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09- September 23, 2013 Special Mtg. Minutes CITY OF OPA-LOCKA "The Great City" CLERK'S ACTION SUMMARY MINUTES SPECIAL COMMISSION MEETING September 23,2013 4:00 P.M. Opa-locka Municipal Complex 780 Fisherman Street,2"d Floor Opa-locka, FL 33054 1. ROLL CALL: Mayor Myra L. Taylor called the meeting to order at 4:00 p.m. on Monday, September 23, 2013 on the 2"1 Floor of the Opa-locka Municipal Complex, 780 Fisherman Street, Opa-locka, Florida. The following members of the City Commission were present: Commissioner Dorothy Johnson, Commissioner Luis B. Santiago, Commissioner Timothy Holmes and Mayor Myra L. Taylor. Also in attendance were: City Manager Kelvin L. Baker, Sr., City Attorney Joseph S. Geller and City Clerk Joanna Flores. Vice Mayor Joseph L. Kelley joined the meeting at 4:31 p.m. 2. INVOCATION: The Invocation was delivered by Mayor Myra L. Taylor. 3. PLEDGE OF ALLEGIANCE: The Pledge of Allegiance was recited in unison. 4. RESOLUTION: 4-A: A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF OPA- LOCKA, FLORIDA, SELECTING UNITED HEALTHCARE/ NEIGHBORHOOD HEALTH AS THE CITY'S HEALTH INSURANCE PROVIDER FOR FY 2013-2014; AND SELECTING BENEFIT LEVELS FOR THE COVERAGE; THIS IS A BUDGETED ITEM; PROVIDING FOR INCORPORATION OF RECITALS; PROVIDING FOR AN EFFECTIVE DATE. Sponsored by C.M. The above resolution was read by title by City Attorney Geller. It was moved by Commissioner Johnson, seconded by Commissioner Santiago to pass the resolution. Commissioner Santiago stated that the last time this issue was discussed there were concerns with the city's current agent of record and the increase for the health coverage which would affect next fiscal year's budget. The discussion was to go back to the table Special Commission Meeting Minutes—09/23/2013 1 and work on getting a reduction on the cost for health coverage. He requested that the City Manager provide an update on this issue. Manager Baker explained that the purpose of this meeting is to present several options to the Commission and Mr. Charles Citrin of Citrin Financial would be presenting those options. He said that it has been a very lengthy process as they tried to get their arms around the insurance prices and things of that nature. He requested that the Commission allow Mr. Citrin to come forward and present the various options available. Charles Citrin of Citrin Financial Insurance, 300 71st Street, Suite 300, Miami Beach, Florida, came forward and stated that he met with city staff including the City Manager, City Attorney, HR Director, Assistant City Manager and an HR Assistant. He heard what Commissioner Santiago asked for and discussed it with United Health. United Health shaved 3% off of the bigger number and it comes out differently on the smaller alternatives. Citrin Financial lowered its commission and there are three (3) options. United Health was asked to provide a zero (0) % increase option which is not provided yet, but the inquiry was just made today. Nancy Rincon and Terry Jones of United Health are in attendance and they are available to answer questions. Commissioner Santiago asked Manager Baker if United Healthcare was the only option. Manager Baker said, yes, this late in the process. Commissioner Santiago asked if this is going to affect the budget. He wanted clarification on the options. Mr. Citrin said the fourth option would be on a zero % option basis. Manager Baker said United Healthcare is the only option this late in the process. He continues to try to get the pricing to match what is allocated in the budget. That is what Mr. Citrin has alluded to. He is mostly concerned with how it impacts the employees and to look at the options and gain understanding. The current plan going forward would cost the city about 50% more than what the city is paying at this time. Now the question is what the city can afford in its budget. The proposed budget is $1,200,000.00. The desire is to compress the numbers to be in line with the proposed budget. Commissioner Santiago asks if there are any other options. Manager Baker said the current carrier United Healthcare is what the city has to stay with at this point. The current policy expires in a few days. If the desire was to do something different, it would have to be in the future. In the interim, United Healthcare needs to stay in place. Mr. Citrin said there were only two (2) quotes from United Healthcare and Blue Cross & Blue Shield and United Healthcare gave the best quote. He said that the other companies denied quotation (Coventry, Aetna and Cigna) due to the four to five major insurance claims that threw the numbers off. United Healthcare paid out $1.54 for every $1.00 they received in premiums not including overhead. The whole insurance market was canvassed and the other alternatives would be unpleasant for the city. Either the city keeps a plan it cannot afford and pay an additional $550,000.00 a year or choose a plan Special Commission Meeting Minutes—09/23/2013 2 that puts more pressure on the employees. The current plan is very generous to employees, which was put in place last year. The City Manager told him the 10.16% or 15% increase put on the table is not affordable to the city. He went back and asked for a plan with a 0% increase and it will not be pretty for the employees. This is a difficult choice. Commissioner Santiago said the city is responsible and needs to consider how this impacts the employees. This may have to impact the budget and this should have been taken into account months ago. Mr. Citrin said Manager Baker acted as quickly as he could, as soon as the increase was found out, they hit