SUBJECT:
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Approval of a resolution authorizing the President & CEO, or her designee, to finalize and execute a contract with Voya Employee Benefits for medical stop loss insurance for claims above $225,000, with a base term of one year, in a total amount not to exceed $988,378.
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FISCAL IMPACT:
Funding for this action is available in the FY2026 Operating Budget.
STRATEGIC PLAN:
Strategic Goal Alignment:
? 1. Customer ? 2. Community
? 3. Workforce ? 4. Organizational Effectiveness
EXPLANATION OF STRATEGIC ALIGNMENT: Purchase of stop loss insurance for high-cost health claims supports fiscal responsibility by mitigating CapMetro's risk if employees or family members covered by CapMetro's self-insured health care plan experience annual claim costs exceeding $225,000 annually per claim.
BUSINESS CASE: Each year CapMetro works with Gallagher Benefits Services to assess the level of stop loss insurance recommended based on our large claims history. Gallagher then works with the insurance market to obtain quotes for the recommended stop-loss insurance. For Calendar Year 2026, CapMetro recommends maintaining the stop loss limit of $225,000, based on the analysis of large claims history compared to the cost of stop loss insurance.
COMMITTEE RECOMMENDATION: The item was presented and recommended for approval by the Finance, Audit and Administration Committee on December 10, 2025.
EXECUTIVE SUMMARY: Gallagher Benefits Services has obtained quotes for stop loss insurance from Voya Employee Benefits, Sun Life, WellPoint, Symetra, and BCS Financial. The price quote from Voya for $225,000 individual stop loss insurance is the lowest of the quotes received from bidders at the $225,000 individual stop loss level. The Stop Loss coverage provided by Voya Employee Benefits is underwritten by ReliaStar Life Insurance Company, a member of the Voya family of companies. ReliaStar Life Insurance Company has an...
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