Res No 094-21-15714LVb*
9
RESOLUTION NO.094-21-15714
A Resolution authorizing the City Manager to purchase group health insurance
benefits from Neighborhood Health Plan (NHP) for full-time employees and
participating retirees.
WHEREAS, the Benefits Consultant, Brown and Brown of Florida secured more than three
quotes for the City's Group Health Insurance and recommended Neighborhood Health Plan (NHP)
as the selected provider; and
WHEREAS, the City staff and its Agent of Record, Brown and Brown of Florida, compared
the insurance rates, benefits plan design, provider network, as well as the City's previous claims
experience/ratio; and
WHEREAS, the City Manager wishes to recommend the selection of NHP's HMO 2021 CIA
BXLH/Rx NHSY plan for the provision of group health 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 foregoing recitals are hereby ratified and confirmed as being true and they
are incorporated into this resolution by reference as if set forth in full herein.
Section 2. The Commission hereby authorized the City Manager to purchase group health
insurance benefits from NHP for their HMO 2021 CIA BXLH/Rx NHSY plan for the City of South
Miami full-time employees and participating retirees for the 2021-2022.
Section 3. Corrections. Conforming language or technical scrivener -type corrections
may be made by the City Attorney for any conforming amendments to be incorporated into the
final resolution for signature.
Section 4. 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 S. Effective Date. This resolution shall become effective immediately upon
adoption.
PASSED AND ADOPTED this 17th day of August2021.
Page 1 of 2
Re; Nd. 094-21-15714
ATTEST:
A) kCITY CLEENK 6
READ AND APPROVED AS TO FORM,
APPROVED:
MAY
•
COMMISSION VOTE:
5-0
Mayor Philips:
Yea
Commissioner Corey:
Yea
Commissioner Harris: Yea
Commissioner Liebman: Yea
Commissioner Gil: Yea
Page 2 of 2
Agenda item No:5.
City Commission Agenda Item Report
Meeting Date: August 17, 2021
Submitted by: Samantha Fraga-Lopez
Submitting Department: Human Resources
Item Type: Resolution
Agenda Section:
Subject:
A Resolution authorizing the City Manager to purchase group health insurance benefits from Neighborhood
Health Plan (NHP) for full-time employees and participating retirees. 3/5 (City Manager)
Suggested Action:
Attachments:
Memo Health Insurance.docx
Reso Health Ins 21-22.docx
21-22 Health Rate Comparison.pdf
Proposal & Disclaimers REV_2021_CSM.pdf
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER -OFFICE MEMORANDUM
To: The Honorable Mayor & Members of the City Commission
FROM: Shari Karnali, City Manager
VIA: Samantha Fraga-Lopez, Assistant City Manager
DATE: August 17, 2021
SUBJECT: A Resolution authorizing the City Manager to purchase group health
insurance benefits from Neighborhood Health Plan (NHP) for full-time
employees and participating retirees for Fiscal Year 2021-2022.
BACKGROUND: The City's Benefit Consultant, Brown and Brown, solicited quotes for the
employee group insurance coverage for South Miami full-time employees
for the 2021-2022 benefit year. After lengthy negotiations, NHP, the City's
current health insurance carrier, proposed a renewal rate which
represented an 8.9% increase in premiums for a plan identical to the
current plan. NHP offered an alternate plan with a $S increase in co -pays
but a much lower out -of -pocked maximum and less expensive options for
hospital services and outpatient services. Prices for prescription drugs
remain the same. This plan is priced at a 7.7% increase over present and is
the recommended plan for approval.
Due to expensive claims for serious health issues experienced during Fiscal
Year 2020-2021, Florida Blue offered a quote that was not competitive
(33.6% increase), and Aetna and Cigna declined to quote since they were
unable to offer a competitive rate. NHP offered the best plan with the most
competitive rates.
Based on prior plan rates, coverage offered including co -pays for
employees, and overall cost, the NHP HMO 2021 OA BXLH/Rx NHSY offers
the best plan for the City and its employees. Monthly rates are as follows:
Coverage
2021-2022
Employee
$655.56
Employee &
Spouse
$1,560.24
Employee &
Children
$1,206.23
Family
$2,045.35
E
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER -OFFICE MEMORANDUM
The City currently contributes $608.83 per eligible employee per month
toward health insurance coverage. As outlined above, this amount will
increase to $655.56, which is 7.7% more than Fiscal Year 2020-2021.
However, NHP has offered a one-time credit, which will be received in
September 2021 in the amount of approximately $29,000 (exact amount
to be determined based on number of enrollees). Once the credit is
received, the increase in cost to the City will be approximately 3.5% as
opposed to 7.7%
Through ongoing health and wellness initiatives, the City hopes to reduce
the rates in Fiscal Year 2022-2023. The proposal is appropriately funded in
the proposed budget for Fiscal Year 2021-2022.
RECOMMENDATION: Based upon the proposals received, City staff recommends the City
purchase the health insurance plan offered by NHP.
AMOUNT: The estimated total annual premiums cost paid by the City for health
benefits after the credit are approximately $923,000 based on today's full-
time personnel.
ACCOUNT: Premium charges for the health insurance will be charged to the
designated departmental budget line items as proposed in the Fiscal Year
2021-2022 budget.
ATTACHMENTS: Proposed resolution
2021-2022 Benefits Renewal Summary
Health Insurance Quote Comparison Chart
3
I RESOLUTION NO.
2
3 A Resolution authorizing the City Manager to purchase group health insurance
4 benefits from Neighborhood Health Plan (NHP) for full-time employees and
5 participating retirees.
6
7 WHEREAS, the Benefits Consultant, Brown and Brown of Florida secured more than three
8 quotes for the City's Group Health Insurance and recommended Neighborhood Health Plan (NHP)
9 as the selected provider; and
10
11 WHEREAS, the City staff and its Agent of Record, Brown and Brown -of Florida, compared
12 the insurance rates, benefits plan design, provider network, as well as the City's previous claims
13 experience/ratio; and
14
15 WHEREAS, the City Manager wishes to recommend the selection of NHP's HMO 2021 CIA
16 BXLH/Rx NHSY plan for the provision of group health insurance benefits for all full-time
17 employees and participating retirees; and
18
19 WHEREAS, the premium shall be charged to departmental line items in their respective
20 account numbers.
21
22 NOW THEREFORE BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY
23 OF SOUTH MIAMI, FLORIDA THAT;
24
25 Section 1. The foregoing recitals are hereby ratified and confirmed as being true and they
26 are incorporated into this resolution by reference as if set forth in full herein.
27
28 Section 2. The Commission hereby authorized the City Manager to purchase group health
29 insurance benefits from NHP for their HMO 2021 CIA BXLH/Rx NHSY plan for the City of South
30 Miami full-time employees and participating retirees for the 2021-2022.
31
32 Section 3. Corrections. Conforming language or technical scrivener -type corrections
33 may be made by the City Attorney for any conforming amendments to be incorporated into the
34 final resolution for signature.
