4.13 SR 11-15-2021
Request for Action
To Item Number
Mayor and City Council 4.13
Agenda Section Meeting Date Prepared by
Consent November 15, 2021 Lauren Wipper, Human Resources Manager
Item Description Reviewed by
2022 Flexible Benefits Plan Cal Portner, City Administrator
Reviewed by
Action Requested
Approve, by motion, the Joint Powers Agreement to join the Sourcewell Service Cooperative.
Approve, by motion, the Proposed Rates provided by Sourcewell.
Approve, by motion, the 2022 Flexible Benefits Plan design.
Background/Discussion
The Public Employee’s Insurance Program had a 9% premium increase again this year. Our claims experience is
the best we can remember so we decided to test the market. We received bids from BlueCross BlueShield of MN,
Medica, HealthPartners, Minnesota Healthcare Consortium, and Sourcewell Service Cooperative.
In evaluating the bids we considered premium rates, plan design, 2023 rate caps, provider networks, and others.
We are pleased to recommend the Sourcewell bid. Sourcewell contracts with HealthPartners to provide medical
coverage. Before we moved to the Public Employees Insurance Program in 2018, we were with Medica and
offered two different insurance plan designs: a $500 deductible plan and a Health Savings Account (HSA)
compatible High Deductible Health Plan (HDHP). We will be going back to these two plan designs. Staff
estimates an overall decrease in premium of about 1%.
There are no changes to any of the other plans in our Flexible Benefits Plan. In this plan we offer medical, dental,
additional life insurance, long-term and short-term disability, health care savings plans, and health and dependent
care flexible benefits accounts.
The city maintains a cafeteria-style plan with a predetermined contribution for all insurance benefits. The annual
budget is based on the last known enrollment, which is subject to change throughout the year.
The plan is designed to provide a dollar amount to each employee based on the family level of medical coverage
they elect. We take the total budget available and determine the best way to allocate that among enrolled
employees. Because we have a new provider with a new premium rate structure, it provided an opportunity to
redistribute the budgeted city funds. Employees electing the $500 Deductible plan will pay a portion of their
premium. Employees electing a HDHP will have city contribution funds remaining to contribute to their HSA or
to spend on other coverage offered through the plan. As well, employees who contribute to an HSA will have an
additional contribution made to their HSA each month.
The Elk River Vision
A welcoming community with revolutionary and spirited resourcefulness, exceptional
service, and community engagement that encourages and inspires prosperity.
Updated: August 2020
Financial Impact
Funds for the 2022 Flexible Benefits Plan are included in the 2022 preliminary budget.
Mission/Policy/Goal
Meet changing needs
Ethical, efficient, and responsible
Responsible for every dollar – good stewards
Attachments
Joint Powers Agreement
Proposed Rates
2022 Flexible Benefits Plan Renewal Spreadsheet
N:\\Public Bodies\\Agenda Packets\\11-15-2021\\Final\\x4.13 sr 2022 Flex Plan.docx
JOINT POWERS AGREEMENT
FOR GROUP EMPLOYEE BENEFITS AND OTHER FINANCIAL AND RISK MANAGEMENT
SERVICES
(Revision 7.2)
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RECITALS .................................................................................................................................... 3
SECTION 1:PURPOSE, INTENT AND OBJECTIVE ........................................................... 3
1.1 Purpose. ................................................................................................................................ 3
1.2 Compliance with Applicable Laws ...................................................................................... 3
1.3 Prior Agreements. ................................................................................................................ 3
SECTION 2:DEFINITIONS ....................................................................................................... 4
SECTION 3: JOINT POWERS GOVERNING BOARD OF TRUSTEES ............................. 5
3.1 Board Membership............................................................................................................... 5
3.2 Upon Dissolution of the SC. ................................................................................................ 6
SECTION 4: RIGHTS AND RESPONSIBILITIES OF THE TRUSTEES ........................... 6
4.1 Authorized Powers. .............................................................................................................. 6
4.2 Group Employee Benefits. ................................................................................................... 7
4.3 Other Financial and Risk Management Services. ................................................................ 7
4.4 Operating Agreement. .......................................................................................................... 8
4.5 SC Service Fees.. ................................................................................................................. 8
4.6 Service Providers. ................................................................................................................ 8
4.7 Premiums and/or Contract Charges. .................................................................................... 8
4.8 Advisory Committee(s). ....................................................................................................... 8
4.9 Authority of Board of Trustees ............................................................................................ 9
4.10 Liability Limited.. ................................................................................................................ 9
4.11 Withdrawal by Board of Trustees. ....................................................................................... 9
SECTION 5: RIGHTS AND RESPONSIBILITIES OF PARTICIPANT MEMBERS ........ 9
5.1 Enrollment and Renewal. ..................................................................................................... 9
5.2 Participant Members to Furnish Data. ................................................................................. 9
5.3 Remittance of Premiums and Contract Charges. ................................................................. 9
5.4 CBA Employee Benefits. ..................................................................................................... 9
5.5 Participant Member Withdrawal. ....................................................................................... 10
5.6 Effect of Participant Member Withdrawal. ........................................................................ 10
SECTION 6: PROGRAM FUNDS ADMINISTRATION ...................................................... 11
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6.1 Program Funds. .................................................................................................................. 11
6.2 General Rules Regarding Management and Disposition of Program Funds. .................... 11
6.3 Investment of Program Funds. ........................................................................................... 12
6.4 Withdrawal of Participant Member. .................................................................................. 12
6.5 Termination of Pool. ......................................................................................................... 12
6.6 Funding of Risk.................................................................................................................. 13
SECTION 7: LENGTH OF AGREEMENT AND TERMINATION .................................... 13
SECTION 8: LIABILITY OF PARTIES ................................................................................. 13
SECTION 9: AGREEMENT BY PARTICIPATION ............................................................. 13
SIGNATURES..............................................................................Error! Bookmark not defined.
