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Res No 095-22-15848RESOLUTION NO. 095-22-15848 A Resolution authorizing the City Manager to purchase dental and vision insurance benefits from Humana for full-tim e employees and participating retirees for the 2022-2023 Fiscal Year. WHEREAS, th e City, through it s Agent of Record , Brown and Brown of Florida. so licited more than t hr ee quotes, compared the in surance rates, dental a nd vis io n p lan desig n, provider network , as wel l as the C ity's previou s c laim s experi ence/ratio ; and WHEREAS, City staff recommend th e sele ct ion of Humana for the prov is ion of dental and v is ion insurance benefits for all fu ll-tim e employees a nd participating retiree s: and WHEREAS, the premium s hall be cha rged to departmenta l lin e items in the ir re specti ve account number. NOW THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY COMMISSIONERS OF THE CITY OF SOUTH MJAMI, FLORIDA : Section 1. The foregoing recital s are hereby rat ified and con firm ed as being true and they are incorporated into thi s re so lution by reference as if set fo rth in full herein. Section 2. The Comm iss io n hereb y authorized the City Ma nager to execute the dental and vision insurance renewal policy with Humana for the C it y of So uth Miami full -time emp loyees and part ic ipatin g retiree s for th e 2022-2023. Section 3. Corrections. Conformi ng language or techn ica l sc ri ve ner-ty pe correction s may be made by the City Atto rn ey for any conforming amendments to be inco rp orated in to the final resolution for s ignature. Section 4. Severability. If any se cti on c lause. s entence, or phra se of thi s re so lu tion is for any rea so n held invalid or un const ituti ona l by a cou1i of competent juri sdiction , the holding s hall not affect the va lidity of the rem a ining po1iion s of thi s re so luti o n. Section 5. Effective Date. Thi s re s olu ti on s hal l become effective immediatel y upo n adoption. PASSED AND ADOPTED thi s 16th day of August, 2022. A0~~J .0 ?i~~ C ITYLERK~ /MAY~ / READ AND APPROV E D AS TO FORM, COMMISSION VOTE: 5-0 LANGUAGE, LEGALITY AND Mayo r Philip s : Yea Page 1 of 2 Res. No. 095-22-15848 NTH E Com mi ssioner Cor ey: Yea Com mi ssioner Harri s : Yea Commissioner Liebman: Yea Commissio ner G il: Yea Page 2 of 2 Agenda Item No:2. City Commission Agenda Item Report Meeting Date: August 16, 2022 Submitted by: Samantha Fraga-Lopez Submitting Department: City Manager 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 for the 2022-2023 Fiscal Year. 3/5 (City Manager) Suggested Action: Attachments: Memo Vision and Dental 22-23.docx Reso Dental and Vision 22-23.doc Comparison_Dental_2022_CSM.pdf COSM_Vision_EyeMed_2022.pdf 1 CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER-OFFICE MEMORANDUM TO:The Honorable Mayor & Members of the City Commission FROM: Shari Kamali, City Manager VIA:Samantha Fraga-Lopez, Assistant City Manager DATE: August 16, 2022 SUBJECT:A Resolution authorizing the City Manager to purchase dental and vision insurance benefits from Humana for full-time employees and participating retirees for Fiscal Year 2022-2023. BACKGROUND:The City’s benefits consultant, Brown and Brown of Florida, Inc., solicited quotes from Humana, MetLife, Aetna, Cigna, Florida Blue, and Guardian for the employee’s dental