35
36 Section 4. Severability. If any section clause, sentence, or phrase of this resolution is for
37 any reason held invalid or unconstitutional by a court of competent jurisdiction, the holding shall
38 not affect the validity of the remaining portions of this resolution.
39
40 Section 5. Effective Date. This resolution shall become effective immediately upon
41 adoption.
42
43 PASSED AND ADOPTED this day of 12021.
4
1
2
3
4
5
6
7
8
9
10
11
12
13
ATTEST:
CITY CLERK
APPROVED:
MAYOR
READ AND APPROVED AS TO FORM, COMMISSION VOTE:
LANGUAGE, LEGALITY AND Mayor Philips:
EXECUTION THEREOF Commissioner Corey:
Commissioner Harris:
Commissioner Liebman:
Commissioner Gil:
CITY ATTORNEY
5
October 2021 Medical Plan Comparison for City of South Miami
Carver Name
Plan, Type
Product name
Calendar Year Deductible (CYD)
Individual / Family
Coinsurance
Provider Services
Primary Care Office Visit
Specialist Office Visit
Virtual Visit -Designated Virtual Provider
Preventative Care
Hospital Services
Inpatient Hospital Facility
Hospital Physician Services
Outpatient Hospital Facility
Emergency Room Facility
Outpatient FacllltylDiagnustic
Ambulatory Surgery Center
ASC Physician Services
Lab /X-Ray
Major Diagnostic (MRI,CAT,CT,PET)
Urgent Care
Annual Out -of -Pocket Maximum
Includes Deductible (Yes / No)
Individual / Family
Lifetime Maximum
Prescription Drugs
Tier i/Tier 2/Tier 3/Tier 4/Tier 5
Mail Order 90 Day Supply)
Preferred, Specialty Retail Netvork
Coinsurance
Emergency Room Facility
All Other Services
Deductible - Individual/Family
Annual Out -of -Pocket - Indiv/Family
Lifetime Maximum
Employee
Emplo & Spouse
Employee & Child(ren)
Family
Monthly Total by Product
Annual Total
$ Change In Monthly Premium
% Change in Total Annual Premium
$ Chan a in Total Annual Premium
NHP
NHP HMO 2020 CIA
BXLG-M21 Fix NH21
None
100%
Open Access
$10
$25
so
$0
$500
$0
$500
$250'
$500
s0
$o
$250
$75
Yes
$4,000 / $8,000
Unlimited
$10/$35/$70
$25/$87.50/$175
$10/$150/$500
Na
$250
Na
n/a
Na
n/a
$608.83
$1,449.02
$1,120.25
$1,899.55
$59,275.72
$711 308.64
Per FL Statute, Must Be Medical Emergency Defined by 641.31097
74
0
11
74
74
0
tt
$5.301.27 $5,301.27 $4,549.60 $4,549.60
8.9% 4.7% 7.7% 3.5%
$63615.24 $33673.24 $54595.20 $24653.20
Inronnatmn shaven a based, on census data provided. For4lustrahve purposes only. The cedibcste ofwmrage, final rates. and, final enollmentW/ supersede any and all matenals pmvlded herein. Page loft/
October 2021 Medical Plan Comparison for City of South Miami
Cartier Name
Plan Type
Product name
IN -NETWORK
Calendar Year Deductible (CYD)
Individual / Family
Coinsurance
Provider Services
Primary Care Office Visit
Specialist Office Visit
Virtual Visit -Designated_ Virtual_ Provider
Preventative Care
Hospital Services
Inpatient Hospital Facility
Hospital Physician Services_ _
Outpatient Hospital Facility
Emergency Room Facility
Outpatient Facility/Diagnostic
Ambulatory Surgery Center _
ABC Physician Services
Lab /X-Ray _
Major Diagnostic (MRI,CAT,CT,PET)
Urgent Care
Annual Outof-Pocket Maximum
Includes Deductible (Yes / No)
Individual / Family
Lifetime Maximum
Prescription Drugs
Tier 1/Tier 21Tier 3/Tier 47Tier 5
Mail Order 90 Day Supply)
Preferred Specialty Retail Network
Coinsurance
Emergency Room Facility _
All Other Services
Deductible - Individual/Family
Annual Outof-Pocket - Indiv/Family
Lifetime Maximum
Employee
_Employee & Spouse _
Employee & Child(ren)
Family
Monthl Total b Product
Annual Total
$ Change in Monthly Premium
% Change in Total Annual Premium
$ Change in Total Annual Premium
74
0
11
1
NHP
NHP HMO 2020 CA
BXLG-M2/Rx NH21
None
100%
Open Access
$10
$25
$0
$0
$500
$0
$500
$250'-----
$500
$0
$0
$250
$75
Yes
$4,000 / $8,000
Unlimited
$10/$35/$70
$25/$87.50/$175
$10/$150/$500
Z
$608.83
$1,449.02
$1,120.25
$1,899.55
$59,275.72
$711 308.64
Per FL Statute. Must Be Medical Emergency Defined by 641.31097
74
0
ii
1
$4,631.09
$54 373.08
74
0
I1
1
74
0
11
1
Open Access
$25
$45
$25 / $45
$0
0% Aft Ded _
0% Aft Ded
0% Aft Ded
0% Aft Ded
0% Aft Ded
$0
$50
$10/$35/$70
$25/$87.50/$175
Na
74 1 $646.50
0 $1,538_67
11 _ _ $1,189.56
1 $2.017.08
$3,667.52 $3,667.52
6.2 % 2.0%
$44010.24 $14068.24
Infonvdllon shown is based on census data povided. For iflustrativepurposes only The corificate of coverage, final rates, and finalenrollmenl Wlsupersede any and all andlenalsprciededherein Page 2of7
October 2021 Medical Plan Comparison for City of South Miami
Carrier Name
Plan Type
Product name
IN -NETWORK
Calendar Year Deductible (CYD)
Individual / Family
Coinsurance
Provider Services
Primary Care Office Visit
Specialist Office Visit
Virtual Visit -Designated Virtual Provider
Preventative Care
Hospital Services
Inpatient Hospital Facility
Hospital Physician Services
Outpatient Hospital Facility
Emergency Room Facility
Outpatient Facility/Diagnostic
Ambulatory Surgery Center
ASC Physician Services
Lab / X-Ray
Major Diagnostic (MRI,CAT,CT,PET)
Urgent Care
Annual Out -of -Pocket Maximum
Includes Deductible (Yes / No)
Individual / Family
Lifetime Maximum
Prescription Drugs
Tier 1/Tier 2/Tier 3/Tier 4iTier 5
Mail Order 90 Day Supply)
Preferred SQ2cialty Retail Network
OLIt-Of-Network Benefits
Coinsurance
Emergency Room Facility
All Other Services
Deductible - Individual/Family _
Annual Out -of -Pocket - Indiv/Family
Lifetime Maximum
Employee
Employee & Spouse
Employee & Child(ren)
Family
Monthly Total by Product
Annual Total
$ Change in Monthly Premium
% Change in Total Annual Premium
$ Change in Total Annual Premium
Rill
NHP
NHP HMO 2020 OA
BXLG-M2 / Rx NH21
None
100%
Open Access
$10
$25
$0
$0
$500
$0
-- $500
$250*
$500
$0
$0
$250
$75
Yes
$4,000 / $8,000
Unlimited
$10/$35/$70
$25/$87.50/$175
$10/$150/$500
n/a
$250
n/a
n/a
n/a
n/a
$608.83
$1,449.02
$1,120.25
$1,899.55
$59,275.72
$711 308.64
* Per FL Statute, Must Be Medical Emergency Defined by 641.31097
Florida Blue
BlueCare
55
None
100%
Open Access
$10
$10
$0/$10
$0
$250
$0
$150
$100
$100
$10
$0/$10
$50
$10
Yes
$2,500 / $7,500
Unlimited
$10/$50/$80
$25/$125/$200
n/a
$100
n/a
n/a
n/a
n/a
74 $805.75
0 $1,917.69
11 $1,547.04
1 $2,578.40
$79,221.34
$950 656.08
._]
$19,945.62
33.6%
$239 347.44
Information shown is based on census data provided. For illustrative purposes only. The certificate of coverage, final rates, and final enrollment w11 supersede any and all materials provided herein. Page 3 of
Group Insurance
City of South Miami
Located At:
6130 Sunset Drive
South Miami, FL 33143
Presented By:
Samantha Graveline
SVP, Employee Benefits
Shadi Kamyab
Senior Account Executive
All Information is Strictly Confidential
Table of Contents
Introduction
- Marketing Summary
- Decline to Quote Letters
i
Medical Coverage 2
- Medical Comparison
Ancillary Coverages 3
- Dental Comparison
- Vision Comparison
- Basic Life / LTD Comparison
- Voluntary STD Comparison
- Voluntary Life Comparison
C!
