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20-9798 Renewal of Insurance with Avmed
Sponsored by: City Manager RESOLUTION NO. 20-9798 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA, AUTHORIZING THE CITY MANAGER TO ENTER INTO RENEWAL INSURANCE CONTRACTS WITH AVMED, INC. AND METLIFE FOR MEDICAL, DENTAL, AND VISION INSURANCE FOR CITY EMPLOYEES; PROVIDING FOR INCORPORATION OF RECITALS; PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, there is a continued need for municipal health insurance coverage for City of Opa-Locka ("City") employees; and WHEREAS, the Human Resources Department has worked diligently with the City's Agent of Records firm to assess the existing group insurance policies and proposed premium rates from other carriers (See Exhibit "A" Presentation). Staff has recommended to renew coverage with the current carriers; and WHEREAS, the City desires to renew its current AvMed, Inc. and Metlife policies for medical, dental, and vision insurance for City employees and their dependents; and WHEREAS, it is in the best interest of the City to renew the contracts with AvMed and Metlife as the City's benefits providers. NOW THEREFORE, BE RESOLVED BY THE COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA: Section 1. The recitals to the preamble herein are incorporated by reference. Section 2. The City Commission of the City of Opa-Locka, Florida hereby authorizes the City Manager to enter into Renewal Contracts, between the City of Opa-Locka, AvMed, Inc., and Metlife for medical, dental, and vision insurance coverage for City employees and dependents. Section 3. The City Manager and Proper City Officials are hereby authorized to execute any required documents in order to implement the intent of this resolution. Section 4. Sections of this Resolution may be renumbered or re -lettered and corrections of typographical errors which do not affect the intent may be 1 Resolution No. 20-9798 authorized by the City Manager or the City Manager's designee, without the need of a public hearing, by filing a corrected copy of same with the City Clerk. PASSED AND ADOPTED this 27th day of August, 2020. Attest to: Flores City Clerk Moved by: COMMISSIONER BURKE Seconded by: COMMISSIONER BASS VOTE: 5-0 Commissioner Bass YES Commissioner Burke YES Commissioner Kelley YES Vice -Mayor Davis YES Mayor Pigatt YES Matthew Pigatt, Mayor Approved as to form and legal sufficiency: Burnadette Norris- - •ks, P.A. City Attorney 2 City of Opa-locka Agenda Cover Memo Department Director. Kierra Ward, MBA Department Director Signature: City Manager: John E. Pate CM Signature: dfel.N.�l Commission Meeting Date: 8/27/2020 Item Type: (EnterX in box) Resolution 04Vdinance Other X Fiscal Impact: (Enter xin box) Yes No Ordinance Reading (Enter X in box) 1St Reading 2A Reading X Public Hearing: (Enter X in box) Yes No Yes No X X Funding Source: Account#: (Enter Fund & Dept) Ex: Advertising Requirement: (EnterX in box) Yes No X Contract/P.O. Required: (Enter X in box) Yes No RFP/RFQ/Bid#: X Strategic Plan Related (Enter X in box) Yes No Strategic Plan Priority Enhance Organizational Bus. & Economic Dev Public Safety Quality of Education Qual. of Life & City Image Communcation Area: Strategic Plan Obj./Strategy: (list the specific objective/strategy this item will address) 0 III IN MI • • Sponsor Name City Manager Department: City Manager Short rode: A resolution authorizing the City Manager to enter into an agreement with AvMed, Metlife, and American Public Life for the City Employee's health, vision and dental plans. Staff Summary: It is in the best interest of the City to renew the contract with the AvMed, Metlife, and American Public Life Insurance Companies. Financial Impact - This expense was budgeted for a 10% increase in the FY 21 budget whereas it is indicated that the proposed rates are unchanged from FY 20. This will result in a $91,327 savings to the FY 21 budget with $74,488 of savings in the General Fund and $16,839 of savings in the Enterprise Funds. This budget appears in each division having personnel with the account number XX-XXX230 where the first five numbers vary by division. Proposed Action: Staff recommends approval. Attachment: Renewal Quote. Memorandum TO: oftr <0/ aaacqloQaa tWoriata Mayor Matthew A. Pigatt Vice -Mayor Chris Davis Commissioner Sherelean Bass Commissioner Alvin Burke Commissioner Joseph Kelley FROM: John E. Pate, City Manager DATE: August 21, 2020 RE: Proposed Health, Dental, Vision Carrier for Fiscal Year 2020/2021. Request: A RESOLUTION OF THE CITY OF OPA-LOCKA, FLORIDA AUTHORIZING THE CITY MANAGER TO SELECT AVMED HEALTH PLAN AS THE PROVIDER FOR THE CITY OF OPA-LOCKA HEALTH PLAN, METLIFE AS THE PROVIDER FOR THE CITY OF OPA-LOCKA'S DENTAL AND VISION GROUP PLANS, FOR THE BENEFIT YEAR BEGINNING OCTOBER 1, 2020 EXPIRING SEPTEMBER 30, 2021. Description: The Human Resources Department has worked diligently with the City's Agent of Records, Sapoznik Insurance and Associates, Inc to assess the existing group insurance policies and proposed premium rates from other carriers. Staff has recommended to renew with the current carriers. A resolution of the City Commission of Opa-locka, Florida authorizes the City Manager to enter into an agreement with AvMed and Metlife for the medical, dental, and vision group plans, respectively. Financial Impact: This item is estimated to present an annual cost of $759,148, and is subject to change upon employee dependant coverage election. This item is currently included in the proposed budget and is less than the proposed allocated amount. Implementation Timeline: October 1, 2020- September 30, 2021 Legislative History: Resolution NO. 19-9696 Recommendation(s): This approval is based on staffs analysis of the proposed services, providers, and costs. Additionally, the City is proposing to renew the agreement with AvMed and MetLife for the FY 2020-21 Benefit Year. Analysis: Staff has analyzed the results of the competitive Bid Process for Insurance Carriers facilitated by the City's current Agent of Records Sapoznik Insurance and Associates. It has been determined that it would be in the City's best interest to renew the contract with the current carriers. Sapoznik has successfully negotiated the initial renewal of 7.98 % increase with AvMed to a rate pass. The renewal of this plan will present no fiscal impact to the City's budget and would allow the reallocation of funding that was anticipated to absorb the increase projected. Although the City has two open large claims in excess of $50,000, the continued relationship with AvMed has presented an opportunity to utilize the same benefit plans with no fiscal increase. Metlife also provided a rate pass for the renewal of the dental and vision insurance with no increase. The packet attached identifies additional quotes and plans received and formal declination letters from carriers that declined to provide a quote. Attachments: Plan design and Insurance Bid Results PREPARED BY: Kierra Ward, MBA Human Resources Director 2020-2021 EMPLOYEE :3ENEFIT PRESENTATION Presented By: Rachel Sapoznik President & CEO Eugene Mintze III VP, Benefits Consultant 1-877-948-8887 www.sapoznik.com Fly scpoznik HERE HEALTH BENEFITS Exhibit #1 Medical Claims 877.948.8887 www.sapoznik.com a SInill( WHERE HEALTH BENEFITS All CITY OF OPA LOCKA Month Contracts 129 Members 216 Premium Capitation Hospital Outpatient ER Specialty PCP Other Pharmacy Medical TotalCost $41,901.03 07/2018 $70,748.69 $1,512.00 $1,220.17 $15,324.49 $729.90 $6,278.08 $1,823.00 $7,337.11 $7,676.28 $32,712.75 08/2018 126 210 $69,226.79 $1,470.00 $0.00 $22,647.09 $480.00 $6,800.88 $2,266.53 $9,460.01 $4,708.05 $41,654.51 $47,832.56 09/2018 123 207 $68,056.10 $1,449.00 $0.00 $5,481.32 $899.20 $1,727.39 $1,078.18 $6,029.54 $5,303.39 $15,215.63 $21,968.02 10/2018 127 208 $72,456.35 $1,456.00 $15,011.48 $42,909.70 $3,025.15 $6,525.83 $2,155.33 $8,866.63 $4,670.70 578,49412 $84,620.82 11/2018 123 204 $70,817.99 $1,428.00 $17,385.00 $4,260.82 $1,772.79 $2,957.11 $1,627.03 $14,856.24 $10,374.54 $42,858.99 554,66153 12/2018 122 201 $69,179.64 $1,407.00 $118,099.02 $40,855.24 -52,111.50 $8,318.12 $3,402.97 $8,020.68 $18,060.35 $176,584.53 $196,051.88 01/2019 119 197 $68,401.42 $1,379.00 $0.00 $7,049.72 $5,862.80 $6,339.99 $1,834.98 $1,703.37 $8,192.28 $22,790.86 $32,362.14 02/2019 121 198 $69,220.60 $1,386.00 $26,409.05 $48,088.30 $0.00 $5,955.19 $1,635.63 $6,502.51 $6,086.36 $88,590.68 $96,063.04 03/2019 118 191 $67,131.70 $1,337.00 $17,967.58 $56,862.80 $2,862.85 $5,728.27 $3,430.24 $8,480.29 $18,422.53 $95,332.03 $115,091.56 04/2019 118 189 $66,353.48 $1,323.00 $691.35 $26,238.84 $1,162.00 $4,944.60 $2,458.85 $7,444.83 $7,199.08 $42,940.47 $51,462.55 05/2019 118 189 $66,353.48 $1,323.00 $0.00 $17,483.18 $0.00 $7,813.85 $1,740.77 $10,808.98 $19,583.91 $37,846.78 $58,753.69 06/2019 118 188 $65,943.89 $1,316.00 $630.79 $25,614.82 $1,515.00 $5,415.19 $2,807.28 $9,747.31 $13,506.46 $45,730.39 $60,552.85 07/2019 119 189 $66,722.11 $1,323.00 $9,899.99 $38,725.27 $365.77 $11,430.91 $2,128.51 $10,560.57 $8,586.57 $73,111.02 $83,020.59 08/2019 123 193 $68,360.47 $1,351.00 $305.00 $4,329.38 $0.00 $2,573.77 $1,646.53 $6,370.08 $3,513.51 $15,224.76 $20,089.27 09/2019 122 192 $67,950.88 $1,344.00 $0.00 $50,895.00 $2,245.00 $4,254.68 $1,597.60 $3,233.03 $4,163.90 $62,225.31 $67,733.21 10/2019 122 196 $72,367.59 $1,372.00 $26,310.38 $35,936.69 $0.00 $5,272.23 $1,426.34 $10,266.14 $20,981.53 $79,211.78 $101,565.31 11/2019 121 196 $71,936.06 $1,372.00 $7,849.18 $36,093.17 $3,989.04 $8,431.82 $2,534.98 $4,601.02 $2,474.82 $63,499.21 $67,346.03 12/2019 118 192 $70,554.08 $1,344.00 $0.00 $19,411.54 $1,924.18 $3,226.31 $3,632.11 $5,903.19 $12,016.27 $34,097.33 $47,457.60 01/2020 119 193 $70,985.61 $1,351.00 $0.00 $14,436.78 $782.69 $1,700.12 $694.19 $2,934.86 $6,064.44 $20,548.64 $27,964.08 02/2020 119 194 $71,417.14 $1,358.00 $4,972.00 $21,169.70 $1,238.44 $3,933.85 $1,100.53 $5,672.45 $2,959.64 $38,086.97 $42,404.61 03/2020 119 194 $71,417.14 $1,358.00 $0.00 $16,388.84 $1,571.74 $4,122.35 $2,034.21 $24,441.62 $11,880,77 $48,558.76 $61,797.53 04/2020 120 196 $71,805.52 $1,372.00 $0.00 $35,444.74 -$14.00 $6,207.89 $924.03 $3,253.82 $10,577.55 $45,816.48 $57,766.03 05/2020 121 198 $72,625.43 $1,386.00 $0.00 $25,984.56 $800.00 $2,056.53 $1,365.10 $869.59 $4,780.57 $31,075.78 $37,242.35 06/2020 122 198 $73,056.96 $1,386.00 $84,781.14 $15,787.60 $3,339.68 $3,848.20 $1,631.31 $3,762.27 $3,803.94 $113,150.20 $118,340.14 High Cost Claimants Report CITY OF OPA LOCKA Members with >$50,000 in Total Paid Claims Paid Dates: 07/2019 through 06/2020 AvMed Rank Most Costly Medical ICD-9 Diagnosis Pharmacy Medical Total Expenses Member Status 1 10.1 DISEASES OF THE URINARY SYSTEM 2 16.2 FRACTURES *Above data excludes capitation costs Prepared by: Group Analytics Source: AvMed Enterprise Data Warehouse Monday, July 27, 2020 $2,378.59 $182,393.03 $184,771.62 $40.49 $90,490.66 $90,531.15 Active Active This report is based on paid claims and is intended to provide clients with information regarding the total amount of paid claims for their high cost claimants at a specific point in time. For experience -rated groups, the actual amount pooled as part of their renewal rate development may vary in both the time frame and the data incorporated. Page 1 of 1 r scpoznik HEALTH BENEFITS • Exhibit #2 AvMed Current/Renewal 877.948.8887 www.sapoznik.com i 44311U(INHERE HEALTH BENEFITS " W H E R E H E A L T H B E N E F I T S C a r r i e r N a m e P l a n N a m e N e t w o r k A c c e s s D e d u c t i b l e D e d u c t i b l e M e m b e r C o - I n s u r a n c e M a x B e n e f i t s O u t o f P o c k e t M a x i m u m L i f e t i m e m a x P h y s i c i a n O f f i c e S e r v i c e s P h y s i c i a n S p e c i a l i s t P r e v e n t i v e C a r e D i a g n o s t i c S e r v i c e s I n d e p e n d e n t C l i n i c a l L a b D i a g n o s t i c T e s t i n g F a c i l i t y M R I , M R A , C T & P E T S c a n s E R a n d U r g e n t C a r e E m e r g e n c y R o o m U r g e n t C a r e O u t p a t i e n t & I n p a t i e n t S e r v i c e s O u t p a t i e n t S u r g e r y - H o s p i t a l & A m b u l a t o r y S u r g i c a l C e n t e r ( A C S ) I n p a t i e n t H o s p i t a l P r o v i d e r S e r v i c e s I n p a t i e n t H o s p i t a l P h a r m a c y S e r v i c e s P r e s c r i p t i o n A v M e d - C u r r e n t / R e n e w a l A v M e d H M O O A 7 2 5 4 R e n e w a l : H M O O A 7 4 2 2 I n N e t w o r k O n l y $ 5 0 0 0 / $ 1 0 0 0 0 2 0 % $ 6 8 5 0 / $ 1 3 7 0 0 U n l i m i t e d $ 2 5 $ 5 0 C o v e r e d 1 0 0 % P a r t i c : C o v e r e d 1 0 0 % A l l O t h e r s : $ 2 5 I n d p : $ 2 5 0 / A l l O t h e r s : $ 5 0 0 R e n e w a l : A l l O t h e r s : $ 5 0 0 A f t e r D e d $ 5 0 0 $ 7 5 / $ 2 5 2 0 % A f t e r D e d 2 0 % A f t e r D e d 2 0 % A f t e r D e d $ 1 0 / 3 5 / 7 5 ; 3 0 % / 3 0 % A f t e r $ 2 5 0 / $ 5 0 0 D e d R e n e w a l : $ 0 / 3 5 / 7 5 . 3 0 � / % / 3 0 � / 0 A f t e r D e d C i t y O f O p a - L o c k a O c t o b e r 1 , 2 0 2 0 A v M e d A v M e d C h o i c e 6 0 8 3 / 4 0 1 0 C h o i c e 7 4 7 0 I n N e t w o r k P H C S O u t o f N e t w o r k I n N e t w o r k P H C S O u t o f N e t w o r k $ 3 0 0 0 / $ 6 0 0 0 $ 4 5 0 0 / $ 9 0 0 0 $ 6 0 0 0 / $ 1 2 0 0 0 $ 2 5 0 0 / $ 5 0 0 0 $ 7 5 0 0 / $ 1 5 0 0 0 1 5 % 4 0 % 1 0 % 4 0 % $ 4 0 0 0 / $ 8 0 0 0 $ 6 0 0 0 / $ 1 2 0 0 0 $ 8 0 0 0 / $ 1 6 0 0 0 $ 6 5 0 0 / $ 1 3 0 0 0 $ 1 9 5 0 0 / $ 3 9 0 0 0 U n l i m i t e d U n l i m i t e d $ 2 5 4 0 % A f t e r D e d $ 2 5 4 0 % A f t e r D e d $ 5 0 4 0 % A f t e r D e d $ 5 0 4 0 % A f t e r D e d C o v e r e d 1 0 0 % 4 0 % C o v e r e d 1 0 0 % 4 0 % A f t e r D e d P a r t i c : C o v e r e d 1 0 0 % A l l O t h e r s : 1 5 % A f t e r D e d 1 5 % A f t e r D e d 4 0 % A f t e r D e d P a r t i c : C o v e r e d 1 0 0 % A l l O t h e r s : $ 5 0 4 0 % A f t e r D e d 1 5 % A f t e r D e d 4 0 % A f t e r D e d I n d p : $ 2 0 0 A l l O t h e r s : $ 4 0 0 A f t e r D e d 4 0 % A f t e r D e d $ 1 0 0 $ 3 5 0 $ 4 0 / $ 2 5 $ 6 0 $ 7 5 / $ 2 5 1 4 0 % A f t e r D e d 1 5 % A f t e r D e d 4 0 % A f t e r D e d 1 0 % A f t e r D e d 4 0 % A f t e r D e d $ 2 5 0 P e r D a y 5 D a y M a x C o v e r e d 1 0 0 % 4 0 % A f t e r D e d 4 0 % A f t e r D e d 1 0 % A f t e r D e d 1 0 % A f t e r D e d 4 0 % A f t e r D e d 4 0 % A f t e r D e d $ 2 0 / 4 0 / 6 0 / 7 5 / 5 0 % N C $ 1 0 / 2 5 / 5 0 / 1 0 0 , 3 0 % A f t e r 5 0 0 / 1 0 0 0 D e d N C T o t a l E n r o l l e d : - C u r r e n t R e n e w a l N e g o t i a t e d �% C u r r e n t R e n e w a l N e g o t i a t e d E m p l o y e e 9 4 $ 4 3 1 . 5 3 $ 4 6 5 . 9 5 $ 4 4 6 . 6 9 $ 6 1 2 . 6 6 $ 5 6 7 . 6 9 $ 5 4 6 . 6 7 E m p l o y e e / S p o u s e 0 $ 8 6 3 . 0 6 $ 9 3 1 . 8 9 $ 8 9 7 . 3 8 0 $ 1 , 2 2 5 . 3 1 $ 1 , 1 3 5 . 3 8 $ 1 , 0 9 3 . 3 4 E m p l o y e e / C h i l d ( r e n ) 1 3 $ 8 1 9 . 9 1 $ 8 8 5 . 3 0 $ 8 5 2 . 5 1 1 $ 1 , 1 6 4 . 0 5 $ 1 , 0 7 8 . 6 2 $ 1 , 0 3 8 . 6 7 E m p l o y e e / F a m i l y 9 $ 1 , 3 3 7 . 7 4 $ 1 , 4 4 4 . 4 3 $ 1 , 3 9 0 . 9 4 0 $ 1 , 8 9 9 . 2 4 $ 1 , 7 5 9 . 8 5 $ 1 , 6 9 4 . 6 7 C o m m e n t s 1 1 6 C u r r e n t 7 . 9 8 % 3 . 6 8 % 1 C u r r e n t - 7 . 3 4 % - 1 0 . 7 7 % M o n t h l y T o t a l $ 6 3 , 2 6 2 . 3 1 $ 6 8 , 3 0 8 . 0 7 $ 6 5 , 5 8 9 . 9 5 $ 1 , 1 6 4 . 0 5 $ 1 , 0 7 8 . 6 2 $ 1 , 0 3 8 . 