Res No 167-14-14261RESOLUTION NO.167-14-14261
A Resolution authorizing the City Manager to purchase group health
insurance benefits from Blue Cross Blue Shield and dental and vision
insurance benefits from MetLife for the City of South Miami full time
employees and participating retirees.
WHEREAS,the Benefits Consultant,SapoznikHealth&Wellness secured more than three
competitive quotes for the City's Group Health,DentalandVisionInsuranceand recommended Blue
Cross andBlueShieldandMetLifeas the selected providers;and
WHEREAS,the City's Benefits Consultant compared the insurance rates,benefit plan
design,provider network aswellas the City's previous claims experience/ratio;and
WHEREAS,the City Commission wishes to approve the selection ofBlue Cross Blue
Shield for the provision of group health insurance benefitsandMetLife for the provision of
dental andvision group benefits for all full time employees and participating retirees.
WHEREAS,the City Commission further wishes to continue to provide life insurance
andlong term disability insurance to full time employees through LincolnFinancial Group under
the existing rate guaranteed policy;and
WHEREAS,the premiumchargesshallbecharged to departmental lineitemsin account
numbers :
6I01110-5132310,6I01110-5212310,6I01110-5542310,6I01110-5692310,0011200-5122310,
00II3I0-5I323I0,0011320-5132310,0011330-5132310,0011410-5132310,0011610-5242310,
0011620-5242310,0011640-5242310,0011710-5192310,0011720-5342310,0011730-5412310,
IIII730-54I23I0,0011750-5192310,0011760-5192310,0011770-5192310,0011790-5192310,
0011910-5212310,0012000-5722310,0012020-5192310.
NOW THEREFORE BE IT RESOLVED BY THE MAYOR AND CITY
COMMISSION OF THE CITY OF SOUTH MIAMI,FLORIDA THAT,
Section I.TheCity Manager ishereby authorized topurchasegrouphealth insurance benefits from
Blue Cross Blue Shield anddentaland vision insurance benefits from MetLife fortheCityofSouth Miami
full time employees and participating retireesforthe 2015 fiscal yearin conformity withthequotes
obtained and to be charged to the accounts listedin the recitals to this resolution.
Pg.2 of Res.No.167-14-14261
Section 2.This resolution shall take effect immediately upon adoption.
PASSED ANDADOPTEDthis j_9_dayof August ,2014.
ATTEST:APPROVED:
CITY CLERK
READ AND APPROVED AS TOJORM,
LANGUAGE^G^LITY AN{
EXECUflSWOBEftEOF:,
COMMISSION VOTE:5-0
MayorStoddard:Yea
Vice MayorHarris:Yea
Commissioner Welsh:Yea
Commissioner Liebman:Yea
Commissioner Edmond Yea
South'Miami
THE CITY OF PLEASANT LIVING
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER-OFFICE MEMORANDUM
To:
From:
Date:
Subject:
Background:
The Honorable Mayor &Members of the City Commission
Steven Alexander,City Manager
August 11,2014 Agenda ItemNo.
Employee Benefits
The City's benefits consultant,Sapoznik Health &Wellness,
solicited quotes for the employee group insurance coverage for
South Miami full time employees for the 2014-2015 benefit year.
Florida Blue,the City's health insurance carrier's,first proposed
renewal rate represented a 15.68%increase.Despite the City's
high medical loss ratioof125%for the current benefit year,after
negotiations,the final renewal increase is 10.32%.This is in-line
with this year's industry standard increase of 10%.
The City currently contributes $493.76 per eligible employee per
month toward health insurance coverage.This amount will
increase to $543.98 under the proposed renewal.The increase is
appropriately funded in the proposed Budget for Fiscal Year 2014-
2015.
The UHC DentalA/ision proposed renewal rates were not
competitive with comparable plans this year witha proposed
renewal increase of 22%.Staff recommends the selection of
MetLife as the provider forits dental and vision plans for the 2014-
2015 benefit year.In addition to the lower rate,MetLife offers
comparable or increased benefits with asignificantlylargerplan
network.
Based upontheproposalsreceived,staff recommends the City
renew the current health insurance plans withBlue Cross Blue
Shield.Stafffurther recommends a change in carriers to MetLife
for the dentalandvision coverage.The proposed rates are based
on the current number of enrollees and as follows:
South'Miami
THECITYOF PLEASANT LIVING
Amount:
Account:
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER-OFFICE MEMORANDUM
Low HMO High HMO POS
Employee $543.98 580.80 628.31
Employee +
Spouse
$1294.68 1382.28 1495.38
Employee +
Children
1000.93 1068.66 1156.09
Employee +
Family
1697.23 1812.08 1960.33
Employee.