Disclosures
- A.M. Best Ratings/Compensation Disclaimer
10
Section
1
Marketing Summary
Below is a summary of our marketing efforts.
We requested proposals from the following:
Medical Plan
• United Healthcare/NHP — Current Carrier
• Florida Blue — Received/shown
• Aetna — Declined to quote, uncompetitive
• Humana — Declined to Quote, uncompetitive
• CIGNA — Declined to quote, uncompetitive
Dental Plan
• Humana — Current Carrier
• MetLife — Received/shown
• Aetna — Declined to quote, uncompetitive
• Lincoln — Declined to Quote, uncompetitive
• Mutual of Omaha — Declined to quote, uncompetitive
• The Standard — Declined to quote, uncompetitive
• United Healthcare — Declined to quote, uncompetitive
• CIGNA — Market checked / Need response
• Florida Blue — Market checked / Need response
• Guardian — Market checked / Need response
Vision Plan
• Humana — Current Carrier
• MetLife — Received/shown
• Aetna — Declined to quote, uncompetitive
• Lincoln — Declined to Quote, uncompetitive
• Mutual of Omaha — Declined to quote, uncompetitive
• The Standard — Declined to quote, uncompetitive
• United Healthcare — Declined to quote, uncompetitive
• CIGNA — Market checked / Need response
• Florida Blue — Market checked / Need response
• Guardian — Market checked / Need response
Basic Life, Voluntary Life, Short -Term Disability and Long -Term Disability
• Mutual of Omaha — Current Carrier
• MetLife — Received/shown (Basic Life / Voluntary Life)
• MetLife — Declined to quote, uncompetitive (Disability)
• The Standard — Received/shown (Basic life / Voluntary Life)
• The Standard — Market checked / Need response (Disability)
• Cigna — Market checked / Need response
• Florida Blue — Market checked / Need response
• Humana — Market checked / Need response
• Guardian- Market checked / Need response
• Lincoln — Declined to Quote, uncompetitive
• United Healthcare — Declined to quote, uncompetitive
1 1 P a g e
261 N. University Drve
Plantation, FL 33324
July 27, 2021
Maria E. Panizo
Brown & Brown of Florida, Inc.
1201 W. Cypress Creek Road, Suite 130
Fort Lauderdale, FL 33309
mpanizo@bbftlaud.com
I :� may: �•(i] �YiDl:: � ��i I Ie\ ��i I I
Dear Ms. Panizo:
Aetna thanks you for the opportunity to prepare a medical benefit quote for CITY OF SOUTH
MIAMI. After reviewing the submitted information, UW is declining to generate a quote as our
proposal will not be competitive.
Thank you for your confidence and trust in Aetna and our family of health benefit solutions.
We look forward to serving you and your valuable clients in the future. Please call me at (954)
593-2951 if you have any questions, or if I can be of further assistance.
Sincerely,
Mriana Perez
Account Executive
14
July 27, 2021
Brown & Brown Ft. Lauderdale
Dear Maria:
Thank you for providing Aetna the opportunity to quote the dental and vision coverage for City of South Miami.
Unfortunately we are unable to offer the requested dental or vision proposals to this prospect. After reviewing the
specs submitted, I do not feel we would be able to offer a financially competitive quote due to the following
reasons:
• Our rates are not competitive.
While I was unable to assist you this time, I appreciate your consideration of Aetna and look forward to working
with you on the next case.
Sincerely,
M%kel
Michael Puglisi
Sales Director Dental/Vision/Voluntary South Florida
15
Maria Panizo
From: Bishop Primo <bishop.primo@cigna.com>
Sent: Tuesday, July 27, 2021 2:45 PM
To: Maria Panizo
Subject: Response To Your Inquiry - City of South Miami
[External]
Daniel Imme
New Business Manager
Sunrise, FL 33323
July 27, 2021
Samantha Graveline
Brown & Brown of Florida, Inc.
1201 W. Cypress Creek Road, Suite 130
Fort Lauderdale, FL33309
RE: City of South Miami
Thank you for considering Cigna HealthCare for City of South Miami.
Based upon our evaluation of the information provided with your request
for proposal, we do not believe that we can offer a competitive
proposal. Therefore, we respectfully decline to offer a quote at this time.
We appreciate being given the opportunity to review your request for a
proposal and we look forward to working with you on future prospects.
Please do not hesitate to contact me if you have any questions.
Sincerely,
Daniel Imme
New Business Manager
(954) 514-6847
Attention California Agents/Brokers: A copy of this letter must immediately
be forwarded to the client in order to comply with California law, SB 1163
(2010).
16
17
Maria Panizo
From: Mickey Wells <MWells13@humana.com>
Sent: Tuesday, July 27, 2021 10:41 AM
To: Maria Panizo
Cc: Shadi Kamyab; Samantha Graveline; Natasha Neita
Subject: Humana Medical - City of South Miami
[External]
Good morning Maria,
I have spoken to Shadi but I wanted to share with the team that we are unfortunately not a great fit for the City of South
Miami's medical this year. We value our partnership with the City on the ancillary lines and appreciate the opportunity
to have competed for the medical. We hope to be more competitively priced next year.
