Res No 183-13-14001RESOLUTION NO.: 183-13-14001
A Resolution approving the selection of Blue Cross and Blue Shield to provide group health
insurance and UHC to provide dental and vision coverage for the City of South Miami full time
employees to be charged to departmental account numbers respectively.
WHEREAS, the Benefits Consultant, Sapoznik Health & Wellness secured more than three
competitive quotes for the City's Group Health, Dental and Vision Insurance and recommended Blue
Cross and Blue Shield and UHC as the selected providers; and
WHEREAS, the City Commission compared the insurance rates, benefit plan design, provider
network as well as the City's previous claims experience /ratio; and
WHEREAS, the City Commission wishes approve with the selection of Blue Cross and Blue
Shield for the provision of Group Health and UHC for the provisions of Dental and Vision Insurance
Benefits for all full time employees and participating retirees.
WHEREAS, the premium charges shall be charged to departmental line items in account numbers
6101110 - 5132310, 6101110 - 5212310, 6101110 - 5212310, 6101110 - 5542310, 6101110 - 5692310,
6101110- 5742310, 0011200 - 5122310, 0011310 - 5132310, 0011320 - 5132310, 0011330 - 5132310,
0011410- 5132310, 0011610 - 5242310, 0011620 - 5242310, 0011640 - 5242310, 0011710 - 5192310,
0011720 - 5342310, 0011730- 5412310, 1111730- 5412310, 0011750 - 5192310, 0011760 - 5192310,
0011770 - 5192310, 0011790 - 5192310, 0011910 - 521.2310, 0012000 - 5722310, 0012020 - 5192310.
NOW THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION
OF THE CITY OF SOUTH MIAMI, FLORIDA, THAT:
Section l: The City Commission hereby approves and selects Blue Cross and Blue Shield to
provide of Group Health and UHC to provide Dental and Vision Insurance for the City of South Miami
full time employees for the 2014 fiscal year.
Section 2: This resolution shall take effect immediately upon adoption.
PASSED AND ADOPTED this 3rd day of Sept. , 2013.
ATTEST:
ITVCLIERIC-
READ AND APPROVED AS TO FORM
Approved:
v.
COMMISSION VOTE:
5 -0
Mayor Stoddard:
Yea
Vice Mayor Liebman:
Yea
Commissioner Newman:
Yea
Commissioner Harris:
Yea
Commissioner Welsh:
Yea
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South Miami
All•AmerleaCdy
INCORPORATED
CITY OF SOUTH MIAMI 1111if
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OFFICE OF THE CITY MANAGER
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INTER- OFFICE MEMORANDUM
To: The Honorable Mayor, Vice Mayor and Members of the City Commission
Via: Steven Alexander, City Manager
From: LaTasha Nickle, Human Resources Director
Date: August 26, 2013 Agenda Item No.:
Subject: Health Insurance Resolution ��
Request: A Resolution approving the selection of -Blue Cross and Blue Shield to provide
group health insurance and UHC to provide dental and vision coverage for the City
of South Miami full time employees to be charged to departmental account numbers
respectively; providing for an effective date.
Reason/Need: The City's Benefits Consultant, Sapoznik Health & Wellness solicited quotes from all
carriers in the market. The companies responded as follows:
Aetna Submitted proposal
AvMed Submitted proposal
Blue Cross Blue Shield Submitted proposal
Cigna Healthcare Declined to quote
Coventry Submitted proposal
Humana Submitted proposal
Neighborhood Health Partnership Submitted proposal
Staff recommends that the City Commission select Blue Cross and Blue Shield as health and UHC as
dental and vision insurance providers for the 2013 -2014 benefit plan year. Blue Cross Blue and Shield
and UHC have proposed the following monthly premium rates for the upcoming plan year. This year,
the health insurance industry rates increased by an average of 12.1 %. The proposal recommended by
staff is significantly lower than the industry average.
LOW HMO
HIGH HMO
POS
(BCBS Bluecare 60)
(BCBS Bluecare 56)
(Blue Option 03768 LG)
Employee
$ 493.76 (6.02% increase)
$ 526.95
$ 547.28
Employee/ Children
$ 908.52
$ 969.59
$1,006.99
Employee/ Spouse
$1,175.15
$1,254.15
$1,302.52
Employee/ Family
$1,540.52
$1,644.10
$1,707.50
UIIC
Dental Rates:
DMO
PPO
Employee
$10.98
$34.76
Employee/ Children
$22.07
$78.12
Employee/ Spouse
$22.84
$70.10
Employee/ Family
$36.19
$125.21
UHC
Vision Rates:
Employee
$6.66
Employee/ Children
$12.66
Employee/ Spouse
$13.32
Employee/ Family
$26.21
The FY 2014 health plan rates represent an increase of 6.02% above the current FY 2013 rates. The City
currently contributes $474.39 per covered employee per month toward health coverage which will
increase to $493.76. In order to keep costs increases at a minimum while still obtaining a good plan we
proposed several changes to the current plan design. Most significantly, the current plan includes a
deductible of $1,500 individual /$3,000 family which will reduce to $500 /individual and $1,000 /family.