6 7 Q u o t e s a r e b a s e d o n t h e c e n s u s e c e i v e d . R a t e s c o u l d b e a d j u s t e d b a s e d o n f i n a l e n r o l l m e n t . T h i s d a t a i s p r o v i d e d f o r i n f o r m a t i o n p u r p o s e s o n l y . I t i s n o t i n t e n d e d t o r e p r e s e n t a b i n d i n g o b l i g a t i o n . T h e g o v e r n i n g d o c u m e n t f o r t h i s p u r p o s e w o u l d b e t h e C O C i s s u e d b y t h e c a r r i e r . P l e a s e s e e d e t a i l e d b e n e f i t s u m m a r y . 1 1 : 1 0 A M I n f o r m a t i o n p r o v i d e d b y S a p o z n i k I n s u r a n c e i s p r o p r i e t a r y . I t m a y n o t b e c o p i e d , e m u l a t e d o r d i s t r i b u t e d w i t h o u t e x p r e s s p e r m i s s i o n . 8 / 1 2 / 2 0 2 0 Wznik. HERE HEALTH BENEFITS Carrier Name Plan Name Network Access Deductible Deductible Member Co -Insurance Max Benefits Out of Pocket Maximum Lifetime max Physician Office Services Physician Specialist Preventive Care Diagnostic Services Independent Clinical Lab Diagnostic Testing Facility MRI, MRA, CT & PET Scans ER and Urgent Care Emergency Room Urgent Care Outpatient & Inpatient Services Outpatient Surgery- Hospital & Ambulatory Surgical Center (ACS) Inpatient Hospital Provider Services Inpatient Hospital Pharmacy Services Prescription Total Enrolled: Employee AvMed - Current Renewal $5000/$10000 20% $6850/$13700 Unlimited $25 $50 Covered 100% Partic: Covered 100% All Others: $25 Indp: $250 / All Others: $500 Renewal: All Others: $500 After Ded $500 $75/$25 20% After Ded 20% After Ded 20% After Ded $10/35/75; 30%/30% After $250/$500 Ded Renewal $10/35/75; 30%/30% After Ded In Network PHCS Out of Network City Of Opa-Locka October 1, 2020 In Network PHCS I Out of Network $3000/$6000 I $4500/$9000 15% $6000/$12000 40% $2500/$5000 10% I$7500/$15000 40% $4000/$8000 I $6000/$12000 $8000/$16000 Unlimited $6500/$13000 Unlimited l$19500139000 $25 40% After Ded $25 40% After Ded $50 40% After Ded $50 40% After Ded Covered 100% 40% Covered 100% 40% After Ded Partic: Covered 100% All Others: 15% After Ded 15% After Ded 40% After Ded Partic: Covered 100% All Others: $50 40% After Ded 15% After Ded 40% After Ded Indp: $200 All Others: $400 After Ded 40% After Ded $100 $350 $40/$25 $60 $75/$25 40% After Ded 15% After Ded 40% After Ded 10% After Ded 40% After Ded $250 Per Day 5 Day Max 40% After Ded 10% After Ded 40% After Ded Covered 100% 40% After Ded 10% After Ded 40% After Ded ■ Current Renewal Negotiated Cost Shift ■ 94 $431.53 $465.95 $446.69 $431.53 0 $20/40/60/75/50 % NC Current $612.66 $10/25/50/100, 30% After $500/$1000 Ded Renewal $567.69 NC Negotiated Cost Shift $546,67 $525.76 Employee/Spouse 0 $863.06 $931.89 $897 38 $863 06 0 $1, 225.31 $1,135.38 $1, 093.34 $1, 051.52 Employee/Child(ren) 13 $819.91 $885.30 $852.51 $819 91 1 $1,164.05 $1,078.62 $1, 038.67 $998.95 Employee/Family 9 $1,337.74 $1,44443 $1, 390.94 $1, 337.74 0 $1,899.24 $1, 759.85 $1, 694.67 $1,629-86 Comments 116 Current 7.98°/ 3.68 % 0.00% 1 Current -7.34% -10.77% -14.18% Monthly Total $63,262.31 $68,308.07 $65,589.95 $63,262.31 $1,164.05 $1,078.62 $1,038.67 $998.95 Quotes are based on the census received. Rates could be adjusted based on final enrollment. This data is provided for information purposes only. It is not intended to represent a binding obligation. The governing document for this purpose would be the COC issued by the carrier. Please see detailed benefit summary 9:47 AM Information provided by Sapoznik Insurance is proprietary. It may not be copied, emulated or distributed without express permission. 8/17/2020 Pik. WHERE HEALTH BENEFITS Carrier Name Plan Name Network Access Deductible Deductible Member Co -Insurance Max Benefits Out of Pocket Maximum Lifetime max Physician Office Services Physician Specialist Preventive Care Diagnostic Services Independent Clinical Lab Diagnostic Testing Facility MRI, MRA, CT & PET Scans ER and Urgent Care Emergency Room Urgent Care Outpatient & Inpatient Services Outpatient Surgery- Hospital & Ambulatory Surgical Center (ACS) Inpatient Hospital Provider Services Inpatient Hospital Pharmacy Services Prescription AvMed HMO OA 7254 Renewal: HMO OA 7422 AvMed HMO OA 7424 In Network Only In Network Only $5000/$10000 $5000/$10000 20% 20% $6850/$13700 $7550/$15100 Unlimited Unlimited $25 $35 $50 $70 Covered 100% Covered 100% Partic: Covered 100% Partic: Covered 100% All Others: $25 All Others: $25 Indp: $250 / All Others: $500 Indp: $250 Renewal: All Others: $500 After Ded All Others: $500 After Ded $500 $500 $75/$25 $75/$35 20% After Ded 20% After Ded 20% After Ded 20% After Ded 20% After Ded 20% After Ded $10/35/75, 30°/0/30% After $250/$500 Ded Renewal $10/35/75, 30%/30% After Ded $10/25/50/100, 30% After $500/$1000 Ded AvMed - Alternates AvMed Choice 6083/4010 AvMed Choice 7470 In Network PHCS Out of Network In Network PHCS Out of Network $3000/$6000 $4500/$9000 $6000/$12000 $2500/$5000 $7500/$15000 15% 40% 10% 40% $4000/$8000 $6000/$12000 $8000/$16000 $6500/$13000 $19500/$39000 Unlimited Unlimited $25 40% After Ded $25 40% After Ded $50 40% After Ded $50 40% After Ded Covered 100% 40% Covered 100% 40% After Ded Partic: Covered 100% All Others: 15% After Ded 15% After Ded 40% After Ded Partic: Covered 100% All Others: $50 40% After Ded 15% After Ded 40% After Ded Indp: $200 All Others: $400 After Ded 40% After Ded $100 $350 $40/$25 $60 $75/$25 40% After Ded 15% After Ded 40% After Ded 10% After Ded 40% After Ded $250 Per Day 5 Day Max 40% After Ded 10% After Ded 40% After Ded Covered 100% 40% After Ded 10% After Ded 40% After Ded $20/40/60/75/50% NC $10/25/50/100; 30% After $500/$1000 Ded NC Total Enrolled: Current Negotiated Negotiated Alternate ■ Current Negotiated Employee 94 $431.53 $446.69 $436.38 0 $612 66 $546 67 Employee/Spouse 0 $863.06 $897 38 $872.76 0 $1,225.31 $1,093 34 Employee/Child(ren) 13 $819 91 $852.51 $829.12 1 $1,164.05 $1,038.67 Employee/Family 9 $1, 337.74 $1,390.94 $1,352.78 0 $1,899.24 $1,694.67 Comments 116 Current 3.68% 1.12% 1 Current -10.77°/ Monthly Total $63,262.31 $65,589.95 $63,973.30 $1,164.05 $1,038.67 Quotes are based on the census received. Rates could be adjusted based on final enrollment This data is provided for information purposes only. It is not intended to represent a binding obligation. The governing document for this purpose would be the COC issued by the carrier. Please see detailed benefit summ• 4:38 PM Information provided by Sapoznik Insurance is proprietary. It may not be copied, emulated or distributed without express permission scpoznik HERE HEALTH BENEFITS Exhibit #4 Gap 877.948.8887 www.sapoznik.com WHERE HEALTH BENEFITS k. WHERE HEALTH BENEFITS Carrier Plan Name Rate Structure Contribution Premium Breakdown Employee Employee/Spouse Employee/Child(ren) Employee/Family Comments Monthly Total 47 7 9 9 72 APL Inpatient: Up to $3,000 Outpatient: Up to $1,000 Composite Voluntary Current/Renewal $41.25 $93.53 $70.38 $122.65 Rate Pass $4,330.73 Plan Provisions $300 ER Deductible Quotes are based on the census received. Rates could be adjusted based on final enrollment. City Of Opa-Locka October 1, 2020 Gap TransAmerica Inpatient: Up to $3,000 Outpatient: Up to $1,500 Composite Employer Paid- Participation 100% Voluntary- Participation 50% $41.17 $88.51 $72.57 $128.52 TransAmerica Inpatient: Up to $4,000 Outpatient: Up to $4,000 Composite Employer Paid- Participation 100% Voluntary- Participation 50% $59.01 $126.65 $103.42 $188.82 This data is provided for information purposes only. It is not intended to represent a binding obligation. The goveming document for this purpose would be the COC issued by the carrier. Please see detailed benefit summary 11:10 AM Information provided by Sapoznik Insurance is proprietary. It may not be copied, emulated or distributed without express permission. 