260125_10312025_City_of_Tucson_DHMO_Report_23-24.ppt

PPT presentation 780 KB Posted

Attached to
Medical/Telehealth/Pharmacy, Wellness, Health Savings Account (HSA) and Health Reimbursement Arrangement (HRA) Administration, Dental, and Employee Assistance Program (EAP) Coverage
Solicitation number
260125
Issued by
Pima County, Tucson City, Arizona

About this file

The document is a PowerPoint presentation (260125_10312025_City_of_Tucson_DHMO_Report_23-24.ppt) related to the City of Tucson's Dental Health Maintenance Organization (DHMO) coverage for 2023-2024. The presentation provides a detailed demographic and membership analysis for the current contract period, which reflects claims incurred between July 2023 and June 2024. The average membership during this period was 3,591, with an average family size of 1.91. The population breakdown shows employees representing 52.3%, spouses 20.4%, and dependents 27.3% of the total membership.

Cigna is the current incumbent for the dental coverage, and the presentation is part of a broader Request for Proposal (RFP #260125) by the City of Tucson for comprehensive healthcare and benefits administration services. The RFP covers multiple service lines including Medical/Telehealth, Pharmacy, Wellness, Employee Assistance Program (EAP), and Dental Coverage for approximately 4,498 employees and 2,306 retirees. The dental DHMO current monthly rates range from $8.67 to $21.16, with the city paying 100% of employee and dependent costs. The solicitation allows bidders to propose services for one or more lines, with a potential contract term of one initial year and six potential one-year renewals, targeting a July 1, 2026 effective date.

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Text version

Copyright 2025 Cigna - Confidential and Privileged - Not for Distribution City of Tucson DHMO 23/24

Table of Contents

• Dental

Percent of membership by age band and product Percent of spend by age band and product

Dental - Membership Summary Comments

· Average membership in the current period was 3,591

· Average family size was 1.91. Average family size measures the ratio of members to employees

· Employees represented 52.3% of the population in the current period, spouses 20.4% and dependents 27.3%

20% 15% 10% 5% 0%

Current Period reflects claims incurred between Jul. 2023 and Jun. 2024, paid through Jun. 2024 24% 18% 12% 6% 0%

CITY OF TUCSON-Request 1587932-View 1958284-RPT_ID 371_CN-Tier 3 <1 1-17 18-29 30-39 40-49 50-59 60-64 65+ Summary of membership

Current

Average Populations Employees Spouses & Dependents Members Average Family Size Percent Female Percent Male

Dental Care 1,878 1,713 3,591 1.91 46.6% 53.4%

Total 1,878 1,713 3,591 1.91 46.6% 53.4% <1 1-17 18-29 30-39 40-49 50-59 60-64 65+

Dental Care - Summary Comments

· Dental Care reporting is limited to encounter data submitted by providers, therefore service counts can be understated when utilization detail is not provided

· Savings percentage was 77.6%, 8.0% less than the norm of 85.6%

· Cigna DHMO is also known as Cigna Dental Care and includes Cigna Dental Care Access and Cigna Dental Care Access Plus

Current Period reflects claims incurred between Jul. 2023 and Jun. 2024, paid through Jun. 2024 Savings percentage 100.0% 75.0% 50.0% 25.0% 0.0%

CITY OF TUCSON-Request 1587932-View 1958284-RPT_ID 276_CN-Tier 3

Demographic Summary

Average Number of Employees 1,878

Average Number of Members 3,591

Key Statistics

Norm Variance Services 12,576

Services per 1,000 3,502.0 3,371.6 3.9% Total Patient Copays $337,537

National Average Charges $1,504,983

Savings on Dental Services $1,167,756

Savings Percentage 77.6% 85.6% -8.0%

Norm 77.6% 85.6%

Dental Care - Utilization by Type of Service

Current Period reflects claims incurred between Jul. 2023 and Jun. 2024, paid through Jun. 2024

CITY OF TUCSON-Request 1587932-View 1958284-RPT_ID 277_CN-Tier 3 Comments

· There are 4 categories greater in utilization per thousand and 4 category lower in cost than the norm for an overall utilization variance of 0.0%

· High utilization for Diagnostic/Preventive services can lead to lower usage of other service categories

Gross Services by Type

Count Percent of Total

Diagnostic/Preventive

9,626 76.5%

72.1%

Basic Restorative

3.5%

5.8%

Major Restorative

3.4%

Endodontics

0.6%

0.9%

Periodontics

1,282 10.2%

9.0%

Oral Surgery

1.9%

2.9%

Orthodontics

1.5%

Other Services

2.4%

2.3%

Total

12,576 100.0%

Services per 1,000 Members by Type

Diagnostic/Preventive

2,680.5 76.5%

2,430.4 72.1%

Basic Restorative

121.4

195.7 5.8%

Major Restorative

120.0 3.4%

118.1

Endodontics

22.3 0.6%

29.2 0.9%

Periodontics

357.0 10.2%

304.1 9.0%

Oral Surgery

65.4 1.9%

98.1 2.9%

Orthodontics

51.2 1.5%

117.3

Other Services

84.1 2.4%

78.7 2.3%

Total

3,502.0

3,371.6

Report Parameters

Global Parameters

Overall Dates

Incurred 07/2023 to 06/2024

Incurred Runout 07/2023 to 06/2024

Catastrophic Threshold $100,000 Exclude Pharmacy No Package :1958284

Package Name:

City of Tucson DHMO 22/23

Structure:

Status = *, Division = *, Product Codes = DHMO

Package Parameters PMPM,CN,Override:No

Normative Values 202504

CITY OF TUCSON:3342685

File details come from the government source that posted it. Updated .