The comparable plan from our current provider, NHP was proposed at an increase of 11.6% above the
current year premium. The proposed change to Blue Cross provides a better plan at significant savings
over the renewal rate.
Premium charges for the health, dental and vision benefits shall be charged to the following budget line
items as proposed in the Fiscal Year 2014 Budget.
DEPARTMENT
ACCT #
CRA- ADMINISTRATIVE
6101110- 5132310
CRA- PROTECTIVE SERVICES
6101110 - 5212310
CRA- ECONOMIC DEVELOPMENT EMPLOYMENT
6101110- 5212310
CRA- PROPERTY MANAGEMENT
6101110- 5542310
C'R A- PUBLIC ASSISTANT SERVICES
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ti7 -V 'I I I A
V1Ud1- lU- ✓V/L✓_1V
CRA- SPECIAL EVENTS
6101110- 5742310
CITY CLERK
0011200-5122310
CITY MANAGER
0011310- 5132310
CENTRAL SERVICES
0011320 - 5132310
HUMAN RESOURCES
0011330- 5132310
FINANCE
001 14 10- 5 13231 0
BUILDING DEPT
0011610- 5242310
PLANNING
0011620- 5242310
CODE ENFORCEMENT
0011640- 5242310
PW -BLDG MAINT
0011710- 5192310
PW -SOLID WASTE
0011720-5342310
PW- STREETS
0011730- 5412310
STORM WATER
1111730-5412310
PW- LANDSCAPE
0011750- 5192310
PW -EQUIP MAINT
0011760- 5192310
PW- OFFICE OF DIR
0011770-5192310
PW- ENGINEERING
0011790- 5192310
POLICE
0011910- 5212310
PARKS & REC
0012000 - 5722310
COMMUNITY CENTER
0012020 - 5192310
Backup Documentation:
❑ Proposed resolution.
❑ Sapoznik Health & Wellness Summary Report
Group Name: City of South Miami
Effective Date: October 1, 2013
BCBS
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Physician
$25 CO -PAY
$25 CO -PAY
$25 CO-PAY
$15 CO-PAY
$25 CO -PAY
DED & 80%
$20 CO -PAY
DED & 50%
Specialist
$45 CO -PAY
$45 CO-PAY
$45 CO-PAY
$35 CO-PAY
$45 CO -PAY
DED & 80%
$45 CO -PAY
DED & 50
Adult & Child Wellness
Adult Wellness Max
COVERED 100%
(NO MAX)
COVERED 100%
(NO MAX)
COVERED 100%
(NO MAX)
COVERED 100%
(NO MAX)
COVERED 100%
(NO MAX)
DED & 80%
(NO MAX)
COVERED 100%
(NO MAX)
50%
(NO MAX
Mammograms
COVERED 100%
COVERED 1000%
COVERED 100%
COVERED 100%
COVERED 100%
DED & 80%
COVERED 100%
DED & 50%
Emergency Room - Waived if
Admitted
$200 CO -PAY
$100 CC-PAY
DED THEN 100%
$10D CO-PAY
$200 CO-PAY
$200 CO -PAY
Urgent Care
$50 CO -PAY
$45 CO-PAY
$50 CO-PAY
$35 CO-PAY
$50 CO-PAY
DED & 80%
$50 CO -PAY
DED & 50%
Independent Clinical Lab
COVERED 100 %
COVERED 100%
COVERED 100%
COVERED 100%
COVERED 100%
DED & 80%
COVERED 100%
DED & 50
Diagnostic Testing / MRI,
CAT Scans
$200 CO -PAY
$80 CO -PAY
DED & $100 CO -PAY
$80 CO -PAY
$200 CO-PAY
DED & 80%
$200 CO-PAY
DED & 50
Outpatient Surgery -
Ambulatory Surgical Center
DED & $250 CO-PAY
$200 CO -PAY
DED THEN 100%
$100 CO -PAY
DED & $250 CO-
PAY
DED, $250 CO-
PAY & 80%
$200 CO-PAY
DED & 50
Provider Services Ambulatory
Surgery Center(ASC)
DED THEN 100%
COVERED 100%
COVERED 100%
$35 CO -PAY
DED THEN 100%
DED & 80%
$45 CO -PAY
DED & 50%
Outpatient Surgery - Hospital
