Res No 180-16-14735RESOLUTION NO.180-16-14735
A Resolution authorizing the City Manager to purchase dental and vision insurance
benefits from Humana for the City of South Miami full time employees and participating
retirees.
WHEREAS,the Benefits Consultant,Brown &BrownofFlorida,secured more than three competitive
quotesfortheCity'sGroupDentaland Vision InsuranceandstaffrecommendsHumanaastheselecteddental
andvision Insurance provider;and
WHEREAS,theCity'sstaffcomparedtheinsurancerates,dentaland vision plans,providernetworks
aswellas the City'spreviousclaimsratio;and
WHEREAS,theCityCommissionwishestoapprovetheselectionofHumanafortheprovisionof
dentalandvision insurance benefitsforall full time employees and participating retirees.
NOW THEREFORE BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF
THE CITY OF SOUTH MIAMI,FLORIDA THAT:
Section I.TheCityCommissionherebyauthorizestheCityManagerto execute thedentalandvisioninsurance
renewalpolicywithHumanafor full timeemployeesand retirees forthe 2016-2017 Fiscal Year.
Section 2.This resolution shall take effectimmediatelyupon adoption.
PASSED AND ADOPTED this 20thday of Sept.2016.
ATTEST:
CITY CLERK v-/Y
READ AND
LANGUAGJ
DAS TO FORM,
YANC
EOF:
APPROVED:
MAYOR
»ft.M.
COMMISSION VOTE:
Mayor Stoddard:
ViceMayorWelsh:
Commissioner Edmond:
Commissioner Harris:
Commissioner Liebman:
5-0
Yea
Yea
Yea
Yea
Yea
hhfui'Soutff'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
September 20,2016 Agenda Item No.:
RECOMMENDED ACTION:
A Resolution authorizing the CityManager to purchase DentalandVision
Insurance benefits from Humana for the City of South Miami full time employees
and participating retirees.
Typically,healthcare costs are expected to raise10-15%each year and based on
that industry forecast theCity budgeted foran increase of15%toallowfor proper
assumptions inthisregard.The City's benefits consultant,Brown&Brownof
Florida,Inc.per Resolution 137-16-14692,solicited quotes for the employee dental
and vision insurance coverage for South Miamifull time employees for the PlanYear
2016-2017.Metlife,theCity's current health insurance carrier,first proposed
renewal rate represented a10.9%increase.The City currently contributes $12.57
per eligible employee,per month,toward dental insurance coverage.This amount
will decrease to$8.49 under the proposed Humana renewal.Additionally,the
current visionplanis$6.60and the proposed ratehasbeen reduced to$5.54.
After intense negotiations with Humana,staff recommends Humana as the provider
for its dental and visionplans for the FY 2016-2017.Humana provides an enhanced
and improved plan than our current provider.Humana provided the Citya proposed
a savings of 26.75%on dental and a savings of 10.54%on vision.
Amount:
Account:
Attachments:
The estimated total annual cost for dental is $27,986.28 based on today's personnel
2016/2017 Budget.