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JOINTPOWERS AGREEMENT
FOR GROUPEMPLOYEEBENEFITSANDOTHERFINANCIALANDRISKMANAGEMENT
SERVICES
effective upon the date
hereofand is between Participant Member________________________ and otherParticipantMembers
asare now or mayhereafterbecome parties to this Agreement, and theNationalJointPowersAlliance
(NJPA)C
RECITALS
Whereas,Minn. Stat. 471.59, Subds. 1 and 10 authorizes twoor more governmental unitsto exercise
jointlyorcooperativelypowers which theypossessincommon, and
Whereas, Minn. Stat. 123A.21, establishes service cooperatives, thepurposeofwhich among other
things,isto assist participatinggovernmentalunits in meeting certain specificneedswhich can most
advantageouslybe met on a regionalbasis, and
Whereas,the Participant Members wish to createajointBoardofTrusteesfor the purpose of exercising
certain powers as set forth in the Agreement, and
NOW THEREFORE, the parties hereto agree asfollows:
SECTION1:
PURPOSE,INTENTANDOBJECTIVE
1.1Purpose. Under theprovisions of Minnesotalaw, governmental units may enterinto contracts
forthe purposes ofprovidingGroup Employee Benefits for their employees and toobtain Other Financial
and Risk ManagementServicesdeemed necessary orbeneficialfor their operation. Under the provisions
ofMinn. Stat. 471.59, two ormore governmental units(including, but notlimitedto, school districts,
counties, towns, other governmentalagencies and servicecooperatives)mayagreeto exercise jointlyor
cooperativelypowerswhich they possess in common. The purpose ofthis Agreement is to authorize the
JointPowersBoardofTrusteestoexercisethecommon powers oftheparticipating governmental unitsin
connection with certain matters pertaining to the administration and fundingofGroup Employee Benefits
and the provision ofOtherFinancialand Risk ManagementServices,allasdescribed herein.Itis not the
purpose of this Agreement to transfer tothe Board ofTrusteesthe authority toexecutecontracts on behalf
ofParticipantMembersunless explicitly statedin this Agreement, or toin any mannerbecome involved
in any collective bargaining process.The Board of Trustees will have authority toexecute contracts on
behalfof the Board of Trusteesandthe Risk Management Pool.
1.2Compliancewith Applicable Laws.cable
statutoryrequirementpertainingto requests forproposals for group insurance,self-insurance, COBRA
and its Minnesotaextensions, service cooperatives, and all otherapplicable federal andstatestatutes.
1.3Prior Agreements. Any priorRiskManagementPoolJointPowers Agreements are hereby
superseded and terminated effective as of the datehereof and shall be without further force or effect.
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SECTION 2:
DEFINITIONS
2.1 Advisory Committee(s) means committees appointed by the Board of Trustees in accordance
with Section 4.8 of this Agreement which are representative of the Participants as deemed appropriate by
the Board of Trustees for this purpose or recommending policies, procedures and actions to the Board of
Trustees.
2.2 Agreement means this Joint Powers Agreement as the same may be amended from time to time.
This document, and all other documents in the same form executed (or deemed executed as provided in
Section 9 of the Agreement ) by SC and other Participant Members, all as amended from time to time,
shall together constitute a single Agreement.
2.3 Joint Powers Board means the Risk Management Pool Board of Trustees (hereinafter referred to
authorized to exercise certain powers of the Participant Members, as permitted in Minn.
Stat. 471.59, Subd. 2 and as set forth in this agreement.
2.4 CBA means collective bargaining agreement.
2.5 CBA Employee Benefits means employee welfare and retirement benefits made available by the
Trustees from time to time for adoption by a Participant pursuant to the terms of a CBA, and may include,
but shall not be limited to health benefits coverage, wellness and employee assistance programs, life
insurance, disability income protection, dental insurance, flexible spending programs, retirement
programs and long term care insurance. In no event shall any Discretionary Employee Benefits be
considered CBA Employee Benefits unless and until they become part of a collective bargaining
agreement between a union and a Participant.
