Res No 104-19-15376RESOLUTION NO. 104-19-15376
A Resolution authorizing the City Manager to purchase dental and vision insurance
benefits from Humana for full-time employees and participating retirees.
WHEREAS, the City, through its Agent of Record, Brown and Brown of Florida, solicited more
than three quotes, compared the insurance rates, dental and vision plan design, provider network, as
well as the City's previous claims experience/ratio; and
WHEREAS, the City staff recommend the selection of Humana for the provision of dental and
vision insurance benefits for all full-time employees and participating retirees; and
WHEREAS, the premium shall be charged to departmental line items in their respective account
numbers.
NOW THEREFORE BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF
SOUTH MIAMI, FLORIDA THAT;
Section 1. The Commission hereby authorized the City Manager to execute the dental and
vision insurance renewal policy with Humana for the City of South Miami full time employees and
participating retirees for the 2019-2020.
Section 2: Severability. If any section, clause, sentence, or phrase of this resolution is for any
reason held invalid or unconstitutional by a court of competent jurisdiction, the holding shall not affect
the validity of the remaining portions of this resolution.
Section 3. Effective Date: This resolution shall be effective immediately upon its adoption.
PASSED AND ADOPTED this 201h day of August2019.
ATTEST: APPROVED:
1M_
CITY CL K MAYO
READ AND APPROVED AS TO FORM,
LANGUAGE, LWA'QtY AND I —,
COMMISSION VOTE: 5-0
Mayor Stoddard: Yea
Vice Mayor Harris: Yea
Commissioner Welsh: Yea
Commissioner Liebman:
Commissioner Gil: Yea
Yea
Agenda item No:3.
City Commission Agenda Item Report
Meeting Date: August 20, 2019
Submitted by: Samantha Fraga-Lopez
Submitting Department: Human Resources
Item Type: Resolution
Agenda Section:
Subject:
A Resolution authorizing the City Manager to purchase dental and vision insurance benefits from Humana for
full-time employees and participating retirees. 3/5 (City Manager -Human Resources)
Suggested Action:
Attachments:
Final Memo Vision and Dental.docx
Final Reso Vision and Dental WLCArev.doc
Copy of Comparison_Vision_sec_2019_City of South Miami.pdf
Comparison_Dental_draft_2019_City of South Miami 1.pdf
DTC,_Lincoln_COSM_2019EMAIL.pdf
Comparison Vision_2019_City of South Miami.pdf
CITY OF SOUTH MIAMI
South Miami OFFICE OF THE CITY MANAGER
THE CITY OF PLEASANT LIVING INTER -OFFICE MEMORANDUM
TO: The Honorable Mayor & Members of the City Commission
FROM: Steven Alexander, City Manager
DATE: August 20, 2019
SUBJECT: A Resolution authorizing the City Manager to purchase dental and vision
insurance benefits from Humana for full-time employees and participating
retirees.
BACKGROUND: The City's benefits consultant, Brown and Brown of Florida, Inc., solicited
quotes from Humana, Lincoln, United Healthcare, Guardian, and Principal,
for the employee's dental and vision insurance coverages for South Miami
full-time employees for the 2019 - 2020. Humana, the City's current dental
and vision insurance carrier, renewal rate represented a 0% increase from
last year's rate for the DHMO dental plan offered by the City. The dental
PPO, which can be elected at the employees' expense, increased by $1.10
per pay period. The City currently contributes $8.49 per eligible employee,
per month, toward dental insurance coverage and vision is voluntarily paid
by the employee. The Humana plans provide the best coverage including
rates, and co -pays. The rates for vision remain the same as in Fiscal Year
2018-2019. The renewal is appropriately funded in the proposed budget
for Fiscal Year 2019-2020.
RECOMMENDATION: Based upon the proposals received, Brown and Brown and City Staff
recommend the City renew with the current Humana carrier for dental and
vision insurances.
