11THE CITY OF PLEASANT LIVING
TO:
FROM:
DATE:
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER-OFFICE MEMORANDUM
The Honorable Mayor & Members of the Ci~y Commission
Steven Alexander, City Manager
Agenda Item No.:ll August 15, 2017
SUBJECT: A Resolution authorizing the City Manager to purchase dental and vision
insurance benefits from Humana for full time employees and participating
retirees.
Background: Typically, healthcare costs are expected to increase 10-15% each year
and based on that industry forecast the city budgeted for an increase of
15% to allow for proper assumptions in this regard. The City's benefits
agent on record, Brown & Brown of Florida, Inc. per Resolution #137-16-
14692, solicited quotes for the employee's dental and vision insurance
coverages for South Miami full time employees for the Plan Year 2017-
2018. Humana, the City's current dental and vision insurance carrier,
renewal rate represented 0% increase from last year. The City currently
contributes $8.49 per eligible employee, per month, toward dental
insurance coverage and the vision is voluntary paid by employee. The
renewal is appropriately funded in the proposed Budget for Fiscal Year
2017-2018.
Recommendation: Based upon the proposals received, staff recommends the City renew
with the current Humana carrier for dental and vision insurances.
Amount: The estimated total annual premium cost for dental benefits paid by the
City is about $10,000 based on today's personnel.
Account: Premium charges for the dental insurances will be charged to the
designated departmental budget line items as proposed in the Fiscal Year
2017-2018.
Attachments: Proposed resolution and 2017-2018 comparison.
1 RESOLUTION NO.
2 A Resolution authorizing the City Manager to purchase dental and vision insurance
3 benefits from Humana for the City of South Miami full time employees and participating
4 retirees.
5 WHEREAS, the City, through its Agent of Record, Brown & Brown of Florida secured more than three
6 competitive quotes for the City's Group Dental and Vision Insurance and recommended Humana as the selected
7 Dental and Vision Insurance provider.
8 WHEREAS, the City, through its Agent of Record, Brown & Brown of Florida compared the insurance
9 rates, dental and vision plan design, provider network as well as the City's previous claims experience/ratio; and
10 WHEREAS, the City Commission wishes to approve the selection of Humana for the provision of dental
11 and vision insurance benefits for all full time employees and participating retirees.
12 WHEREAS, the premium shall be charged to departmental line items in their respective account
13 numbers.
14 NOW THEREFORE BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF
15 THE CITY OF SOUTH MIAMI, FLORIDA THAT:
16 Section I. The City Commission hereby authorizes the City Manager to execute the dental and
17 vision insurance renewal policy with Humana for full time employees and retirees for the 2017-2018
18 Fiscal Year.
19 Section 2. This resolution shall take effect immediately upon adoption.
20
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32
33
34
35
36
37
38
PASSED AND ADOPTED this __ day of ____ " 2017.
ATTEST:
CITY CLERK
READ AND APPROVED AS TO FORM,
LANGUAGE, LEGALITY AND
EXECUTION THEREOF:
CITY ATTORNEY
APPROVED:
MAYOR
COMMISSION VOTE:
Mayor Stoddard:
Vice Mayor Welsh:
Commissioner Harris:
Commissioner Liebman:
Commissioner Edmond
October 2017 Dental Comparison for City of South Miami
Description
Preventive (Class I)
Basic (Class II)
Major (Class III)
Annual Benefit
(IndividuaUFamily)
DeduCtible Waived -Class I
(coveragenifetime max)
Schedule"
Routine Exams -9430
Teeth Cleaning -1110
Full MouthlPanoramic X-rays -0330
Simple Extractions -7111
Root Canal (Endodontics) -3330
ScaHngiRoot Planning -4341
Full or Partial Dentures -5110
Crowns -6752
Specially Services performed by an
participating specialist-not a general
dentist
Participation Requirement
% Change in Monthly Premium by Plan
$ Change in Monthly Premium by Plan
$ Change in Total Monthly Premium
% Change in Total Annual Premium
$ Change in Total Annual Premium
I I
DM0205
NA
NA
NA
NA
NA
NA
$2,650 Child & Adult
No Charge
No Charge
No Charge
No Charge
$250
$55 per quad
$375
$270
Contracted Biscount
Contributory
None
$19.11
$30.74
$825.56
PPO
In-Network I Out of Network
100% 100%
80010 80010
50% 50%
Unlimited Unlimited
$501$150 $50/$150
Yes Yes
$1,000 Child Only $1,000 Child Only
Fee Schedule
100%
100%
100%
80%
80%
80%
50%
50%
N/A
$2,661.56
$31
Contributory
Combined 50%
None
$73.16
$114.78
$1,836.00
MAC
100%
100%
100%
80%
80%
80%
50%
50%
N/A
I I
I I
DM0205
NA
NA
NA
NA
NA
NA
$2,650 Child & Adult
No Charge
No Charge
No Charge
No Charge
$250
$55 per quad
$375
$270
Contracted Discount
Contributory
None
$16.98
$19.11
$30.74
$825.56
PPO
In-Network Out of Network
100% 100%
80% 80%
50% 50%
Unlimited Unlimited
$501$150 $501$150
Yes Yes
$1,000 Child Only $1,000 Child Only
Fee Schedule MAC
100% .;:;:. 100%
100% 100%
100% 100%
80% 80%
'\\ .....