2.6 Discretionary Employee Benefits means employee welfare and retirement benefits made
available by the Trustees from time to time for adoption by a Participant, exclusive of any CBA
Employee Benefits, and may include, but shall not be limited to health benefits coverage, wellness and
employee assistance programs, life insurance, disability income protection, dental insurance, flexible
spending programs, retirement programs and long term care insurance. Discretionary Employee Benefits
may be terminated or reduced by the Trustees at any time. In the event any Discretionary Employee
Benefit is terminated by the Trustees but continued by one or more Participants, the provision of such
Discretionary Employee Benefit shall become the sole responsibility of such Participants.
2.7 Group Contract shall mean an agreement for the rendering of services by and between a
Participant and a Provider of such services. In connection with the self-insurance of employee health
-
insurance.
2.8 Group Employee Benefits shall mean CBA Employee Benefits and Discretionary Employee
Benefits.
2.9 Other Financial and Risk Management Services may include, but shall not be limited to,
technical advice regarding borrowing programs, contracted legal services, property/casualty safety group
protection, personal property and casualty protection, student accident, coverage and other services as
made available by Group Contract for Participants from time to time by the Trustees.
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2.10 Operating Agreement means an agreement by and between the Trustees and a Provider which
establishes terms for the benefits, administration or funding of Group Employee Benefits or Other
Financial and Risk Management Services.
2.11 Participant Member means any governmental unit as defined in Minn. Stat. 471.59 which is
accepted for participation in this Agreement by the Trustees, certifies that its employee benefit plans
Agreement (or is deemed to have so agreed as provided in Section 9 or this Agreement). It does not refer
to individual employees obtaining insurance or other benefit coverage pursuant to a plan offered by a
Participant Member which is funded or administered in whole or in part pursuant to this Agreement.
2.12 Risk Management Pool means the collective group of Participants in a given program of Group
Employee Benefits or Other Financial and Risk Management Services, as the context shall require.
Absent an agreement expressly to the contrary a separate Pool shall exist for each such program and a
separate Group Contract shall exist between the Provider and each Participant for the rendering of
services or benefits for which such Pool is formed.
2.13 Program Funds means any monies, reserves, excesses, or other amounts, whether acquired
through contributions, payments, discounts, dividends, refunds, credits, reserves, savings, interest or
otherwise, that are held and administered in accordance with Section 6 of this Agreement.
2.14 Provider means the person, insurance carrier, third party administrator, or other entity which is
selected by the Trustees, in its discretion, to provide Participants with Group Employee Benefits or Other
Financial and Risk Management Services or, as in the case of self-insured health benefits, to provide
administrative or other services in connection with such Benefits or Services.
2.15 SC means the National Joint Powers Alliance, a governmental agency and public corporation,
whose existence is authorized by Minn. Stat. 123A.21.
SECTION 3:
JOINT POWERS GOVERNING BOARD OF TRUSTEES
3.1 Board Membership. The Risk Management Pool is governed by a Joint Powers Board of
Trustees, consisting of members of the SC Board of Directors, K-12 school representatives,
cities/counties/other governmental agencies (CCOGA) representatives, and school labor or CCOGA labor
representatives. The initial Board of Trustees will be appointed as follows: seven (7) representatives will
be appointed by the SC to include three (3) Trustees representing the SC Board of Directors and four (4)
Trustees representing Participant Members. Thereafter, the Board of Trustees, as outlined in the By-
Laws, will be composed of three (3) representatives appointed by the SC and the remaining
representatives appointed by the current Advisory Committee. After the initial Board of Trustees, the
Board of Trustee members will serve four (4) year terms. The initial Board of Trustees will serve a
staggered term as follows:
i. A Labor Representative will be appointed by the Advisory Committee to serve an initial
term that will expire December 31, 2017.
ii. rustees will expire December
31, 2015. That Board Member will be replaced by an appointee of the Advisory
Committee.
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iii.
December 31, 2016. One of those will be replaced by an appointee of the Advisory
Committee and one will be replaced by an appointee of the NJPA Board.
iv.
December 31, 2017. That Board Member will be replaced by an appointee of the NJPA
Board.
v.
expire on December 31, 2018. One of those will be replaced by an appointee of the
Advisory Committee and one will be replaced by an appointee of the NJPA Board.
3.2 Upon Dissolution of the SC. In the event that the SC is dissolved, the Board of Trustees shall
continue to exist and its members shall be elected or appointed solely from the governing bodies of the
Participant Members to this Agreement in a manner consistent with the provisions of the Joint Powers
Act, Minn. Stat. 471.59, Subd. 2. Any administrative services provided by the SC prior to its dissolution
shall be provided thereafter as determined by the SC Board of Directors in its discretion.