AMOUNT: The estimated total annual premiums cost for dental benefits paid by the
City is about $13,450 based on today's personnel.
ACCOUNT: Premium charges for the health will be charged to the designated
departmental budget line items as proposed in the Fiscal Year 2019-2020
budget.
ATTACHMENTS: Proposed resolution
Comparison Vision
Comparison Dental
Month Year Vision Comparison for
Network Provider
Network Status
Eye Care Wellness
Eye Exam
Frequency
Lenses
Single Vision
Bifocals
Trifocal
Frequency
Frames
Selected Frames
Frequency
Contacts
Medically Necessary
Elective Contacts
Contribution Type
Participation Requirements
Rate Guarantee
Employee
Employee + Spouse
Employee + Child
Family
Monthly Total
Annual Total
% Change in Total Annual Premium
$ Change in Monthly Premium by Plan
$ Change in Total Annual Premium
52
11
EyeMed
In -Network
OON
$0 Copay
up to $30
Every 12 Months
$0 Copay
Reimbursement
up to $25
$0 Copay
up to $40
$0 Copay
up to $60
Every 12 Months
$200 allowance +
20 /o discount over
Reimbursement
up to $100
Every 24
Months
`
100%
Reimbursement
up to $210
$200 allowance +
15 /o discount over
up to $160
Voluntary
$6.73
$13.45
$14.41
$21.71
$771.11
$9,263.32
52
11
EyeMed
In -Network
OON
$0 Copay
up to $30
Every 12 Months
$0 Copay
Reimbursement
up to $25
$0 Copay
up to $40
$0 Copay
up to $60
Every 12 Months
$200 allowance +
20% discount over
Reimbursement
up to $100
Every 24
Months
100%
Reimbursement
up to $210
$200 allowance +
15 /o discount over
up to $160
Voluntary
6ME Expires 9/30/2020
$6.73
$13.45
$14.41
$21.71
$771.11
$9,253.32
0%
$0
$0
4
Rates shown are based on census data provided. Final rates are subject to underwriting and actual enrolment. This comparison is for
nr ur rrT illustrative purposes only. The full policy and certificate of coverage will supersede any and all materials provided herein. Page 1 of 1
October 2019 Dental Comparison for City of South Miami
Plan Name
Provider Acess
Benefit Description
Preventive (Class 1)
Basic (Class II
Major Class 111
Maximum Annual Benefit
Deductible(individual/Family)
Deductible Waived - Class 1
Orthodontia (coverage/lifetime max
Reimbursement Schedule
Benefits
Routine Exams - 9430
Teeth Cleanin - 1110
Full Mouth/Panoramic X-rays - 0330
Simple Extractions - 7111
Root Canal Endodontics) - 3330
Perio. Scaling/Root Planning - 4341
Full or Partial Dentures - 5110
Crowns - 6752
Employer Contribution
Minimum Participation Requirement
Waiting Period Major Services
Rate Guarantee
Employee
Employee + Spouse
Employee + Child(ren)
Family
Monthly Premium By Product
Total Monthly Premium
Total Annual 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
48
3
8
2
Humana
Humana
DMO HD205 OR
PPO
In Network Only
In -Network
Out of Network
n/a
100%
100%
n/a
80%
80%
n/a
50%
50%
Unlimited
Unlimited
Unlimited
n/a
$50/$150
$50/$150
n/a
Yes
Yes
$2,650 Child & Adult
$1,000 Child Only
$1,000 Child Only
Fee Schedule
Fee Schedule
MAC
No Charge
No Charge
100%
100%
_ 100%
100%
No Char a
100%
100%
No Charge
80%
80%
$250
80%
80%
$55 per quad
80%
80%
$375
50%
50%
$270
50%
50%
Contributory
Contributory
None
None
12 Months
12 Months
Current
Current
$8.49
25
1
2
6
$32.29
$16.98
$67.41
$19.11
$75.97
$30.74
$119.18
$672.82 $1,741.68
$2,414.50
— - — $28 974.00 - - ---- - --
48
3
8
2
V114i
Humana
Humana
DMO HD205 OR
