Discussion and possible action on any and all matters regarding the approval of Run-Out Claims Process by 90 Degrees. (Susan Posada, Broker and Consultant)
 

Due to the Third-Party Administrator change, a Run-Out Claims Process is required. The run-out period refers to the period of time, immediately following termination, during which time all claims incurred prior to the termination date are being paid. Timely claims submission, determination of medical necessity, clarification of issues, and claims processing all contribute to the run-out period. 90 Degree Benefits offers 12 months of run-out claims processing for an amount equivalent to six months of current administration fees.  It is recommended to have 90 Degrees to process the run-out claims since they have the accumulation of deductibles and out-of-pocket maximums.

The administrative fees for processing 12 months of run-out claims are as follows:

• $43,299.00 for medical claims.
• $5,058.00 for dental claims.
• $300 for HIPAA Certificates for City Employees.
• $2,500 run-out claims reports which includes census, deductible, and out-of-pocket reports, and benefit maximum report.

I MOVE TO APPROVE RUN-OUT CLAIMS PROCESS BY 90 DEGREE BENEFITS, ALONG WITH ASSOCIATED FEES AS PRESENTED, AND DIRECT THE EXECUTIVE ADVISORS TO TAKE ALL STEPS TO FURTHER SUCH PROCESSING.