Exhibit 54a - Cal Yr 2025 City of Miami CIGNA Medical - Administrative Services Only ASO And Stop Loss Fees Schedule.pdf
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- Attached to
- RFP No. 2130386 - Employee Health Benefits Plan
- Solicitation number
- RFP No. 2130386
- Issued by
- Florida
About this file
This document is an Administrative Services Only (ASO) fees and stop loss rates exhibit from the City of Miami for a healthcare benefits contract with CIGNA, effective 1/1/2025. The document details current and proposed administrative service fees and stop loss rates for various health plan options, including OAP (Open Access Provider) plans with and without prescription coverage, dependent care, and flexible spending accounts. The contract covers 2,248 total lives across different plan types, with a contract term from 1/1/2025 to 12/31/2025.
The pricing structure shows no change in administrative service fees for the proposed period, with total annual administrative and access fees remaining at $977,701. However, there is a 7% increase in stop loss rates, with individual stop loss increasing from $4,368,224 to $4,675,750 and aggregate stop loss rising from $164,823 to $176,423. The total fixed cost is projected to increase from $5,510,748 to $5,829,874, representing a 5.8% overall increase. Key stop loss parameters include a $350,000 pooling point, 120% corridor amount, and paid-in-12 contract type with no terminal liability run-out months.
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Text version
City of Miami As-Is w May exp - ASO 1/1/2025
ASO Fees and Stop Loss Rates
ASO Fees - Current OAP form Comp OAP no Rx OAP w Rx ependent Care FS Healthcare FSA Vision Total Administrative Service Fees 17.06$ 16.73$ 16.73$ 5.90$ 5.90$ -$ 451,308$ Network Access Fees 11.73$ 19.53$ 19.53$ -$ -$ -$ 526,373$ Additional Programs Vision -$ -$ -$ -$ -$ 0.35$ -$ Total PEPM ASO Fee 28.79$ 36.26$ 36.26$ 5.90$ 5.90$ 0.35$ Employees 5 169 2,074 - - -
Current Annual Administrative & Access Fees 1,727$ 73,535$ 902,439$ -$ -$ -$ 977,701$
ASO Fees - Proposed OAP form Comp OAP no Rx OAP w Rx ependent Care FS Healthcare FSA Vision Total % Change From 1/1/2025 to 12/31/2025
Administrative Service Fees 17.06$ 16.73$ 16.73$ 5.90$ 5.90$ -$ 451,308$ 0.0% Network Access Fees 11.73$ 19.53$ 19.53$ -$ -$ -$ 526,373$ 0.0% Additional Programs Vision -$ -$ -$ -$ -$ 0.35$ -$ 0.0% Total PEPM ASO Fee 28.79$ 36.26$ 36.26$ 5.90$ 5.90$ 0.35$ Employees 5 169 2,074 - - -
Proposed Annual Administrative & Access Fees 1,727$ 73,535$ 902,439$ -$ -$ -$ 977,701$ 0.0%
Stop Loss 1 1 1 1 1 1
OAP form Comp OAP no Rx OAP w Rx Total % Change Current 161.93$ 161.93$ 161.93$ 4,368,224$ Proposed 173.33$ 173.33$ 173.33$ 4,675,750$ Lives 5 169 2,074
Proposed Annual Individual Stop Loss 10,400$ 351,513$ 4,313,837$ 9,351,500$ 7.0%
* Pooling Point 350,000$
* Contract Type Paid in 12
* Terminal Liability Run-Out Months 0
* Renewal Rate Predictability Product None
* Rx Accumulation Y
* Commissions (Net or %) 0.0% OAP form Comp OAP no Rx OAP w Rx Total % Change
Current 6.11$ 6.11$ 6.11$ 164,823$ Proposed 6.54$ 6.54$ 6.54$ 176,423$ Lives 5 169 2,074
Proposed Annual Aggregate Stop Loss 392$ 13,263$ 162,768$ 352,846$ 7.0%
* Pooling Point 350,000$
* Corridor Amount 120%
* Contract Type Paid in 12
* Terminal Liability Run-Out Months 0
* Minimum Attachment Percentage 100%
* Rx Accumulation Y
* Commissions (Net or %) 0.0%
Current Total Annual Stop Loss 4,533,047$ Proposed Total Annual Stop Loss 4,852,173$ 7.0%
Total Fixed Cost - Current 5,510,748$ Total Fixed Cost - Proposed 5,829,874$ 5.8%
Individual Stop Loss
Aggregate Stop Loss
Date Printed: 4/11/2025
EXHIBIT 54a
File details come from the government source that posted it. Updated .