Employee +Spouse
Employee
Children
Employee +Family
DHMO
11.86
20.75
24.90
34.99
DPPO
37.42
78.12
88.03
138.11
Vision
Employee 6.60
Employee +Spouse 13.22
Employee +Children 11.19
Employee +Family 18.46
The City will continueto provide life insurancefor1xannualsalary
uptoamaximumof $75,000 andLongTerm Disability Insurance
for60%of salary for full time employees.Staff recommends the
continuation of coverage under the current policieswithLincoln
FinancialGroupatthe same rate as the current policyyear.
The projected total annual employer costs is $753,476.28.
Premium charges for the health,dental and vision benefits will be
charged to the designated departmental budget lineitems as
proposed in the Fiscal Year 2015 Budget.
DEPARTMENT ACCT#
CRA-ADMINISTRATIVE 6101110-5132310
CRA-PROTECTIVE SERVICES 6101110-5212310
CRA-PROPERTY MANAGEMENT 6101110-5542310
CRA-PUBLIC ASSISTANT SERVICES 6101110-5692310
CITY CLERK 0011200-5122310
CITY MANAGER 0011310-5132310
Soutlf Miami
THE CITY OF PLEASANT LIVING
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER-OFFICE MEMORANDUM
CENTRAL SERVICES 0011320-5132310
HUMAN RESOURCES 0011330-5132310
FINANCE 0011410-5132310
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
Attachments:Proposed resolution
2014 Benefits Renewal Summary from Sapoznik Insurance
•*•'••:.'r-.•
St112014 2014 Benefits Renewal Summary
CITY OF SOUTH MIAMI
INTRODUCTION
Sapoznik Insurance is pleased to provide The City of South Miami withour renewal analysis for the 2014-
2015 benefits period.TheCity currently offers a comprehensive benefits package toits 136 Full-Time
employees;including health,dental,andbasiclifeinsurancefully subsidized for employees only.In addition
employees have the option of Voluntary benefits including,Visioninsurance,Employee,Spousal andChildLife
insurance,Short-Term and Long-Term disability insurance.
HEALTH INSURANCE
The City currently offers3medicalplans through Florida Blue (formerly Blue Cross Blue Shield),with an
average of 110 employees enrolled.EmployeeshavetheoptiontoenrollonanHMOplan,fullysubsidized
byTheCityor2buy-upoptionspartiallysubsidized.Dependent coverage isalso offered forallbenefits,
and are partially subsidized by TheCity.
Carrier renewal increases inthelargegroupmarket (100+Employees)arelargelyduetoa group's medical
claims experience.The medical claimstimeperiod reviewed forthe 2014 renewalwas October 2013to
March 2014.In onemonth,TheCity experienced anincreasein claims expenditure of1 17%as illustrated
below.
Month Medical Claims Spent Medical Loss Ratio (claims vs premiums)
June 2014 $154,877 57%
July 2014 $499,034 125%
It is also important to note that during the renewal review period,there were two (2)members each having
claims inexcessof$25,000;claims billedandpaidwereas follows:
Claimant ClaimsBilledClaimsPaid
#1 $62,873.72$15,849.82
#2 $850,114.63$300,531.44
We can see from this data that one member's claims expenditure equals 60%of the total claims paid for the
entiregroup forthe renewal review period.
Along with claims expenditures,medical trend increases and new Affordable Care Act fees and taxes,the
renewalincreasewith BCBS areasfollows (see Exhibit A):
Initial Renewal Increase Negotiated Increase Final Increase
"g=^~^=•-••••-
15.68%13.48%10.32%
Page
CITY OF SOUTH MIAMI
Currently The City contributes 100%ofthe cost ofthe employee only tier for Base HMO plan.Based on
this contribution level and current enrollment below arethe City's true proposed costs for all Florida Blue
plans offered (see Exhibit B)z
Current Costs Projected Renewal Costs Projected Renewal Cost %Increase
$679,913 $704,998 3.69%Increase
Aspartofourduediligencewe reviewed alternateplan combinations with Florida Blue tolowerThe
City's overall costs andhave included a scenario (see Exhibit C&D)thatreducesthe City's costs as follows.
The downside to this option isthatemployees will assume moreofthe financial responsibility with higher
co-pays and deductibles.
Current Costs Projected Alternate Renewal Projected Alternate Renewal Cost %Increase
$679,913 $677,575 0.34%Decrease
We examined the marketplace tofindsimilarplanoptionswith alternate carriersandourfindingsareas
follows (see Exhibits E&F):
NHP -Option 1 NHP Option 2 Humana
10.7%Increase 11.20%Increase 11.79%Increase
Other carriers were also approached forour market analysis,but based on current claim experience and
carrier history,the following carriers were non-competitive and declined to provide a quote:
Aetna /Coventry AvMed Cigna
IEALTH INSURANCE;REC O (Vi M ENDAT5 O N
Our recommendation this year isforThe City to renew withFloridaBlue with the current plans offered.
Thisis based in consideration of current claims expenses,this being afirst year renewal and with
alternate carrier options available the disruption of a carrier change would not resultin any substantial
savings.