80% 80%
80% 80%
,:50% 50%
50% 50%
N/A N/A
Contributory
Combined 50%
None
12 Months ...
$31.69
$66.15
$74.55
$116.96
$1,870.84
$2,696.40
$32,356.80
Rates'sl1own are Dased on census data prOVided. Final rates are subject to underwriting and actual ,enl'OJlment This compariSon is for
i/JustrBtive purposes only. Th:e full policy and certificate of coverage will supersede any and all materialspl'Ovidedl1erein. Page 1 of8 II
il
il ==~==~~~~::::~~:::::==========~~~:::::::--.... -~~j!
October 2017 Dental Comparison for City of South Miami
DesCription
Preventive (Class I)
Basic (Class II)
Major (Class III)
Annual Benefit
(IndividuallFamily)
Deductible Waived -Class I
(coveragenlfetime max)
Schedule-
Routine Exams -9430
Teeth Cleaning -1110
Full MouthlPanoramic X-rays -0330
Simple Extractions -7111
Root Canal (Endodontics) -3330
ScalinglRoot Planning -4341
Full or Partial Dentures -5110
Crowns -6752
Specialty Services performed by an
participating specialist-not a general
dentist
Contribution
Participation Requirement
Period Major Services"
Premium By Product
% Change in Monthly Premium by Plan
$ Change in Monthly Premium by Plan
$ Change in Total Monthly Premium
% Change in Total Annual Premium
$ Change in Total Annual Premium
DM0205
NA
NA
NA
NA
NA
NA
$2,650 Child & Adult
No Charge
No Charge
No Charge
No Charge
$250
$55 per quad
$375
$270
Contracted Discount
Contributory
None
$16.98
$19.11
$30.74
$825.56
PPO
In-Network Out of Network
100% 100%
80% 80%
50% 50%
Unlimited Unlimited
$50/$150 $50/$150
Yes Yes
$1,000 Child Only $1,000 Child Only
Fee Schedule MAC
100% 100%
100% 100%
100% 100%
80% 80%
80% 80%
80% 80%
50% 50%
50% 50%
NlA N/A
Contributory
Combined 50%
None
I I I I In-Network Out of Network
NA 100% 100%
NA 80% 80%
NA 50% 50%
NA $3,000 $3,000
NA $50/$150 $50/$150
NA Yes Yes
$2,680 Child & Adult Not Covered Not Covered
Fee Schedule 90th Percentile
No Charge 100% .:::, 100%
$5 100% 100%
No Charge 80% 80%
$5 80% 80%
$265 80% '\,'''"~ 80%
$50 per quad 80% 80%
$440 50"A. 50%
$290 50% 50%
Contracted Rates
I I
N/A N/A
Contributory Contributory
95% Combined (Min. 5 in DHMO, Min. 10 in DPPO)
None I
$31.36
$975.20
18.1%
$149.64
I
$42,184.56
$853.82
32.1%
$10,245.84
None
$93.32
$93.59
$150.94
$2,540.18
38.4%
$704.18
Rates shown are based on census data provided. Final rates are subject to underwriting and actual ,enPDIJment. Thiscomparison,js for
illustrative purposes only. The fun policy and certificate of coverage will $oupersede any and aIJ materials provided herein. Page 4 of8
.-= ..... " .. _.,.~"' ... ~C., .• ,':"~<"7c~'...,~"?:!'C.'.. F"c''''~'''''''''~~.&;'''''''''_''':''''~'T;C·'''~~:'?"'''f~''is:'c''3~0~;·{~'';C:''l\~i,;'';?;_'
October 2017 Dental Comparison for City of South Miami
Preventive (Class I)
Basic (Class II)
Major (Class III)
Annual BeneFit
(IndividuallFamily)
Deductible Waived -Class I
(coveragenifetime max)
Schedule"
Routine Exams -9430
Teeth Cleaning -1110
Full MouthlPanoramic X-rays -0330
Simple Extractions -7111
Root Canal (Endodontics) -3330
ScalinglRool Planning -4341
Full or Partial Dentures -5110
Crowns -6752
Specially Services performed by an
participating specialist-not a general
dentist
Participation Requirement
Period MajOr Services·
Premium By Product
Monthly Premium
% Change in Monthly Premium by Plan
$ Change in Monthly Premium by Plan
$ Change in Total Monthly Premium
% Change in Total Annual Premium
$ Change in Total Annual Premium .
