Exhibit_5_-_Stop_Loss_Information.pdf

This exhibit document provides stop-loss insurance policy information for the City of Orlando's self-funded health plan, specifically detailing the current stop-loss coverage issued by Symetra Life Insurance Company under Policy 16-012839-000. The stop-loss policy establishes a specific deductible of $1,000,000 per covered unit for the 2025 policy period, with an associated premium rate of $6.79 per covered unit. This coverage protects the city against catastrophic claims exceeding the specified deductible threshold, providing financial risk management for the self-funded group medical and pharmacy benefit plans serving approximately 9,000 covered lives with projected gross annual healthcare claims of $85 million (65% medical, 35% pharmacy). The exhibit includes the policyholder acceptance documentation and references the executed RFP15-0097 2025 Extension agreement, indicating continuity of stop-loss protection through the current plan year.

The stop-loss policy serves as critical risk mitigation infrastructure for the city's self-funded benefits structure, which currently operates under UnitedHealthcare's administration since 2001. The $1,000,000 per-unit deductible represents the city's retained risk threshold, above which the stop-loss carrier assumes liability for individual claims. This policy framework directly impacts the financial modeling and risk assessment for the new Health Plan Administrative Services solicitation (RFP26-0046), as prospective administrators must account for existing stop-loss parameters when evaluating claim management strategies and potential cost implications under the three-year initial contract term beginning January 1, 2027, with potential renewal options extending through 2034.