I will send a DTQ letter for your records as soon as I have it back.
Thank you,
Mickey Wells
Public Sector Sales Executive 100-299 1 Commercial Sales ( Florida
Humana
C 954 477 1251
E mwellsl3@humana.com
Your Humana Business Sales Team ( Medical / Dental / Vision / Life / Go365 / EAP
• Go365
Continually updated resources and information can be found at
www.humana.com/coronavirus
Still have questions or concerns?
We're committed to ensuring you have the support. Your Humana representative will continue to be available
to assist you locally. We have also established a dedicated
service line, specifically for agents: Phone number: 1-800-592-300501
and Email: COVIDguestions@humana.com
The information transmitted is intended only for the person or entity to which it is addressed
and may contain CONFIDENTIAL material. If you receive this material/information in error,
please contact the sender and delete or destroy the material/information.
Humana Inc. and its subsidiaries comply with applicable Federal civil rights laws and
do not discriminate on the basis of race, color, national origin, ancestry, age, disability, sex,
marital status, gender, sexual orientation, gender identity, or religion. Humana Inc. and its subsidiaries do not
exclude people or treat them differently because of race, color, national origin, ancestry, age,
disability, sex, marital status, gender, sexual orientation, gender identity, or religion.
18
English: ATTENTION: If you do not speak English, language assistance services, free
of charge, are available to you. Call 1-877-320-1235 (TTY: 711).
Espanol (Spanish): ATENCIbN: Si habla espanol, tiene a su disposicion servicios
gratuitos de asistencia linguistica. Llame al 1-877-320-1235 (TTY: 711).
ME X(Chinese):: 'J%:AU12 13,1G QJL:l%1R' Q A #]
00 eft% 1-877-320-1235 (TTY: 711)o
Kreyol Ayisyen (Haitian Creole): ATANSION: Si w pale Kreyol Ayisyen, gen sevis ed
you tang ki disponib gratis you ou. Rele 1-877-320-1235 (TTY: 711).
Polski (Polish): UWAGA: Jeieli mowisz po polsku, moiesz skorzystac z bezptatnej
pomocy jgzykowej. Zadzwon pod numer 1-877-320-1235 (TTY: 711).
`E � (Korean): T°�: �F � F �fgc of �� � oT, °i 7C� a Jl1tl� � z -r MEp
01 o —Lz T M d l_l C[. 1-877-320-1235 (TTY: 711) t�i 2 0H -r � 12.
19
Maria Panizo
From:
Sent:
To:
Cc:
Subject:
[External]
Dear Shadi and Samantha,
Johnson, Sue <Sue.Johnson@lfg.com>
Friday, July 23, 2021 9:58 AM
Shadi Kamyab
Brown, Jeremy; Maria Panizo; Samantha Graveline
City of South Miami
Thank you for the opportunity to provide a proposal on City of South Miami.
Unfortunately we were unable to provide a quote more competitive than the Inforce carrier.
Please accept this email as our formal decline. We apologize that our response is not more favorable. If you
have any questions or concerns please do not hesitate to call Jeremy or myself .
Sincerely,
A.
Sue ales C000n
rdinator
r] Sr. Sales Coordinator
Lincoln Financial Group
8900 Keystone Crossing
Suite 535
Indianapolis, IN 46240
317-249-6175 Office
317-753-1431 Mobile
Lincol n Fi na n cia I.com
Follow us on:
OOOO O in
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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and may be unlawful. If you have received this E-mail in error, please notify the
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and any printout. Thank You.**
20
METLIFE
Employee Benefits Sales and Service
4010 Boy Scout Boulevard
Suite 950
Tampa, FL 33607
813-393-5888
800-972-6177
FAX: 813-393-5843
866-277-3913
July 28, 2021
Jorge Villavicencio
Brown and Brown Of Florida Inc
To Whom It May Concern,
Thank you for your interest in MetLife and for the opportunity to quote on the benefit program
of City Of South Miami.
Unfortunately, we are unable to provide competitive disability rates at this time. Therefore, we
respectfully decline to issue a disability proposal for this group account.
If we can be of any assistance to you in the future, please don't hesitate to call us at the above
number.
We welcome the opportunity to serve you again.
Yours truly,
Jorge Villavicencio
MetLife
Metropolitan Life Insurance Company, New York. New York 10166
21
Maria Panizo
From: Karen.Plunkett@mutualofomaha.com
Sent: Monday, July 19, 2021 10:00 AM
To: Maria Panizo
Subject: City of South Miami
[External]
Hi Maria —
Good Morning!
Thank you for considering Mutual of Omaha as a potential carrier for the above group. I regret that we will not be
releasing a quote. Please accept this e-mail as our formal declination.
Once again, thanks for thinking of us. We appreciate the opportunity and look forward to working with you on other cases.
Have a great week!
Karen S. Plunkett, FLMI, HIA, ACS, AIAA, AIRC, ARA
Mutual of Omaha I South Florida Group Sales Office
1000 Sawgrass Corporate Parkway I Suite 158 1 Sunrise, FL 33323
C: (954) 830-6676 O: (954) 626-5200 1 F: (964) 845-6077 1 E: Karen.PlunkettCa mutualofomaha.com
Customer Service / Service Team: FLAservice(&mutualofomaha.com or (800) 769-7159
BILLING, ELIGIBILITY, and GENERAL SERVICE QUESTIONS, please contact your dedicated SERVICE TEAM
P: (800) 769-7169 (8 AM— 8 PM EST) I E: FLAservice(o mutualofomaha.com
CLAIM PHONE NUMBERS
Life: (800) 775-8805 1 Disability: (800) 877-5176 1 Dental: (800) 927-9197
This e-mail and any files transmitted with it are confidential and are solely for the use of the addressee. It may contain
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applicable laws.
Maria Panizo
From: Athena Gray <Athena.Gray@standard.com>
Sent: Tuesday, July 27, 2021 12:17 PM
To: Maria Panizo
Cc: Jacqueline Accetta
Subject: City of South Miami - Dental Vision DTQ
[External]
Maria -
We appreciate the opportunity to provide a dental and vision proposal for City of South
Miami. Unfortunately due to plan design requirements we feel that we are unable to provide a
competitive proposal and, therefore, must decline to issue a quote for dental and vision at this time.
Thank you for considering The Standard!
I am here to support you and create an excellent experience in doing business with The Standard. Please click here to
take a quick 2 to 3 minute survey to let me know how I am doing.