SECTION 4:
RIGHTS AND RESPONSIBILITIES OF THE TRUSTEES
4.1 Authorized Powers. The Trustees will exercise all lawful powers and duties necessary and
incidental to the implementation of the purposes set forth herein, including, but not limited to, the
adoption of by-laws to govern the functioning of the Board of Trustees, provided that no by-law or action
of the Trustees will be contrary to the terms of this Agreement or statute. Pursuant to Minn. Stat. 471.59,
Subd. 2, in addition to any other powers specifically delegated to the Trustees by this Agreement, the
Trustees are hereby authorized to:
i. adopt by-laws to guide the processes of the Trustees sufficient to support the day-to-day
operations of the Risk Management Pool;
ii. approve the annual budget;
iii. contract with other parties for the provision of programs, services, expertise or as
otherwise necessary for the effective operation of the Board of Trustees and the Risk
Management Pool.
iv. establish, procure and administer Group Employee Benefits and Other Financial and Risk
Management Services;
v. define and clarify requests for proposals, rights and responsibilities, length of contract,
premium or contribution rates and other costs, termination guidelines, the relative
liability of the parties, and the method(s) by which parties to this Agreement shall
exercise their common powers;
vi. receive, collect, hold, invest, expand, disburse, and account for Program Funds in
connection with the exercise of its powers under this Agreement; and
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vii. except as restricted below, delegate to officers or committees any powers or duties which
may be performed by the Trustees subject to such limitations as set forth in the action
delegating such power or duty. The Trustees will not delegate the following duties:
a. amendments to the Agreement;
b. addition of Participant Members;
c. adoption of By-laws;
d. approval of annual budget;
e. approval of annual financial statements;
f. retention or engagement of financial auditors and legal counsel, except on a
temporary or emergency basis.
4.2 Group Employee Benefits.
i. CBA Employee Benefits. The Trustees may from time to time make employee welfare
and retirement benefits available for adoption by Participant Members pursuant to a
CBA. The Trustees may arrange alternative financing arrangements respecting such
benefits, and may administer or arrange for the administration of such benefits. Any
employee or collective bargaining representative notification of alternative financing
arrangements shall be the responsibility of the Participant Member. The Group Contact
for the provision of such benefits shall be between the Participant Member and the
Provider Pursuant to Minn. Stat. 471.59, Subd. 5, the Trustees have no authority nor
authorization to change a policy or benefit respecting a Participant Member
Employee Benefits in a manner that would reduce the aggregate value of such benefits.
ii. Discretionary Employee Benefits. The Trustees may from time to time make available
for adoption by Participants Discretionary Employee Benefits. The Trustees may arrange
alternative financing arrangements respecting such benefits, and may administer or
arrange for the administration of such benefits. The Group Contact for the provision of
such benefits shall be between the Participant Member and the Provider.
Notwithstanding that a Group Contract for Discretionary Employee Benefits be between
a Participant Member and a Provider, the Trustees, upon reasonable notice to Participant
Members, may prospectively amend, reduce or terminate any such Discretionary
Employee Benefits in its sole and absolute discretion.
iii. Reserves. The Trustees shall from time to time determine the minimum amount of funds
needed for purposes of risk management and rate stabilization. Any such funds shall be
held and used in accordance with, and subject to the limitations set forth in, Section 6.
iv. Self-Insurance of Health Benefits. In accordance with Minn. Stat. 471.617, Group
Employee Benefits that are employee health benefits may be self-insured. A self-
insurance Pool made available by the Trustees shall be a pool established and operated by
the Trustees, or by the Trustees and one or more other joint powers governing boards
governed by Minn. Stat. 471.59 or service cooperatives by Minn. Stat. 123A.21.
4.3 Other Financial and Risk Management Services. The Trustees may make available Other
Financial and Risk Management Services for electing Participant Members and may administer, or
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arrange for the administration of such services. The Trustees will determine the most cost-effective and
appropriate manner in which to deliver Other Financial and Risk Management Services and the service
fees and other costs pertaining to the same.
4.4 Operating Agreement. The Trustees, alone or in collaboration with other governmental units,
whether acting alone or jointly, including other service cooperatives, may negotiate Operating
Agreements for the benefit of the SC and each of the Participant Members with respect to any Group
Employee Benefit or Other Financial and Risk Management Service. Such Operating Agreements may
establish, among other things:
i. the terms and conditions for any program,
ii. premium or contribution rates and other costs,
iii. funding arrangements,
iv. administrative arrangements, including the extent to which the SC shall provide
administrative services,
v. the applicable responsibilities of the Trustees, and
vi. the amount of service fees payable to the SC.
4.5 SC Service Fees. The SC may be paid a service fee in consideration for services rendered
pursuant to this Agreement and any Operating Agreements. The amount and source of such service fee
shall be established from time to time by the SC and agreed to by the Trustees.
4.6 Service Providers.
i. Selection. The Participant Members hereby delegate to the Trustees the right to select
the Providers for Group Employee Benefits and Other Financial and Risk Management
Services on behalf of the Participant Members.
ii. Governmental Unit Bidding and Contract Laws. As applicable, the Trustees shall
comply with all state and federal laws relating to requests for proposals, review of
proposals, length of Group Contract rules, and other laws and regulations relating to
contracting for Group Employee Benefits and Other Financial and Risk Management
Services.
iii. Service Provider Rate Increases. The Trustees will annually review renewal
information as presented by Providers, make recommendations and determine if requests
for proposals are necessary. Rate renewals for group insurance will be determined on the
basis of the aggregate change of premiums.