8/12/2020 APL AMERICAN PUBLIC LIFE Expanding the Benefits Horizon' JUNE 29, 2020 CITY OF OPA LOCKA 780 FISHERMAN ST OPA LOCKA, FL 33054 RE: Group # 17672 Dear Group Administrator: Your MEDlink® Series Supplemental Limited Benefit Medical Expense Insurance plan will renew on OCTOBER 01, 2020. Your current rates will not change if you renew your current plan design with no change in benefits, riders or contribution strategy. Please contact your broker for assistance in reviewing the attached renewal documents. Your renewal is contingent upon: 1. meeting and maintaining the required participation (groups not meeting participation at renewal are subject to termination) 2. your broker returning, and Underwriting approving, the completed APL Group Coverage & Participation Form (APL reserves the right to adjust premium, decline coverage or non -renew based on review of submitted form) 3. your current plan meeting the size classification guidelines per Florida regulation If we do not receive your information by OCTOBER 01, 2020, billing, for the above referenced product, will be suspended until your plan is renewed. Claims, for the above referenced product, with a date of service of OCTOBER 01, 2020 and later will also be suspended until your plan is renewed. Thank you for doing business with APL. We appreciate the opportunity to provide you and your employees with this valuable benefit. Sincerely, American Public Life Insurance Company cc: RACHEL SAPOZNIK THE SOUTHERN REGION LLC 2305 LAKELAND DRIVE I FLOWOOD, MS 39232 1800.256.8606 Renewal Information Group Name: CITY OF OPA LOCKA Group Number: 17672 Current Plan 1— MEDlink® Select Voluntary Renewal Effective Date: October 1, 2020 APL. AMERICAN PUBLIC LIFE Family Benefit Max In -Hospital Benefit In -Hospital Benefit Type Outpatient Benefit Outpatient Benefit Type ER Deductible ER Deductible Type ER Deductible Waived Acc $9,000 $3,000 CY $1,000 CY $300 PO No Current Rates Plan 1— MEDlink® Select Voluntary Employee Employee & Spouse Employee & Child(ren) Employee & Family Ages 18-99 $41.25 $93.53 $70.38 $122.65 Renewal Information Group Name: CITY OF OPA LOCKA Group Number: 17672 Renewal Plan 1— MEDIink® Select Voluntary Renewal Effective Date: October 1, 2020 APL AMERICAN PUBLIC LIFE Family Benefit Max In -Hospital Benefit In -Hospital Benefit Type Outpatient Benefit Outpatient Benefit Type ER Deductible ER Deductible Type ER Deductible Waived Acc $9,000 $3,000 CY $1,000 CY $300 PO No Renewal Rates Plan 1— MEDIink® Select Voluntary Employee Employee & Spouse Employee & Child(ren) Employee & Family Ages 18-99 $41.25 $93.53 $70.38 $122.65 HELPING WITH YOiiR MEDICAL COSTS TransConnect for Florida, underwritten by Transamerica Life Insurance Company Andrea was involved in a serious car accident. After the whirlwind of the ambulance ride, ER, surgery, and hospital stay, she's nervous about how much her major medical insurance will pay. It's a relief to remember that she signed up for TransConnect which can pay for out-of-pocket expenses like deductibles, co-insurance, and co -payments. INPATIENT HOSPITAL BENEFITS $3000 Your policy pays benefits for inpatient hospital stays, inpatient procedures, inpatient physician charges, and even routine nursery care for dependent children. Your employer determines your calendar year maximum benefit (multiplied by three for an insured family). OUTPATIENT HOSPITAL BENEFITS WITH OUTPATIENT LAB RIDER $1500 Your policy also pays benefits (separate from the inpatient hospital benefits) for: • Radiological diagnostic testing performed in a hospital outpatient facility or a magnetic resonance imaging (MRI) facility 0 Customer Service: • Radiation therapy or chemotherapy authorized by a radiologist, 888-763-7474 chemotherapist, or an oncologist for outpatient cancer treatment • Outpatient surgery performed in a hospital facility, free-standing surgery center, or physician's office • MRIs, CT scans, PET scans, diagnostic ultrasounds, and electrocardiogram (EKG) tests performed in a physician's office (X-rays and lab fees are not included) • Cardiac catheterizations and stress tests • Accident, injury, or emergency condition treatment in a hospital ER or urgent care center • Laboratory tests performed on an outpatient basis in an independent laboratory (a lab that is independent of both an attending or consulting physician's office and of a hospital). MONTHLY PREMIUM You You and your spouse You and your child(ren) $41.17 $88.51 $72.57 $128.52 You, your spouse and your child(ren) Visit: transamerica.com ACCIDENT -ONLY AMBULANCE BENEFIT $1000 This benefit is payable when ambulance transportation (ground or air) is required to a hospital or emergency center for injuries sustained in an accident. Ambulance transportation must be within 72 hours of the accident and must be provided by a licensed professional ambulance company. ELIGIBILITY You must be actively employed qualifying as an eligible insured (defined by the employer) and have an employer's basic, major medical, or comprehensive medical plan. TRANSAMERICA• 4 HELPING WITH YOUR MEDICAL COSTS TransConnect for Florida, underwritten by Transamerica Life Insurance Company Andrea was involved in a serious car accident. After the whirlwind of the ambulance ride, ER, surgery, and hospital stay, she's nervous about how much her major medical insurance will pay. It's a relief to remember that she signed up for TransConnect which can pay for out-of-pocket expenses like deductibles, co-insurance, and co -payments. INPATIENT HOSPITAL BENEFITS $4000 Your policy pays benefits for inpatient hospital stays, inpatient procedures, inpatient physician charges, and even routine nursery care for dependent children. Your employer determines your calendar year maximum benefit (multiplied by three for an insured family). OUTPATIENT HOSPITAL BENEFITS WITH OUTPATIENT LAB RIDER $4000 Your policy also pays benefits (separate from the inpatient hospital benefits) for: • Radiological diagnostic testing performed in a hospital outpatient facility or a � magnetic resonance imaging (MRI) facility CH Customer Service: • Radiation therapy or chemotherapy authorized by a radiologist, 888-763-7474 chemotherapist, or an oncologist for outpatient cancer treatment • Outpatient surgery performed in a hospital facility, free-standing surgery center, or physician's office • MRIs, CT scans, PET scans, diagnostic ultrasounds, and electrocardiogram (EKG) tests performed in a physician's office (X-rays and lab fees are not included) • Cardiac catheterizations and stress tests • Accident, injury, or emergency condition treatment in a hospital ER or urgent care center • Laboratory tests performed on an outpatient basis in an independent laboratory (a lab that is independent of both an attending or consulting physician's office and of a hospital). You You and your spouse You and your child(ren) $59.01 $126.65 $103.42 $188.82 You, your spouse and your child(ren) Visit: transamerica.com ACCIDENT -ONLY AMBULANCE BENEFIT $1000 This benefit is payable when ambulance transportation (ground or air) is required to a hospital or emergency center for injuries sustained in an accident. Ambulance transportation must be within 72 hours of the accident and must be provided by a licensed professional ambulance company. ELIGIBILITY You must be actively employed qualifying as an eligible insured (defined by the employer) and have an employer's basic, major medical, or comprehensive medical plan. TRANSAMERICA• 03/20 IMPORTANT POLICY PROVISIONS Your employer selects benefit amounts, paid only for deductibles, co-insurance, and co -pays incurred when your major medical plan pays for specified treatments and care. HOW TO SUBMIT A CLAIM The ID card you'll receive after enrollment should be presented at time of service so providers are paid directly after your major medical carrier determines what you owe. If you don't do so at time of service, simply submit a