and vision insurance coverages for South Miami full-time employees and retirees for the 2022 – 2023 Fiscal Year. Humana, the City’s current dental and vision insurance carrier’s 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, was quoted at a $1.75 monthly increase. The City currently contributes $8.49 per eligible employee, per month, toward dental insurance coverage and vision is voluntarily paid by the employee. The City currently offers vision insurance through Humana for 2022-2023 there is a flat renewal with no plan changes and no rate increases. The renewal is appropriately funded in the proposed budget for Fiscal Year 2022-2023. RECOMMENDATION:Based upon the proposals received, 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 $11,720 based on today’s full-time personnel. ACCOUNT:Premium charges for the health will be charged to the designated departmental budget line items as proposed in the Fiscal Year 2022-2023 budget. ATTACHMENTS: Proposed resolution Comparison Vision Comparison Dental 2 THE CITY OF PLEASANT LIVING October 2022 Dental Comparison for City of South Miami Carrier Humana Humana Plan Name DMO HD205 OR DMO HD205 OR Provider Acess In Network Only In-Network Out of Network In Network Only In-Network Out of Network Benefit Description Preventive (Class I)n/a 100%100%n/a 100%100% Basic (Class II)n/a 80%80%n/a 80%80% Major (Class III)n/a 50%50%n/a 50%50% Maximum Annual Benefit Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Deductible (Individual/Family)n/a $50/$150 $50/$150 n/a $50/$150 $50/$150 Deductible Waived - Class I n/a Yes Yes n/a Yes Yes Orthodontia (coverage/lifetime max)$2,650 Child & Adult $1,000 Child Only $1,000 Child Only $2,650 Child & Adult $1,000 Child Only $1,000 Child Only Reimbursement Schedule Fee Schedule Fee Schedule MAC Fee Schedule Fee Schedule MAC Benefits Routine Exams - 9430 No Charge 100%100%No Charge 100%100% Teeth Cleaning - 1110 No Charge 100%100%No Charge 100%100% Full Mouth/Panoramic X-rays - 0330 No Charge 100%100%No Charge 100%100% Simple Extractions - 7111 No Charge 80%80%No Charge 80%80% Root Canal (Endodontics) - 3330 $250 80%80%$250 80%80% Perio. Scaling/Root Planning - 4341 $55 per quad 80%80%$55 per quad 80%80% Full or Partial Dentures - 5110 $375 50%50%$375 50%50% Crowns - 6752 $270 50%50%$270 50%50% Employer Contribution Contributory Contributory Minimum Participation Requirement Waiting Period Major Services None None Rate Guarantee Expires 9/30/22 12 Months Rates Current Renewal Employee 34 $8.49 39 34 $8.49 39 Employee + Spouse 6 $16.98 4 6 $16.98 4 Employee + Child(ren)7 $19.11 1 7 $19.11 1 Family 4 $30.74 6 4 $30.74 6 Monthly Premium By Product $647.27 $647.27 Total Monthly Premium Total Annual Premium % Change in Monthly Premium by Plan 0.0% $ Change in Monthly Premium by Plan $0.00 $ Change in Total Monthly Premium % Change in Total Annual Premium $ Change in Total Annual Premium 4.9% $125.73 $125.73 3.9% $1,508.76 $40,080.00$38,571.24 $35.73 $78.23 $138.32 $88.17 $3,340.00 $74.58 $131.86 $84.05 $2,567.00 $3,214.27 $2,692.73 $37.48 PPO Humana Current Humana Renewal Contributory PPO Expires 9/30/22 Contributory None None 12 Months 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 1 of 85 1-------------11 1----1 -----I October 2022 Dental Comparison for City of South Miami Carrier Humana Plan Name DMO HD205 OR