4.7 Premiums and/or Contract Charges. To the extent not established by the applicable Operating
Agreement or in any other manner prescribed by this Agreement, premium and/or contract charges shall
be determined by the Trustees in its discretion; provided, however, that in accordance with Section 6.5, no
retroactive assessment may be made without the consent of the affected Participant Members.
4.8 Advisory Committee(s). The Trustees may, but is not required to, appoint one or more advisory
committees. The purpose of any such committee may include, without limitation, the receipt and
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processing of information relating to group employee benefits, and the future direction of such benefits as
well as other programs and services. The Trustees shall consider, but is not required to adopt, advisory
committee recommendations and proposals. Labor representation, when appropriate, on any advisory
committee formed by the Trustees shall be, in so far as is reasonably possible, representative of the
bargaining representatives of individuals covered in the relevant Pool. Notwithstanding anything to the
contrary in this Section 4.8, the Trustees shall create a labor-management committee to advise it on
certain matters as required by law.
4.9 Authority of Board of Trustees. The Trustees, with due consideration given to
recommendations submitted by any advisory committee which may be established, shall, unless otherwise
expressly agreed, retain final authority in all matters relative to this Agreement and to the Group
Employee Benefits and Other Financial and Risk Management Services subject to this Agreement,
provided, however, that nothing in this Agreement shall permit the Trustees to enter into a Group
Contract on behalf of a Participant Member, and that, subject to any applicable notice rules, nothing in
this Agreement shall prevent a Participant Member from withdrawing from this Agreement, any Group
Employee Benefit, or any Other Financial and Risk Management Service.
4.10 Liability Limited. The Trustees, its authorized representatives, employees and designees shall
have no duty or liability to any of the Participant Members or Providers with respect to the fees,
premiums and/or contract charges, offers, acceptances or binders of coverage, cancellation notices, or
other matters relating to a Participant Membersponsibility of the
Participant Member. The Trustees, its authorized representatives, employees and designees, and each
Participant Member shall have no duty or liability due to negligence of other Participant Members and
Providers. When it is not exercising the joint powers authorized by this Agreement (and therefore not
acting as the Trustees), the Trustees shall have no duty or obligation whatsoever to act for the benefit of
Participant Members (as Participant Members).
4.11 Withdrawal by Board of Trustees. The undertakings for the provision of Group Employee
Benefits in this Agreement may be terminated by the Trustees or the SC (as applicable) at any time.
SECTION 5:
RIGHTS AND RESPONSIBILITIES OF PARTICIPANT MEMBERS
5.1 Enrollment and Renewal. Participant Members may elect whether to participate in any Group
Employee Benefit and any Other Financial and Risk Management Service made available by the Trustees.
If a Participant Member elects to participate in a Group Employee Benefit or Other Financial or Risk
Management Service, the Participant Member must execute any applicable Group Contract, Group
Contract Amendment, enrollment and renewal documents directly with the Provider.
5.2 Participant Members to Furnish Data. Each Participant Member agrees to furnish all
reasonably necessary employee data directly to the SC or its designee.
5.3 Remittance of Premiums and Contract Charges. The Participant Member shall remit
premiums and/or contract charges in the time and manner as from time to time determined by the
Trustees.
5.4 CBA Employee Benefits. Each Participant Member that participates in CBA Employee Benefits
shall be solely responsible for the collective bargaining of such benefits, and for providing any notices
regarding CBA Employee Benefits, including, without limitation, the obligation to notify certain
representatives regarding the adoption of a self-insured health benefit plan set forth in Minn. Stat.
471.617, Subd. 4.
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5.5 Participant Member Withdrawal.
i. Voluntary Withdrawal. At any time during a year, (but at least (5) months
prior to renewal), a Participant Member may terminate its participation in this Agreement
or in a Pool upon one hundred fifty- three (153) days written notice to the Trustees and
to all Providers of programs in which it participates.
a. In non-leap years, written notice would be due August 1 for groups renewing on
January1 and February 1 for groups renewing on July 1.
b. Voluntary withdrawal within (5) months of renewal may result in a financial
penalty including, but not limited, to the amount billed to NJPA for
administrative services, beyond the termination date and charged by the
appropriate provider.
ii. Withdrawal Relating to Participant Member Rate Solicitation. Participant Members
are allowed to solicit bids and other information from competing sources of health
coverage at any time other than within five months prior to the end of the contract period
if so permitted by the relevant laws, rules and regulations. Risk Management Pool
members are allowed, to the extent permitted by law, to solicit bids and indicate their
intent to withdraw at least one hundred and fifty three (153) days prior to the next
renewal date.
a. In non-leap years, written notice would be due August 1 for groups renewing on
January1 and February 1 for groups renewing on July 1.
iii. Withdrawal Relating to Dual Offering. If a Participant Member offers Group
Employee Benefits through an additional or different plan which, in the discretion of the
Trustees, are considered to be substantially similar to those provided by a Pool in which
the Participant Member participates, then the Trustees retains the right to deem that such
Participant Member has withdrawn from the pool.