Page2
CITY OF SOUTH MIAMI
ENTAl &VISION INSURANCE
The City's dental and vision plans are currently offered through United Healthcare.City employees have
two dental plan options to choose from;a base DHMOplan and a buy-up DPPO option.Currently there
are 94 employees enrolled on the DHMOplanand 18 on the DPPOplan.Currently TheCity contributes
100%of the cost of the employee only tierforBaseDHMOplan.
Employees also have one visionplan option withUHC,with 78 employees enrolled.Vision coverage is
100%voluntary.
There are noclaims expenditure details available foranyofthe dental orvisionplans offered because
enrollment is below 100 employees and therefore the renewal increase is based on manual rates with
minimal flexibility.The renewal increase on the DHMOplan was 22%and 10%on the DPPO.The
vision plan has a rate guarantee until 2015.
BasedonTheCity's contribution levelfordental coverage andcurrentenrollmentbelowaretheCity's
true proposed costs for all plans offered (see Exhibit G):
Current Costs Projected Renewal Costs Projected Renewal Cost %Increase
$14,757 $18,010 22%Increase
We also examined the marketplace fordentaltofind similar planoptionswith alternate carriersandour
findings are asfollows (see Exhibits H,I &J):
Plan UHC Renewal MetLife Guardian Humana BCBS
DHMO +22.04%+3.9%+15.88%+16.06%+41.71%
DPPO +10.01%+9.38%+7.48%+4.32%+0.87%
Vision 0%-9.16%-0.94%-5.83%-15.59%
DENTAL &VISION INSURANCE RECOMMENDATION
Our recommendation for The City's dental and vision coverage is to consider a change of carriers to
MetLife.This is based on the fact thatthe DHMO plan,which is the cost driver with the highest number of
enrollment,received the highest renewal increase and as such MetLife is the most competitive increase.
For the DPPO,although there would still bean increase the proposed plan with MetLife would change
from annual maxof$1,000 (FEE)to$5,000 (UCR).Employee would also seea savings on their vision
coverage with MetLife as well.In terms of carrier comparison,MetLife isthe largest provider of Dental
coveragewiththestrongernetworkboth local andnationwideascomparedto UHC.
Page3
CITY OF SOUTH MIAMI
LIFE INSURANCE
City employees are all given life insurance fully subsidized for one times their annual salary and offered
by Lincoln Financial Group.Employees also havethe option of purchasing voluntary Life insurance on
themselves,their spouse and children.The Life insurance benefithasarate guarantee until 2015.
Current annual expenditure for The City for the employer paid Basic Life benefit is approximately
$15,395.40.
DISABILITY INSURANCE
The City also fully subsidizes Long Term Disability (LTD)insurance for all City employees,covering 40%
of their salaryupto$6,000a month andofferedby Lincoln Financial Group.Employees can purchase a
buy-upoptionfortheir LTD benefittocover60%oftheirsalary and/or fully voluntary Short Term
Disability (STD).Boththe STD and LTD benefits havearate guarantee until 2015.Currentannual
expenditure forTheCityforthe employer paid LTD benefit is approximately $17,142.96.
AFFORDABLE CARE ACT
The Affordable CareAct (ACA)nowrequiresemployerswith 100+employees tocomplywiththe
requirement of offering compliant healthcare coverage toall of their employees.Requirements under
ACAcallfor compliant plansto meet two requirements;
(1)Minimum Essential Coverage /Minimum Value and
(2)Affordability -cost of coverage to employee cannot exceed 9.5%of their W2 income.
In order forTheCityto be compliant withtheACA's Minimum Value requirement,FloridaBlueplanswill
now change toincludean employee's prescription expenses in the annualout of pocket maximum.
With this change,and withcurrent employer contributionlevels,TheCitywill be compliant forthe 2014-
2015 benefit year with both requirements of The Affordable Care Act.
