Missouri City Council on Monday, Oct. 6, 2025, voted unanimously to authorize the city manager to negotiate and execute contracts with selected carriers for employee medical, dental, vision, life insurance and long-term disability benefits in amounts not to exceed the city’s approved budget allocations.

The action followed a presentation from Shauna Shepherd, the city’s director of human resources, and Julian Fontana, a consultant with HUB International, who reviewed responses to a request for proposals and recommended awarding combined medical and dental coverage to Cigna because its bundled proposal produced the largest projected savings for the city.

The recommendation matters because the city sought to align benefit providers with strategic and financial goals while maintaining service quality and managing premium exposure. Fontana said three carriers submitted competitive medical proposals — Cigna, Blue Cross Blue Shield and UnitedHealthcare — and that Cigna’s combined medical-and-dental package offered the greatest net savings for the city. “Cigna offered credits of $385,000,” Fontana said during the presentation.

Details from the RFP and staff recommendation
- Proposals shown to the council put UnitedHealthcare’s proposed annual medical premium at about $8,290,000, Blue Cross Blue Shield at about $6,960,000 and Cigna at about $6,560,000. Fontana said the RFP also solicited implementation, wellness and technology credits; Cigna offered approximately $385,000 in credits and Blue Cross Blue Shield offered about $85,000 in credits.
- For dental, the current UnitedHealthcare dual-option (HMO and PPO) premium was shown at roughly $226,000 annually; proposals included Delta Dental ($201,000), Cigna ($203,000) and Blue Cross (reported as matching current premiums). For vision, the city’s current annual cost was shown around $49,000; Vision Service Plan (VSP) and Blue Cross proposals were roughly $51,000–$53,000, and VSP offered a frame benefit allowing replacement annually rather than every two years plus a small credit allowance.
- Life and long-term disability benefits are currently provided through OAKS (using Securian for life and Madison National for long-term disability). OAKS proposed reduced costs and a three-year rate guarantee; staff recommended renewing with OAKS for those coverages.

Rate guarantees, future exposure and employee impacts
Fontana said the recommended Cigna offer includes a minimum two-year rate guarantee for medical, with a maximum possible medical increase of up to 15% in year two depending on the city’s claims experience. Vision Services Plan provided a four-year rate guarantee for vision, and OAKS provided a three-year guarantee for life and long-term disability.

To help employees adapt to plan changes, staff proposed increasing the city’s health savings account (HSA) contribution for employees in the high-deductible plan to $1,500 for individual coverage and $2,750 for employee-plus-dependent coverage. Shepherd said the city currently funds about 91% of total medical plan costs on average, which is above the cited public-entity benchmark of about 85%.

Wellness incentives and timeline
Council members asked about wellness incentives and timing. Shepherd and Fontana said the RFP credits and some lower renewal rates are tied to implementing wellness programs and other initiatives. The council was told a wellness-premium differential (a lower premium for employees who complete required wellness activities, such as an annual physical) is planned to take effect in January 2027; employees would need to complete qualifying physicals between January and August 2026 to be eligible. Cigna’s bundled credits include amounts for medical and dental combined, plus smaller allocations for wellness and technology to support the city’s planned benefits administration system.

Questions from council and public
Council members pressed staff on customer service, provider networks, large-case management and coverage for services such as autism therapies. Fontana said Cigna’s provider network in the Houston metro area is broad and includes major local hospitals; he also said large-case or complex-case management is typically invoked by diagnosis or once claims reach an identified threshold (he noted $50,000 as a common dollar threshold for outreach).

Several council members asked whether preexisting-condition rules would change if the city switched carriers; Fontana and staff cited the federal Affordable Care Act’s protections and said preexisting conditions are not a barrier for covered employees. Staff also said preventive services — including annual physicals and well-woman exams — are covered at no cost under the recommended plan designs.

Formal action and next steps
Council Member Boney moved to authorize the city manager to negotiate and execute the contracts as recommended; Council Member Emery seconded. The motion carried unanimously. Shepherd said, with council approval, staff will begin employee communications and open-enrollment preparations, including informational sessions and open-enrollment centers for employees.

What remains unclear or for follow-up
Staff projected net savings compared with the current renewal scenario, but Fontana noted the year-two outcome depends on claims experience and program implementation. The presentation included several credit and savings figures; staff will present final contract terms and definitive premium impacts to employees during open enrollment. Shepherd said staff would verify specific coverage details that some public speakers requested, including the extent of autism-related services and whether ABA (applied behavior analysis) and other therapies would be covered, and report back to employees during enrollment outreach.

Council action: motion carried unanimously; mover: Council Member Boney; second: Council Member Emery.