Next Friday the largest employer south of San Antonio will be conducting a public interview of 14 vendors who responded to their Request For Proposals for administration of their self-funded health plan. This poses an excellent opportunity to ask questions, an opportunity not to be wasted.
The Brownsville Independent School District annual budget is over $500,000,000. Health insurance costs represent a large and growing budget expense. Consistent year after year plan deficits continue to erode remaining funds resulting in less monies allocated for other expenses including salaries.
Blue Cross is the current plan administrator nearing the end of their five year contract with the district. Under their management health care costs have continued to escalate despite significant increases in plan contributions. The district contributes over $7,200 per participating employee per year and nothing for those who don’t.
Of the 14 vendors who submitted proposals, Aetna, Blue Cross and United Healthcare are the only three who made the initial cut according to their insurance consultant during an insurance committee presentation last week. It is our understanding, and is common knowledge within the community, United Healthcare has been ranked #1 although we don’t know why.
These three finalists, along with the other 11 RFP respondents, will be given the opportunity to present to a group of more than 50 insurance committee members. Each will have 10 minutes to present followed by 5 minutes of questioning.
We expect each of the top three to tout (1) Name recognition, (2) Broadest network of doctors and hospitals, (3) Best discounts, (4) Better plan oversight and management, (5) Cost sharing on pharmacy commissions (rebates), (6) Premium vacation for the first 3 months, (7) Local representation with full time rep. devoted to BISD, (8) Multi-year administration rate guarantee fees, (9) Performance guarantees, (10) Real time state-of-the-art claim reporting, (11) Other school districts references.
As the Brownsville Independent School District journeys into the Age of Aquarius here are a few questions to be asked. Since time is short, the answers must be in a “YES” or “NO” format allowing for no filibustering. There are no right or wrong answers:
- Will you provide a copy of your hospital contract with Valley Baptist and Rio Grande Regional hospital? (New Federal Transparency Rules)
- Does your company participate in shared PPO discount savings with medical providers, particularly hospitals? (Re: Weslaco ISD vs Aetna), Oakland County vs Blue Cross, Anheiser Busch vs Cigna, etc)
- Do you share revenue with a PBM aggregator?
- Are commissions, direct or indirect, included in fees to be charged to the district?
- Will you allow BISD to contract directly with area medical providers and will you administer those contracts?
- Would your company be a fiduciary to our plan?
- Will you allow full and unfettered claim audit rights to the district without limitation?
- Is the Moon round? (This is not a trick question)
- Will your current contract with Valley Baptist and Rio Grande Regional expire sometime during our first contract year should we go with you?
- Are all PPO physicians paid the same?
- Are all PPO hospitals paid the same?
- Do you agree all paid and pending claim data belongs to the Brownsville Independent School District?
- Does Blue Cross have the best PPO discounts in the universe?
- Will your claim data reports show billed charges?
- Do you understand that under the Texas Constitution political subdivisions like the Brownsville Independent School District cannot enter into a contract that commits current fiscal year funds beyond the fiscal year in which a contract is let?
- Does Aetna have the best PPO discounts on the planet?
- Have you reviewed our claim experience and is it your expectation our claim costs will reduce under your management?
- Have you had any discussion or agreement with our consultant regarding renumeration of any kind to be paid to him, directly or indirectly, should your company be awarded our business?
- Have you or any of your representatives had any contact with members of the Board of Trustees during this Request for Proposal process?
- Is our insurance consultant under any kind of contract with your company at this time?
- Have you assigned an Agent of Record for our account?
- Can we assign our own Agent of Record?
- Are we required to have an Agent of Record?
- Does United Healthcare have the best PPO discounts bar none?
- Can you bind and commit on behalf of your company?
- Have you ever lied in your life (White Lies included)?
- Are you happy to be here?
Selling a +$50,000,000 contract in under 15 minutes can be challenging. Is there a secret ingredient to success? Is it content? Is it appearance? Is it proper alignment of the stars and the Moon? Is it luck? Is it politics? Or is it best in class salesmanship?
FROM THE DESK OF MOLLY MULEBRIAR
The BISD is conducting a public meeting this week to interview all 14 vendors who responded to their RFP for group medical insurance on Friday, September 1? That’s insane. How can BISD board members along with more than 50 employees comprising the Employee Benefits Committee make a prudent business decision on a $50 million spend when none have any background in health care delivery or finance?
Each vendor is required to distribute a complete copy of their proposal to all the attendees. Are committee members graduates of Evelyn Wood Speed Reading course? Paul Bunyan and his crew are working overtime to supply enough pulp product for the event. “Can’t see the trees for the forest” has earned a new meaning in deep South Texas.
Each vendor will be gifted 10 minutes to present, followed by a 5 minute question and answer session. By the time of the 14th presentation, it is rumored medics will be standing by ready and anxious to administer aid to those suffering from fading visceral functions. Nursing students from South Texas ISD wishing to earn additional class credits are urged to attend.
We understand the BISD consultant has narrowed down the health plan administrator finalists to Aetna, Blue Cross and United Healthcare. It is further our understanding all three proposals were represented by the incumbent insurance agent.
The Brownsville rumor mill says United HealthCare will win the business as their proposal was ranked #1 by the BISD consultant. We do not know the status of any of the other respondents, nor do we know what they proposed.
In view of the catastrophic presentation by the BISD consultant last week anything can happen now. He has lost all credibility with the board of trustees. Hence, the board has taken full control of the process meaning all bets are off. Well laid plans have failed to materialize. Vendors are scrambling.
“This is better than watching As The World Turns”