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Res No 138-15-14477RESOLUTION NO.138-15-14477 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 BenefitsConsultant,SapoznikHealth&Wellness secured morethan three competitivequotesfortheCity'sGroupHealth,Dentaland Vision Insuranceandrecommended Blue Cross andBlueShieldandMetLifeas the selected providers;and WHEREAS,theCity's Benefits Consultant comparedtheinsurancerates,benefitplan design,provider network aswellas the City'sprevious claims experience/ratio;and WHEREAS,the CityCommissionwishesto approve the selection ofBlue Cross Blue Shield fortheprovisionofgrouphealthinsurancebenefitsand MetLife fortheprovisionof dentalandvision group benefits for all full time employees and participating retirees. WHEREAS,the CityCommission further wishes to continue to provide life insurance andlong term disabilityinsurance to full timeemployees through Lincoln Financial Group under the existingpolicy;and WHEREAS,the premium charges shallbe charged to departmental lineitemsin account numbers : 6I0III0-5I323I0,6I0III0-52I23I0,6I01110-5542310,6I0III0-56923I0,0011200-5122310, 00II3I0-5I323I0,0011320-5132310,0011330-5132310,00II4I0-5I323I0,0011610-5242310, 0011620-5242310,0011640-5242310,0011710-5192310,0011720-5342310,0011730-5412310, 1111730-5412310,0011750-5192310,0011760-5192310,0011770-5192310,0011790-5192310, 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.TheCityManagerishereby authorized to purchase group healthinsurancebenefitsfrom Blue Cross Blue Shield anddentalandvisioninsurancebenefitsfrom MetLife for the CityofSouth Miami full time employees andparticipating retirees for the 2016 fiscal yearin conformity with the quotes obtained and to be charged to the accounts listedin the recitals to this resolution. Pg.2 of Res.No.138-15-14477 Section 2.Thisresolution shall take effect immediatelyupon adoption. PASSED AND ADOPTED thislst day of _Septembej2015. ATTEST:APPROVED: CITY CtERK READ AND APPROVED AS TO FO{ LANGUAGE,LEGAkfTY AND, EXECUJJOM&flEREOF: COMMISSION VOTE:4-0 MayorStoddard:Yea ViceMayor Harris:absent Commissioner Welsh:Yea Commissioner Liebman:Yea Commissioner Edmond Yea Ka\Soutlf Miami THE OTY OF PLEASANT LIVING CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER-OFFICE MEMORANDUM To: From: Date: Subject: Background: TheHonorableMayor&MembersoftheCityCommission StevenAlexander,City Manager September 1,2015 AgendaItemNo.: AResolutionauthorizingtheCityManagertopurchasegrouphealth insurance benefits from Blue Cross Blue Shield and dental and vision insurance benefits from MetLife fortheCity of South Miami full time employees and participating retirees. TheCity'sbenefitsconsultant,Sapoznik Health&Wellness,solicited quotes for theemployee group insurance coverage for South Miami foil time employees for the 2015-2016 benefityear.Florida Blue,the City'shealth insurance carrier's,first proposedrenewalrate representeda26.28%increase.Despite the City'shighmedicalloss ratio of 108.75%for thecurrentbenefityear,afternegotiations,the final renewal increase was reduced to 12.20%.This reflects a 53.58%reduction dueto negotiations. The increase is appropriately fundedintheproposed Budget for Fiscal Year 2015-2016. Staff further recommends the renewal of MetLife asthe provider for its