I I
I I
DM0205
NA
NA
NA
NA
NA
NA
$2,650 Child & Adult
No Charge
No Charge
No Charge
No Charge
$250
$55 per quad
$375
$270
Contracted Discount
Conhibutory
None
$16.98
$19.11
$30.74
$825.56
I I PPO
In-Network Out of Network
100% 100%
80% 80%
50% 50%
Unlimited Unlimited
$501$150 $501$150
Yes Yes
$1,000 Child Only $1,000 Child Only
Fee Schedule
100%
100%
100%
80%
80%
80%
50''10
50%
NIA
Conhibutory
Combined 50%
None
$64.92
$73.16
$114.78
$1,836.00
MAC
100%
100%
100%
80%
80%
80%
50%
50%
NIA
$2,661.56
$31,938.72
DMO S800B-SHP
NA
NA
NA
NA
NA
NA
$3,360 Child 1 $3,460 Adult
$5
No Charge
$50
$65
$350
$80 per quad
$502
$290
Contracted Rates
Conhibutory
None
$18.59
$23.01
$29.21
$970.90
17.6%
$145.34
PPO
In-Network Out of Network
100% 100%
80% 80%
50% 50%
$3,000 $3,000
$501$150 $501$150
Yes Yes
$1,000 Child Only $1,000 Child Only
Fee Schedule MAC
100% 100%
100% 100%
100% . 100%
'-"
80% 80%
80% 80%,
: 80"/0 80"/0
50% 50%
50% 50%
NIA NIA
Conhibutory
in DHMO, Min. 20% in DPPOl
None
$2,841.40
$34,096.80
6.8%
$2,158.08
12 Months
$33.12
$65.06
$74.99
$111.93
$1,870.50
1.9%
$34.50
Rates shown are based on census data pmvided. Final rates are subject t{) underwriting and actual enrollment. This comparison is for
mustrative purposes only. The full policy and certificate {)f coverage will supersede any and all materials pmvided herein. Page5of8
~-.-.--. '~""~C-''''''.-''-'-'''''-'' • .-: .• ......,r .. , .... ,.x~!~·.,",,~i.-.·: .. ,.:".-~"''':.':<~'''''·'·:;~f:''''5'~'!''!i'''''·~r(:'7:''{'~:···
October 2017 Dental Comparison for City of South Miami
Description
Preventive (Class I)
Basic (Class II)
Major (Class III)
IMaximum Annual Benefit
Deductible (IndividuaUFamily)
Deductible Waived.-Class I
(coverage/Jifetime max)
IReimbursement Schedule-
Routine Exams -9430
Teeth Cleaning -1110
Full MouthlPanoramic X-rays -0330
Simple Extractions -7111
Root Canal (Endodontics) -3330
FriOdontics ScalingiRoot Planning -4341
Full or Partial Dentures -5110
Crowns -6752
Specialty Services performed by an
participating specialist-not a general
dentist
I Employer Contribution
Minimum PartiCipation Requirement
Period Major Services·
Premium By Product
% Change in Monthly Premium by Plan
$ Change in Monthly Premium by Plan
$ Change in Total Monthly Premium
% Change in Total Annual Premium
$ Change in Total Annual Premium
DM0205
NA
NA
NA
NA
NA
NA
$2,650 Child & Adult
No Charge
No Charge
No Charge
No Charge
$250
$55 per quad
$375
$270
Contracted Discount
Contributory
None
Until 9130/2017 • $8.49
$16.98
$19.11
$30.74
$825.56
I I PPO
In-Network Out of Network
100% 100%
80% 80%
50% 50%
Unlimited Unnmiled
$501$150 $501$150
Yes Yes
$1,000 Child Only $1,000 Child Only
Fee Schedule MAC
100% 100%
100% 100%
100% 100%
80% 80%
80% 80%
80% 80%