the market. He found out what the major claims were and this affected the quotations. Commissioner Johnson said to Manager Baker and Mr. Citrin that the information provided is too much to digest on the dais and in this setting. The information should have been provided earlier. Mr. Citrin said this information had been provided to the city, he just put the information into a package for the meeting. Commissioner Johnson said shame on the Manager's office for not getting this material out for consideration. She told the City Clerk she did not remember receiving any of the information. City Clerk Flores said this was the first time she had seen the information package provided. Commissioner Johnson said she agrees with Commissioner Santiago that the city needs to find the money; she does not want this to hurt the employees. She is appreciative that Manager Baker went back to negotiate in the insurance issue and that was a job well done. She is concerned on the Wellness Program. Mr. Citrin explained that United has a program and although there have been some false starts, there is some stability now and Nancy Rincon can speak to the specifics. Nancy Rincon, United Healthcare, 3100 SW 145`h Avenue, Miramar, Florida came forward and said that they budgeted $10,000.00 and give that amount to the city to use it towards a Wellness Program for the employees. Part of the initiative included meetings with the city's HR Department. The results of the meetings were to include Baptist Health System coming to city to perform bio-metric testing, raffle prizes, and providing seminars and other program implementation. There has been one program implemented at this time. Commissioner Johnson said she is mostly concerned with intervention, not prizes because quality of life is the most important issue going forward. She asked, what is the plan in specific terms. Mayor Taylor asked Clerk Flores to record that Vice Mayor Kelley has joined the dais. Special Commission Meeting Minutes—09/23/2013 3 Ms. Rincon said a follow-up plan is being worked on to provide support through their website at myuhc.com including a health risk assessment after bio-metric testing. There are coaching materials and other materials to provide information to the employees. These options were discussed with city HR personnel. Note: This portion of the minutes is transcribed in verbatim. Commissioner Johnson: "I think that whatever you are agreeing to it need to be first written and secondly I would assume that there's someone in your company that can follow up to let the Commission know where we are, through the Manager, where we are because when I'm talking about intervention I'm looking at an ongoing process if you're talking about a child like we, we're with War on Poverty and we're talking about childhood obesity as well as maintenance of our employees, health and wellness, I'm looking for something more concrete to make sure they are at least offered whether they take a advantage of it or not at least it's offered. And for those that are not taking advantage perhaps there should be some sort of counseling to let them know the importance and how it does impact the bottom line which is the budget as well as their health because I do understand the importance of claims. I'm coming from an agency that had over 50 to 60 different, United State Postal Service, so this is nothing new to me and I understand that claims part but I think some bells should have been going off there to let us know, you know, you're getting in the red and we have some concerns, blah, blah, blah, because right now the other ones are saying we are non-negotiable with you because of your past history. So I think it's a part on us as well as a part on you guys. And I would like to see that improved and I would like to see a more concrete and maybe you can't flush it out here but to the Attorney, we need something in writing that can be presented and kept up with HR. I know there have been some transitions over this year, but that transitions should still be a hard copy that we can follow through with legislation and/or monitor and it should be monitored through HR and you know not the Commission. So that's one of my pet peeves so if you're chosen then that needs to happen. So I want that part Madam Clerk in the minutes to be verbatim and then to the City Manager I need if it's chosen to be followed up accurately. " Note: This concludes the verbatim portion of the minutes. Commissioner Holmes asked, if this plan is accepted, how much more do the employees have to pay with the increase? Mr. Citrin said there are three different options and all of them have different affects on the deductibles and contributions that the employees will have to pay. Even the same plan going forward will increase the obligations of the employees. There are other options besides 0% or 45%. He said that everything will land a little more on the employees and the employees will take less of hit with the current plan as opposed to the three alternatives. Commissioner Holmes expressed his concerns relating to the employee co-pays. Commissioner Johnson asked Manager Baker if he'd taken advantage of any of the drug discounts passed in legislation three years ago. Special Commission Meeting Minutes—09/23/2013 4 Manager Baker said those discounts were mostly for individuals that do not have health insurance. He would prefer to yield to Mr. Citrin. Commissioner Johnson asked the City Clerk to provide the legislation to Manager Baker as it was before his time. Mr. Citrin said he would work with city staff to see if the legislation would impact cost. Commissioner Johnson asked Manager Baker what