dentalandvisionplans for the 2015-2016 benefit year.MetLife proposesanincrease of 6%on the DentalHMO Plan andno increase onthevision plan for theupcoming benefit year.The Dental PPO Plan proposed increase is 12.51%negotiated down from an initial increase of 15%.Representing a 16.60%decrease dueto negotiation. Baseduponthe proposals received,staffrecommendstheCityrenew thecurrenthealth insurance planswithBlue Cross BlueShieldand MetLife for the dental and vision coverage.The proposed rates are based on the current number of enrol lees and as follows: Sou#Miami THE CITY OF PLEASANT LIVING Amount- Account: CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER-OFFICE MEMORANDUM Low HMO High HMO POS Employee $610.32 $653.98 $752.08 Employee+ Spouse $1452.57 $1556.47 $1789.9,5 Employee+ Children $1122.99 $1203.32 $1383.83 Employee+ Family $1904.21 $2040.41 $2346.49 DHMO DPPO Employee $12.57 $42.10 Employee +Spouse $22.00 $87.89 Employee+ Children $26.39 $99.04 Employee+Family $37.09 $155.38 Vision Employee $6.60 Employee +Spouse $13.22 Employee +Children $11.19 Employee +Family $18.46 The City will continue to provide life insurance for 1x annual salary uptoa maximum of$75,000and Long Term Disability Insurancefor 60%ofsalaryfor full timeemployees.Staff recommendsthe continuation ofcoverage under the current policieswithLincoln FinancialGroup. Theprojectedtotalannual employer costs forhealth,dental,life and LTD benefits is $1,060,424. Premium charges forthehealth,dentalandvisionbenefitswillbe chargedto the designated departmental budgetlineitemsas proposed intheFiscalYear 2016 Budget South'Miami THE CITY OF PLEASANT LIVING CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER-OFFICE MEMORANDUM 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 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-OFFICEOFDIR 0011770-5192310 PW-ENGINEERING 0011790-5192310 POLICE 0011910-5212310 PARKS &REC 0012000-5722310 COMMUNITY CENTER 0012020-5192310 Attachments:Proposedresolution 2015 BenefitsRenewalSummaryfromSapoznikInsurance Croup N«mw CityofSouthMiami effective Data*October 1,»IS Mttnmoamms fmertfancy Room-Waived ff Admitted] Urgent Cero Independent Clinical tab DiagnosticTeatJno /MM,CAT Scant Outpatient Surgery -Ambulatory Surgical Canter Provider Sendees Ambulatory Surgery Center (ASC) Outpatient Surgery -Hospital Inpatfsnt Hospital Provider Services Hospital OutpatientTherapy Deductible Deductible Included bi Out of Pocket Max Maximum Out of Pocket COVERED 100% $100CO*AY $45 GO-PAY COVERED 100% $80OM>AY $200 CO-PAY $2S/$45 CO-PAY $2750>I>AY $3250>PAVP6tDAY, 5DAYMAX COVERED 100% COVERED 100% 60 VISITS $45 CO-PAY 30 VISITS $500/11000 $3S00>$7000 RENEWAL $i00O>PAY $35 CO-PAY COVERED 100% $40CO-PAY $100 CO-PAY $15/$350>PAY $150 CO-PAY $200 CO-PAYPERDAY,5DAYMAX COVERED 100% COVERED 100% 60 VISITS $35 CO-PAY 30 VISITS N/A $2500/$75O0 $50O>PAY COVERED100% $200CO-PAY $700 CO-PAY $20/$45 CO-PAY $300/$600 CO-PAY $700/$1000 CO-PAY DEDTHEN 100% 20vBrrs $45COPAY 35 VISITS $2S0/$75O $3000/$6000 $200CO4»AY $50 CO-PAY DEDft 50% DED&50% 20 VISITS DED&50% 35 VISITS $1000/$3000 50% $6000/$12000 Out of Pocket Indodea DED,CO-PAY,CO-INS ft RX CO-PAY,CO-INS&RX DED,CO-PAY,CO-INS ftRX $10/$3u7$50 $uv$3oy*»$10/$30/$S0 Ufatlma Maximum UNUMITED Premium Breakdown im&m ^•••••!