Provider Acess In Network Only In-Network Out of Network Benefit Description Preventive (Class I)n/a 100%100% Basic (Class II)n/a 80%80% Major (Class III)n/a 50%50% Maximum Annual Benefit Unlimited Unlimited Unlimited Deductible (Individual/Family)n/a $50/$150 $50/$150 Deductible Waived - Class I n/a Yes Yes Orthodontia (coverage/lifetime max)$2,650 Child & Adult $1,000 Child Only $1,000 Child Only Reimbursement Schedule Fee Schedule Fee Schedule MAC Benefits Routine Exams - 9430 No Charge 100%100% Teeth Cleaning - 1110 No Charge 100%100% Full Mouth/Panoramic X-rays - 0330 No Charge 100%100% Simple Extractions - 7111 No Charge 80%80% Root Canal (Endodontics) - 3330 $250 80%80% Perio. Scaling/Root Planning - 4341 $55 per quad 80%80% Full or Partial Dentures - 5110 $375 50%50% Crowns - 6752 $270 50%50% Employer Contribution Contributory Minimum Participation Requirement Waiting Period Major Services None Rate Guarantee Expires 9/30/22 Rates Current Employee 34 $8.49 39 Employee + Spouse 6 $16.98 4 Employee + Child(ren)7 $19.11 1 Family 4 $30.74 6 Monthly Premium By Product $647.27 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 $38,571.24 $35.73 $74.58 $131.86 $84.05 $2,567.00 $3,214.27 PPO Humana Current Contributory Expires 9/30/22 None Humana DMO HD205 OR 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 None 12 Months Renewal 34 $8.49 39 6 $16.98 4 7 $19.11 1 4 $30.74 6 $647.27 0.0% $0.00 0.0% $0.00 $0.00 Humana PPO Contributory None 12 Months Negotiated Renewal $35.73 $74.58 $84.05 $131.86 $2,567.00 $3,214.27 $38,571.24 0.0% $0.00 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 2 of 86 1-------------11 1----1 -----I October 2022 Dental Comparison for City of South Miami Carrier Humana Plan Name DMO HD205 OR Provider Acess In Network Only In-Network Out of Network Benefit Description Preventive (Class I)n/a 100%100% Basic (Class II)n/a 80%80% Major (Class III)n/a 50%50% Maximum Annual Benefit Unlimited Unlimited Unlimited Deductible (Individual/Family)n/a $50/$150 $50/$150 Deductible Waived - Class I n/a Yes Yes Orthodontia (coverage/lifetime max)$2,650 Child & Adult $1,000 Child Only $1,000 Child Only Reimbursement Schedule Fee Schedule Fee Schedule MAC Benefits Routine Exams - 9430 No Charge 100%100% Teeth Cleaning - 1110 No Charge 100%100% Full Mouth/Panoramic X-rays - 0330 No Charge 100%100% Simple Extractions - 7111 No Charge 80%80% Root Canal (Endodontics) - 3330 $250 80%80% Perio. Scaling/Root Planning - 4341 $55 per quad 80%80% Full or Partial Dentures - 5110 $375 50%50% Crowns - 6752 $270 50%50% Employer Contribution Contributory Minimum Participation Requirement Waiting Period Major Services None Rate Guarantee Expires 9/30/22 Rates Current Employee 34 $8.49 39 Employee + Spouse 6 $16.98 4 Employee + Child(ren)7 $19.11 1 Family 4 $30.74 6 Monthly Premium By Product $647.27 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 $38,571.24 $35.73 $74.58 $131.86 $84.05 $2,567.00 $3,214.27 PPO Humana Current Contributory Expires 9/30/22 None Guardian DHMO N100G In Network Only In-Network Out of Network n/a 100%100% n/a 80%80% n/a 50%50% Unlimited $2,000 $2,000 n/a $50/$150 $50/$150 n/a Yes Yes $2,545 Child / $2,845 Adult $1,000 Child Only $1,000 Child Only Fee Schedule Fee Schedule MAC $15 100%100% No Charge 100%100% No Charge 100%100% $20 80%80% $350 80%80% $75 per quad 80%80% $580 50%50% $430 50%50% Contributory None 12 Months 34 $8.90 39 6 $17.81 4 7 $21.30 1 4 $32.18 6 $687.28 6.2% $40.01 0.4% $170.52 $83.21 $130.54 $2,541.20 $3,228.48 $38,741.76 -1.0% -$25.80 $14.21 Guardian PPO Contributory 85% None 12 Months $35.37 $73.83 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 3 of 87 .