iv. Withdrawal at Annual Renewal. If a material change in any term or condition of a
Group Employee Benefit or Other Financial or Risk Management Service in which a
Participant Member participates is proposed to commence as of the Participant Member
annual renewal date, the Participant Member may withdraw from the applicable Pool as
of the renewal date, provided the Participant Member gives advance written notice of its
intent to withdraw promptly (within 30 days) after receiving notice of the material
change, even if such notice is given less than 120 days in advance of the renewal date.
v. Applicable Laws. Participant Members are responsible for adhering to all applicable
laws, rules and regulations, including those relating to bid frequency and timing, when
initiating a voluntary withdrawal.
5.6 Effect of Participant Member Withdrawal. Upon a Participant Member
deemed withdrawal from this Agreement or from a Pool, the following rules shall apply:
i. Withdrawal from this Agreement. Upon its withdrawal from this Agreement, a
Participant Member shall be deemed to have withdrawn from all Pools maintained under
this Agreement in which the Participant Member is participating at the time of such
withdrawal. If a Participant Member no longer participates in any Pool, the Participant
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Member shall be deemed to have withdrawn from this Agreement, as well as from the
applicable Pool(s).
ii. Withdrawal from a Pool. Withdrawal by a Participant Member from any Pool shall not
affect the Participant Member
iii. Program Funds. No Program Funds or any other amounts that may, in any way, be
attributable to a Participant Member
Participant Member in the event such Participant Member
iv. Future Participation Limited. If a Participant Member withdraws or is deemed by the
Trustees to have withdrawn from a Pool, such Participant Memberation in such
Pool shall be prohibited for a period of twelve (12) months from the date of such
withdrawal or deemed withdrawal. If a Participant Member withdraws or is deemed by
the Trustees to have withdrawn from this Agreement, such Participant Members
participation in this Agreement (and any Pool offered hereunder) shall be prohibited for a
period of twelve (12) months from the date of such withdrawal or deemed withdrawal.
SECTION 6:
PROGRAM FUNDS ADMINISTRATION
6.1 Program Funds. It is understood and agreed that, in connection with the Group Employee
Benefits and Other Financial and Risk Management Services made available pursuant to this Agreement,
the Trustees may acquire Program Funds. The Trustees may, in its discretion, establish and maintain
separate accounts for specified portions of the Program Funds, and may designate specific purposes, such
as the payment and financing of Group Employee Benefits or the stabilization of the cost of such benefits,
for which the amounts credited to such accounts shall be used, but it shall not be required to do so.
6.2 General Rules Regarding Management and Disposition of Program Funds. Program Funds
shall be used solely for the purposes of providing Group Employee Benefits and Other Financial and Risk
Management Services, providing related services, defraying the reasonable expenses of administering
such benefits and services, and, if the Trustees determine that such use would either directly or indirectly
benefit Participant Members (e.g., by spreading risk, achieving economies of scale, generating revenues
or enhancing the ability to negotiate with Providers as a result of the visibility,
presence in the marketplace or enhanced expertise), establishing, providing and administering similar
benefits and services offered by the joint action of other governmental units. Program Funds shall not
inure to the benefit of the Trustees; this prohibition shall not, however, prohibit the payment of service
fees to an SC as provided below. Subject to the foregoing, the Trustees, in its sole discretion, shall
determine the management and disposition of the Program Funds. The Trustees may consider Advisory
Committee recommendations regarding the use of Program Funds before any determinations are made.
Funds may only be used for the purposes of managing and maintaining the pool. Acceptable uses
include, but are not limited to, the following:
i. to negotiate the purchase of, administer, provide and maintain (either directly or through
the purchase of insurance, or both) Group Employee Benefits (including, but not limited
to programs related to the purpose for which the Fund was created, such as, for example,
in the case of a Health Pool, an Employee Assistance Program (EAP) and Wellness
Program) and Other Financial and Risk Management Services;
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ii. to pay or provide for the payment of reasonable and necessary expenses of administering
Group Employee Benefits and Other Financial and Risk Management Services including,
without limitation, all expenses which may be incurred in connection with the
establishment and administration of Pools, the employment of administrative, legal,
accounting, other expert and clerical assistance, the leasing of such premises and the
purchase of lease materials, supplies, equipment, and liability and property insurance;
iii. to establish and accumulate funds deemed adequate by the Trustees to carry out the
purpose of the Pools, for example, for purposes of rate stability and risk reserve;
iv. to pay any federal, state or local income, employment, death or other tax which may be
properly imposed on or levied against Group Employee Benefit, Other Financial and Risk
Management Service, a Pool, or on benefits paid therefrom;
v. to pay for any bond and to pay the premiums on any insurance purchased by a Pool,
intended to pay directly or indirectly the benefits established with respect to a Pool; and
vi. to pay the SC any service fee payable to it pursuant to, or authorized pursuant to, this
Agreement.