TransConnect® claim form, UB92 or HCFA (the itemized service provider's bill), and the Explanation of Benefits (EOB) from the major medical carrier showing what you owe after what they paid. EXCLUSIONS No benefits are payable under this policy/certificate for any expenses incurred: • Late enrollees subject to a 30-day waiting period • During any period the insured person does not have coverage under another medical plan • As the result of suicide or any attempted suicide, while sane or insane • For any intentionally self-inflicted injury or sickness • For rest care or rehabilitative care and treatment • For voluntary abortion except, with respect to the insured or insured spouse where the insured or the insured's dependent spouse's life would be endangered if the fetus were carried to term; or where medical complications have arisen from abortion • As a result of commission of a felony • As a result of participation in a riot, civil commotion, civil disobedience, or unlawful assembly. Excludes loss occurring while acting in a lawful manner within the scope of authority. • As a result of participation in a contest of speed in power - driven vehicles, parachuting, or hang gliding • As a result of air travel, except as a fare -paying passenger on a commercial airline on a regularly scheduled route or as a passenger for transportation only and not as a pilot or crew member • As a result of intoxication as determined and defined by the laws and jurisdiction of the geographical area in which the loss occurred • For alcoholism or drug use, unless such drugs were taken on the advice of a physician and taken as prescribed while hospital confined as an inpatient • For any loss incurred while on active duty status in the armed forces of any country. If you notify us of such active duty, we will refund any premium paid for any period for which no benefits are provided as a result of this exclusion. • For pregnancy of a dependent child • For sex changes • For experimental treatment, procedures, devices, drugs, or surgery (except that bone marrow transplants will not be considered experimental in the treatment of cancer) • For accident or sickness arising out of and in the course of any occupation for compensation, wage, or profit (does not apply to sole proprietors or partners not covered by workers' compensation) • For mental illness or functional or organic nervous disorders — regardless of the cause — if the other medical plan does not cover these conditions • For dental or vision services, including, but not limited to, treatment, surgery, extractions, or X-rays, unless resulting from an accident occurring while the insured person's insurance under this policy is in force and if performed within 12 months of the date of such accident; or due to congenital disease or anomaly of an insured newborn child; and to assure the safe delivery of necessary dental care provided to an insured person meeting certain criteria • For routine physical examinations and rest cures TERMINATION OF INSURANCE INSURANCE ON AN INSURED WILL END ON THE EARLIEST OF THE FOLLOWING DATES: • The end of the last period for which premium has been paid • The policy is terminated • The insured retires • The insured ceases to be on active service • The insured's coverage in the underlying medical plan ends INSURANCE ON A DEPENDENT WILL END ON THE EARLIEST OF THE FOLLOWING DATES: • The insured's insurance terminates • The end of the last period for which premium has been paid • The dependent no longer meets the definition of dependent • The dependent's coverage in the underlying medical plan ends • The policy is modified so as to exclude dependent insurance THE COMPANY MAY END THE INSURANCE IF: • Any insured person submits a fraudulent claim • Participation requirements are not met • On any premium due date, if the company or employer sends written notice 45 days in advance requesting termination • If the underlying medical plan terminates This is a brief summary of TransConnect® Supplemental Medical Expense insurance, underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa. Policy form series CPGAP2FL and CCGAP2FL, rider form number TRLB1000-1119. Forms and form numbers may vary. This insurance may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate, and riders for complete details. Up-to-date information regarding our compensation practices can be found in the disdosures section of our website at tebcs.com 253889 © 2020 Transamerica soixanik. WHERE HEALTH BENEFITS Exhibit #5 Dental 877.948.8887 www.sapoznik.com znik. WHERE HEALTH BENEFITS Dental DHMO City Of Opa-Locka October 1, 2020 Dental DPPO Carrier Name Plan Name Network Access Deductible Ded waived for Preventive Preventive Basic Major Periodontics / Endodontics Annual Maximum Benefit Out of Network Reimbursement Level Orthodontic Orthodontic Eligibility Orthodontic Maximum Rate Guarantee Premium Breakdown Employee 44 MetLife Met290 In Network Only No Ded $5 Office Visits None Some procedures Covered 100% Co -Pays Apply Co -Pays Apply Co -Pays Apply None In Network Only United MotLife D1058-S700B In Network Only No Ded $0 Office Visits None Some procedures Covered 100% Co -Pays Apply Co -Pays Apply Co -Pays Apply None In Network Only Co -Pays Apply Co -Pays Apply Adult & Child Adult & Child None None Next Renewal: 10/01/2022 Current/Renewal $11.86 1 Year $12.61 30 DPPO United DPPO In Network Out of Network In Network Out of Network $50/$150 $50/$150 $50/$150 $50/$150 Yes No Yes 100% 90% 100% 90% 70% 90% 60% 40% 60% Major Simple Extractions: Basic Yes 90% 70% 40% Ma'or Simple Extractions: Basic $3,000 $1,500 $3,000 $1,500 Fee Fee Fee Fee 50% 50% Child(ren) to age 19 Child(ren) to age 19 $1,000 $1,000 Next Renewal: 10/01/2022 Current/Renewal $40.42 1 Year $36.37 Employee/Spouse 6 $20.75 $22.06 7 $80.83 $72.75 Employee/Child(ren) Employee/Family Comments 6 $24.90 $27.31 4 60 Rate Pass 5.78% 9 10 56 $97.48 $145.48 Rate Pass $82.98 $125.57 -12.35% Monthly Total $935.70 $989.74 $4,110.53 $3,602.87 Quotes are based on the census received. Rates could be adjusted based on final enrollment. This data is provided for information purposes only. It is not intended to represent a binding obligation. The governing document for this purpose would be the COC issued by the carrier. Please see detailed benefit summary. Information provided by Sapoznik Insurance is proprietary. 11:10 AM It may not be copied, emulated or distributed without express permission. 8/12/2020 rif Scooinik M • II WHERE HEALTH BENEFITS Exhibit #6 Vision 877.948.8887 www.sapoznik.com sWHznik. ERE HEALTH BENLHI Vision City Of O pa - Loc ka October 1, 2020 Carrier Name MetLlfe 'Must be sold with Dental' United Plan Name 50 M130D-10/10 Vision Network Access In Network Allowance I Out of Network Reimbursement In Network I Allowance Out of Network Reimbursement Eye Care Co -pay Eye Exam $10 I Up to $45 $10 I Up to $40 Frequency 12 Months 12 Months Materials Co -pay $10 I N/A $10 N/A Lenses Single $0 After Co -pay Up to $30 $0 After Co -pay Up to $40 Bifocal $0 After Co -pay Up to $50 $0 After Co -pay Up to $60 Trifocal $0 After Co -pay Up to $65 $0 After Co -pay Up to $80 Lenticular $0 After Co -pay Up to $100 $0 After Co -pay Up to $80 Frequency 12 Months 12 Months Frames Frames Up to $130 + 20% off Balance Up to $70 Up to $130 + 30% off Balance Up to $45 Frequency 24 Months 24 Months Contact Lens Co -pay In lieu of any other eyewear benefits In lieu of any other eyewear benefits Elective Up to $130 Up to $105 Up to $130 Up to $105 Medically Necessary $0 After Co -pay Up to $210 $0 After Co -pay Up to $210 Frequency 12 Months 12 Months Rate Guarantee Premium Breakdown Employee Next Renewal. 