PPO
In Network Only
In -Network
Out of Network
n/a
100%
100%
n/a
80%
80%
n/a
50%
50%
Unlimited
Unlimited
Unlimited
n/a
$50/$150
$50/$150
n/a
Yes
Yes
$2,650 Child & Adult
$1,000 Child Only
$1,000 Child Only
Fee Schedule
Fee Schedule
MAC
No Charge
100% _
100%
100%
r 100%
No Charge
No Charge
100%
100%
No Charge
80%
80%
$250
80%
80%
$55 per quad
80%
80%
$375
50%
50%
$270
50%
50%
Contributory
Contributory
None
None
12 Months
12 Months
Renewal
Renewal
$8.49
25
1
2
6
$33.39
$16.98
$69.70
$19.11
$78.55
$30.74
$123.23
$672.82 $1,800.93
$2,473.75
-- �- $29 685.00 ` --- -- - - -
0.0% 3.4%
$0.00 $59.25
$59.25
2.5%
$711.00
5
Information shown is based on census data provided. For illustrative purposes only. The certificate of coverage, final rates, and final enrollment wfl supersede any and all materials provided herein. Page 1 of 2
Samantha Graveline
From:
Valdez, Geni <Geni.Valdez@lfg.com>
Sent:
Tuesday, July 23, 2019 9:57 AM
To:
Maria Panizo
Cc:
Brown, Jeremy; Valdez, Geni
Subject:
City of South Miami RFP -
Hi Maria,
Good morning and happy Tuesday. Thank you for the opportunity to quote on City of South Miami. Unfortunately we
are unable to offer any savings for the group at this time.
Please let me know if you have any questions.
We look forward to working with you on the next one and thanks again for the opportunity.
Have a great day,
e Valdez 407-551-2171 Office Follow us on:
Saler] s Coordinator
Lincoln Financial Group O O O O
1800 Pembrook Or Suite 150
Lincoln Financial.com
Orlando, FL 32810
Please note upcoming PTO 07125-07129
From: Maria Panizo <mpanizo@bbftlaud.com>
Sent: Thursday, July 18, 2019 2:50 PM
Subject: City of South Miami RFP - Email 1 of 1- SECML
"'This email is from an external source. Only open links and attachments from a Trusted Sender.***
You've received an encrypted message from mpanizo@bbftlaud.com
To view your message
Save and open the attachment (message.html), and follow the instructions.
Sign in using the following email address: Geni.Valdez@lfg.com
This email message and its attachments are for the sole use of the intended recipient or recipients and may contain confidential information. If
you have received this email in error, please notify the sender and delete this message.
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Notice of Confidentiality: **This E-mail and any of its attachments may contain
Lincoln National Corporation proprietary information, which is privileged, confidential,
or subject to copyright belonging to the Lincoln National Corporation family of
companies. This E-mail is intended solely for the use of the individual or entity to
which it is addressed. If you are not the intended recipient of this E-mail, you are
hereby notified that any dissemination, distribution, copying, or action taken in
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sender immediately and permanently delete the original and any copy of this E-mail
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N
October 2019 Vision Comparison for City of South Miami
Network Provider
Network Status
Eye Care Wellness
Eye Exam
Frequency
Lenses
Single Vision
Bifocals
Trifocal
Frequency --
Frames
Selected Frames
Frequency
Contacts
Medically Necessary
Elective Contacts
Contribution Type
Partici ation Requirements
Rate Guarantee