-mm lii Employee $543.98 $686,56 $654*37 $629,20 $610*32 $736,10 $701.10 $674.21 $653.90 $628.31 $846,52 $80635 $775.34 $752,08 ErftplOyee/Spousg $1,294,68 $1,634,96 $1,557.39 $1,497.49 %%/nasf $1,362.28 $1,751.^1 $1,668,79 $M>04.61 $1,556.47 $1,49538 $2,014,71 $1,919.12 $1,845,31 $1,789,95 Emptoyee/Ch3<Kren)$1^00,93 $1,264,00 $1,204.03 $1457.72 $1,122.99 $1,068.66 $1,35*42 $1,290.16 $1,240,54 $1,203.32 $1,15649 $1,557.59 $1,483,70 $1/426.63$1,383.83 6mptovee/Fam3y $1^97.23 $2,14331 $2,041.62 $1,963.10 $1,904.21 $1,812.03 $2,296.62 $2,187.66 $2,10152 $2,040.41 $1,96033 $2^4l;13 $2,515,82 $2,419.05 $2,346.49 Current Increase 26.28%Increase 20.29%Increase 15*7%Increase 1230%Current Increase 26.74%Increase 20.73%Increase 16,03%Increase 12.60%Currant Increase 34.73%Increase 2834%Increase 23.40%Increase 19.70% Monthly Total $51,315.87 $48,881.38 $47,001.19 ♦4g,890J3 $18,31832 $23,21038 $22,118.11 $21,264.52 020,626.50 »2,940.49 $3,981.70 «nhU data bprc^ad for Information purpose*only.ItItnot Intended torepresenta binding obligation.The governing documentfortide purpose wouldbothe CQC Issued bythe carrier" $3,773.75 $3,828.60 $3,519.74 -12:30 PM information providedbySapoznikinsuranceis proprietary,itmaynotbecopied,emulatedor distributed withoutexpress permission.8/14/2015 w* H A uN I K •*&** Com^riy^gianj Deductible Co-Insurance Dentist Specialist Cleanings Preventive Network Non Network Basic Coverage Network Non Network Major Coverage Orthodontic Coverage Orthodontic Maximum (Age limits) Rate Guarantee Annual Maximum Dependent Child/Student *8£ Premium Breakdown Employee Employee/Spouse Employee/Child(ren) Employee/Family Comments Monthly Total Group Name:City of South Miami Effective Date:October 1,2015 DHMO 26 $iifiiiitj NONE 10Q% $5 CO-RAY CO-PAY APPLIES 1EVERY6 MONTHS MOST PROCEDURES COVERED 100% SOME PROCEDURES HAVF CO-PAYS SOME PROCEDURES COVERED 100% MOSTPROCEDURES HAVFrtVPAYc; CO-PAY APPLIES CO-PAY APPLIES 1YEAR NONE UP TO AGE 26 IB liiMllii $11.86 $12.57 $20.75 $22.00 $24.90 $26.39 $34.99 $37.09 Current Increase 6% $581.67 $616.56 UHC D0037 800 NONE 100% $5 CO-PAY 25%REDUCTION 1 EVERY 6MONTHS MOSTPROCEDURES COVERED 100% SOME PROCEDURES HAVFCO-PAYS SOME PROCEDURES COVERED 100% MOST PROCEDURES HAVF CO-PAYS CO-PAY APPLIES 25%REDUCTION 1YEAR NONE UP TO AGE 26 $10.90 $19.10 $23.41 $30.00 Decrease 9.20% $528.18 Humana HS210 NONE 100% $10 CO-PAY CO-PAY APPLIES 1EVERY6 MONTHS MOST PROCEDURES COVERED 100% SOME PROCEDURES HAVPm.PAY«; SOME PROCEDURES COVERED 100% MOSTPROCEDURES HAVFOVPftYS CO-PAY APPLIES CO-PAY APPLIES 1YEAR NONE UP TO AGE 26 $11.96 $23.91 $26.90 $43.28 Increase 13.34% $658.78 Lincoln LDC S700 NONE 100% COVERED 100% CO-PAY APPLIES 1EVERY6MONTHS MOST PROCEDURES COVERED 100% SOME PROCEDURES HAV/F m-PAYS SOMEPROCEDURES COVERED 100% MOST PROCEDURES HAVFfD-PAYS CO-PAY APPLIES CO-PAY APPLIES 1YEAR NONE UP TO AGE 26 $15.56 $27.07 $33.30 $42.63 Increase 29.09% $750.89 **Thls 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 bv the carrier** UtiftfrAMtion provided by Sapoznik Insurance Is proprietary.It may not be copied,emulated or distributed without express periWiSBEOIS N A POZNIK Group Name:City of South Miami Effective Date:October 1,2015 Deductible Co-Insurance Dentist Specialist Gleanings Preventive Network Won Network Basic