95-994qs- ���
DEPARTMENT/OfFICE/COIJNCIL OATE �NITIATED IV L/ U b U
c�t coun��i 8/16/95 GREEN SHEE
� INITIAVDATE INITIAL/DATE
CONTACf PERSON & PHONE � DEPARTMENT DIRECTOR � qN COUNqL
Councilmember Megard p�g�GN �CINAl70RNEY �CINCLERK
MUSTBEONCOUNQLAGENDABY(DATE) NUY9ENPOR ❑BUDGETDIRECrOR �FIN.&MGT.SERVICES�IR.
NOUTiNG
8/16/95 ORUEH �MAYOR(ORASSISTAN� �
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTED:
Congratulating Alvin and Eleanor Weber on.their SOth wedding anniversary.
RECOMMENDATIONS: Approve (A) or Relect (R) pEHSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PLANNING COMMISSION __ CIVIL SEFiVICE COMMISSION �� Has this petson/firm ever wOfked Untlef a CAntfaCt fof this depariment?
_ CIB COMMITfEE YES NO
_ S7AFF 2. Has this person/fvm ever been a ciry employee?
— YES NO
_ DiSTRIC7 CoUar _ 3. Does this person/firm possess a skill not normally possessed by any current ciry employee?
SUPPoR7S WHICH COUNCIL O&IECTIVE� YES NO
Ezplain all yes answers on separate sheet anE attach to green sheet
INITIATING PROBLEM, ISSUE, OPPORtUNITV (Who, What, When, Where, Why)
ADVANTAGESIFAPPROVED
DISADVANTAGES IF APPROVED.
DISADVANTAGES IF NOT APPFOVED�
70TALAMOUNTOFTFANSACTION $ COST/REVENUE BUDGETED(CIRCLE ONE) VES NO
FUNDIfdG SOUFiCE ACTIVITY NUMBER
FINANCIAL INFORMATION. (EXPLAIN)
Council File # �� � + `�
Green Sheet #i � `��
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RESOLUTIO
F SAINT PAUL, I
NNESOTA
Piesented By
Committee: Date
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Refezxed To
WHEREAS, Medica xeceives approximately $15 million annually in piemiums fzom the City,
its employees, and zetirees, and
WHEREAS, the City is concerned with the level of network pzovidei savings zetained by
Medica far netwosk management fees, method of coordinating Medicaie benefits for
retirees, and administxation oE out-of-netwoxk pxescxiption dxug claims, and
WHEREAS, a medical claims audit of Medica would assist in the development of baseline
peifoxmance factois and impzovements to be negotiated in future contiacts with medical
caixiexs, and
WHEREAS, the Mayor pursuant to Section 10.07.4 of the City Chaxtex recommends the
following transfeis in the 1995 Genesal Fund Budget, and
Curxent
Budaet
Txansfei Fiom:
Genexal Government Accounts
Contingent Reserve - Genexal
GL Contingency
Txansfex To:
General Goveznment Accounts
Retiiee Insuiance
GL Fees - Othei Ptof Svs
0-
Chanaes
(100,000)
100,000
Amended
Budaet
i4'S�IiiIQ�l
100,000.
BE IT RESOLVED, that the City Council appsoves these changes to the 1995 budget.
p•1o�2
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Budget Diiectox
250.000
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Requested by Depastment of:
'�_ t �l '(�.�CS- � �� � QQ/�
BY � � \ / ��
Fozm Appzoved by City Attozney
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Appx
Cour
BY :
y Council: Date l�\,, __�
Cexti£ied by Council S cietary
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DEPAFTMENT/pFFICE/COUNCIL DATE INITIATED N� 313 3 7
GREEN SHEE
" an e t2isk & Em 1 Ben M t Div 08 14 95 INITIAWATE INITIAL/DATE
CONTACT PEqSON & PHONE � DEPAFiTMENT DIflECTOF � CITY CAUNGIL
ASSIGN � CITV ATTORNEY � CITV CLERK
MUST BE ON CpUNCIL AGENOA BY (OA NUYBEB FOP � BUDGE701ftECTOR � FIN. & MGT. SERVICES OIH.
ROU'fING
OflDER �MAVOfl(ORASSISTAN'� � ('}�iPF ACC
TOTAI # OF SIGNATURE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTED:
Approve the transfer of $100,000 from GL 001 09060 0548 (Contingency) to GL 001 09002 0219
in order to hire William A Mercer Inc to conduct a medical claims audit of the City's
benefits carrier, Medica.
RECOMMENDA710NS: Approve (A) a Reject (R) pERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PLANNING COMMISSION __ CIVIL SERVICE COMMI$$ION �� Has ihi5 pEf50ntlitm BVeI Wofked Untlef a ConVaCt fOr thi5 tlBpartment?
_ CIB COMMffTEE YES NO
_ S7AFF i 2. Has this person/Firm ever been a ciry employee?
— YES NO
_ DISTRICT COURT _ 3. Does this person/firm possess a skill not normall
y possessed by any current city employee?
SUPPORTSWHICHCAUNCILO&IECTIVE7 YES NO
Explain ell yes anawers on separate sheet antl anach to green sheet
INITIATING PROBLEM, ISSUE, OPP�fiTUNIN (Who, What, When, Where. Why)�
Medica receives approximately $15 million annually in premiums from the City, its employees,
and retirees. The City has never conducted a medical claims audit. It is a prudent
business decision to periodically audit any entity tfiat receives such large payments.
The City is concerned with the level of network provider savings retained by Medica for
its network management fees; Medica's method of coordinating Medicare benefits on retiree
claims, and with the administration of out—of—network prescription drug claims.
ADVANTAGES IF APPFOVED:
The audit would greatly assist in the development of baseline performance factors and
suggested improvements to be negotiated in future contract(s) with Medica or other
carriers. As a result of the audit, the City would be in a better position to potentially
locate recoveries from Medica and other carriers.
DISADVANTAGES IF APPROVED ����
P7
None AUG 14 i995
AUG 15 1995
��� a��°� ������ �� �T� �� � �.��. � ��
DISADVANTAGES IF NOT APPROVED:
The City, its employees and retirees, will continue to pay a total of approximately $15
million in premiums to a health carrier without a claims audit. It would be extremely
difficult for the City to negotiate per£ormance star.dards and suggested improvements
for claims administration in future contracts with Medica and other carriers without
having the results of a thorough claims audit.
TOTAL AMOUNT OF THANSACTION S L OO .00O COSTIREVENUE BUDGETED (CIHCLE ONE) YES NO
PUNDING SOURCE GL 001 ACTIVITY NUMBER 09060 0548
FINANCIAL INFORMATION. (EXPLAIN)