Sweetwater approves UnitedHealthcare after staff say it cuts planned premium spike for city employees

The City Commission of the City of Sweetwater on Aug. 25 voted to select UnitedHealthcare as the city—s employee medical insurer, a move staff and the city—s broker said would reduce the projected premium increase for the coming year.

City finance staff told commissioners that the incumbent carrier—s renewal would have raised medical costs by 26.5, or about $778,000; the UnitedHealthcare quote presented to the commission was an 8.969 percent increase, equal to roughly $263,000, a city finance official said. Scott Mendelsberg, with the City of Sweetwater finance department, summarized the fiscal comparison at the meeting.

Yoli, a city staff member who led the procurement presentation, said brokers had gone to market and that UnitedHealthcare returned an "apples-to-apples" benefit design that matched copays and specialist fees currently in place. "So if there's a co pay of $10, it's a co pay of $10," Yoli said when introducing the broker.

Evelyn Alvarez, executive vice president and employee benefits practice leader for Brown & Brown in Miami-Dade, told the commission her firm solicited carriers and that UnitedHealthcare offered the most competitive combination of price and network access. "When we look at apples to apples from a network perspective, it was definitely UnitedHealthcare from a price standpoint," Alvarez said, noting Cigna's offer relied on a narrower network that would not include some local hospitals.

Brian Garrison, vice president of sales and account management for UnitedHealthcare—s South Florida office, acknowledged prior problems raised by commissioners and said his team would work ‘‘very closely with you and your HR team and your members.'" He described a high approval rate for claims and prior authorizations when carriers and client HR teams collaborate, and repeated a commitment to address individual claims or prior-authorization issues as they arise.

Commissioners voiced reservations based on past experience with UnitedHealthcare but emphasized the need to control costs. Several commissioners said they would expect close, proactive account management and an early look at future renewals. The mayor and other commissioners asked that UnitedHealthcare and Brown & Brown coordinate directly with city HR to resolve any network or continuity-of-care questions prior to plan implementation.

The commission took a formal motion to approve UnitedHealthcare as the city—s medical carrier. The motion was made by Commissioner Saldea and seconded by Commissioner Reynaldo Rey; the body voted in favor and the motion passed.

Staff and the broker also said the city would realize additional premium relief by bundling dental and vision, and that UnitedHealthcare would match $10,000 in wellness funding provided by the prior carrier and add an incentive program that allows employees to earn up to $1,000 in gift cards for completing wellness activities.

Clarifying details discussed at the meeting: • Finance projected AvMed renewal: 26.5% medical increase, $778,000 in additional cost (per Scott Mendelsberg). • UnitedHealthcare quote: 8.969% medical increase, $263,000 projected additional cost (per Scott Mendelsberg). • Estimated gross savings compared with the AvMed renewal: approximately $515,000 for the medical line (finance figures provided at the meeting). • Small prescription-tier changes were noted (an $85 tier dropping to $70 in specific prescriptions), and co-pay tiers were represented as matching current 10/20/65 structure aside from limited prescription adjustments (Evelyn Alvarez). • Wellness incentives: UnitedHealthcare proposed a points-based program that allows members to earn up to $1,000 in gift cards for meeting stated wellness activities (Yoli; UnitedHealthcare).

Speakers (selected): Evelyn Alvarez, executive vice president, Employee Benefits Practice Leader, Brown & Brown (business); Brian Garrison, vice president of sales and account management, UnitedHealthcare (business); Scott Mendelsberg, Finance Department, City of Sweetwater (government); Yoli (city staff); Mayor Diaz (government); Commissioner Saldea (government); Commissioner Reynaldo Rey (government).

The approval authorizes staff to finalize contracts with UnitedHealthcare and to proceed with the transition steps identified by HR and the broker. The commission did not record a roll-call vote listing individual yes/no tallies in the public record during the motion; the mayor called for ayes and the motion carried.