|In 2014, CMS began offering Medicare Advantage plans with prescription drug coverage to annuitants and survivors in the State Employees Group Insurance Program, the Teachers Retirement Insurance program, and the College Insurance Program. In FY 2013, CMS awarded four contracts: one to Aetna, two to Humana (Humana Benefit Plan and Humana Benefit Plan formerly known as Humana Health Plan), and one to UnitedHealthcare. These contracts were awarded as result of an RFP issued under IPB# 22030665. Aetna and Humana offer HMO plans. UnitedHealthcare offers a PPO plan. CMS is seeking to renew these contracts for CY2018 to reflect the annual negotiated per member rates. CMS is satisfied with the services provided by these vendors. |
The contracts provide for annual adjustment to the per member per month premium rates based upon verified demographics, other documented actuarial factors and projected health care cost trends. The contracts allow for rate negotiations annually under the initial term and for each renewal term.
The vendors of these plans receive revenue from the federal government in order to operate the plan. In order to maximize federal revenue, the State offers these plans on a calendar year basis to retirees. The estimated value of all four contracts for CY2018 is approximately $390,186,009.