Athena Gray I Sales Analyst, Employee Benefits
The Standard
Standard Insurance Company
4300 W. Cypress St., Suite 750 1 Tampa, FL 33607
Phone 813.878.0288 (Office) 1813.422.2755 (Cell) I Fax 813.879.2431
standard.com
23
Maria Panizo
Sent: Wednesday, August 4, 20214:23 PM
To: Maria Panizo
Cc: Vidal, Joseph L; kasunrisequoting; Schwartz, Shara
Subject: City of South Miami 922135 - UHC Ancillary DTQ
[External]
Hi Maria:
After reviewing the information for Dental, Vision, Life and Disability, our decision is to decline
to quote due to uncompetitive rates across all lines.
We appreciate being given the opportunity to review this request and we look forward to working with
your office on future prospects.
Thank you!
Gliset Garrido
Specialty Sales Coordinator, Key Accounts
Office: 954.378.0751
Email: glisetiarridoOluhc.com
3100 SW 1451 Ave, Suite 200
Miramar, FL 33027
unitedhealthgroup.com
Our United Culture The way forward
Integrity I Compassion I Relationships I Innovation I Performance
24
Section 2
October 2021 Medical Plan Comparison for City of South Miami
Carrier Name
Plan Type
Product name
Calendar Year Deductible (CYD)
Individual / Family
Coinsurance
Provider Services
Primary Care Office Visit _
Specialist Office Visit _
Virtual Visit -Designated Virtual_ Pinned at
Preventative Care
Hospital Services
Inpatient Hospital Facility
Hospital Physician Services
Outpatent Hospital Facility
Emergency Room Facility
Outpatient Facility/Diagnostic
Ambulatory Surgery Center
_ _ABC Physician Services
Lab /X-Ray
Major Diagnostic (MRI,CAT,CT,PET)
Urgent Care
Annual Out -of -Pocket Maximum
_includes Deductible (Yes / No) _
Individual / Family
Lifetime Maximum
Prescription Drugs
Tier 11'Tier 2(Tier 3/Tier 4/-rier 5
Mail Order 90 Day Supply)
Preferred Specialty Retail Network
Coinsurance _
Emergency Room Facility
All Other Services
Deductible - Individual/Family
Annual Out -of -Pocket - Indiv/Family
Lifetime Maximum
Employee
Employee & Spouse _
Employee & Child(ren)
Family
Monthly Total by Product
Annual Total
$ Change in Monthly Premium
Change in Total Annual Premium
$Chan a in Total Annual Premium
74
0
11
1
NHP
NHP HMO 2020 OA
BXLG-M27 Rx NH21
None
100%
Open Access
$10
$25
$0
$0
$500
so
S500 _
S250'
$500
$0
$0 _
$250
$75
_ Yes
$4,000 / $8,000
Unlimited
$10/$35/$70_
$25/$87.50/$175
_0/$150
/$500
/a
$250
lefilaa
fil
n/a $608.83
$1.449.02
$1,120.25
$1,699.55
$59,275.72
$711 308.64
Per FL Statute, Must Be Medical Emergency Defined by 641.31097
74
0
H
1
74
0
i/
1
74
0
11
7
$5,301.27 $5,301.27 $4,549.60
8.9 % 4.7 % 7.7%
-� $63615.M — - -- $33673.24 - - -- $54595.20
$30
$0
$0
_ 0% Aft Ded
0%Aft Ded
0% Aft Ded
$350'
0% Aft Ded
0% Aft Ded
_ $0
0% Aft Ded
$50
Yes_
$1.500 / $3,000
Unlimited
$10/$35/$70
$25/$87.50/$175
$10/$150/$500
Iva
$350
Na
Iva
nta
we
74 $655.56
0 _ 31,560.24
11 $1,206.23
1 $2.045.35
Inlmmallen all is based on census daleprovided. For Jlusdabvepurposes only The cani0cafe or coverage. final rates, and final enmlluarl u0supersede any and all reatenalspmvldedherein Page126
October 2021 Medical Plan Comparison for City of South Miami
Carrier Name
Plan Type
Product namn
•.
Calendar Year Deductible (CYD)
Individual / Family
Coinsurance
Provider Services
Primary Care Office Visit
Specialist Office Visit
Virtual Visit-0esignated Virtual Provider
Preventative Care
Hospital Services
Inpatient Hospital Facility
Hospital Physician Services
Outpatient Hospital Facilily
Emergency Room Facility
Outpatient Facility/Diagnostic
Ambulatory Surgery Center
ASC Physician Services
Lab /X-Ray
Major Diagnostic (MRI,CAT,CT,PET)
Urgent Care
Annual Out -of -Pocket Maximum
Includes Deductible (Yes / No)
Individual / Family
Lifetime Maximum
Prescription Drugs
Tier 1 [Tier 27Tier 37Tier 41Tier 5
Mail Order (90 Day Supply)
Preferred Specialty Retail Network
Coinsurance
Emergency Room Facility
All Other Services
Deductible - Individual/Family
Annual Out -of -Pocket - Indiv/Family
Lifetime Maximum
Employee
Emplo ee & Spouse
Employee & Child(ren)
Family
Monthly Total by Product
Annual Total
$ Change In Monthly Premium
% Change in Total Annual Premium
$ Chan a In Total Annual Premium
11
NHP
NHP HMO 2020 OA
BXLG-M2I Fix NH21
None
100%
Open Access
$10 _
$25
$0
$0
$500
$0
$500
$250'
$500
s0
s0
$250
$75
Yes
$4,000 / $8,000
Unlimited
$10/$35/$70
$25/$87.50/$175
$10/$150/$500
na
$250
Na
n/a
n/a
n/a
$608.83
$1,449.02
$1,120.25
$1,899.55
$59,275.72
$711 308.64
Per FL Statute, Must Be Medical Emergency Defined by 641.31097
74
74
74
74
lbr nnafoh shown is based on census data pho ded For dlusunom purposes only The certificate of coverage, Anal rates. and final enrolli wll supersede any and all braledals provided herein Page 227
October 2021 Medical Plan Comparison for City of South Miami
Carrier Name
Plan Type _
Product name
IN -NETWORK
Calendar Year Deductible (CYD)
Individual / Family
Coinsurance
Provider Services
_ Primary_Care _0ffice Visit _
Specialist Office Visit
Virtual Visit -Designated Virtual Provider_
Preventative Care
Hospital Services
Inpatient Hospital Facility
Hospital Physician Services
Outpatient Hospital Facility
Emergency Room Facility
Outpatient Facility/Diagnostic
Ambulatory Surgery Center
ASC Physician Services
Lab / X-Ray
Major Diagnostic (MRI,CAT,CT,PET_)
Urgent Care
Annual Out -of -Pocket Maximum
Includes Deductible_ (Yes / No)
Individual / Family
Lifetime Maximum
Prescription Drugs
Tier 1/Tier 2/Tier 3/Tier 4/Tier 5
Mail Order 90 Day Supply)
Preferred Specialty Retail Network
Out -Of -Network Benefits
Coinsurance
Emergency Room Facility
All Other Services
Deductible - Individual/Family
Annual Out -of -Pocket - Indiv/Fa_ m_ ily_
Lifetime Maximum
Employee _
Employee & Spouse
Employee & Child(ren)
Family
- - - --- -- --
Monthly Total by Product
Annual Total
$ Change in Monthly Premium
% Change in Total Annual Premium
$ Change in Total Annual Premium
111111
NHP
NHP HMO 2020 OA
BXLG-M2 / Rx NH21
None
100%
Open Access
$10
-- — $25 -
$0 ---
$500
- $0
$250' -
$500
$0
$250- ---
— $75
Yes
$4,000 / $8,000
Unlimited
- $10/$35/$70
$25/$87.50/$175
$10/$150/$500
n/a
_ $250
_n/a
n/a
n/a -
$608.83
$1.449.02
$1.120.25
$1.899.55
$59,275.72
$711 308.64