10/01 /2022 3 Years $6.59 Current/Renewal $6.80 Employee/Spouse 13 $13.62 $13.20 Employee/Child(ren) 9 $14.02 $13.58 Employee/Family 1 $21.79 $21.11 Comments 73 Rate Pass -3.10% Total Monthly S665.03 $644.43 Quotes are based on the census received. Rates could be adjusted based on final enrollment. This data is provided for information purposes only. It is not intended to represent a binding obligation. The governing document for this purpose would be the COC issued by the carrier. Please see detailed benefit summary 11:10 AM Information provided by Sapoznik Insurance is proprietary. It may not be copied, emulated or distributed without express permission. 8/12/2020 " s c o z n i k W H E R E H E A L T H B E N E F I T S E x h i b i t # 7 L i f e & D I 8 7 7 . 9 4 8 . 8 8 8 7 w w w . s a p o z n i k . c o m s o o l i k 9 H E A L T H B E N E F I T PHEALTH BENEFITS • Life & AD&D Company/Plan Clare Description Lincoln Class 1: All Active FT Non -Officials Class 2: Chief of Police & All FT City Managers Class 3: All FT Assistant City Manager & Assistant Chief of Police Class 4: All FT Non -Salaried Officials, Mayor, Vice Mayor & Commissionsers Life Amount Class 1 & 3. 1x Annual Class 2: 2x Annual Class 4: $100,000 Maximum Benefits Class 1 & 4: $100,000 Class 2: $300,000 Class 3: $100,000 Reduction Factor 35% At Age 70 15% At Age 75 Guaranteed Issue Amount Class 1 & 4: $100,000 Class 2: $300,000 Class 3: $100,000 Rate Guarantee Next Renewal: 10/01/2021 Contribution Employer Paid Participation 100% Premium Breakdown Current $0.287 Life AD&D $0.022 Comment Under Rate Guarantee Volume $7,146,350 Approx. Monthly Premium $2,208.22 11:10 AM STD Company/Plan Lincoln Class Description Class 1: All FT Employees excluding City Managers, City Managers, City Clerks, Commissioners & Mayor Class 2: All FT City Managers, City Clerks, Commissioners & Mayor Maximum Weekly Benefit Amount 60% To $1,000 Elimination Period Accident 14 Days Elimination Period Sickness 14 Days Maximum Benefit Period 11 Weeks Rate Guarantee Next Renewal: 10/01/2021 Contribution Voluntary Participation Premium Breakdown Current Rate Per $10 of Benefit $0.41 Comment Under Rate Guarantee Volume $22,315 Approx. Monthly Premium $914.92 City Of Opa-Locka October 1, 2020 LTD Company/Plan Lincoln Class Description Class 1: Elected Officials Class 2 All Other Active FT Employees except City Managers, City Clerks, Commissioners & Mayor Class 3: All FT City Managers, City Clerks, Commissioner & Mayor Maximum Benefit Amount Class 1 & 3: 60% To $10,000 Class 2: 60% To $5,000 Guaranteed Issue Amount Class 1 & 3: $10,000 Class 2: $5,000 Benefit Period To Age 65 or SSNRA Elimination Period 90 Days Own Occupation 24 Months Pre -Existing Period 3/12 Rate Guarantee Next Renewal: 10/01/2021 Contribution Voluntary Participation Premium Breakdown Current Rate Per $100 of Monthly Income Age Banded; See Attached Rates Comment Under Rate Guarantee Volume TBD Approx. Monthly Premium $1,224.18 Quotes are based on the census received Rates could be adjusted based on final enrollment. This data is provided for information purposes only. It is not intended to represent a binding obligation. The governing document for this purpose would be the COC issued by the carrier. Please see detailed benefit summary. Information provided by Sapoznik Insurance is proprietary. It may not be copied, emulated or distributed without express permission. 8/12/2020 nLincoln Financial Group° You're In Charge• Renewal Information 2019 Renewal Rates LTD Long Term Disability 000010208159 00000 Class 1 Age band Renewal rate 0 - 29 $0.206 30-34 $0.316 35 - 39 $0.536 40 - 44 $0.811 45 - 49 $1.141 50 - 54 $1.457 55 - 59 $1.883 60-64 $1.567 65 - 69 $1.223 70-74 $0.976 75 - 99 $1.072 Long Term Disability 000010208159 00000 Class 2 Age band Renewal rate 0 - 29 $0.206 30 - 34 $0.316 35 - 39 $0.536 40 - 44 $0.811 45 - 49 $1.141 50 - 54 $1.457 55 - 59 $1.883 60-64 $1.567 65 - 69 $1.223 70 - 74 $0.976 75 - 99 $1.072 Page 4 nLincoln Financial Group° You're In Charge• Renewal Information Long Term Disability 000010208159 00000 Class 3 Age band Renewal rate 0 - 29 $0.206 30 - 34 $0.316 35 - 39 $0.536 40 - 44 $0.811 45 - 49 $1.141 50 - 54 $1.457 55 - 59 $1.883 60-64 $1.567 65 - 69 $1.223 70 - 74 $0.976 75 - 99 $1.072 nLincoln Financial Groups upplemental Life and AD&D Insurance The Lincoln Term Life and AD&D Insurance Plan: • Provides a cash benefit to your loved ones in the event of your death • Provides an additional cash benefit to your loved ones if you die — or to you if you lose a limb or your eyesight — in a covered accident • Features group rates for City of Opa Locka employees • Includes LifeKeys® services, which provide access to counseling, financial, and legal support services SM • Also includes TravelConnect services, which give you and your family access to emergency medical help when you're traveling Full -Time Employees of City Of Opa Locka Benefits At -A -Glance Employee Guaranteed coverage amount during initial offering or approved special enrollment period $150,000 Newly hired employee guaranteed coverage amount $150,000 Continuing employee guaranteed coverage annual increase amount Choice of $10,000 or $20,000 Maximum coverage amount 5 times your annual salary ($300,000 maximum) Minimum coverage amount $10,000 AD&D coverage amount Equal to the life insurance amount chosen Spouse Guaranteed coverage amount during initial offering or approved special enrollment period $30,000 Newly hired employee guaranteed coverage amount $30,000 Continuing employee guaranteed coverage annual increase amount Choice of $5,000 or $10,000 Maximum coverage amount 50% of the employee coverage amount ($150,000 maximum) Minimum coverage amount $5,000 AD&D coverage amount Equal to the life insurance amount chosen Dependent Children 6 months to age 19 (to age 25 if full-time student) guaranteed coverage amount $10,000 Age 14 days to 6 months guaranteed coverage amount $250 The Lincoln National Life Insurance Company 1 What your benefits cover Employee Coverage Guaranteed Life and AD&D Insurance Coverage Amount • Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to $150,000 without providing evidence of insurability. • Annual Limited Enrollment: If you are a continuing employee, you can increase your coverage amount by $10,000 or $20,000 without providing evidence of insurability . If you submitted evidence of insurability in the past and were declined for medical reasons, you may be required to submit evidence of insurability. • If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense. • You can increase this amount by up to $20,000 during the next limited open enrollment period. Maximum Life Insurance Coverage Amount • You can choose a coverage amount up to 5 times your annual salary ($300,000 maximum) with evidence of insurability. See the Evidence of Insurability page for details. • The maximum coverage amount for employees 70 and older who are electing coverage for the first time is$50,000. • Your coverage amount will reduce by 35% when you reach age 65; an additional 25% of the original amount when you reach age 70; an additional 15% of the original amount when you reach age 75; and an additional 15% of the original amount when you reach age 80. Spouse Coverage - You can secure term life and AD&D insurance for your spouse if you select coverage for yourself. Guaranteed Life and AD&D Insurance Coverage Amount • Initial Open Enrollment: When you are first offered this coverage, you can choose a coverage amount up to 50% of your coverage amount ($30,000 maximum) for your spouse without providing evidence of insurability. • Annual Limited Enrollment: If you are a continuing employee, you can increase the coverage amount for your spouse by $5,000 or $10,000 without providing evidence of insurability. If you submitted evidence of insurability in the past and were declined for medical reasons, you may