09 - Annual Health Benefit Broker Fees Disclosure
ITEM NO. 09
Costa Mesa Sanitary District
Memorandum
To:
Board of Directors
Via:
Scott Carroll, General Manager
From:
Anna Sanchez, Administrative Service Manager
Date:
February 25, 2014
Subject: Annual Health Benefit Broker Fees and Commission Disclosure
Summary
As required by Section 1367.08 of the California Health and Safe
10604.5 of the California Insurance Code, the Costa Mesa Sanitar
any group health insurance premiums, fees, and commissions paid
providers, and brokers.
Staff Recommendation
Staff recommends the Board receive and file the report for calen
Analysis
Section 1367.08 of the Health and Safety Code
A health care service plan shall annually disclose to the govern
agency that is the subscriber of a group contract, the name and
paid to, any agent, broker, or individual to whom the plan paid
to the public agency's group contract. As part of this disclosur
plan shall include the name, address, and amounts paid to the sp
individuals involved in transactions with the public agency. The
required by this section is in addition to any other compensatio
that exist under law.
Section 10604.5 of the Insurance Code
An insurer shall annually disclose to the governing board of a p
policyholder of a group health insurance policy, the name and ad
paid to, any agent, broker, or individual to whom the insurer pa
lection services.
www.cmsdca.gov
Board of Directors
February 25, 2014
Page 2 of 3
insurance
related to the public agency's group health policy. As part of this disclosure, the
insurer shall include the name, address, and amounts paid to thespecific agents, brokers,
or individuals involved in transactions with the public agency.
disclosure required by this section is in addition to any other
requirements that exist under law.
Summary of Health Benefits
CalPERS administers and negotiates rates and coverage for all Di
Services provided by CalPERS includes: plan design, negotiating
pharmaceutical carriers, developing and printing plan summaries,s,
billing, claims processing, hosting an online database for enrol
participant appeals and grievances, website design and maintenan
workshops/seminars for employers, employees, and retirees.
All non-medical health plans which include dental, vision, life, long-term disability,
voluntary AD&D, and other individual plans such as cancer, and s-term disability are
brokered by SDRMA and Aflac. Services provided by SDRMA and Afl
design options, negotiating rates and benefits with carriers, legal and compliance updates
and advice, open enrollment support, assistance with claims proc
free workshops and seminars to staff.
Although the District obtains non-medical health plans through SDRMA, the disclosure
codes do not apply because the agency only administers the non-medical programs
through the California State Associations of Counties Excess Ins-
EIA Health) and do not contract directly with brokers or insuraners of the Health
Benefit Programs.
Agents/ Brokers of Record
Medical Broker/
Administrator Non-Medical Broker
California Public Employee American Family Life Assurance
Retirement Services (CalPERS) Company of Columbus (Aflac)
400 Q Street P.O. Box 15879
Sacramento, CA 94229 San Diego, CA 92175
Strategic Plan Element & Goal
Not applicable
Board of Directors
February 25, 2014
Page 3 of 3
Legal Review
Not applicable
Environmental Review
Disclosure of commissions and fees paid to brokers of insurance plans is an administrative action
and is exempt from the requirements of the California Environmental Quac
Resources Code Section 21000 et. seq.). Section 15300.4 of CEQA
Financial Review
Plan Broker Total Fees/ Percent of Fees
Year Administrator Coverage Premiums Commissions to Premiums
2013 CalPERS Medical $ 64,070.81 $ 288.14 0.45%
2013 Aflac Non-Medical $ 10,743.72 $ 3,847.58 35.81%
Public Notice Process
Copies of this report are on file and will be included with the
February 25, 2014 Board of Directors regular meeting at District Headquarters and on
Alternative Actions
1. Refer the matter back to staff