6.3 Investment of Program Funds. Program Funds shall be held and invested in a manner that is
consistent with any applicable legal requirements regarding the holding and investment of funds by the
Participant Members who are governmental units within the meaning of Minn. Stat. 471.59.
6.4 Withdrawal of Participant Member. In the event of the withdrawal of a Participant Member
prior to the termination of this Agreement or of a Pool, Program Funds attributable to contributions of
such Participant Member shall not be returned to such Participant Member.
6.5 Termination of Pool. In the event of termination of a Pool, any portion of the Program Funds
that has been designated for use solely in connection with the terminating Pool, and any other portion
allocated to the terminating Pool by the Trustees in its sole discretion, shall be distributed to the Pool
Participant Members in a manner to be determined by the Trustees, which may include the following:
i. payment of benefits to or on behalf of enrolled employees with respect to claims
arising prior to such termination;
ii. provision of similar benefits for such employees;
iii. payment of reasonable and necessary expenses incurred in such termination.
iv. payment of taxes; and
v. cash payments to Participant Members according to a formula established by the
Trustees and adopted in the by-laws.
Upon such termination, the Trustees shall continue to serve for such period of time and to the extent
necessary to carry out the directions of the preceding sentence. The Participant Members who receive
such distributions shall be solely responsible for determining whether, and to what extent, any amounts
they receive will be distributed to individuals who were covered by benefit programs provided by the
terminating Pool.
12
Rev. 7/2015
6.6Funding of Risk.Premiums may be adjusted, but no retroactive assessment shall be made
without consent and agreement by the affected Participant Members. Subject to their obligation to
provide accurate information regarding the individuals who will receive benefits from a Pool, no
Participant Member or its employees shall bear any financial risk other than the agreed upon premium.
SECTION 7:
LENGTH OF AGREEMENT AND TERMINATION
Pursuant to Minn. Stat. 471.59, Subd. 4, but subject to the provisions herein relating to Participant
Member withdrawal, this Agreement shall be ongoing.
SECTION 8:
LIABILITY OF PARTIES
Any Participant Member to this Agreement holds the Trustees and its employees and its designees, and
the SC and its Board, employees and designees, harmless from any and all causes of action arising at law
or in equity unless such action shall arise from its or their gross negligence and is permitted, after
application of all doctrines and statutes respecting immunity, by applicable law. The parties agree to
waive any rights to litigation from any dispute arising out of this Agreement unless such action is the
result of intentional wrongdoing. All benefits hereunder are the sole responsibility of the Provider (s) and
the Participant Members, and shall not be the responsibility of the Trustees or the SC.
SECTION 9:
AGREEMENT BY PARTICIPATION
Any governmental unit which participates in any of the Group Employee Benefits or Other Financial and
Risk Management Services and remits premium and/or contract charges in accordance with this
Agreement, shall be deemed to have approved this Agreement and, in the case of an eligible
governmental unit, to have executed this Agreement by its duly authorized officers, and shall be bound by
the terms and conditions of this Agreement to the same extent as if such formal approval had been
obtained and such execution had occurred.
Pursuant to all applicable state and federal laws, this Agreement has been approved by the governing
boards of the parties and is signed by the duly authorized officers of the parties.
PARTICIPANT MEMBER SERVICE COOPERATIVE
________________________________________ National Joint Powers Alliance ____________
Name of Organization Name of Organization
________________________________________ _______________________________________
Authorized signature Authorized Signature
________________________________________ _______________________________________
Name/Title Name/Title
________________________________ ________________________________
Date Date
13
Rev. 7/2015
sourcewellmn.gov/health
CompanyName:CityofElkRiver
EffectiveDate:1/1/2022
RenewalDate:1/1/2023RateCap:12%
ProposedRates
Pleasereviewadditionaldetailsaboutourjointselfinsuredpool'sratesonthefollowingpage.
ActuarialEmployeeTotalBilled
Plan#PlanName/DescriptionNetworkValue(AV)Count(Est)TierRate
8500802000CopayRxOpenAccess87.59Single$591.74
8500802000CopayRxOpenAccess87.53EE+Sp$1,291.76
8500802000CopayRxOpenAccess87.52EE+Ch$1,281.88
8500802000CopayRxOpenAccess87.52Family$1,870.11
3SmartPlan3:28001002800PrevRxOpenAccess80.50Single$512.62
3SmartPlan3:28001002800PrevRxOpenAccess80.50EE+Sp$1,121.65
3SmartPlan3:28001002800PrevRxOpenAccess80.50EE+Ch$1,113.23
3SmartPlan3:28001002800PrevRxOpenAccess80.50Family$1,614.73
3BSmartPlan3:28001002800PrevRxAchieve80.50Single$485.17
3BSmartPlan3:28001002800PrevRxAchieve80.50EE+Sp$1,062.64
3BSmartPlan3:28001002800PrevRxAchieve80.50EE+Ch$1,054.72
3BSmartPlan3:28001002800PrevRxAchieve80.50Family$1,526.14
Authorization:
Onbehalfofthisgroup,IapproveSourcewelltobillusingthehealthrateslistedaboveandupdatedenrollmentsforthetimeperiodbetweenthe
effectiveandrenewaldateslistedabove.