Per FL Statute, Must Be Medical Emergency Defined by 641.31097
Florida Blue
_ BlueCare
55
None
100%
Open Access
$10
$10 -
$250
-- $150 --
$100
$100
$10
$0/$10
$50
$10 -
Yes
$2,500 / $7,500
Unlimited
$10/$50/$80
$25/$125/$200
n/a
- $100 - -
- Na
rVa
--- Na --
$805.75 -
$1,917.69
$1, 547.04
$2, 578.40
$79,221.34
$950 666.08
$19,945.62
33.6%
$239 347.44
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 marenals provided herein Page 328
Section 3
October 2021 Dental Comparison for City of South Miami
Carrier
Plan Name
Provider Acess
Benefit Description
Preventive (Class 1)
Basic (Class II)_
Major Class III
Maximum Annual Benefit
Deductible (IndividuaUFamily)
Deductible Waived - Class
Orthodontia coves a/lifetime max
Reimbursement Schedule
Benefits
Routine Exams - 9430
_Teeth Cleaning - 1110
Full M_ outh/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_ _ 37
Employee + Spouse _ 6
Employee +_C_hild(ren) 5
Family 2
Monthly Premium By Product
Total Month! 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
DMO HD205 OR
In Network Only
n/a
—n/a
Unlimited
--- n/a -
n/a
$2,650 Child & Adult
Fee Schedule
_ No Charge
_ No Charge
No Charge
No Charge
$250
$55 per quad
- $375
$270
Contributory
None
Expires 9/30/21
PPO
In -Network
Out of Network
100%
100%
- 80%
80%
50%
50%- -- - -
Unlimited
Unlimited
$50/$150
$50/$150
Yes
Yes
$1,00OChildOnly
$1,000 Child On1
Fee Schedule
MAC
1_00%
100%
- 100% —
--
— - 100%
100%
100% ---
__100%
80%
80%
80% -
- 80%-
80%--
- 80% --
- -
- 50% -
50%
50%
50%
None
$8.49
34
$33.39
$16.98
-
3
--
$69.70 -- -
$19.11
4
-- - -
- - - $78.55 -- -
$30.74
8
$123.23
$573.04
$2,644.40
$3,217.44
-
$38 609.28--
37
6
5
2
Humana
Humana
DMO HD205 OR
PPO
In Network Only
In -Network
Out of Network
n/a
_n/a -- --
100%
_ 100%
8_0%
80% 4
Unlimited
Unlimited
Unlimited
n/a -
n/a
$50/$150- -
Yes
$50/$150
Yes
$2,650 Child & Adult
$1,000 Child Only
$1,000 Child Only
Fee Schedule
Fee Schedule
MAC
No Charge _
_ No Charge
No Charge
- - No Charge -
$250 - $250 -
$55 per quad
$375
- $270 -
100%
100%
100%
100%
100%
—�- 80%
80% -
80%
50%
100%
80%
- -- --80% - - -
80%
50%
50% --
--- 50%
Contributory
Contributory
None
None
12 Months
12 Months
Renewal
Renewal
$8.49
34
$_36.70
$16.98
$19.11
$30.74
3
4
8
$76.60
$86.33
$135.43
$573.04
$3,479.40
$2,906.36
- - - - $41 752.80 -
_ 0.0%
J $0.00
9.9%
$261.96
$261.96
8.1 %
-- —� � --- $3,143.52
Information shown is based on census data provided For illustrative purposes only The certificate of coverage, final rates, and final enrollment wll supersede any and all materials provided herein Page 130
October 2021 Dental Comparison for City of South Miami
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%
No Charge
100%
100%
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
Expires 9/30/21
Expires 9/30/21
Current
Current
$8.49
34
3
4
8
$33.39
$16.98
$69.70
$19.11
$78.55
$30.74
$123.23
$573.04
$3,217.44
$2,644.40
_
$38 609.28
% 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
37
DMO MET290
PPO
In Network Only
In -Network
Out of Network
n/a
100%
100%
n/a
80%
80%
n/a
50%
50%
Unlimited
$5,000
$5,000
n/a
$50/$150
$50/$150
n/a
Yes
Yes
$2,680 Child & Adult
$1,000 Child Only
$1,000 Child Only
Fee Schedule
Fee Schedule
MAC
No Charge
100%
100%
$5
100%
100%
No Charge
100%
100%
$5
80%
80%
$265
80%
80%
$50 per quad
80%
80%
$440
50%
50%
$290
50%
50%
Contributory
Contributory
10 enrolled
5 enrolled
None
12 Months
12 Months
$11.76
34
3
4
8
$34.43
$20.58
$71.88
$24.69
$81.00
$34.68
$127.07
$751.41
$3,478.23
$2,726.82
$41 738.76
31.1 %
3.1 %
$178.37
$260.79
$82.42
8.1 %
$3,129.48
0
Information shown is based on census data provided. For illustrative purposes only. The certificate of coverage, final rates, and final enrollment wll supersede any and all materials provided herein. Page 231
October 2021 Dental Comparison for City of South Miami
66
Plan Name
Provider Acess
Benefit Description
_Preventive (Class 1) _
Basic (Class 11) _
Major Class III
Maximum Annual Benefit
Deductible (Individual/Family)
Deductible Waived - Class I
Orthodontia (coverage/lifetime max
Reimbursement Schedule
Benefits
_Routine Exams - 9430
Teeth Cleaning - 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
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
$5.0/$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%
No Charge
100% -
100%
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
Expires 9/30/21
Expires 9/30/21
Current
Current
$8.49
34
$33.39
- $16.98
3
-- - $69.70 —
- $19.11 -
4
- $78.55
$30.74
8
$123.23
$573.04 $2,644.40
$3,217.44
- - --
$38,609.28
Aetna
Declined
Cigna
MM
Information shown is based on census data provided. For illustrative purposes only The certificate of coverage, final rates, and final enrollment 1441 supersede any and all materials provided herein Page 332
October 2021 Dental Comparison for City of South Miami
Humana
Humana
DMO HD205 OR
PPO
In Network Only
In -Network
Out of Network
n/a _
n/a
100%
100%
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%
No Charge
100%
100%
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
Ex ires 9/30/21
Expires 9/30/21
Current
Current
$8.49
34
3
4
$33.39
$16.98
$69.70
$19.11
$78.55
_
$30.74
8
$123.23
$573.04
$3,217.44
$2,644.40
_
$38 609.28
% 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
Florida Blue
Not Quoted
EME 0 E
016J
Information shown is based on census data provided For illustrative purposes only The certificate of coverage, final rates, and final enrollment wll supersede any and all materials provided herein Page 433
October 2021 Dental Comparison for City of South Miami
Carrier
Plan Name
Provider Acess
Benefit Description
Preventive (Class 1)
Basic (Class II)
Major Class III
Maximum Annual Benefit
Deductible (Individual/Family)
Deductible Waived - Class I
Orthodontia (coverage/lifetime max
Reimbursement Schedule
Benefits
Routine Exams - 9430
Teeth Cleaning - 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 37
Employee + Spouse 6
Employee + Child(ren) 5
Family 2
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
DMO HD205 OR
In Network Only
n/a
n/a
nia
Unlimited
-- - n/a
n/a
$2,650 Child & Adult
Fee Schedule
No Charge
No Charge
No Charge
No Charge
- $250 - -
