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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/