Page 4
•<>>-.N I 1^
Group Name:City of South Miami
Effective Date:October 1,2014
RENEWAL -EXHIBITA
Physician $25 CO-PAY $15CO-PAY $20 CO-PAY DED &50%
Specialist $45CO-PAY $35CO-PAY $45 CO-PAY DEDH 50%
Adult &Child Wellness
Aihili Wellness Max
COVERED 100%
(NO MAX)
COVERED 100%
(NO MAX)
COVERED 100%
(NOMAX)
50%
(NO MAX)
Mammograms COVERED 100%COVERED 100%COVERED 100%DED&50%
Emergency Room -Waived if
Admitted $100 CO-PAY $100 CO-PAY $200 CO-PAY
Urgent Care $45 CO-PAY $35CO-PAY $50CO-PAY DED &50%
Independent Clinical Lab COVERED 100%COVERED 100%COVERED 100%DED El 50%
Diagnostic Testing /MRI,CAT Scans $80 CO-PAY $80 CO-PAY $200 CO-PAY DED &50%
Outpatient Surgery -Ambulatory
Surgical Center $200CO-PAY $100 CO-PAY $200CO-PAY DED 8t 50%
Provider Services Ambulatory
Surgery Center (ASC)$25/$45 CO-PAY $15/$35 CO-PAY $20/$45 CO-PAY DED &50%
Outpatient Surgery -Hospital $275 CO-PAY $150 CO-PAY $300/$600 CO-PAY DED 8i 50%
Inpatient Hospital $325 CO-PAYPERDAY,
5DAYMAX $200CO-PAYPERDAY,5DAYMAX $700/$1000 CO-PAY DED &50%
Provider Services Hospital COVERED 100%COVERED 100%$50 CO-PAY
Home Health COVERED 100%
60 visrrs
COVERED 100%
60 VISITS
DEDTHEN 100%
20 VISITS
DED6.50%
20 VISITS
Outpatient Therapy $45 CO-PAY
30 VISITS
$35CO-PAY
30 VISITS
$45CO-PAY
35 VISITS
DED &50%
35 VISITS
Deductible $500/$1000 NONE $250/$750 $1000/$3000
Deductible Included in Out of Pocket
Max YES N/A YES
Co-Insurance 90%90%100%50%
Maximum Out of Pocket $3500/$7000 $2500/$7500 $30O0/$6000 $6000/$12000
Out of Pocket Includes Current:DED,CO-PAY &CO-INS
Renewal:DED,CO-PAY,CO-INS &RX
Current:CO-PAY 8<CO-INS
Renewal:CO-PAY,CO-INS 8i RX
Current:DED,CO-PAY &CO-INS
Renewal:DED,CO-PAY,CO-INS &RX
Prescription $1C/$30/$50 $10/$30/$50 $10/$30/$50 i 50%
Lifetime Maximum UNLIMITED UNLIMITED UNLIMITED
Premium Breakdown Current Renewal Negotiated Re-Negotiated Current Renewal Negotiated Re-Negotiated Current Renewal Negotiated Re-Negotiated
Employee 72 $493.76 $571.18 $560.30 $543.98 14 $526.95 $609.84 $598.22 $580.80 0 $547.28 $659.73 $647.16 $628.31
Employee/Spouse 2 $1,175.15 $1,359.41 $1,333.52 $1,294.68 2 $1,254.15 $1,451.39 $1,423.75 $1,382.28 0 $1,302.52 $1,570.15 $1,540.24 $1,495.38
Employee/ChiId(ren)11 $908.52 $1,050.98 $1,030.96 $1,000.93 3 $969.59 $1,122.09 $1,100.72 $1,068.66 2 $1,006.99 $1,213.89 $1,190.77 $1,156.09
Employee/Family 2 $1,540.52 $1,782.09 $1,748.15 $1,697.23 0 $1,644.10 $1,902.68 $1,866.44 $1,812.08 0 $1,707.50 $2,058,35 $2,019.14 $1,960.33
Comments 87 Current Increase 15,68%Increase 13.48%Increase 10.17%19 Current Increase 15.73%Increase 13.52%Increase 10.22%2 Cunent Increase 20.55%Increase 18.25%Increase 14.81%
Monthly Total $50,975.78 $58,968.74 $57,845.50 $56,160.61 $12,794.37 $14,806.81 $14,524.74 $14,101.74 $2,013.98 $2,427.78 $2,381.54 $2,312.18
**This data is prat ided for information purposes only Itisnot intended to represent abinding obligation.The governing documentfor this purpose would be theCOC issued by the carrier**
3:41 PM Inforrnation provide d by Sapoznik Insurance is o rnnr etarv.It mav r tit A
City ofSouth Miami
2014-2015 TmyCoyer Contribution JAnaCysis
Exhibit B
2013/2&i4^ekmm^i§^g^iiM^
Current Employer Contributions
>noridfrBlne«Bluc^
Number of
Employees
Current
Premium
Total
Monthly
Premium
Employer's
Monthly
Contribution
%
Employee's
Monthly
Deduction
Employee
Semi-
Monthly
Deduction
EE 72 $493.76 $35,550.72 $493:76 100%$m.
ES $1,175.15 $2,350.30 >$./493y76 42%681.39 mm
EC 11 $908.52
FA $1,540.52
$9,993.72
$3,081.04
$493:76;.
