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� The Honorable Paul Osborne <br /> ' City of Decatur <br /> August 30, 2006 <br /> Page 5 <br /> (options elected, coverage tier, etc.); possibly compensation, as it is relevant to benefits options; <br /> and historical enrollment summaries by option and coverage tier(if available). <br /> � Cost data, including, at a minimum, triangulated incurred/paid claim histories for self-funded <br /> medical and prescription benefits; administration fees and budget or "equivalent" premium rates <br /> for self-funded plans; information about stop-loss insurance provisions, premium rates, and <br /> claims; and descriptions of any internal accounting policies, if applicable. <br /> AREAS TO CONSIDER AND EVALUATE <br /> I. Funding Analysis <br /> � The financial risk issues involved, alternatives for addressing that risk and the financial <br /> implications for the City; <br /> ❑ Cash flow and liability projections, including claim run-in and run-out, policy and annual <br /> costs; <br /> � An analysis of the administrative costs needed to operate the self-funded plan and the <br /> potential changes that may occur with a fully-insured structure; <br /> J The functional obligations the City assumes under the current self-insured structure, <br /> including: <br /> Health Plan Governance requirements; <br /> » Establishment of contribution rates; <br /> >- Legal, auditing and reporting requirements; <br /> >> HIPAA considerations; <br /> � Treatment of retiree health obligations; <br /> Maintenance of plan documents and SPDs; <br /> �- Involvement in claims and appeals processes; <br /> � Contracting for plan administration; and <br /> � Entry and termination of participating employers. <br /> � Potential employee attitudes and bargaining implications. <br /> I I. Evaluation of Current Vendors <br /> � An analysis of PPO savings net of fees; and <br />