be required to submit evidence of insurability. • If you decline this coverage now and wish to enroll later, evidence of insurability may be required and may be at your own expense. • You can increase this amount by up to $10,000 during the next limited open enrollment period. Maximum Life Insurance Coverage Amount • You can choose a coverage amount up to 50% of your coverage amount ($150,000 maximum) for your spouse with evidence of insurability. • Coverage amounts are reduced by 35% when an employee reaches age 65 Dependent Children Coverage - You can secure term life insurance for your dependent children when you choose coverage for yourself. Guaranteed Life Insurance Coverage Options: $io,000 Supplemental Life and AD&D Insurance Benefits At -A -Glance LFE-ENRO-BRC001-FL 2 Additional Plan Benefits Accelerated Death Benefit Included Premium Waiver Included Conversion Included Portability Included Seat Belt & Airbag Included with AD&D Common Carrier Included with AD&D Benefit Exclusions Like any insurance, this term life and AD&D insurance policy does have exclusions. For life insurance, a suicide exclusion may apply. For AD&D, benefits will not be paid if death results from suicide, or death/dismemberment occurs while: • Inflicting or attempting to inflict injury to one's self • Participating in a riot or as a result of war or act of war • Serving as a member of the military, including the Reserves and National Guard • Committing or attempting to commit a felony • Deliberately inhaling gas (such as carbon monoxide) or using drugs other than those prescribed by a physician and administered as prescribed • Flying in a non-commercial airplane or aircraft, such as a balloon or glider • Driving while intoxicated (with a blood alcohol level of .08 grams or more per 100 milliliters of blood) In addition, the AD&D insurance policy does not cover sickness or disease, including the medical and surgical treatment of a disease. A complete list of benefit exclusions is included in the policy. State variations apply. Questions? Call 800-423-2765 and mention Group ID: CTYOPALOCK. This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Refer to your certificate for your maximum benefit amounts. Should there be a difference between this summary and the contract, the contract will govern. LifeKeys services are provided by ComPsych* Corporation, Chicago, IL. ComPsych., EstateGuidance' and GuidanceResources Online are registered trademarks of ComPsych Corporation. TravelConnectsMservices are provided by UnitedHealthCare Global, Baltimore, MD. ComPsych and UnitedHealthCare Global are not Lincoln Financial Group companies. Coverage is subject to actual contract language. Each independent company is solely responsible for its own obligations. Insurance products (policy series GL1101) are issued by The Lincoln National Life Insurance Company (Fort Wayne, IN), which does not solicit business in New York, nor is it licensed to do so. Product availability and/or features may vary by state. Limitations and exclusions apply. nLincoln Fina ncial ©2018 Lincoln National Corporation LCN-2016746-020518 R 1.0 — Group ID: CTYOPALOCK Supplemental Life and AD&D Insurance Benefits At -A -Glance LFE-ENRO-BRC001-FL 3 Semi -Monthly Supplemental Life and AD&D Insurance Premium Here's how little you pay with group rates. Employee Age Range Life & AD&D Premium Rate 0-24 25 - 29 30-34 35 - 39 40-44 0.0000560 0.0000560 0.0000610 0.0000710 0.0001060 45 - 49 0.0001610 50 - 54 0.0002860 55 - 59 0.0004460 60 - 64 0.0005210 65 - 69 0.0009260 70 - 74 0.0017910 75-79 0.0048010 80 - 99 0.0109310 Employee Age Range Life & AD&D Premium Rate 0-24 25-29 30-34 35 - 39 40-44 45 - 49 50-54 55 - 59 60-64 65 - 69 0.0000560 0.0000560 0.0000610 0.0000710 0.0001060 0.0001610 0.0002860 0.0004460 0.0005210 0.0009260 Dependent Children Semi - Monthly Premium for Life Insurance Coverage Coverage Semi -Monthly Amount Premium $10,000 $1.00 Group Rates for You The estimated semi-monthly premium for life and AD&D insurance is determined by multiplying the desired amount of coverage (in increments of $10,000) by the employee age -range premium rate. $ X coverage amount = $ premium rate semi-monthly premium Note: Rates are subject to change and can vary over time. Group Rates for Your Spouse The estimated semi-monthly premium for life and AD&D insurance is determined by multiplying the desired amount of coverage (in increments of $5,000) by the employee age -range premium rate. $ X = $ coverage amount premium rate semi-monthly premium Note: Rates are subject to change and can vary over time. Group Rates for Your Dependent Children One affordable semi-monthly premium covers all of your eligible dependent children. Note: You must be an active City of Opa Locka employee to select coverage for a spouse and/or dependent children. To be eligible for coverage, a spouse or dependent child cannot be confined to a health care facility or unable to perform the typical activities of a healthy person of the same age and gender. The Lincoln National Life Insurance Company Please see prior page for product information. Supplemental Life and AD&D Insurance Premium Calculation LFE-ENRO-BRC001-FL 4 r scpoznik HERE HEALTH BENEFITS Exhibit #8 Declines/Uncompetitive 877.948.8887 www.sapoznik.com a SCC2111( WHERE HEALTH BENEFITS Declined & Non -Competitive Carriers City Of Opa-Locka Medical Florida Blue- Base Plan: 28.63% Humana- Base Plan: 12.04% Aetna —Non-competitive Cigna —Non -Competitive 000 I www.sapoznik.com 1877.948.8887 Group Proposal For: CITY OF OPA LOCKA Quote Number: LG-I-31053 Health Benefits and Rates Summary Proposal Expiration Date: 10/01/2020 Coverage Effective Date: 10/01/2020 Pac e.1- Pllan B Deductible (DED)1 (Per Person/Family Aggregate) In -Network Out -of -Network BlueOptions • • i.•j.,.,_w .Cost BlueCare Non- Fade :... ,... Quail ` `-BlueOptIons __ !._., ...,.: 1 , um BlueOptfons •.:., ,, 7.j., ! . ii $5,000 / $10,000 / $30,000 CneOa`rs Non- , .. , ederally Iifled $2,000 / $6,000 NA / NA BlueOptions ' .., ,! .,= ... .,...,_. $2,500 / $7,500 $5,000 / $15,000 $3,000 / $9,000 $6,000 / $18,000 $5,000 / $10,000 NA / NA $5,000 / $10,000 Combined with In-$10,000 Network Coinsurance (Plan Pays/Member Pays) In -Network Out -of -Network 80% / 20% 50% / 50% 80% / 20% NA / NA 70% / 30% 50% / 50% 70% / 30% 50% / 50% 80% / 20% NA / NA 80% / 20% 50% / 50% Out of Pocket Maximum2 (Per Person/Family Aggregate) In -Network Out -of -Network $6,350 / $12,700 $15,000 / $30,000 $7,900 / $15,800 NA / NA $6,350 / $12,700 $10,000 / $20,000 $6,350 / $12,700 $20,000 / $40,000 $5,500 / $11,000 NA / NA $6,350 / $12,700 $13,000 / $26,000 Office Service - Value Choice PCP $0 Copayment $0 Copayment $0 Copayment $0 Copayment $0 Copayment $0 Copayment Office Services - Family Physician $40 Copayment $10 Copayment $35 Copayment $30 Copayment $35 Copayment $35 Copayment Office Services - Specialist $100 Copayment $100 Copayment $50 Copayment $55 Copayment $65 Copayment $85 Copayment Virtual Visits - Family Physician $10 Copayment $10 Copayment $10 Copayment $10 Copayment $10 Copayment $10 Copayment Inpatient Hospital Facility Option 1: $500 PAD + DED + 20% / Option 2: $500 PAD+DED+20% DED + 20% Option 1: DED + 30% / Option 2: DED +30% Option 1: DED + 30% / Option 2: DED + 30% $100 PAD + DED + 20% Option 1: $300 PAD + DED + 20% / Option 2: $300 PAD + DED + 20% Emergency Room Facility $400 Copayment DED + $250 Copayment + 20% DED + 30% $300 Copayment $300 Copayment $350 Copayment Urgent Care Centers $100 Copayment $75 Copayment DED + 30% $60 Copayment $70 Copayment $100 Copayment Retail Pharmacy Deductible 3 Generic/Brand/Non-Preferred $0 $10 / $50 / $80 $0 $10 / $50 / $80 $0 $10 / $50 / $80 $0 $10 / $50 / $80 $0 $10 / $50 / $80 $0 $10 / $50 / $80 Group Proposal For: CITY OF OPA