To: BOARD OF SUPERVISORS
From: Executive Office
Meeting Date: October 21, 2025
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Department Contact: |
Cherie Johnson |
Phone: |
707-234-6600 |
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Item Type: Consent Agenda |
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Time Allocated for Item: N/A |
Agenda Title:
title
Approval of Agreement (Third Amendment to Agreement No. EO-23-14) with Self Insured Service Company, Dba Benefit Coordinators Corporation, in the Amount of $125,000, to Continue Providing Administrative Services for the Employee Health Benefits Plan and Add the Family Advantage Health Plan Effective January 1, 2026, through December 31, 2026, Automatically Renewing Annually Thereafter, Extending the Termination Date from December 31, 2025, Until the Calendar Year in which a Rate Increase is Presented to the County
End
Recommended Action/Motion:
recommendation
Approve Agreement (third amendment to Agreement No. EO-23-14) with Self Insured Service Company, dba Benefit Coordinators Corporation, in the amount of $125,000, to continue providing administrative services for the Employee Health Benefits Plan and add the Family Advantage Health Plan effective January 1, 2026, through December 31, 2026, automatically renewing annually thereafter, extending the termination date from December 31, 2025, until the calendar year in which a rate increase is presented to the County; authorize the Chief Executive Officer or Designee to approve future amendments that modify administrative fees in an amount equal to or less than 5% annually; and authorize Chair to sign same.
End
Previous Board/Board Committee Actions:
On October 4, 2022, the Board approved Agreement No. 22-249. On September 12, 2023, the Board
approved Agreement No. 22-249-A1.
Summary of Request:
Members of the PRISMHealth (PRISM) program contract with a PRISM approved Third Party Administrator (TPA) to perform high level administrative services that are not typically performed by County staff. Benefit Coordinators Corporation (BCC) is the contracted TPA. BCC has been satisfactorily performing administrative services for the Employee Health Benefits Plan since January 1, 2023.
Through its relationship with BCC, the County may add the Family Advantage Health Plan (FAHP) as an additional service administered by BCC. The FAHP is a type of medical expense reimbursement program for employees with access to an alternate employer sponsored medical plan, such as a spousal plan. The alternate plan must provide medical and prescription drug coverage but cannot be Medicare, MediCal, TriCare, an Individual Policy, a Limited Benefit Health Plan, and cannot include active contributions to a health savings account (HSA). The employee must waive the County plan as a new hire, through a qualifying life event or during the annual open enrollment period to be eligible to enroll in the FAHP. The health plan budget will reimburse eligible deductibles, co-pays and co-insurance costs incurred on the spousal plan, providing up to 100% benefit coverage for eligible expenses. A specific bank account will be designated for this purpose only. Participants will be issued a debit card to use at the point of service, but manual claims can also be submitted. BCC will adjudicate all claims to confirm they are eligible expenses. Participants can use BCC’s SmartCare app to manage their reimbursement requests. The FAHP does not reimburse medical plan premiums.
The cost to administer the FAHP is 10% of the savings that are realized as a direct result of the FAHP. The savings are calculated by determining the difference between the amount the County would have contributed towards the member’s premium, minus the member reimbursements.
The FAHP will replace CompleteCare, a similar reimbursement plan that is in place today and is terminating December 31, 2025. The FAHP will create greater savings for the health plan due to significantly lower administrative costs. 90% of estimated fees will be invoiced monthly and a “square up” will be performed after the benefit year is completed, to determine if additional monies are due to the administrator or if a credit is due back to the County.
Ongoing annual costs of the Agreement will depend on the type of services that are provided, enrollment and utilization of the FAHP.
Alternative Action/Motion:
Do not approve and provide direction to staff
Strategic Plan Priority Designation: A Safe and Healthy County
Supervisorial District: All
Vote Requirement: Majority
Supplemental Information Available Online At: N/A
Fiscal Details:
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source of funding: HI 0715 |
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current f/y cost: $125,000 (est.) |
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budget clarification: N/A |
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annual recurring cost: $125,000 (est.) |
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budgeted in current f/y (if no, please describe): Yes |
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revenue agreement: No |
AGREEMENT/RESOLUTION/ORDINANCE APPROVED BY COUNTY COUNSEL: Yes
CEO Liaison: Darcie Antle, CEO
CEO Review: Yes
CEO Comments:
FOR COB USE ONLY
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Executed By: Deputy Clerk |
Final Status: Item Status |
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Date: Date Executed |
Executed Item Type: item |
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Number: |
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