?$•.>m)t&
54%
32%
414.76
$1,046.76
>;$?&
tsg&g&foj
'MONTHLY E&P£t)$Mc6ti^
ANNUAL EMPLOYER CONTRIBUTION
monthlyempeo^et^^^^r *V^**®
ANNUAL EMPLOYEE DEDUCTIONS
TOTAt;]ilbNtHiY:PRE^!j|}j^;%^?/:1
ANNUAL PREMIUM
T6TAL PARTICIPANTS \~<j\'^>>\SJ'i'<l'ty\
50,975.78
Total
Employer's
Monthly
Contribution
$35,550.72
987.52
5,431.36
Florida Blue BlueCare 56 HMO ^wm^myjiwmm
Employee
Semi-
Monthly
Total
Employer's
Monthly
Cnnfrihntinn
Number of
Employees
Current
Premium
Total
Monthly
Premium
Employer's
Monthly
Contribution
Employee's
Monthly
Deduction
EE 14 $526.95
ES $1,254.15
$7,377.30
$2,508.30
v£ii§il!
|WB 39%
94%33.19
760.39
EC $969.59 $2,908.77 naum 51%475.83
FA $1,644.10 $30%$1,150.34
MONTHIM*!^!^^
ANNUAL EMPLOYER CONTRIBUTION
MONTHLY^wmmuumam
ANNUAL EMPLOYEE DEDUCTIONS
-'^(yt^Mms^^imim^^^^M
ANNUAL PREMIUM
T(yrM,^mS^SSi^9l^9^^^S
$6,912.64
987.52
1,481.28
2014/2015 Benefit Year -Commission Structure
Current Employer Contributions
Florida Blue BlueCare 60 HMO
Employer's
Monthly
Contribution
$543.98 lb\*m
42%
54%
Employee's
Monthly
Deduction
$750.70
Employee
Semi-
Monthly
Total
Employer's
Monthly
CnntrihuHnn
$39,166.56
$1,087.96
Number of
Employees
Current
Premium
Total
Monthly
Premium
EE 72 $543.98 $39,166.56
ES 2 $1,294.68 $2,589.36
EC 11 $1,000.93 $11,010.23 1
iMreWJWWEMEftl $543.98 EEPlM>l-J:f4-f $576.63 f^HBJBJ
MONTHLY EMPLOYER CONTRIBUTION $47,326.26
$567,915.12
MONTHLY EMPLOYEE DEDUCTIONS $8,834.35
Number of
Employees
EE 14
ES
EC
FA
ANNUAL EMPLOYER CONTRIBUTION
ANNUAL EMPLOYEE DEDUCTIONS
ANNUAL PREMIUM
S56,160.61
Current
Premium
$580.80
$1,382.28
$1,068.66
pituti
TOTAL PARTICIPANTS
iiiiwmmiiijBSHIUIttll
Total
Monthly
Premium
$8,131.201
$2,764.56]
$3,205.98 |
Employer's
Monthly
Contribution
543.98 BiSaHllHAKM $634.05
Employee's
Monthly
Deduction
MONTHLY EMPLOYER CONTRIBUTION
ANNUAL EMPLOYER CONTRIBUTION
DEDUCTIONS
ANNUAL EMPLOYEE DEDUCTIONS
ANNUAL PREMIUM
TOTAL PARTICIPANTS
$106,012.20
$56,160.61
$673,927.32
Employee
Semi-
Monthly
Total
Employer's
Monthly
rnntrihntinn
$18.41 $7,615.72
$419.15 $1,087.96
$262.34 $1,631.94
$634.05 $
$10,335.62
$124,027.44
$3,766.12
$45,193.44
$14,101.74
$169,220.88
Florida Blue BlueOptions 03768
Number of
Employees
Current
Premium
Total
Monthly
Premium
Employer's
Monthly
Contribution
%
Employee's
Monthly
Deduction
Employee
Semi-
Monthly
Total
Employer's
Monthly
EE 0 S 547.28 s $493.76 90%$53.52 $26.76 $.
ES 0 $1,302.52 $$493.76 38%$808.76 $404.38 $.
EC 2 $1,006.99 $2,013.98 $493,76 49%$513.23 $256.62 s 987.52
FA 0 S 1,707.50 $$493:76 29%$1,213.74 $606.87 J_.
MONTHLY EMPLOYER CONTRIBUTION
ANNUAL EMPLOYER CONTRIBUTION
MONTHLY EMPLOYEE DEDUCTIONS
ANNUAL EMPLOYEE DEDUCTIONS
$";:;987i5'2?:
$11,850.24;
\T 1,026.46
:$12,317.52
TOTAL MONTHLY PREMIUM $2,013.98
TOTAL ANNUAL PREMIUM :•$•24,167.76;
TOTAL PARTICIPANTS 2
MONTHLY EMPLOYER CONTRIBUTION $53,326.08
ANNUAL EMPLOYER CONTRIBUTION $639;9i2.96
ANNUAL CONSULTING FEE $40,000.00
TOTAL ANNUAL EMPLOYER COSTS s 679,912.96
MONTHLY EMPLOYEE DEDUCTIONS $12,458.05
ANNUAL EMPLOYEE DEDUCTIONS $149,496.60
TOTAL MONTHLY PREMIUM $,65,784.13
TOTAL ANNUAL PREMIUM :,$.789,409.56
TOTAL PARTICIPANTS 108
Number of
Employees
EE
ES
EC
FA
Current
Premium
$628.31
S 1,495.38
FloridaBlue BlueOptions 03768
Total
Monthly
Premium
s
Employer's
Monthly
Contribution
1$543.98 tailljgEMl S 42.17
$543.98 Ep|jlr^E3E!3l $475.70
$543.98 E^fMfSSl $306.06
$543.98 EBISKHJISI $708.18
MONTHLY EMPLOYER CONTRIBUTION
Employee's
Monthly
Deduction
ANNUAL EMPLOYER CONTRIBUTION
MONTHLY EMPLOYEE DEDUCTIONS
ANNUAL EMPLOYEE DEDUCTIONS
TOTAL ANNUAL PREMIUM
TOTAL PARTICIPANTS
2,312.18
MONTHLY EMPLOYER CONTRIBUTION
ANNUAL EMPLOYER CONTRIBUTION
N/A
TOTAL ANNUAL EMPLOYER COSTS
MONTHLY EMPLOYEE DEDUCTIONS
ANNUAL EMPLOYEE DEDUCTIONS
TOTAL MONTHLY PREMIUM
TOTAL ANNUAL PREMIUM
TOTAL PARTICIPANTS
Employee
Semi-
Monthly
nednpfiriri
Total
Employer's
Monthly
rnnrrihnfinn
1,087.96
$58,749.84
$704,998.08
S\l»O 7.MK
Group Name:City of South Miami
Effective Date:October 1,2014
DHMO
MetLife Met29 ••'•':•':•'•'•'•'.