Coverage Network Non Network Major Coverage Periodontic ft Endodontic Coverage Orthodontic Coverage Orthodontic Maximum (Age Limits) Rata Guarantee Annual Maximum Dependent Child/Student Age Reimbursement Level Premium Breakdown Employee Employee/Spouse Employee/Chlld(ren) Employee/Family Comments Monthly Total 23 35 DPPO IN/OUT:$50/$150 IN/OUT:100%/80%/SO% Current $37.42 $78.12 $88.03 $138.11 Current IN/OUT:DED &CO-INS IN/OUT:DED &CO-INS 1 EVERY6MONTHS IN/OUT:DED WAIVED, COVERED 100% IN/OUT:DED&80% IN/OUT:DED &50% BASIC 50%COINS CHILD(REN)T019 $1000 LIFETIME MAX 1YEAR IN:$5000 OUT:$2500 UP TO AGE26 CON-FEE Renewal Negotiated $43.03 $42,10 $89.84 $87.89 $101.23 $99.04 $158.83 $155.38 Increase 15%Increase 12.51% $2,017.71 $2,320.30 $2,270.05 IN/OUT:$50/$150 IN/OUT:100%/80%/50% IN/OUT:DED 8i CO-INS IN/OUT:DED &CO-INS 1EVERY 6 MONTHS IN/OUT:DED WAIVED, COVERED 100% IN/OUT:DED&80% IN/OUT:DED&50% BASIC OralSurgery:Major 50%CO-INS CHILD(REN)T019 $1000 LIFETIME MAX 1YEAR $2,000 UP TO AGE 26 OON-FEE $29.53 $61.65 $69.47 $108.99 Decrease 21.08% $1,592.29 IN/OUT:$50/$150 IN/OUT:100%/80%/50% IN/OUT:DED&CO-INS IN/OUT:DED&CO-INS 1EVERY6MONTHS IN/OUT:DED WAIVED, COVERED 100% IN/OUT:DED &80% IN/OUT:DED&50% BASIC 50%CO-INS CHILD(REN)T019 $1000 LIFETIME MAX 1YEAR UNLIMITED UP TO AGE 26 OON-FEE $33.33 $69.57 $78.40 $123.00 Decrease 10.94% $1,797.04 IN/OUT:$50/$150 IN/OUT:100%/80%/50% IN/OUT:DED&CO-INS IN/OUT:DED &CO-INS 1EVERY6MONTHS IN/OUT:DED WAIVED, COVERED 100% IN/OUT:DED&80% IN/OUT:DED 8t 50% BASIC 50%CO-INS CHILD(REN)TO19 $1000 LIFETIME MAX 1YEAR IN:$5000 OUT:$2500 UP TO AGE 26 OON-FEE $37.42 $78.12 $88.03 $138.11 No Increase $2,017.71 **Thls data is provided for information purposes only.It Is not intended to represent a binding obligation.The governing document for this purpose wouldbe the COC Issued bythe carrier** UltfifrrtMtion provided by Sapoznik Insurance is proprietary.It may not be copied,emulated or distributed without express pen8te#ia)i5 K K I*O '*.V Group Name:City of South Miami K EffectiveDate:October1,2015 Exam Materials Maximum Allowances Eye Exam Lenses Contacts-Necessary (Legally Blind) Contacts-Elective Frames Employee EmployeeSpouse EmployeeChildren EmployeeFamily Comments Total Monthly 50 10 70 **$10 CO-PAY (EVERY 12 MONTHS) **$10 CO-PAY Lenses:(EVERY 12 MONTHS) Frames:(EVERY 24MONTHS) NETWORK DOCTOR PAID INFULL AFTER CO-PAY PAID INFULL AFTER CO-PAY PAID INFULL AFTER CO-PAY UPTO $130 ALLOWANCE UPTO$130 ALLOWANCE +20% OFF BALANCE NON-NETWORK DOCTOR REIMBURSEMENT UPTO$45 REIMBURSEMENT UPTO$30 SINGLE $50BIFOCAL $65TRIFOCAL $100 LENTICULAR UPTO $210 REIMBURSEMENT UPTO$105 REIMBURSEMENT UPTO$70 REIMBURSEMENT Current $6.60 $13.22 $11.19 $18.46 Next Renewal:10/1/2017 $600.30 **$10 CO-PAY (EVERY 12 MONTHS) **$25 CO-PAY Lenses:(EVERY 12 MONTHS) Frames:(EVERY24MONTHS) NETWORK DOCTOR PAID INFULL AFTER CO-PAY PAID INFULL AFTER CO-PAY PAID INFULL AFTER CO-PAY UPTO $105 ALLOWANCE UPTO $100 ALLOWANCE*30% OFFBALANCE NON-NETWORK DOCTOR REIMBURSEMENT UPTO$40 REIMBURSEMENT UPTO$40SINGLE $60 BIFOCAL $80 TRIFOCAL $80 LENTICULAR UPTO $210 REIMBURSEMENT UPTO$105 REIMBURSEMENT UPTO$45 REIMBURSEMENT 50/50 Medical Package Saving $5 PEPM $4.99 $9.99 $8.46 $13.96 Decrease 24.40% $453.85 VISION **$10 CO-PAY (EVERY 12 MONTHS) **$15CO-PAY Lenses:(EVERY 12 