Signature:
Date:
Name:
Title:
ImportantRateSheetDetails
FixedCosts
Thesearecomponentsofyourgroup'sTotalBilledRate,disclosedforthepurposeoftransparentreportingandaccounting.Alladditionalcomponentsofyourrates
areestimatedbypoolmanagement,andincludeexpectedclaimsandqualityimprovementprogramcosts.Thevarianceinactualvsexpectedclaimsimpactspool
reserves,andisariskmanagedforthebenefitofallpoolmembers,asdescribedintheJointPowersAgreementandreviewedindetailduringeachAnnualMeeting
ofpoolmembers.
SpecificStopAggregateHPAdminBrokerServices
LossPremiumStopLossFeesFeeTotalFixedCosts
$36.70$1.41$13.99$18.04$70.14
Single
Family$96.48$3.78$34.74$18.04$153.04
StopLossInsurance
Theseprovisionsareinplacetoprotectthepool'sabilitytoprovidemembergroupsriskfreepremiumequivalentsasatotalbilledrate.
*12/18(claimsincurred1/1/2022through12/31/22andpaidthrough6/30/2023)
*$250,000SpecificDeductibleperMember,UnlimitedLifetimeMaximum
*AggregateAttachmentPoint110%ofExpectedClaims
HealthPartnersAdministration
ThirdPartyAdministrativeServices,ProviderNetwork,PharmacyBenefitManagement,Case&DiseaseManagement,EmployeeAssistanceProgram,andStopLoss
InsuranceservicesprovidedtothepoolbyHealthPartnersAdministrators,Inc.
BrokerServices
Sourcewelldoesnotprovidecertainservicesthatareprovidedbybrokers,agents,andbenefitsconsultants,asdetailedonour"BrokerAcknowledgement"form.
Anyservicesprovidedbyabrokertothegrouparetobenegotiatedbythegroupandthebroker,thetermsforwhicharenotmaintainedbySourcewell,withthe
exceptionofanyamountofcommissionrequestedbyyourgroup,whichwe'velistedinthefixedcostsummary,aspartoftheTotalBilledRates,andwilladminister
onyourbehalf.
ActuarialValue
Actuarialvalues(AV's)approximatethepercentageofclaimsthatareexpectedtobepaidbytheplanforagivenpopulation,basedonapplyingthescheduled
benefitsagainsttheclaimsexperienceofalargenationalpopulation.AV'sarecalculatedusingthemostrecentlyavailableACAAVcalculatorfromtheCentersfor
MedicareandMedicaidServices(CMS).ActuarialvaluewillincreasesignificantlywithevenmodestamountsofemployercontributionstoHSAs,HRAs,orVEBAs,and
thusareveryhelpfulforgroupsreviewingwaystoimpactplandesignwithoutsacrificingplanvalue.
Wellness
Populationhealthmanagementandwellnessprogramshavebeenputinplacebythepoolforthebenefitofpoolgroupmembers,tohelpimprovehealthplan
qualityandpositivelyimpactlongtermhealthoutcomes.Detailsoftheseprograms,thevendorsinvolved,andthevalueoftheseprogramsareexplainedonour
"UnderstandingtheValue"disclosure,whichwasdeliveredtoyoualongwiththisratesheet.
Contingencies
QuoteiscontingentuponreviewandapprovaloftheUnderwritingRequirementsandProvisionsandSourcewellBoardApproval.
AnyrenewalrateincreasecapsinthisproposalarenullandvoidifyourgroupdecidestoconducttheirownRFPprocessratherthanbenefitfromourpool's"Better
Together"renewalprocess.
RatesassumecompliancewithallSourcewellProvisions(seeenclosed).Forexample,cashinlieuofwaiverscannotexceed50%ofthelowestcostƦƌğƓƭsingle
premium.
Single +Spouse +Child(ren)Family
City Contribution 575.00 1,202.00 1,193.00 1,656.00
HealthPartners through Sourcewell
$500 Deductible 591.74 1,291.76 1,281.88 1,870.11
Monthly Employee Cost 16.74 89.76 88.88 214.11
Annual Employee Cost 200.88 1,077.12 1,066.56 2,569.32
HSA Open Access 512.62 1,121.65 1,113.23 1,614.73
Monthly Employee Cost -62.38 -80.35 -79.77 -41.27
Annual Employee Cost -748.56 -964.20 -957.24 -495.24
HSA Achieve 485.17 1,062.64 1,054.72 1,526.14
Monthly Employee Cost -89.83 -139.36 -138.28 -129.86
Annual Employee Cost -1,077.96 -1,672.32 -1,659.36 -1,558.32
Opt-Out of Medical 300.00
DeltaDental 40.80 107.98
Add'l Monthly HSA Contribution 130.00 130.00 130.00 130.00
2022 Flexible Benefits Plan Renewal Rates