.  Provide an ACA compliance review of employee communications.