Proposed resolution
2016/2017 Benefits Renewal Summary fromBrown&Brown Insurance
October 2016Dental Comparison for City of South Miami
Plan
Provider Acess
BenefitDescription
Preventive(Class I)
Basic (Class II)
Major (Class III)
Maximum Annual Benefit
Deductible(IndividuatfFamify)
DeductibleWaived-Class I
Orthodontia (coverage/lifetime max)
Reimbursement Schedule**
Benefits
Routine Exams-9430
Teeth Cleaning-1110^
FullMouth/Panoramic X-rays -0330
Simple Extractions-7111
RootCanal(Endodontics)-3330
Periodontics Scaling/Root Planning -4341
FullorPartial Dentures -5110
Crowns •6752
SpecialtyServices performed byan
participatinq speciaJist-nota penera!dentist
EmployerContribution
Minimum Participation Requirement
WaitingPeriodMajor Services*
Rate Guarantee
EE
ES
EC
Family
Monthly PremiumByProduct
TotalMonthlyPremium
Total Annual Premium
Met290
NA
NA
NA
NA
NA
$2,680 Child
NoCharge
$5
NoCharge
$5
$265
$50perquad
$440
$290
Contracted Discount
Contributory
5 enrolled
None
12 Months
In-Network OutofNetwork
100%100%
80%80%
50%50%
$5,000 $2,500
$50/5150 $50/$150
Yes Yes
$1,000Child $1,000 Childt
Fee Schedule MAC
100%100%
100%100%
100%100%
80%80%
80%80%
80%80%
50%50%
50%50%
N/A N/A
Contributory
None
12Months
$12.57 18 $42.10
$22.00 4 $87.89
$26.39 2 $99.04
$37.09 4 $155.38
$1,255.10 $1,92a96
$3,184.06
$38,208.72
DMOHS205 PPO
In-Netorork Outof Network
N/A .100%100%
N/A 80%80%
N/A 50%50%
N/A Unlimited Unlimited
N/A $50/$150 $50/$150
N/A Yes •Yes
$2,650Child&Adult $1,000Child Only $1,000 Child Only
Fee Schedule MAC
NoCharge 100%100%
NoCharge 100%100%
NoCharge 100%100%
NoCharge 80%80%
$250 80%80%
$55perquad 80%80%
$375 50%50%
$270 50%50%
Contracted Discount N/A N/A
Contributory Contributory
Combined 50%Combined 50%
N/A None
24Months 24Months
$8.49 18 $31.10
$16.98 4 $64.92
$19.11 2 $73.16
$30.74 4 $114.78
$907.27 $1,424.92
$2,332.19
$27,986.28
%Change inAnnual Premium */&*'«
*Waling period forMajor services iswaived for members whohavebeencovered under current plan for more than 12months.
"MACreimbursement meansthatbenefits forout-of-network servicesarebasedonthe in-network negotiated fee schedule.Patients
maybe balance billed thedifference bytheir dentist
Rates shown are based on census dataprovided.Pinalratesaresubjectto underwriting andactualenrollment.Thiscomparisonisfor
illustrativepurposesonly.The fuD policyandcertificateofcoveragewB supersede anyand afimaterialsprovided herein
October 2016 Vision Comparison forCity of South Miami
Network Provider
Network Status
EyeCareWellness
EyeExam
Frequency
Lenses
Single Vision
Bifocals
Trifocal
Frequency
Frames
Selected Frames
Frequency
Contacts
Medically Necessary
Elective Contacts
Rate Guarantee
EmployerContribution
Participation Requirements
Employee
Employee +SP
Employee+CH
Family/+2
MonthlyTotal
Annual Total
%Change in Annual Premium
In-Network
$10Copay upto$45
Every 12Months
$10Copay
$10Copay
$10Copay
OON
Reimbursement
upto$30
upto$50
upto$65
Every12 Months
Reimbursement
$130 allowance+20%
discount over
upto$70
Every24Months
$10Copay
$130 allowance
Reimbursement
upto $210
upto$105
12 Months
Voluntary
$6.60
$11.19
$13.22
$18.46
$635.55
$7,626.60
In-Network OON
$0 Copay upto$30
Every 12 Months
$0Copay
$0 Copay
$0 Copay
Reimbursement
upto$25
upto$40
upto$60
Every12 Months
$200 allowance+20%
discount over
Reimbursement
upto$100
Every24Months
Covered 100%
$200allowance
Reimbursement
upto$210
upto$160
24 Months
Voluntary
50%
$5.61
$11.21
$12.01
$18.09
$568.58
$6,822.96
-10.54%
Rates shown are based on census dataprovided.Final rates are subject to underwrite.an6 actual enrollment This comparison istor
ffluslratrve purposes onty.The ful poHcyandcertificateof coverage v/fi supersede anyandaBmaterialsprovidedherein.Page 2ot3