50% 50%
50% 50%
N/A N/A
Contributory
Combined 50%
None I
$64.92
$73.16
$114.78
$1,836.00
$2,661.56
$31,938.72
DMOD1058 PPO
In-Network Out of Network
NA 100% 100%
NA 80% 80%
NA 50% 50%
NA $5,000 $5,000
NA $501$150 $501$150
NA Yes Yes
$2,835 Child 1 $2,935 Adult $1,000 Child Only $1,000 Child Only
Fee Schedule MAC
"':::
No Charge 100% 100%
No Charge 100% 100%
$50 100010 100%
$50 80%
... ;~
80%
$245 80% 80%
$50 per quad ·80% 80%
$325 50% 50%
$245 50% 50%
Contracted Rates N/A N/A
Contributory Contributory
I None None
$22.06 $61.66
$27.31 $69.49
4 $34.67 $109.02
$1,152.60 $1,743.87
$2,896.47
$34,757.64
39.6%. I I -5.0%
$327.04 -$92.13
$234.91
8.8%
$2,818.92
Rates slloYin are based on census data provided. Final rates are subject to underwriting and actualenmllment. This comparison is fDr
illustrative pUrpDSes Dnly. The full policy and certificate of coverage will supersede any and all materials pmvided herein. Page8of8
~I ~~ -~!-.~l ~l -.1 ~----., -
October 2017 Dental Comparison for City of South Miami
Description
Preventive (Class I)
Basic (Class II)
Major (Class III)
IMaximum Annual Benef"rt -
Deductible (IndivicluallFamily)
Deductible Waived -Class I
\Orthodontia (coveragenifetime max)
Routine Exams -9430
Teeth Cleaning -1110
Full MouthlPanoramic X-rays -0330
Simple Extractions -7111
Root Canal (Endodontics) -3330
~riOdOntiCS ScalinglRoot Planning -4341
Full or Partial Dentures -5110
Crowns -6752
Specialty Services performed by an
participating specialist-not a general
dentist
IMinimum Participation Requirement
Period Major Services·
Premium By Product
% Change in Monthty Premium by Plan
$ Change in Monthly Premium by Plan
$ Change in Total Monthly Premium
% Change in Total Annual Premium
$ Change in Total Annual Premium
NA
NA
NA
NA
NA
NA
$2,650 Child & Adult
No Charge
No Charge
No Charge
No Charge
$250
$55 per quad
$375
$270
Contracted Discount
Contributory
None
Until 913012017
$8.49
$16.98
$19.11
$30,74
$825.56
In-NetWork Out of Network
100% 100%
80% 80%
50% 50%
Unlimited Unlimited
$50/$150 $50/$150
Yes Yes
$1,000 Child Only I $1,000 Child Only
Fee Schedule MAC
100%
100%
100%
80%
80%
80%
50%
50%
N/A
$2,661.56
$31,938.72
Contributory
Combined 50%
None
$64.92
$73.16
$114.78
$1,836.00
100%
100%
100%
80%
80%
80%
50%
50%
N/A
In-Network
100%
50%
25%
$750
$15 per visit
No
Not Covered
Fee Schedule
100%
100%
100%
50%
25%
25%
25%
25%
N/A
PPO
Out of Network
100%
50%
25%
$750
$15 per visit
No
Not Covered
MAC
100%
100%
100"A>
50"A>
25%
25%
25%
25%
N/A
Contributory
None
$28.74
$33.12
$48.19
$1,349.76
:-"---" -~-.} \---.-!
PPO
In-Network Out of Network
100%
80%
100%
80%
50% 50%
$3,000
$501$150
Yes
$1,000 Child Only
Fee Schedule
$3,000
$501$150
Yes
$1,000 Child Only
MAC
$3,094.03
<:::
100%
100%
100% .,.,<' ....