DED & $250 CO -PAY
$275 CO -PAY
DED THEN 100%
$150 CO -PAY
DED & $250 CO-
PAY
DED, $250 CO-
PAY & 80%
$300 / $600 Co-
PAY
DED & 50
Inpatient Hospital
DED & $250 CO -PAY
$325 CO -PAY PER DAY, 5 DAY MAX
DED THEN 100%
$200 00-PAY PER DAY, 5 DAY MAX
DED & $250 CO-
PAY
DED, $2S0 CO-
PAY & 80%
$700 / $1000 CO-
PAY
DED & 50%
Provider Services Hospital
DED THEN 100%
COVERED 100%
COVERED 100%
COVERED 100%
DED THEN 100%
DED & 80%
$50 CO-PAY
Home Health
DED THEN 100%
60 VISITS
COVERED 100%
60 VISITS
COVERED 1D0%
60 VISITS
COVERED 1001/6
60 VISITS
DED THEN 100%
60 VISITS
DED & 80%
60 VISITS
DED THEN 1001%
20 VISITS
DED & 50%
20 VISITS
Outpatient Therapy
$50 CO -PAY
20 VISITS
$6S CO -PAY
30 VISITS
$50 CO-PAY
20 VISITS
$55 CO-PAY
30 VISITS
$50 CO-PAY
20 VISITS
DED & 80%
20 VISITS
$45 / $60 CO-PAY
35 VISITS
DED & 50%
35 VISITS
Deductible
$1500/$3000
$500 /$1000
$1000/$2000
NONE
$1000/$2000
$2000/$4000
$250/$750
$1000/$3000
Deductible Included in Out of
Pocket Max
NO
YES
NO
N/A
NO
YES
Co- Insurance
100%
90%
100%
90%
100%
80%
100%
SO%
Maximum Out of Pocket
$3000 PER MEMBER
$3500/$7000
$3000 PER MEMBER
$25001$7500
$3000 PER MEMBER
$5000 /$0000
$3000/$6000
1 $60001$12000
Out of Pocket Includes
CO -PAYS, CO -INS & RX CO-PAY
DED, CO-PAY & CO -INS
CO -PAYS, COINS & RX CO -PAY
CO -PAY & CO -INS
CO-PAYS, COINS & RX CO-PAY
DED, CO -PAY & CO-INS
Prescription
$20/$40/$60/20%
$101$30/$50
$20/$401$6D/20%
$10/$30/$50
$20/$40/$60/20%
NOT COVERED
$101$30/$50
50%
Lifetime Maximum
UNLIMITED
UNLIMITED
UNLIMITED
UNLIMITED
UNLIMITED
UNLIMITED
Premium Breakdown
Current
Re
Negotiated
Package #3
Negotiated
Current
Re-
Negotiated
Package #3
Negotiated
Current
Re- Negotiated
Package #3
Negotiated
Employee
77
$47439
$488.63
$514.33
$493.76
15
$542.60
$558.89
$548.91
$526.95
3
$694.97
$715.83
$570.08
$547.28
Employee/Spouse
2
$934.35
$962.40
$1,224,11
$1,175.15
2
$1,068.70
$1,100.78
$1,306.41
$1,254.15
0
$1,368.80
$1,409.89
$1,356.79
$1,302.52
Employee/Chikl(ren)
12
$839.50
$864.70
$946.37
$908.52
2
$960.21
$989.04
$1,009.99
$969.59
0
$1,229.84
$1,266.75
$1,048.95
$1,006.99
Employee/Family
2
$1,399.13
$1,441.13
$1,604.71
$1,540.52
0
$1,600.31
$1,648.35
$1,712.60
$1,644.10
0
$2,049.71
$2,111.23
$1,778.65
$1,707.50
Comments
93
Current
Increase 3%
Increase 10.43%
Increase 6.02%
19
Current
Increase 3%
Increase 5.49%
Increase 1.27 %
3
Current
Increase 3%
Decrease 17.97%
Decrease 21.25%
Monthly Total
$51,268.99
$52,807.97
$56,617.49
$54,353.10
$12,196.82
$12,562.99
$12,866.45
$12,351.73
$2,084.91
$2,147.49
$1,710.24
$1,641.84
* *This data is provided for information purposes only. It is not intended to represent a binding obligation. The governing document for this purpose would be the COC issued by the carrier **
10:19 AM Information provided by Sapoznik Insurance is proprietary. It may not be copied, emulated or distributed without express permission. 8/14/2013