Ordinance No. 9,427ORDINANCE NO. 9427
AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF BAYTOWN, TEXAS,
AUTHORIZING A RENEWAL OF THE AGREEMENT WITH CHOICENET/INTERCARE
HEALTH PLANS, INC., AS A THIRD PARTY ADMINISTRATOR FOR THE
ADMINISTRATION OF MEDICAL AND DENTAL CLAIMS AND FOR NETWORK
SERVICES ON BEHALF OF THE CITY OF BAYTOWN; AUTHORIZING PAYMENT OF
TWO HUNDRED TWENTY -THREE THOUSAND TWO HUNDRED TWELVE AND
NO 1100 DOLLARS ($223,212.00); AND PROVIDING FOR THE EFFECTIVE DATE
THEREOF.
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF BAYTOWN, TEXAS:
Section 1: That the City Council of the City of Baytown, Texas, hereby authorizes a renewal of the
agreement with ChoiceNet/InterCare Health Plans, Inc., as the third party administrator for the administration of
medical and dental claims and for network services on behalf of the City of Baytown. A copy of the renewal
agreement is attached hereto, marked Exhibit "A," and made a part hereof for all intents and purposes.
Section 2: That the City Council of the City of Baytown authorizes payment to
ChoiceNetAnterCare Health Plans, Inc., of the sum of TWO HUNDRED TWENTY-THREE THOUSANDTWO
HUNDRED TWELVE AND NO/ 100 DOLLARS ($223,212.00), pursuant to the agreement.
Section 3: That the City Manager is hereby granted general authority to approve any change order
involving a decrease or an increase in costs of TWENTY -FIVE THOUSAND AND NO /100 DOLLARS
($25,000.00) or less; however, the original contract price may not be increased by more than twenty -five percent
(25 %) or decreased by more than twenty -five percent (25 %) without the consent of the contractor to such
decrease.
Section 4: This ordinance shall take effect immediately from and after its passage by the City
Council of the City of Baytown.
INTRODUCED, READ and PASSED by the affirmative vote of the City Council of the City of Baytown
this the 26`h day of September, 2002.
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PETE C. ALFARO, Ma or
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C.'Aft W. MITH, City Clerk
APPROVED AS TO ORM:
A RAM[REZ, SR CA
y Attorney
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ChoiceNer/ 110II111:11:UARE
• Hcalth Plans, Inc.
City of Baytown
Renewal Services
•
ChoiceNet/InterCare Health Plans, Inc. will assume the total responsibility for the
administration of the medical fund. These services include:
Monthly list billings (departmentalized if desired).
Payment of override premiums.
Payment of medical claims.
Monthly report of fund transactions and claims recap.
Assistance in filing of governmental reports and forms.
Statistical and actuarial information.
Fees for these services:
Monthly Administrative Fee - Medical - $13.25 per employee per month.
Dental - $2.50 per employee per month
Precertification /Utilization Review Fees - $2.50 per employee per month.
General Services Fee - $300 (one -time) - Through the course of the year,
InterCare is called upon to assist in a variety of additional services outside the
realm of typical TPA claims processing and reporting. These services often
include negotiations with blind (retro) networks, filing and preparing multiple
aggregate claims submissions, filing and preparing advances (aggregate and
specific), negotiating and renegotiating with PPG's, reconciling of bank accounts,
special reporting, broker support, advice, consulting, rate setting, auditor support,
and other miscellaneous, unforeseen services. This fee will be charged at the
beginning of the seventh month of the contract year.
Fees for optional services:
COBRA Administration - $ .85 per employee per month + $10 per participant.
Notification
Record Keeping
Premium Collection
HIPAA Administration - $5.00 per certificate.
PPO Fees - $5.85 per employee per month (PHCS)
EUBiT A
Renewal Services Continued
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Page 2
• Preparation of Form 5500 - $450.00 per form (optional).
■ RX Card (PTIINPS) Administration - $2.00 per employee per month.
■ InterCare On -Line Services - $1.25 per employee per month.
Other miscellaneous service fees are as performed:
• Aggregate Claim Filing, a charge of $1,100.00 will be made.
• Subrogation Services are charged at 10% of recovery, up to a maximum fee of
$2,000.00 per case.
• Transplant Coordination charges amount to a flat fee of $849.00.
• Negotiation Services for out -of- network claims are charged at 23% of negotiated
savings per case.
• In -House Case Management services are $85.00 per hour.
• Preparation for Outside Audits, including file retrieval, computer supports,
interview time, etc., is charged to the Plan at $900.00 per audit or $150.00 per
hour.
•
•
CERTIFICATION
I, Gary W. Smith, the duly appointed and acting City Clerk of the City of
Baytown, Harris County, Texas, do hereby certify and attest that as part of my duties, I
do supervise and act as lawful custodian of the records of the City of Baytown; that the
attached document is a true and correct copy of Ordinance No. 9427.
ORDINANCE NO. 9427
AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF BAYTOWN,
TEXAS, AUTHORIZING A RENEWAL OF THE AGREEENT WITH
CHOICENET/INTERCARE HEALTH PLANS, INC., AS A THIRD PARTY
ADMINISTRATOR FOR THE ADMINISTRATION OF MEDICAL AND
DENTAL CLAIMS AND FOR NETWORK SERVICES ON BEHALF OF
THE CITY OF BAYTOWN; AUTHORIZING PAYMENT OF TWO
HUNDRED TWENTY-THREE THOUSAND TWO HUNDRED TWELVE
AND NO/100 DOLLARS ($223,212.00); AND PROVIDING FOR THE
EFFECTIVE DATE THEREOF.
Adopted by the City Council at its meeting held on September 26, 2002.
WITNESS MY HAND AND SEAL of the City on September 30, 2002.
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_�: .u> • Gary . SrIith, City Clerk
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