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AI- 3097   12. B. 7.    
BOC Regular
Meeting Date: 12/19/2019  
2020 BCBSM Renewal Agreements
Submitted For: Kim Archambault FROM: Kim Archambault, HR Director, Human Resources
Department: Human Resources  

Resolved, the Calhoun County Board of Commissioners does hereby approve the 2020 Blue Cross Blue Shield of Michigan Agreements as presented and authorizes the Board Chair to sign the attached documents.
It is recommended that the Calhoun County Board of Commissioners approve the 2020 Blue Cross Blue Shield of Michigan (BCBSM) Agreements as presented.
The 2020 renewal agreements with BCBSM are attached, including the Schedule A that sets forth the fee structure for the next calendar year and the annual stop loss agreement.  For 2020, the administration fee did not increase and the stop loss fee increased by 16.5%.

For 2020, BCBSM has noted the following in regards to the terms of the Agreement:  They will continue to utilize their ASC Shared Savings initiatives and they are introducing Non-Participating Provider Negotiated Pricing.  The language has been revised to include Negotiated pricing in Section 12 of the Schedule A.  Pre-Payment Forensics, Advance Payment Analytics, Subrogation, and Provider Credit Balance Recovery will remain in effect and BCBSM will continue to retain 30% of any recoveries from these programs as administrative compensation.  They are introducing Blueprint for Affordability to continue efforts at controlling costs.  The language related to this program has been added to the Schedule A in section 18 and is referenced as Exhibit 1 to the Schedule A. The risk arrangements noted will not impact the County 2020, but will have financial impact in 2021 that will be reviewed.

Fiscal Impact
With no increase to the administration fee, the annual cost for 2020 is estimated to be $420,414.
With the 16.5% increase to the stop loss fee, the annual cost for 2020 is estimated to be $649,708.

These amounts were already included in the 2020 Calhoun County approved budget.

2020 BCBSM Schedule A, B, & Stop Loss

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