Label
Medical Third-Party Administrator-Anthem
Human Resources
Michael Niedzielski (x2182)
Revised
Title
Authorizing the Mayor to enter into an Agreement for third party administrator (TPA) services for the City’s self-funded medical insurance plan, to include providing claims administration, compliance, member support, reporting, and other related services for covered employees and their dependents, for a term of three (3) years with two (2), one (1) year optional renewals; authorizing the expenditure of funds from the Healthcare Internal Service Fund; and declaring an emergency.
Body
SUMMARY & BACKGROUND:
The Department of Human Resources sought competitive proposals for medical TPA services from October 3, 2025 through November 18, 2025. Three (3) proposals were received: Anthem, Medical Mutual of Ohio, and United Healthcare. Hylant, the City’s benefit consultant, reviewed and analyzed the proposals and presented these results to the Healthcare Cost Containment Committee (HCCC) and the administration. In addition, all three (3) vendors presented their proposals to the HCCC. Based on this thorough process, we recommend Anthem as the City’s TPA for medical services. Anthem is the City’s current medical TPA, with the current contract term ending June 1, 2026. It is estimated that the administrative cost associated with this new agreement will be approximately $950,000 per year.
Summary
NOW THEREFORE Be it ordained by the Council of the City of Toledo:
SECTION 1. That the Mayor is authorized to enter into a three (3) year agreement with two (2), one (1) year optional renewals for third party administrator (TPA) services for the City’s self-funded medical insurance plan, to include providing claims administration, compliance, member support, reporting, and other related services. Such Agreement shall contain terms and conditions deemed proper and requisite according to the Director of Law and Director of Human Resources.
SECTION 2. That expenditures for healthcare related third party medical TPA services are authorized from the Healthcare Internal Service Fund Account Code 7083-17100-1156001STDSTD. That said costs shall then be allocated to Account Code 517400 within the various City organization units.
SECTION 3. That the Director of Finance is authorized to draw warrant or warrants against the Account Code in Section 2 in payment of the authorized obligations upon presentation of proper voucher or vouchers.
SECTION 4. That this Ordinance is declared to be an emergency measure and shall be in force and effect from and after its passage. The reason for the emergency lies in the fact that same is necessary for the immediate preservation of the public peace, health, safety and property, and for the further reason that the ordinance must be immediately effective in order to maintain quality healthcare coverages for the City of Toledo’s employees and their dependents.
Vote on emergency clause: yeas 10 nays 0.
Passed: March 3, 2026, as an emergency measure: yeas 10, nays 0.
Attest:
Julie A. Gibbons Vanice S. Williams
Clerk of Council President of Council
Approved: March 4, 2026
Wade Kapszukiewicz
Mayor