80"A>
80%
80%
50%
50%
N/A
Contributory
None
$61.67
$69.50
$109.04
$1,744.27
100%
100%
100%
80"A>
80%
80%
50%
50%
N/A
$37,128.36
63.5% I I -5.0%
$524.20 -$91.73
$432.47
'1"6.2%
$5,189.64
Rates shown are based on census dataprovidied. Final rates are subject to underwriting and actual enr-ollment This oomparison is for
illustrative purposes only. The full policy and certificate of coverage Will supersede any and all materials provided herein. Page 6 of8
-.~
October 2017 Vision Comparison for City of South Miami
Carrier
Network Provider
Network Status DON
Eye Care Wellness
Eye Exam
Frequency
Lenses
Single Vision up to $25
Bifocals up to $40
Trifocal up to $60
Frequency Months
Frames Reimbursement
,
Selected Frames I
I
$200 allowance + 20% up to $100 I discount over
I
Frequency ihs
Contacts Reimbursement
Medically Necessary up to $210
Elective Contacts up to $160
Contribution Type
Participation Requirements
Rate Guarantee
Rates
Employee
Employee + Spouse
Employee + Child
60 I $5.61
10 $11.21
10 $12.01
Family 6
Monthly Total
Annual Total
% Change in Total Annual Premil m
$ Change in Monthly Premium by Plan
$ Change in Total Annual Premiu m
'In-Network DON
Reimbursement
$0 Copay up to $30
$0 Copay up to $50
$0 Copay up to $65
Every 12 Months
I Reimbursement
I $180 allowance + 20% up to $70 I discount over
~1I"ft@'teB~M_SS@ : ilM8i
Reimbursement
100% up to $210
$180 allowance up to $145
$8.14
32,54% ~
$220,42
$2,645,04
I
In-Network DON
$10 Copay up to $52
Every 12 Months
Reimbursement
$10 Copay up to $55
$10 Copay up to $75
$10 Copay up to $95
Every 12 Months
Reimbursement
.;.';:
$130 allowance + 20% up to $57 discount over
'\~
I
Every 24 Months
100%
$130 allowance
$5.75
$11.49
$12.31
Reimbursement
up to $210
up to $105
_. 2;50% ---~
$16,96
$203,52
Rates sh,own are based on census data provided!. Final rates are subject to underwritirl1gand actual ·enrollment. This comparison is for
illustrative purposes only. The full pDlicy and certificate of cDverage will supersede any and all materials provided herein. Page 5 of8
---------------~~==::=:~~~~~~~~iiiiiiiiiiiiiiii~~~~~
October 2017 Vision Comparison for City of South Miami
Carrier
Network Provider
Network Status
Eye Care Wellness
Eye Exam
Frequency
Lenses
Single Vision
Bifocals
Trifocal
Frequency
Frames
Selected Frames
i
FrequencY
Contacts
I Medically Necessary
Elective Contacts
Contribution Type
PartiCipation Requirements
Rate Guarantee
Rates
Employee 60
Employee + Spouse 10
Employee + Child 10
Family 6
Monthly Total
Annual Total
% Change in Total Annual Premil m
$ Change in Monthly Premium by Plan
$ Change in Total Annual Premiu m
OON
Reimbursement
up to $25
up to $40
up to $60
Months
$200 allowance + 20%
discount over
discount over
$11.21
$12.01
$18.09
$1
$8
Reimbursement
up to $100
up to $210
up to $160
In-Network
$0 Copay
$0 Copay
$0 Copay
$0 Copay
Months
$180 allowance + 20%
discount over
100%
$180 allowance
$23.34
$37.34
up to $30
up to $50
up to $65
.:;~:'
up to $70
,,~
up to $210
up to $105
272.60% -I
$1,846.42
$22,157.04
Rates sllown a,re based on census data pro-vided. Final rates are subject to underwriting and actual enrollment. Th,is comparison is fDr
illustrative purposes Dnly. The full policy and certificate of CDv·erage will supersede any and all materials pro-vided Ilerein.
---------------~--.~:------::---~-:::--.•• --.-:-~::-.-.-::-:::-.--.=,-~.:;:;:.--'.-----"-'-~::---=--.-~::
Page 8 of8
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