$55 per quad
- $375
$270
None
�ires9/30/21
$8.49
- $16.98 -
$19.11 -
- - $30.74
$573.04
In -Network
Out of Network
100%
100%
50% --
-- - 50%
Unlimited
Unlimited
$50/$150
Yes
$50/$150
Yes
$1,000 Child Only
$1,000 Child Only
Fee Schedule
MAC
100%
_ 100%
100%
- 100%
80%
80%
80%
100%
100% --
80%
80%
50%
50%
50%
- 50%
None
34 $33.39
3 $69.70
4 $78.55 -- -�� -
8 --- $123.23
$3,217.44
$38,609.28 - - --
Mutual of Omaha
Declined • Quote
0
Information shown is based on census data provided For illustrative purposes only. The certificate of coverage. final rates, and final enrollment WI supersede any and all materials provided herein. Page 534
October 2021 Dental Comparison for City of South Miami
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%
No Charge
100%
100%
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
Ex Tres 9/30/21
Expires 9/30/21
Current
Current
$8.49
34
3
4
8
$33.39
$16.98
$69.70
$19.11
$78.55
$30.74
$123.23
$573.04
$3,217.44
$2,644.40
$38,609.28
% 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
Standard
Declined
UnitedHealtheare
Information shown is based on census data provided. For illustrative purposes only. The certrficate of coverage, final rates, and final enrollment wll supersede any and all maferials provided herein. Page 635
October 2021 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
Fre uen
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
51
12
14
E eMed
In -Network
F CON
$o Copay
up to $3_0
Every 12
Months
Reimbursement
_ $0 Copay up to $25
$o Copay_ P to $40
$0 Copay up to $60
Every 12 Months
Reimbursement
$200 allowance +
20% discount over
up to $100
Every 24
Months
Reimbursement
1001%
up to $210
$200 allowance
up to $160
Voluntary
Expires 9/3012022
$7.13
$14.26
$15.27
$23.01
$909.60
$10,915.20
51
12
14
In -Network OON
$0 Copp up to $45
Every 12 Months
$0 Copay _
Reimbursement
__ up to $30
up to $50
$0 Copay
$0 Co ay
_
up to $65
Every 12
Months
Reimbursement
$200 allowance + up to $70
20% discount over
Every 24 Months
Reimbursement
100% up to $210
$200 allowance up to $105
Contributory
68%
24 Months
$9.12
$18.25
$19.54
$29.44 _-
$1,163.76
$13,965.12
27.94%
$254.16
$3,049.92 ---
Declined to Quote
Page 1 01 5 37
October 2021 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
Participation Requirements
Rate Guarantee
Employee
Employee + Spouse
Employee + Child
Family
Monthly Total
Annual Total
% Change in Total Annual Premium
$ Change in Monthl Premium b Plan
$ Change in Total Annual Premium
51
12
14
7
Eye ad
In -Network
I OON
$0 Copal
up to $30
Every 12
Months
$0 Copay
Reimbursement
up to $25
$0 Copay
up to $40
$0 Co a
u to $60
Every 12
Months
$200 allowance +
20 % discount over
Reimbursement
up to $100
Every 24
Months
100%
$200 allowance
Reimbursement
up to $210
up to $160
Voluntary
Expires 9/3012022
$7.13
$14.26
$15.27
$23.01
$909.60
$10,915.20
Cigna
Florida Blue
Page 2 of 5 38
October 2021 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
Fre uen
Contacts
Medically Necessary
Elective Contacts
Contribution Type
Participation Requirements
to 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
51
12
14
EyeMed
In -Network OON
$0 Copay up to $30
Every 12 Months
$0 Copay _
_ $0 Copay
$0 Copay
Reimbursement
up to $25
_ _ up to $40
up to $60
Every 12
Months
$ 200 allowance +
20 k discount over
Reimbursement
up to $100
Months
Every 24
Reimbursement
100% up to $210
$200 allowance up to $160
Volunta
Expires 9/30/2022
$7.13
$14.26
$15.27 ---
$23.01 --- -
$909.60
$10,915.20
Not Quoted
I
Declined to Quote
it
r,,� 3 ar 5 39
October 2021 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
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
51
12
14
7
E eMed
In -Network
OON
Every 12
Months
Reimbursement
$0 Copay 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%
$200 allowance
Reimbursement
up to S210
up to $160
Voluntary
Expires 9/30/2022
$7.13
$14.26
$15.27
$23.01
$909.60
$10,915.20
Mutual of Omaha
Declined
Standard
Declined
Page 4 of 5 40
October 2021 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
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
LI
51
12
14
E eMed
In -Network
OON
$0 Copay
up to $30
Every 12
Months
Reimbursement
$0 Copay 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%
$200 allowance
Reimbursement
up to $210
up to $160
Voluntary
Expires 9/30/2022
$7.13
$14.26
$15.27
$23.01
$909.60
$10,915.20
UnitedHealthcers
Pa gc 5 at 5 41
October 2021 Basic Life and Long -Term Disability Comparison for City of South Miami
TOTAL ANNUAL PREMIUM
TOTAL % Change
ling. Ill
All Full -Time City All other Fall -Time
MwrwOwre Ad'vety et FmplOywav A0livaly at
Wnrh Wmk
2x Sa to $3P0,000 ix Saba to $75,000
2x Sa to $320 000
ix Sala to $75,000
$320,000
$75.000
10 65%
10 50%
80%to$256,000 I 80%to$60.000
Included
Included
Not lrokded
Non -Contributory
100%
24 months
$6,410,350
50.160
$0.020
$7,1S3.86
$13,846.36
0.0%
$0.00
All Full -Time Em "ActivelyatWork
$5,000
_ 60%
90 Da
SSNRA
3112
24 Months
3 Months
24 Months
Non-Conlribulo
100%
Ex hes 9/3012021
mom
mm
$551,383
$0.260
$1,433.60
81Z203.15
All Full -Time City
M..g.,s Activelyat
Wmk
All other Full-Tme
F.m Ployees Adivabyat
Work
2xSalaryk,S320,000 1x Sala to $75,000
2x Salary to S320,000
1x Sale to $75.000
$320.000
$75,000
by 35%
by 50%
80%to S184,u00 1 80%to$60,000
Included
Included
Not lwkded
Non-CuraribWo
100%
24 Months
$6.410.350
$0.169
$0.028
$1.262B4
$15,154.07
9.4%
$15,154.05
$31,049.51 $33,696.14 $15,154.07
8.5%
P., 1.12 43
October 2021 Basic Life and Long -Term Disability Comparison for City of South Miami
Not Quoted
Humana
Not Quoted
WitedHealtheare
TOTAL TOTAL % Change EMINM
®hanga dd
R. P.pv202 =T
October 2021 Short Term Disability Comparison for City of South Miami
Class Defined
Plan Benefits
STD Benefit
Maximum Weekly Benefit
Benefit Duration
Pre-existingCondition Limitation
Elimination Period (days)
Accident
Illness
Contribution Type
Participation Requirement
Rate Guarentee months
Under 20
20-24 _
25-29
30-34
35-39
40-44
45-49
50-54
55-69 _
60-64
65-69
70+
All Full -Time Employees
60%
1 12 Weeks I
50.300
50.300
50.300
S0.300
S0.340
50.400
50.530
$0.640
$0.730
Page 1 of 2 46