Deductible NONE NONE
Co-Insurance 100%100%
Dentist COVERED 100%$5CO-PAY
Specialist CO-PAY APPLIES CO-PAY APPLIES
Cleanings 1 EVERY 6 MONTHS 1 EVERY 6 MONTHS
Preventive
Network
Non Network
MOST PROCEDURES
COVERED 100%
SOME PROCEDURES
HAVE CO-PAYS
MOST PROCEDURES
COVERED 100%
SOME PROCEDURES
HAVE CO-PAYS
Basic Coverage
Network
Non Network
SOME PROCEDURES
COVERED 100%
MOST PROCEDURES
HAVE CO-PAYS
SOME PROCEDURES
COVERED 100%
MOST PROCEDURES
HAVE CO-PAYS
Major Coverage CO-PAY APPLIES CO-PAY APPLIES
Orthodontic
Coverage
Orthodontic
Maximum (Age Limits)
CO-PAY APPLIES CO-PAY APPLIES
Rate Guarantee 1 YEAR 1YEAR
Annual Maximum NONE NONE
Dependent Child/Student
Age
UP TO AGE 26 UP TO AGE 26
Premium Breakdown Current Renewal
Employee 62 $10.98 $13.40 $11.86
Employee/Spouse 11 $22.84 $27.87 $20.75
Employee/Child(ren)13 $22.07 $26.93 $24.90
Employee/Family 8 $36.19 $44.17 $34.99
Comments 94 Current Increase 22.04%Increase 3.90%
Monthly Total $1,508.43 $1,840.82 $1,567.19
**This datais 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**
gjQSbRMation providedbySapoznikInsuranceisproprietary.Itmaynotbecopied,emulatedordistributedwithoutexpress pertHlfetfEBMd
S\l><>Z,IN
Group Name:City of South Miami
Effective Date:October 1,2014
DPPO
MetLife
Deductible IN/OUT:$50/$150 IN/OUT:$50/$150
Co-Insurance IN/OUT:100%/80%/50%IN/OUT:100%/80%/50%
Dentist IN:DED &CO-INS
OUT:DED &CO-INS
IN:DED &CO-INS
OUT:DED &CO-INS
Specialist IN:DED&CO-INS
OUT:DED&CO-INS
IN:DED &CO-INS
OUT:DED &CO-INS
Cleanings 1 EVERY 6 MONTHS 1 EVERY 6 MONTHS
Preventive
Network
Non Network
IN/OUT:DED WAIVED,
COVERED 100%
IN/OUT:DED WAIVED,
COVERED 100%
Basic Coverage
Network
Non Network
IN/OUT:DED&80%IN/OUT:DED&80%
Major Coverage IN/OUT:DED&50%IN/OUT:DED&50%
Periodontic &Endodontic
Coverage BASIC BASIC
Orthodontic Coverage
Orthodontic Maximum (Age
Limits)
50%CO-INS
CHILD(REN)TO19
$1000 LIFETIME MAX
50%CO-INS
CHILD(REN)TO19
$1000 LIFETIMEMAX
Rate Guarantee 1YEAR 1YEAR
Annual Maximum $1,000 IN:$5000
OUT:$2500
Dependent Child/Student
Age UP TO AGE 26 UP TO AGE 26
Reimbursement Level OON-UCR OON-FEE
Premium Breakdown Current Renewal
Employee 13 $34.76 $38.23 $37.42
Employee/Spouse 1 $70.10 $77.10 $78.12
Employee/Child(ren)1 $78.12 $85.92 $88.03
Employee/Family 3 $125.12 $137.71 $138.11
Comments 18 Current Increase 10.01%Increase 9.38%
Monthly Total $975.46 $1,073.14 $1,066.94
**Thisdataisprovidedforinformationpurposesonly.Itisnotintendedtorepresentabindingobligation.The
governing document for this purpose would be the COC issued by the carrier**
aQ&RMation providedbySapoznik Insurance isproprietary.Itmaynotbecopied,emulated ordistributedwithoutexpress pen8ifetfRQ1.4
City ofSouth Miami
2014-2015 ZmpCoyer Contribution AnaCysis
Exhibit G