-------------,1 .------1 -------1 October 2022 Dental Comparison for City of South Miami Carrier Humana Plan Name DMO HD205 OR Provider Acess In Network Only In-Network Out of Network Benefit Description Preventive (Class I)n/a 100%100% Basic (Class II)n/a 80%80% Major (Class III)n/a 50%50% Maximum Annual Benefit Unlimited Unlimited Unlimited Deductible (Individual/Family)n/a $50/$150 $50/$150 Deductible Waived - Class I n/a Yes Yes Orthodontia (coverage/lifetime max)$2,650 Child & Adult $1,000 Child Only $1,000 Child Only Reimbursement Schedule Fee Schedule Fee Schedule MAC Benefits Routine Exams - 9430 No Charge 100%100% Teeth Cleaning - 1110 No Charge 100%100% Full Mouth/Panoramic X-rays - 0330 No Charge 100%100% Simple Extractions - 7111 No Charge 80%80% Root Canal (Endodontics) - 3330 $250 80%80% Perio. Scaling/Root Planning - 4341 $55 per quad 80%80% Full or Partial Dentures - 5110 $375 50%50% Crowns - 6752 $270 50%50% Employer Contribution Contributory Minimum Participation Requirement Waiting Period Major Services None Rate Guarantee Expires 9/30/22 Rates Current Employee 34 $8.49 39 Employee + Spouse 6 $16.98 4 Employee + Child(ren)7 $19.11 1 Family 4 $30.74 6 Monthly Premium By Product $647.27 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 $38,571.24 $35.73 $74.58 $131.86 $84.05 $2,567.00 $3,214.27 PPO Humana Current Contributory Expires 9/30/22 None UnitedHealthcare D1059 - S800B 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 $3,360 Child / $3,460 Adult $1,000 Child Only $1,000 Child Only Fee Schedule Fee Schedule MAC $5 100%100% No Charge 100%100% $50 100%100% $65 80%80% $350 80%80% $80 per quad 80%80% $502 50%50% $290 50%50% Contributory 75% None 12 Months 34 $8.89 39 6 $15.56 4 7 $19.26 1 4 $24.44 6 $628.20 -2.9% -$19.07 $70.55 $79.51 $124.74 $2,428.35 $3,056.55 $36,678.60 UnitedHealthcare PPO Contributory 75% 12 Months $33.80 -5.4% -$138.65 -$157.72 -4.9% -$1,892.64 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 4 of 88 1-------------11 1----1 -----I October 2022 Dental Comparison for City of South Miami Carrier Humana Plan Name DMO HD205 OR Provider Acess In Network Only In-Network Out of Network Benefit Description Preventive (Class I)n/a 100%100% Basic (Class II)n/a 80%80% Major (Class III)n/a 50%50% Maximum Annual Benefit Unlimited Unlimited Unlimited Deductible (Individual/Family)n/a $50/$150 $50/$150 Deductible Waived - Class I n/a Yes Yes Orthodontia (coverage/lifetime max)$2,650 Child & Adult $1,000 Child Only $1,000 Child Only Reimbursement Schedule Fee Schedule Fee Schedule MAC Benefits Routine Exams - 9430 No Charge 100%100% Teeth Cleaning - 1110 No Charge 100%100% Full Mouth/Panoramic X-rays - 0330 No Charge 100%100% Simple Extractions - 7111 No Charge 80%80% Root Canal (Endodontics) - 3330 $250 80%80% Perio. Scaling/Root Planning - 4341 $55 per quad 80%80% Full or Partial Dentures - 5110 $375 50%50% Crowns - 6752 $270 50%50% Employer Contribution Contributory Minimum Participation Requirement Waiting Period Major Services None Rate Guarantee