percentage is paid for insurance on the current plan. Manager Baker said the city pays for single employees at 100% and the city pays 60% for family coverage. Ms. Rincon said single coverage is paid 100% and family coverage is paid at 60% under the HMO plan. Commissioner Johnson asked what the numbers would be at 75% and 25%. Ms. Rincon said she did not have the information. Commissioner Johnson said most businesses contribute 80%. Who is the mathematician on staff who can crunch the numbers? Manager Baker said he is not an insurance expert, Mr. Citrin is. Mr. Citrin said most plans he sees in the commercial world are not any more generous than the city's plan. This is a generous plan for a city. The problem is that the employees do not make a lot of money and cannot afford some of the out of pocket expenses. The city could freeze the amount that people who are on family plans are currently paying and absorb the increase; that would come close to the 80-20%. There are some ongoing health issues that affect the policy. Due to HIPAA, health issues are not known and privacy regulations prevent sharing information. The largest claim for the city was not known to him, it was processed through claims. It is hard to monitor claims, this information is closely guarded. Commissioner Johnson said this problem needs to be looked at and monitored. The City Manager and staff need to look at relieving the cost to employees. Vice Mayor Kelley asked about freezing rates and what would be the cost should the city absorb the co-pays. Mr. Citrin said the city has 149 plan participants and 105 only have themselves on the plan, the rest have spouses and/or families covered. It would not be as much as the city thinks, because the majority of participants only have single coverage. Vice Mayor Kelley asked about co-pay increase amounts for the HMO basic plan. Special Commission Meeting Minutes—09/23/2013 5 Mr. Citrin said if the city took Alternate 1, the co-pay for a regular doctor visit would be $25.00 and specialist visit co-pays would increase to $45.00. The current plan has $15.00 and $25.00 co-pays. He was speaking about freezing premium cost. NOTE: This portion of the minutes is transcribed in verbatim. Mr. Citrin: "We don't and I have United right here, it is not my intention if I have the permission of the Manager, to just sit for a year with this plan. As soon as possible, and hopefully your claims would have settled down, we're going to do to the market and see if the Aetna's will quote us, whether Coventry or AvMed would quote us because they didn't now. But what we have seen in the last two to three months is a lowering of the claims as far as amounts go. We don't know if somebody's gotten healed, nobody's died, but we don't know the reasons for it. If we would have gone out six months ago, this increase would have been much higher. " NOTE: This concludes the verbatim portion of these minutes. Vice Mayor Kelley asked about prescription drug cost. Mr. Citrin said prescription drug cost for employees does not go up under Alternate 1, but the real pain will be in the deductibles and that is why GAP coverage was looked at to help alleviate the burden of deductible cost. Mayor Taylor said she is not sold on the Wellness Plan because she is aware of plans with metrics that monitor employee progress. She said she is looking for a real Wellness Plan in place. Manager Baker said it is his opinion that a Wellness Plan is necessary. Mayor Taylor asked if one of the plans needs to be chosen tonight. Manager Baker said yes. Mayor Taylor asked Mr. Citrin if he would do due diligence in the future to look for other options. Mr. Citrin said he would. He also wants to implement a fuller Wellness Program. Ms. Rincon said there is not a full Wellness Program under this United Healthcare plan, and the $10,000.00 was given in lieu of this. Attorney Geller said the Commission must choose a plan. Commissioner Johnson said she would like to make a motion to choose Option 1 and to incorporate the National League Prescription Discount Program which was 2010 legislation. It was moved by Commissioner Johnson, seconded by Vice Mayor Kelley to pass the resolution selecting Option 1 without GAP insurance. Special Commission Meeting Minutes—09/23/2013 6 Commissioner Holmes asked Manager Baker's recommendation. Manager Baker said he will have to work with what is currently available. He will have to work this into the budget, as the cost inflates the budget. He said Mr. Citrin could highlight which plan impacts the budget the least. Mr. Citrin asked Manager Baker with or without the GAP Program. Manager Baker said without the GAP Program. Mr. Citrin said with the GAP Plan it would be 15%, without the GAP Plan it is 10.16%. There being no further discussion, the motion passed by a 5-0 vote. Commissioner Johnson Yes Commissioner Holmes Yes Commissioner Santiago Yes Vice Mayor Kelley Yes Mayor Taylor Yes Mr. Citrin asked which plan was approved, with or without the GAP Plan. Manager Baker said without the GAP Plan. Mr. Citrin said the GAP Plan would cost about $45,000.00, but would take a lot of pressure off of the employees. Commissioner Johnson said it is not right to put this on the employees. She will be on this at the next meeting. Manager Baker said to Mr. Citrin that he understands the employees could purchase their own GAP policy. Mr. Citrin replied, yes, that is correct. 5. ADJOURNMENT: There being no further business to come before the Commission, it was moved by Commissioner Johnson, seconded by Vice Mayor Kelley to adjourn the meeting at 5:05 p.m. 1 i MAT OR ATTEST: CITY CLERK Special Commission Meeting Minutes—09/23/2013 7