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 - Employee Health Benefits Plan
- Issued by
- Florida
About this file
This document is an Administrative Services Only (ASO) fees and stop loss rates exhibit for the City of Miami, prepared by CIGNA for the period beginning 1/1/2025. The exhibit details the current and proposed administrative service fees and stop loss insurance rates for various health plan options, including OAP (Open Access Plan) form, comprehensive, and with/without prescription coverage. The contract covers multiple plan types such as dependent care, flexible spending healthcare and vision accounts, with a total of 2,248 covered lives across different plan categories.
The financial summary shows no change in administrative service fees for the 1/1/2025 to 12/31/2025 period, with total annual administrative and access fees remaining at $977,701. However, stop loss insurance rates are increasing by 7.0%, with individual stop loss moving from $4,368,224 to $4,675,750 and aggregate stop loss 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 $350,000 pooling point, 12-month contract type, and 120% corridor amount for aggregate stop loss.
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Text version
City of Miami As-Is w May exp - ASO 1/1/2025
ASO Fees and Stop Loss Rates
ASO Fees - Current OAP form Comp OAP no Rx OAP w Rx ependent Care FS Healthcare FSA Vision Total Administrative Service Fees 17.06$ 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 .