2013/2014 Benefit Year -Service Fee Structure 2014/2015 Benefit Year -Commission Structure
Current Employer Contributions
UHC DHMO
Number of
Employees
Current
Premium
Total
Monthly
Premium
Employer's
Monthly
Contribution
%
Employee's
Monthly
Deduction
Employee
Semi-
Monthly
Dffltirfinn
Total
Employer's
Monthly
rnntrihiitinn
EE 62 S 10.98 $680.76 $10.98 100%$$-$680.76
ES 11 $22.84 $251.24 S 10.98 48%$11.86 $5.93 S 120.78
EC-13 $22.07 $286.91 $10.98 50%S 11.09 $5.55 $142.74
FA 8 $36.19 $289.52 S 10.98 30%$25.21 $12.61 $87.84
MONTHLY EMPLOYER CONTRIBUTION $1,032.12
ANNUAL EMPLOYER CONTRIBUTION $12,385.44
MONTHLY EMPLOYEE DEDUCTIONS $476.31
ANNUAL EMPLOYEE DEDUCTIONS $5,715.72
TOTAL MONTHLY PREMIUM $1,508.43
ANNUAL PREMIUM $18,101.16
TOTAL PARTICIPANTS 94
UHC DPPO
Number of
Employees
Current
Premium
Total
Monthly
Premium
Employer's
Monthly
Contribution
%
Employee's
Monthly
Deduction
Employee
Semi-
Monthly
nr-rinrtinn
Total
Employer's
Monthly
rnntrihiitinn
EE 13 $34.76 $451.88 $10.98 32%$23.78 $11.89 S 142.74
ES 1 $70.10 $70.10 $10.98 16%S 59.12 $29.56 $10.98
EC 1 S 78.12 S 78.12 S 10.98 14%$67.14 $33.57 $10.98
FA 3 $125.21 $375.63 $10.98 9%$114.23 $57.12 S 32.94
MONTHLY EMPLOYER CONTRIBUTION $197.64
ANNUAL EMPLOYER CONTRIBUTION $2,371.68
MONTHLY EMPLOYEE DEDUCTIONS $778.09
ANNUAL EMPLOYEE DEDUCTIONS $9,337.08
TOTAL MONTHLY PREMIUM S 975.73
ANNUAL PREMIUM $11,708.76
TOTAL PARTICIPANTS 18
Number of
Employees
EE 62
ES 11
Number of
Employees
EE 13
ES
EC
FA
Current
Premium
11.86
20.75
Current Employer Contributions
MetLife DHMO Met 290 Plan
Total
Monthly
Premium
735.32
$228.25
Employer's
Monthly
Contribution
%
S 'n.86"|ii!'^S
$11.861
Employee's
Monthly
Deduction
MONTHLY EMPLOYER CONTRIBUTION
ANNUAL EMPLOYER CONTRIBUTION
MONTHLY EMPLOYEE DEDUCTIONS
ANNUAL EMPLOYEE DEDUCTIONS
ANNUAL PREMIUM
Current
Premium
37.42
S 88.03
TOTAL MONTHLY PREMIUM
TOTAL PARTICIPANTS
1,652.87
Metlife PPO Plan 5000 Annnual Max
Total
Monthly
Premium
Employer's
Monthly
Contribution
11.86
11.86
11-86
MONTHLY EMPLOYER CONTRIBUTION
Employee's
Monthly
Deduction
ANNUAL EMPLOYER CONTRIBUTION
MONTHLY EMPLOYEE DEDUCTIONS
ANNUAL EMPLOYEE DEDUCTIONS
ANNUAL PREMIUM
TOTAL MONTHLY PREMIUM
TOTAL PARTICIPANTS
Employee
Semi-
Monthly
y 4.45
$8.08
$14.39
Employee
Se mi-
Monthly
Ofrinrtinn
5 12.78
$33.13
$63.13
Total
Employer's
Monthly
rnntrihiitinn
735.32
130.46
154.18
94.88
Total
Employer's
Monthly
rnntrihiitinn
154.18
11.86
11.86
35.58
UHC VISION
Number of
Employees
Current
Premium
Total
Monthly
Premium
Employer's
Monthly
Contribution
%
Employee's
Monthly
Deduction
Employee
Semi-
Monthly
DprliirHnn
Total
Employer's
Monthly
Pnnfrihiirinn
EE 48 $6.66 $319.68 $0%$6.66 $3.33 $
ES 7 $13.32 $93.24 $0%$13.32 $6.66 $
EC 10 $12.66 $126.60 $0%$12.66 $6.33 $