Expires 9/30/22 Rates Current Employee 34 $8.49 39 Employee + Spouse 6 $16.98 4 Employee + Child(ren)7 $19.11 1 Family 4 $30.74 6 Monthly Premium By Product $647.27 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 $38,571.24 $35.73 $74.58 $131.86 $84.05 $2,567.00 $3,214.27 PPO Humana Current Contributory Expires 9/30/22 None Cigna Not Quoted Aetna Declined to Quote 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 5 of 89 --------ii -: -------1 October 2022 Dental Comparison for City of South Miami Carrier Humana Plan Name DMO HD205 OR Provider Acess In Network Only In-Network Out of Network Benefit Description Preventive (Class I)n/a 100%100% Basic (Class II)n/a 80%80% Major (Class III)n/a 50%50% Maximum Annual Benefit Unlimited Unlimited Unlimited Deductible (Individual/Family)n/a $50/$150 $50/$150 Deductible Waived - Class I n/a Yes Yes Orthodontia (coverage/lifetime max)$2,650 Child & Adult $1,000 Child Only $1,000 Child Only Reimbursement Schedule Fee Schedule Fee Schedule MAC Benefits Routine Exams - 9430 No Charge 100%100% Teeth Cleaning - 1110 No Charge 100%100% Full Mouth/Panoramic X-rays - 0330 No Charge 100%100% Simple Extractions - 7111 No Charge 80%80% Root Canal (Endodontics) - 3330 $250 80%80% Perio. Scaling/Root Planning - 4341 $55 per quad 80%80% Full or Partial Dentures - 5110 $375 50%50% Crowns - 6752 $270 50%50% Employer Contribution Contributory Minimum Participation Requirement Waiting Period Major Services None Rate Guarantee Expires 9/30/22 Rates Current Employee 34 $8.49 39 Employee + Spouse 6 $16.98 4 Employee + Child(ren)7 $19.11 1 Family 4 $30.74 6 Monthly Premium By Product $647.27 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 $38,571.24 $35.73 $74.58 $131.86 $84.05 $2,567.00 $3,214.27 PPO Humana Current Contributory Expires 9/30/22 None Declined to Quote Florida Blue Lincoln Not Quoted 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 6 of 810 --------11 1--------1 October 2022 Dental Comparison for City of South Miami Carrier Humana Plan Name DMO HD205 OR Provider Acess In Network Only In-Network Out of Network Benefit Description Preventive (Class I)n/a 100%100% Basic (Class II)n/a 80%80% Major (Class III)n/a 50%50% Maximum Annual Benefit Unlimited Unlimited Unlimited Deductible (Individual/Family)n/a $50/$150 $50/$150 Deductible Waived - Class I n/a Yes Yes Orthodontia (coverage/lifetime max)$2,650 Child & Adult $1,000 Child Only $1,000 Child Only Reimbursement Schedule Fee Schedule Fee Schedule MAC Benefits Routine Exams - 9430 No Charge 100%100% Teeth Cleaning - 1110 No Charge 100%100% Full Mouth/Panoramic X-rays - 0330 No Charge 100%100% Simple Extractions - 7111 No Charge 80%80% Root Canal (Endodontics) - 3330 $250 80%80% Perio. Scaling/Root Planning - 4341 $55 per quad 80%80% Full or Partial Dentures - 5110 $375 50%50% Crowns - 6752 $270 50%50% Employer Contribution Contributory Minimum Participation Requirement Waiting Period Major Services None Rate Guarantee Expires 9/30/22 Rates Current Employee 34 $8.49 39 Employee + Spouse 6 $16.98 4 Employee + Child(ren)7 $19.11 1 Family 4 $30.74 6 Monthly Premium By Product $647.27 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 $38,571.24 $35.73 $74.58 $131.86 $84.05 $2,567.00 $3,214.27 PPO Humana Current Contributory Expires 9/30/22 None Not Quoted Mutual of Omaha Declined to Quote MetLife 