MONTHS) Frames:(EVERY24 MONTHS) NETWORK DOCTOR PAIDINFULL AFTER CO-PAY PAID INFULL AFTERCO-PAY PAID INFULL AFTER CO-PAY NON-NETWORK DOCTOR REIMBURSEMENT UPTO$35 ALLOWANCE UPTO$25 SINGLE $40 BIFOCAL $60 TRIFOCAL UPTO $210 ALLOWANCE UPTO $150 ALLOWANCE UPTO$50 ALLOWANCE WHOLESALE UPTO$45 ALLOWANCE RETAIL Voluntary $6.49 $12.99 $11.00 $18.14 Decrease 1.69% $590.15 **$10 CO-PAY (EVERY 12 MONTHS) **$25 CO-PAY Lenses:(EVERY 12 MONTHS) Frames:(EVERY24MONTHS) NETWORK DOCTOR PAID INFULL AFTER CO-PAY PAIDINFULL AFTER CO-PAY PAID INFULL AFTER CO-PAY UPTO$125 ALLOWANCE UPTO $130 ALLOWANCE+30% OFFBALANCE NON-NETWORK DOCTOR REIMBURSEMENT UPTO$40 REIMBURSEMENT UPTO$40 SINGLE $60 BIFOCAL $80TRIFOCAL $80 LENTICULAR UPTO $210 REIMBURSEMENT UPTO$125 REIMBURSEMENT UPTO$45 REIMBURSEMENT Voluntary $6.38 $12.09 $14.18 $19.95 Increase 3.45% $621.00 **$10 CO-PAY (EVERY 12 MONTHS) **$10 CO-PAY Lenses:(EVERY 12 MONTHS) Frames:(EVERY 24 MONTHS) NETWORK DOCTOR PAID INFULL AFTER CO-PAY PAIDINFULL AFTER CO-PAY PAID INFULL AFTER CO-PAY UPTO $130 ALLOWANCE UPTO$130 ALLOWANCE+30%OFF BALANCE NON-NETWORK DOCTOR REIMBURSEMENT UPTO$40 REIMBURSEMENT UPTO$40SINGLE $60 BIFOCAL $80 TRIFOCAL $80 LENTICULAR UPTO$210 REIMBURSEMENT UPTO$130 REIMBURSEMENT UPTO$45 REIMBURSEMENT Voluntary $7.14 $14.30 $12.10 $19.96 Increase 8.16% $649.30 **This dataisprovidedfor information purposesonly.Itisnot intended to represent abindingobligation.Thegoverning document forthispurposewouldbe the COC issued bythe carrier** 11:20 AM Information provided by Sapoznik Insurance is proprietary.It may notbe copied,emulated or distributed without express permission.8/24/2015 Group Name:City of South Miami -v i>oz M k Effective Date:October 1,2015 1 LIFE STD LTD |KmmM^y^^l 'SSiiBii Life Amount Class 1:lx Annual Class 2:2x Annual Maximum Weekly Benefit Amount 60%TO$1000 Maximum Benefit Amount 40%TO $6000 60%TO $6000 Class Definition Class1:All OtherEmployees Class2:CityManagers Elimination Period Accident 7DAYS Guaranteed Issue Amount $6,000 $6,000 Maximum Benefits Class1:$75,000 Class2:$320,000 Elimination Period Sickness 7DAYS Benefit Period LATEROFAGE 65 OR SSNRA LATEROFAGE 65 ORSSNRA Reduction Factor 35%ATAGE 65 15%ATAGE 70 Maximum Benefit Period 13 WEEKS Elimination Period 90 DAYS 90 DAYS Guaranteed Issue Amount Class1:$75,000 Class2:$320,000 Rate Guarantee Next Renewal 10/1/2017 Own Occupation 24 MONTHS 24 MONTHS Rate Guarantee Next Renewal 10/1/2017 Premium Breakdown Current /Renewal Pre-Existing Period 3/12 3/12 Premium Breakdown Current Renewal RatePer$10of Benefit AgeBanded Rate Guarantee Next Renewal 10/1/2017 Next Renewal 10/1/2017 Life $0,160 $0,190 Comment No Increase Premium Breakdown Current /Renewal Current /Renewal AD&D $0,020 $0,020 Volume $12,016.00 RatePer $100 of MonthlyIncome $0.24 AgeBanded Comment Approx.Monthly Premium $456.97 Comment No Increase No Increase Volume $5,968,500 $5,968,500 Volume $201,406.00 $38,853.00 Approx.Monthly Premium $1,074.33 $1,253.39 Current Approx. Monthly Premium $3,308.86 Approx.Monthly Premium $1,208.52 $569.04 Renewal Approx. Monthly Premium $3/187.92 **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** 11:20 AM Information provided by Sapoznik Insurance is proprietary. It may not be copied,emulated or distributed without express permission.8/24/2015