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October 2021 Voluntary Life Insurance Comparison for City of South Miami
49
October 2021 Voluntary Life Insurance Comparison for City of South Miami
Cigna
LNot Quoted
Employee Spouse
Florida Blue
Not Quoted
Employee Spouse
Guardian
Employee Spouse
Page 2 of
50
October 2021 Voluntary Life Insurance Comparison for City of South Miami
Lincoln
Employee Spouse
C�
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® t 51
Papa 3 of 3
Section
4
NOTICE OF CARRIER FINANCIAL STATUS
Brown & Brown makes every attempt to place coverage with carriers rated A- or better* through AM Best
(www.ambest.com), a national credit rating agency with a specific focus on the insurance industry. Because
an AM Best rating is not required by the various state departments of insurance, there are many carriers in
the Employee Benefits industry that elect not to participate in AM Best's rating process for various reasons.
Therefore, Brown & Brown periodically places coverage with carriers rated less than A- or non -rated by
AM Best.
Please be advised that Brown & Brown does monitor carriers rated less than A- or non -rated on an ongoing
basis. However, because Brown & Brown cannot certify the financial soundness or stability of any
insurance company or alternative risk transfer entity, or otherwise predict whether the financial condition
of a company might improve or deteriorate, we encourage you to review the financial information for each
carrier at AM Best's website (www.ambest.com), a state department of insurance website, the applicable
carrier website and/or with your accountant, legal counsel and other advisors.
If you need assistance identifying the appliable issuing carriers for your current coverage, renewal coverage,
or the coverage options being presented to you, please feel free to contact us at 954-776-2222 for assistance.
Alternative quotes with an A- or better rated carrier may also be available upon your request.
* AM Best General Rating Guide
A +. A+ Superior
AA-
ExoeteM
+ B+
Good
Fair
++ G+
Mar ' al
Weak
0
Poor
E
Under Regulatory Supervision
F_
In Liquidation
S
Suspended
ass I
Up
1.070Di1,0
[I
(10
000
111
00as
$,
0000
IV
$5,000
to
$10.000
ass V
$10.000
to
$25.000
ass VI
$25.000
to
$50.000
ass VII
$50,000
to
$100,000
Vlll
$100,000
to
$250,000
a
$250,000
to
$500,000
ass X
$500,000
to
il750,000
XI
$750,000
to
$1000 000
ass XII
$1.000,000
to
$1,250,000
ass XIII
$1250 000
to
$1,500 000
XIV
$1,500,000
to
$2,000,000
XV
$2,000,000
or
Greater
2/25/21
53
The proposal must include all pertinent disclaimers and disclosures, including but not
limited to the following:
• The analysis of the following. plans is a summary. Please refer to the policy
certificate for a full list of coverage and exclusions.
• The rates and benefits in this proposal are based upon underwriting factors
which include, but are not limited to, the census provided, the effective date
shown, the status of employees/dependents (i.e. actively at work, COBRA,
FMLA), final enrollment, etc. If any of the aforementioned changes prior to the
proposed effective date, the final provisions, including rates, for these plans may
vary or result in the proposed plan to be withdrawn.
• If you select to change carriers, any existing plans with other carriers should not
be cancelled until advised by Brown & Brown Ft Lauderdale.
• This proposal may not be a complete listing of all available benefit options.
Different benefit levels may be available.
• This presentation is the proprietary work product of Brown & Brown of Ft
Lauderdale and is not authorized for further use or distribution
• All insurance carriers have their own operating procedures. A change in carrier
could affect certain benefits and coverage.
• Brown & Brown of Ft Lauderdale representatives are available to explain any
items presented. It is assumed that the recipients of this proposal will seek an
explanation of any items that may be in question.
• Brown & Brown of Ft Lauderdale representatives may from time to time provide
guidance regarding certain requirements affecting health plans, including the
requirements of federal and state health care reform legislation. Such guidance
is based on good -faith interpretation of laws and regulations currently in effect,
and is not intended to be a substitute for legal advice. Employers should contact
their own legal counsel for advice regarding legal requirements.
• The network provider/facility lists obtained via paper directories or carrier
websites may contain providers and facilities that are no longer participating in
the insurance carriers' networks. We cannot be responsible for any changes to
the provider/facility listings that are not reflected. To ensure that a specific
provider or facility is still participating in the provider's preferred network, we
recommend contacting the provider/facility directly.
• Failure to adhere to provisions of the Affordable Care Act (such as pay -or -play,
employer reporting requirements, benefit mandates, etc.) may result in significant
fees and penalties to the employer. For a more comprehensive explanation of
what fees and penalties may apply to you, you may contact your (Profit Center
Name) representative at any time.
• You are required to comply with Health Care Reform's Summary of Benefits &
Coverage (SBC) distribution guidelines, which include requirements for SBC
distribution at the plan renewal date. If an employee must enroll to continue
coverage, the SBC must be provided when open enrollment materials are
distributed. If enrollment materials are not distributed, employees must receive
an SBC by the first day they are eligible to enroll. For insured plans, if coverage
continues automatically for the next year, the SBC must be provided at least 30
days before the beginning of the new plan year. If the policy is not issued by that
date, the SBC must be provided within seven business days once the information
is available. Please refer to the Department of Health & Human Services' (HHS)
official guidance for complete details regarding renewal and other SBC
distribution guidelines.
Employee Benefit Disclaimers
Revised 2/25/21
54