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 7 of 811 ------ti l_-----1 October 2022 Dental Comparison for City of South Miami Carrier Humana Plan Name DMO HD205 OR Provider Acess In Network Only In-Network Out of Network Benefit Description Preventive (Class I)n/a 100%100% Basic (Class II)n/a 80%80% Major (Class III)n/a 50%50% Maximum Annual Benefit Unlimited Unlimited Unlimited Deductible (Individual/Family)n/a $50/$150 $50/$150 Deductible Waived - Class I n/a Yes Yes Orthodontia (coverage/lifetime max)$2,650 Child & Adult $1,000 Child Only $1,000 Child Only Reimbursement Schedule Fee Schedule Fee Schedule MAC Benefits Routine Exams - 9430 No Charge 100%100% Teeth Cleaning - 1110 No Charge 100%100% Full Mouth/Panoramic X-rays - 0330 No Charge 100%100% Simple Extractions - 7111 No Charge 80%80% Root Canal (Endodontics) - 3330 $250 80%80% Perio. Scaling/Root Planning - 4341 $55 per quad 80%80% Full or Partial Dentures - 5110 $375 50%50% Crowns - 6752 $270 50%50% Employer Contribution Contributory Minimum Participation Requirement Waiting Period Major Services None Rate Guarantee Expires 9/30/22 Rates Current Employee 34 $8.49 39 Employee + Spouse 6 $16.98 4 Employee + Child(ren)7 $19.11 1 Family 4 $30.74 6 Monthly Premium By Product $647.27 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 $38,571.24 $35.73 $74.58 $131.86 $84.05 $2,567.00 $3,214.27 PPO Humana Current Contributory Expires 9/30/22 None Standard Declined to Quote 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 8 of 812 October 2022 Vision Comparison for City of South MiamiCarrierNetwork ProviderNetwork StatusIn-NetworkOONIn-NetworkOONIn-NetworkOONEye Care WellnessEye Exam$0 Copayup to $30$0 Copayup to $30$0 Copayup to $30FrequencyLensesReimbursementReimbursementReimbursementSingle Vision$0 Copayup to $25$0 Copayup to $25$0 Copayup to $25Bifocals$0 Copayup to $40$0 Copayup to $40$0 Copayup to $40Trifocal$0 Copayup to $60$0 Copayup to $60$0 Copayup to $60FrequencyFramesReimbursementReimbursementReimbursementSelected Frames$200 allowance + 20% discount overup to $100$200 allowance + 20% discount overup to $100$200 allowance + 20% discount overup to $100FrequencyContactsReimbursementReimbursementReimbursementMedically Necessary100%up to $210100%up to $210100%up to $210Elective Contacts$200 allowance up to $160$200 allowance up to $160$200 allowance up to $160Contribution TypeParticipation RequirementsRate GuaranteeRatesEmployee565656Employee + Spouse888Employee + Child111111Family666Monthly TotalAnnual Total% Change in Total Annual Premium$ Change in Monthly Premium by Plan$ Change in Total Annual Premium$0.00$7.13$14.26$15.27$23.01$819.39$9,832.680.00%$0.00HumanaEyeMedEvery 12 MonthsEvery 12 MonthsEvery 24 MonthsVoluntary24 MonthsNegotiated RenewalHumanaEyeMedHumanaEyeMed$23.01$819.39$9,832.68Every 12 MonthsEvery 12 MonthsEvery 24 MonthsExpires 9/30/2022$15.27Current$7.13$14.26Voluntary$579.6024 MonthsRenewal$7.55$10,412.28$16.17$15.10$24.37$867.69$48.305.89%VoluntaryEvery 12 MonthsEvery 12 MonthsEvery 24 MonthsPage 1 of 513 ---•s-I 11 I Rate:s shown arer b~0soo' on cens1i1s data pr-ovTd'ed.. f°lflal mtn ,are s-l!ibjeot lo un.oeri...,rjfjlg and a.cllJ'itl SflrotkminL This OOmP@r,ison i!i ror s-lratlve pt1rpc1M-s only. The hi I policy and oertllical.e or oov.mi,ge wil supersede:· HY and au materials 1provi:!ed her-m.