FA 9 $26.21 $235.89 $0%$26.21 $13.11 $
MONTHLY EMPLOYER CONTRIBUTION
ANNUAL EMPLOYER CONTRIBUTION
MONTHLY EMPLOYEE DEDUCTIONS
ANNUAL EMPLOYEE DEDUCTIONS
TOTAL MONTHLY PREMIUM
TOTAL ANNUAL PREMIUM
&<•&*•*•>•<
•$,.;.:,'..:;*..--:V;
$775.41-
$=9,304.92;
^:$'^:-::775M>
$V:9,304v92
TOTAL PARTICIPANTS ;:-v:;^74:;W:^
$775.41
MONTHLY EMPLOYER CONTRIBUTION $1>229.76
ANNUAL EMPLOYER CONTRIBUTION $14/757.12
ANNUAL CONSULTING FEE
TOTAL ANNUAL EMPLOYER COSTS $14,757.12
MONTHLY EMPLOYEE DEDUCTIONS $2,029.81
ANNUAL EMPLOYEE DEDUCTIONS $24,357.72
TOTAL MONTHLY PREMIUM $3,259.57
TOTAL ANNUAL PREMIUM $39,114,84
Number of
Employees
Current
Premium
Total
Monthly
Premium
EE 48 $6.60 $316.80
ES 7 $13.22 $92.54
EC 10 $11.19 $111.90
FA 9 $18.46 $166.14 1
Metlife Vision
Employer's
Monthly
Contribution
Employee's
Monthly
Deduction
MONTHLY EMPLOYER CONTRIBUTION
ANNUAL EMPLOYER CONTRIBUTION
ANNUAL EMPLOYEE DEDUCTIONS
TOTAL ANNUAL PREMIUM
TOTAL PARTICIPANTS
6S7.3S
MONTHLY EMPLOYER CONTRIBUTION
ANNUAL EMPLOYER CONTRIBUTION
N/A
TOTAL ANNUAL EMPLOYER COSTS
MONTHLY EMPLOYEE DEDUCTIONS
ANNUAL EMPLOYEE DEDUCTIONS
TOTAL MONTHLY PREMIUM
TOTAL ANNUAL PREMIUM
Employee
Semi-
Monthly
$3.30
$6.61
$5.60
$9.23
Total
Employer's
Monthly
rnntrihiitinn
-i \l»<">X.iN
Group Name:City of South Miami
Effective Date:October 1,2014
VISION
METLIFE
Exam **$10 CO-PAY
(EVERY 12 MONTHS)
**$10 CO-PAY
(EVERY 12 MONTHS)
Materials
**$10 CO-PAY
Lenses:(EVERY 12 MONTHS)
Frames:(EVERY 24 MONTHS)
**$10 CO-PAY
Lenses:(EVERY 12 MONTHS)
Frames:(EVERY 24 MONTHS)
Maximum Allowances NETWORK DOCTOR
NON-NETWORK
DOCTOR
REIMBURSEMENT
NETWORK DOCTOR
NON-NETWORK
DOCTOR
REIMBURSEMENT
Eye Exam PAIDINFULL
AFTER CO-PAY
UPTO$40
REIMBURSEMENT
PAIDINFULL
AFTER CO-PAY UPTO$45 ALLOWANCE
Lenses PAIDINFULL
AFTER CO-PAY
UPTO $40 SINGLE
$60 BIFOCAL
$80 TRIFOCAL
$80 LENTICULAR
PAIDINFULL
AFTER CO-PAY
UPTO $30 SINGLE
$50 BIFOCAL
$65TRIFOCAL
$100 LENTICULAR
Contacts-Necessary
(Legally Blind)
PAIDINFULL
AFTER CO-PAY
UPTO $210
REIMBURSEMENT
PAID INFULL
AFTER CO-PAY UP TO $210 ALLOWANCE
Contacts-Elective UPTO $105 ALLOWANCE UPTO$105
REIMBURSEMENT UPTO $130 ALLOWANCE UPTO $105 ALLOWANCE
Frames UPTO $130 ALLOWANCE
+30%OFFBALANCE
UPTO $45
REIMBURSEMENT UPTO $130 ALLOWANCE UPTO$70 ALLOWANCE
Current
Employee 55 $6.66 $6.60
Employee Spouse 5 $13.32 $13.22
EmployeeChildren 12 $12.66 $11.19
Employee Family 6 $26.21 $18.46
Comments 78 Next Renewal:10/1/2015 Decrease 9.16%
Total Monthly $742.08 $674.14
-.n.s aata is provided for information purposes only.It is not intended to represent a binding obligation.1he governing document'
forthis purpose would be the COC issued bv the carrier**
Sfl&RMation provided by Sapoznik Insurance is proprietary.It may not be copied,emulated or distributed without express penMlfeBHH/