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HomeMy WebLinkAbout1996-12-16 City Council (36)City of Palo Alto City Manager’s Report TO:HONORABLE CITY COUNCIL FROM:CITY MANAGER DEPARTMENT: Human Resources AGENDA DATE: December 16, 1996 CMR: 500:96 SUBJECT:Claims Administration Services for the City of Palo Alto’s Self- Funded Dental Plan: Renewal of Contract with FIRST HEALTH STRATEGIES, INC. REQUEST The Human Resources Department requests approval to renew an agreement with FIRST HEALTH STRATEGIES, INC. (FIRST HEALTH) for third-party claims administration services for an additional three years. RECOMMENDATIONS Staff recommends that Council authorize the Mayor to execute the attached agreement with FIRST HEALTH. POLICY IMPLICATIONS This request does not represent any change in existing policies. EXECUTIVE SUMMARY The City has contracted with FIRST HEALTH for dental plan claims administration since March 1, 1994. FIRST HEALTH is processing approximately 7,000 claim transactions per year and has performed services at a very high level in terms of accuracy and efficiency in the payment of claims. A Request for Proposal was developed by the Human Resources Department and sent to 25 providers. Five proposals were received. The companies who submitted proposals and their quoted fees are listed below: CMR:500:96 Page 1 of 3 Proposer First Year Second Year Third Year Total 1. John Hancock $33,247 $37,359 $38,768 $109,374 2. FIRST HEALTH $36,218 $36,218 $36,218 $108,654 3. United Concordia $44,642 $44,642 $44,642 $133,926 4. Lipman Company $58,740 $58,740 $58,740 $176,220 5. Delta Dental $80,740 $80,740 $80,740 $242,220 The proposals were reviewed by a selection committee consisting of representatives from the SEIU, Police and Fire representation units, in addition to staff from the Finance and Human Resources Departments. The committee unanimously recommended renewing FIRST HEALTH’s contract for an additional three years. Their reasons for this recommendation include FIRST HEALTH’s record of payment of more than 95 percent of all claims in seven days or less, FIRST HEALTH’s very low error rate and the absence of service complaints from employees. Staff is in agreement with the conclusions reached by the selection committee and recommends renewing FIRST HEALTH’s contract for an additional three year term. FISCAL IMPACT Funding in the amount of $37,000 is included in the 1996-1997 budget. ENVIRONMENTAL ASSESSMENT There is no Environmental Assessment required for this agreement. ATTACHMENTS Amendment to Contract with First Health CMR:500:96 Page 2 of 3 PREPARED BY: Leonard Zucker, Manager of Employee Benefits DEPARTMENT HEAD REVIEW: CITY MANAGER APPROVAL: JAY C. ROUNDS Di~ Manager CMR:500:96 Page 3 of 3 ~MENT NO. ONE TO CONTRACT NO. C-4047581 BETWEEN THE CITY OF PALO ALTO AND FIRST HEALTH STRATEGIES (TPA) INC. FOR DENTAL CLAIMS ADMINISTRATION SERVICES This Amendment No.One to Contract No. C-4047581 ("Agreement") is entered into , by and between the CITY OF PAL0 ALTO, a chartered city and a municipal corporation of the State of California ("CITY"), and FIRST HEALTH STRATEGIES (TPA) INC. a Delaware corporation located at 6975 Union Park Center, Salt Lake City, UT 84047 ("CONTRACTOR"). RECITALS: WHEREAS, the Agreement was entered into between the parties for the provision of dental claims administration services; and WHEREAS, the parties wish to amend the Agreement; NOW, THEREFORE, in consideration of the covenants, terms, conditions, and provisions of this Amendment, the parties agree: follows: SECTION i.Section 2.2 is hereby amended to read as "2.2 CONTRACTOR CONTRACTOR shall assign a Project Director to have overall responsibility for the progress and execution of this Agreement for CONTRACTOR. CONTRACTOR shall assign staff personnel from its Salt Lake City, Utah or its Portland, Oregon offices, or both, in the performance of its obligations hereunder. HARRY B. HARRISON hereby is designated as the Project Director for CONTP~ACTOR. Should circumstances or conditions subsequent to the execution of this Agreement require a substitute Project Director for any reason, the Project Director designee shall be subject to the prior written approval of the Project Manager." follows: SECTION 2. Section 4 is hereby amended to read as "SECTION 4 COMPENSATION For the full performance of the Services described herein by CONTRACTOR, CITY shall pay CONTRACTOR the amount of Three Dollars and Ten Cents ($3.10) per month per employee plus printing costs. Payment shall be made within 45 days of receipt of a billing statement to CITY. Interest on the unpaid balance shall accrue after the thirty-day period at the rate of twelve percent (12%) per annum." 1 follows: SECTION 3. Section 6 is hereby amended to read as "SECTION 6 TERM The term of this agreement, shall commence on January I, 1997 and shall terminate on December 31, 1999, unless sooner terminated by a party." follows: SECTION 4.Section ii is hereby amended to read as "SECTION ii NOTICES All notices hereunder shall be given in writing and mailed, postage prepaid, by certified mail, addressed as follows: To CITY:Office of the City Clerk Post Office Box 10250 Palo Alto, CA 94303 To CONTRACTOR: FIRST HEALTH STRATEGIES, INC. 5000 SW Meadows, Suite 333 Lake Oswego, OR 97035 (503) 639-6600 ATTN: Harry B. Harrison, Project Director IIII IIIIIIIIIIIII/I/II IIIIIIIIii. //I//I Copy to:General Counsel FIRST HEALTH STRATEGIES (TPA), INC. Suite 600 6975 Union Park Center Salt Lake City, UT 84047" 2 961127 lac 0031462 SECTION 5. Except as herein modified, all other provisions of the Agreement, including any exhibits and subsequent amendments thereto, shall remain in ful! force and effect. IN WITNESS WHEREOF, the parties have by their duly authorized representatives executed this Amendment on the date first above written. ATTEST:CITY OF PALO ALTO City Clerk Mayor APPROVED AS TO FORM: Senior Asst. City Attorney FIRST HEALTH STRATEGIES (TPA) INC. APPROVED :Taxpayer I.D. No. 87-0459486 City Manager Director of Human Resources Deputy City Manager, Administrative Services Risk Manager 3 961127 lac 0031462 CERTIFICATE OF ACKNOWLEDGMENT (Civil Code § 1189) STATE OF COUNTY OF ) ) ) On /-~ -& - ~ Q-, before me, the undersigned, a notary .public in and for said County,. personally appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument, and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. 961127 lac 0031462