Employee
Employee + Spouse
Employee + Child
Family
Monthly Total
Annual Total
% Change in Total Annual Premium
$ Change in Monthly Premium by Plan
$ Change in Total Annual Premium
52
Eye ed
In -Network
OON
$0 Copay
up to $30
Every 12 Months
$0 Copay
Reimbursement
up to $25
$0 Copay
up to $40
$0 Copay
up to $60
Every 12 Months
$200 allowance +
20 /o discount over
Reimbursement
up to $100
Every 24
Months
100%
Reimbursement
up to $210
$200 allowance +
15 r6 discount over
up to $160
Voluntary
$6.73
$13.45
$14.41
$21.71
$771.11
$9,253.32
52
Eye ed
In -Network
OON
$0 Copay
up to $30
Every 12 Months
$0 Copay
Reimbursement
up to $25
$0 Copay
up to $40
$0 Copay
up to $60
Every 12 Months
$200 allowance +
20 /o discount over
Reimbursement
up to $100
- Every 24
Months
100%
Reimbursement
up to $210
$200 allowance +
15 /o discount over
up to $160
Voluntary
Expires 9/30/2020
$6.73
$13.45
$14.41
$21.71
$771.11
$9,253.32
0.00%
$0.00
$0.00
52
In
United Healthcare
Davis Vision
In -Network
OON
$0 Copay
up to $40
Every 12 Months
$0 Copay
Reimbursement
up to $40
$0 Copay
up to $60
$0 Copay _
up to $80
Every 12 Months
$200 allowance +
30 /o discount over
Reimbursement
up to $45
Every 24
Months
100%
Reimbursement
up to $210
$200 allowance
up to $200
Voluntary
No participation requirements
6mm 36 Months
$8.65
$17.28
$28.51
$27.89
$1,100.82
$13,209.84
42.76%
$329.71
$3,956.52
iRates shown are based on census data provided. Finatrates are suelect to underwrQmg anK9actual enro¢mEnt Vis comparison e3 for
11 1,(01
%F FIT I r ustratnre purposes only T➢le r4JD paecyr and CertlMate of coverage w® s.upersede ,any aW al) matersa� vrovWed herein Page I of 2
October 2019 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
Frequency
Contacts
Medically Necessary
Elective Contacts
Contribution Type
Participation Requirements
Rate Guarantee
Employee
Employee + Spouse
Employee + Child
Family
Monthly Total
Annual Total
% Change in Total Annual Premium
$ Change in Monthly Premium by Plan
$ Change in Total Annual Premium
E emed
In -Network
OON
$0 Copay
up to $30
Every 12 Months
$0 Copay
Reimbursement
up to $25
$0 Copay
up to $40
$0 Copay
up to $60
Every 12 Months
$ 200 allowance +
20 % discount over
Reimbursement
up to $100
Every 24
Months
100%
Reimbursement
up to $210
$200 allowance +
15 /o discount over
up to $160
Voluntary
$6.73
$13.45
$14.41
$21.71
$771.11
$9,253.32
52
• ..
VSP
In -Network
OON
$10 Copay
up to $45
Everyy 12 Months
$10 Copay
Reimbursement
up to $30
$10 Copay
up to $50
$10 Co ay
up to $65
Evergy 12 Months
$150 allowance
Reimbursement
up to $70
Every 24
Months
100%
Reimbursement
up to $210
$150 allowance
up to $105
Voluntary
20%
12 Months
$6.19
$12.37
$13.26
$19.97
$709.32
$8,511.84
-8.01 %
-$61.79
-$741.48
VSP
In -Network
OON
$10 Copay
up to $45
Every 12 Months
$10 Copay
Reimbursement
up to $30
$10 Copay
up to $50
$10 Copay
up to $65
Every
12 Months
$150 allowance
Reimbursement
up to $70
Every
24
Months
100%
Reimbursement
up to $210
$150 allowance
up to $105
Voluntary
52
Declined To Quote
5
11
9
$0.00
$0.00
D]
Rates snown are based on census date provtse4. t'mal rates are subpct to undesrwrtttng en►d actual enro¢menl This comparison is for
"FIT ; eustraVve purposes on`y The tuo paecyr arm ceftr"te of coverage w® superseae any and all materials provtseci nerem Page 2 of 2