LOCKA Quote Number: LG-I-31053 Illrerageirinikt Employee Only Employee/Spouse Employee/Chlld(ren) Ern • Io ee Famil # Mombe Quoted Rates 94 0 14 9 $706.11 $1,680.55 $1,355.74 $2,259.57 $550.70 $1,310.68 $1,057.35 $1,762.25 28.63% + $676.62 $1,610.35 $1,299.11 $2,165.18 $628.94 $1,496.87 $1,207.56 $2,012.60 Proposal Expiration Date: 10/01/2020 Coverage Effective Date: 10/01/2020 $657.96 $1,565.94 $1,263.28 $2,105.47 $731.88 $1,741.87 $1,405.21 $2,342.01 Group Proposal For: CITY OF OPA LOCKA Proposal Expiration Date: 10/01/2020 Quote Number: LG-I-31053 Coverage Effective Date: 10/01/2020 ... . ackage 1 - Plan Benefits ' BlueCare Non- Federally _ "ip $3,000 / $9,000 NA / NA BI Lower Premium 05 are Non- Federally rw. --- -- kiiiii Deductible (DED)1 (Per Person/Family Aggregate) In -Network Out -of -Network $5,000 / $10,000 $10,000 / $20,000 $5,000 / $10,000 NA / NA Coinsurance (Plan Pays/Member Pays) In -Network Out -of -Network 80% / 20% NA / NA 80% / 20% 50% / 50% 70% / 30% NA / NA Out of Pocket Maximum2 (Per Person/Family Aggregate) In -Network Out -of -Network $6,350 / $12,700 NA / NA $7,900 / $15,800 $20,000 / $40,000 $6,350 / $12,700 NA / NA Office Service — Value Choice PCP $0 Copayment $0 Copayment $0 Copayment Office Services - Family Physician $40 Copayment $10 Copayment $40 Copayment Office Services — Specialist $100 Copayment $100 Copayment $65 Copayment Virtual Visits — Family Physician $10 Copayment $10 Copayment $10 Copayment Inpatient Hospital Facility $500 PAD + DED + 20% Option 1: DED + 20% / Option 2: DED+20% DED + 30% Emergency Room Facility $400 Copayment DED + $250 Copayment + 20% $300 Copayment Urgent Care Centers $100 Copayment $75 Copayment $85 Copayment Retail Pharmacy Deductible' Generic/Brand/Non-Preferred $0 $10 / $50 / $80 $0 $10 / $50 / $80 $0 $10 / $50 / $80 Coverage Tier Employee Only Employee/Spouse Employee/Child(ren) Employee Famil 0 Members Quoted L 94 0 14 9 117 $618.33 $589.75 $596.70 S1.471 62 $1,187.19 $1,978.65 $1,887.18 S92, 551.53 $1,403.59 $1,132.31 $1,420.14 $1,145.66 $1,909.43 Humana proposal for: City of Opa-Locka Effective Date: 10/01/2020 Proposed Plan One Health Plan Highlights Non Par Fee Schedule Coinsurance % Par Individual Annual Par Deductible Family Annual Par Deductible Individual Annual Par OOP Limit Family Annual Par OOP Limit PCP OV Copay Specialist OV Copay Hospital Emergency Copay Urgent Care Copay Lifetime Maximum Benefit Phy/Occup/Cogn/Speech/Hear/Chiro Therapy Limit Visits Outpt Advlmage Freestanding Copay Outpt Advlmage Hospital Copay STANDARD 80% $5000 $10000 $6500 $13000 $25 $50 $350 $75 UNLIMITED 30 300 300 Skilled Nursing Day Limits Home Health Care Day Limits Injection Copay Specialty Drug Admin Office/Home/Clinic RX Copay Tier 1 RX Copay Tier 2 RX Copay Tier 3 RX Coinsurance % Tier 4 Rx Deductible RX Mail Order Copay Tier 1 RX Mail Order Copay Tier 2 RX Mail Order Copay Tier 3 RX Mail Order Coinsurance % Tier 4 State of Issue 1,1' iv, riTETTKli 7T4 fhTl1 Network Key: HMO FL Network - Med: HMO Premier Rx: NATIONAL 60 100 $5 $50 $10 $40 $70 25% $250 $25 $100 $175 25% FL Assumed Subscribers Base Rates Health Insurer Annual Fee (0.4%) Proposed Rates 94 $481.54 $1.93 $483.47 12.04% + 0 $963.07 $3.87 $966.94 14 $914.93 $3.67 $918.60 9 $1,492.76 $6.00 $1,498.76 151 Farmington Avenue,F265, Hartford,CT 06165 Confirmation of Request for Group Health Coverage aetna Aetna has recently completed a review of CITY OF OPA LOCKA's request for a quote of group health coverage (the "Request"). We have determined that we are not currently positioned to provide a competitive proposal. However, as an entity that offers health coverage and consistent with direction provided under Section 2702 of the Patient Protection and Affordable Care Act, we will provide a response to your Request and proceed with an insured quote should CITY OF OPA LOCKA continue to be interested in this information. If it is still CITY OF OPA LOCKA's position to have us provide a quote for group health coverage, please a) Furnish the information indicated below that has not already been provided (where available), and b) Sign and return this notification to us as indicated below. In order for us to provide you the quote, a signed request along with all requested data items is required no later than 30 days prior to the requested quote effective date. REQUIRED DATA: • Please provide a detailed summary of the plan design(s) requested. • Please provide the contribution strategy for the current and proposed plans. • Please provide the following historical information: Monthly claims and corresponding enrollment counts for a recent 12 months minimum, up to a 24-month period. • Please identify the basis for the claim information (i.e., paid vs. incurred and if incurred whether a completion factor has been applied). Provide the information broken down for each unique plan offering. • Please identify if any of the plans are capitated. If so, indicate whether capitations are included/excluded from the claim information. • Large claim information for individual claims in excess of S25,000 based on the same time period as the claims data provided. • For Hospital or Health Systems only: Claims need to be split by domestic and non -domestic. Also please provide home/host/domestic payment arrangement (i.e. discount off billed charges, fee schedules, etc.) • Individual Medical Questionnaires (IMQ) ) (Where allowed by state) — will be required if/when monthly claim data is not available Plan designs: A description of the plans which were in place during the experience period along with a description of any plan changes that occurred during this period and the date the change went into effect • Current and/or Renewal Rates • Please provide a complete census file including the following for all eligible employees: Age/DOB, Gender, Dependent Tier Status, COBRA Participant indicator, Waiver indicator, Retiree indicator, Home Zip Code, and Current Medical Plan Election. Additional Requested Data: • Current Medical Management programs in place • 5-year carrier history • Large Claim Data: including diagnosis and claimant status information. Identify if amounts in excess of any pooling threshold have been included/excluded from the claim experience provided. • Current commission level • A recent utilization report from the current carrier. This should include historical achieved discount and trend information as well as utilization information relative to the use of inpatient hospital, outpatient hospital, and physician/other services. The report should also identify the top utilized facilities • Please provide information/reason on any required data noted as not available CITY OF OPA LOCKA Certification: I understand Aetna position on its product offerings' alignment with our request, but CITY OF OPA LOCKA requests a quote from Aetna as allowed under Section 2702 of the Patient Protection and Affordable Care Act. Signature Title Date Please send this form back c/o Mark Wilson via email wilsonml@aetna.com Health insurance plans are offered, underwritten or administered by Aetna Life insurance Company and its affiliates (Aetna). Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. information is believed to be accurate as of the production date; however, it Signature Title Date is subject to change. For more information about Aetna plans, refer to www.aetna.com. From: Gustavo Orama-Rios To: Linda Jamen; ricardo.villenacigna.com Subject: Response To Your Inquiry - City of Opa-Locka Date: Tuesday, August 04, 2020 11:34:11 AM August 04, 2020 RE: City of Opa-Locka Dear , Thank you for considering Cigna HealthCare for City of Opa-Locka. 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, Ricardo Villena NBM (954) 514-6895 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).