Metrocare_Services_Medical_Renewal_2027_Summary.pdf

This is a medical renewal summary document prepared by Arthur J. Gallagher & Co. for Metrocare Services regarding their 2027 health plan renewals in Texas. The document outlines renewal terms for Administrative Services Only (ASO) and Stop Loss coverage, with the ASO fee renewal increasing 18.8% and the base administrative fee rising 9.4% to $46.37 per employee per month (PEPM). The renewal includes fee guarantees for 2028 (+$2.22 PEPM) and 2029 (+$2.33 PEPM), supplemented by medical rebate credits of $2.20 PEPM and prescription drug credits of $101.20 PEPM. The Health Advocacy Solutions fee decreased by $0.95 to $15.45 PEPM. Stop Loss renewal rates increased significantly, with Individual Stop Loss at $200,000 deductible increasing 36.7% to $210.78 PEPM and aggregate coverage at 125% attachment factor increasing 56.4% to $3.10 PEPM.

The renewal projections include an additional 3% cost or $300,000 budget impact when accounting for May claims data. This renewal summary is directly related to Metrocare Services' concurrent solicitation for an Individual Coverage Health Reimbursement Arrangement (ICHRA) administrator, which seeks qualified vendors to provide comprehensive administration services including plan design, implementation, ongoing administration, compliance support, employee assistance, and reporting capabilities for their Texas-based workforce benefits programs.