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Home My Public Portal About09-7955 Avmed Sponsored by: City Manager RESOLUTION NO. 0 9-79 5 5 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA, AUTHORIZING THE CITY MANAGER TO SELECT AVMED AS THE CITY'S HEALTH INSURANCE CARRIER AND METLIFE AS THE CITY'S DENTAL INSURANCE CARRIER FOR THE PLAN YEAR BEGINNING NOVEMBER 1, 2009 THROUGH OCTOBER 31, 2010. WHEREAS,the City Commission of the City of Opa-locka("City Commission")adopted Resolution 05-6780, appointing Citrin Financial Insurance, Inc., ("Citrin") as the Agent of Record for the City of Opa-locka("City"); and WHEREAS,Citrin,on behalf of the City's Human Resources and Finance Department,has received annual group health plan comparisons and rate proposals for the City's upcoming plan coverage year beginning November 1, 2009 through October 31, 2010; and WHEREAS,after reviewing the group health plan comparisons and rate proposals received from the various providers,the City Manager recommends selecting AvMed as the health insurance carrier and MetLife as the dental insurance carrier for the upcoming plan coverage year beginning November 1, 2009 through October 31, 2010; and WHEREAS, the City Commission desires to select a health insurance carrier and dental insurance carrier for the City for the plan year beginning November 1, 2009 through October 31, 2010. NOW,THEREFORE,BE IT DULY RESOLVED BY THE CITY COMMISSION OF THE CITY OF OPA-LOCKA,FLORIDA: Section 1. The recitals to the preamble herein are incorporated by reference. Resolution No. 0 9—7 9 5 5 Section 2. The City Commission of the City of Opa-locka hereby authorizes the City Manager to select AvMed as the health insurance carrier for the City and MetLife as the dental insurance carrier for the City for the plan year beginning November 1, 2009 through October 31, 2010. Section 3. This resolution shall take effect immediately upon adoption. PASSED AND ADOPTED this 28day of OCTOBER , 2009. OIL 'mg 1 S P L. LLEY i YO ' Attest: Approved as to form and legal su iciency: rs Deborah S. b Burnadette Norris-Weeks City Clerk City Attorney Moved by: JOHNSON Seconded by: TAYLOR Commission Vote: 5-0 Commissioner Holmes: YES Commissioner Johnson: YES Commissioner Tydus: YES Vice-Mayor Taylor: YES Mayor Kelley: YES OQP-Lock\ 'A`. •-1:0\ Memorandum TO: Mayor Joseph L. Kelley Vice Mayor Myra L. Taylor Commissioner Timothy Holmes Commissioner Dor. by Johnson Commissioner ' Tydus FROM: Bryan K. Finnie,�► m City Manager DATE: October 7, 1'.' RE: Insurance Farrier for 2009/2010 Request: APPROVAL OF RESOLUTION AUTHORIZING THE CITY MANAGER TO CONTINUE WITH AVMED/METLIFE FOR MEDICAL/DENTAL INSURANCE Description: Effective October 31, 2009, the City's plan for Medical and Dental coverage via AvMed and MetLife will expire. A Resolution of the City Commission of the City of Opa-Locka, Florida authorizing the continuance of these carriers with minor changes in plan detail for savings of approximately$75,000 for the City. Financial Impact: $1,144,561.00 annually (budgeted per department) Implementation Time Line: November 1, 2009 Legislative History: Resolution No. 08-7369 Recommendation(s): Staff Recommends Approval Analysis: Citrin Financial, our Agent of record requested quotes from a number of insurance carriers. Two declined for various reasons. AvMed is offering two alternatives. Alternative 1 has a 2.6 % increase in premium. Alternative 2 has a 6.1% DECREASE in premium, representing approximately $75,000 savings to 1 the City without a change in the City's contribution. This cost will be allocated by employees who will need Diagnostic Testing in 4 areas via a $250.00 deductible and an additional 10% of contracted rate of these tests. Also, the cost of prescription drugs for employees has increased by $10.00. Staff reviewed both options we recommend the second alternative. Attachments: 1. Letter(packet) from Citrin Financial detailing proposed plan 2. Copy of Resolution No.08-7369 Prepared by: Cassandra Joseph End of Memorandum 2 Ie a nzis Ihi EM 'l�'II►" 'f:AM F:x 10-07-09; 11 :53AM;CitrinFinancialAndInsurance 3059532919 ;3058610032 # 2/ 2 October 2,2009 Cassandra Joseph HR Specialist II City of Opa-Locka City Hall 780.Fisherman Street Opa-Locka, FL 33054 RE: City of Opa-Locka Employee Benefits Renewal Proposal: November 2009 Dear Cassandra: Medical: We have received detailed and competitive quotes from AvMed and also from United Health Care. Vista declined to quote based on claims experience, and the need to review individual employees' health history prior to offering a response. Aetna has also declined to respond due to competitive issues. AvMed is offering a renewal of the current plan with a rate increase of 5.4%. AvMed is also offering two alternatives. Alternative 1 has a 2.6% increase in premium and Alternative 2 has a 6.1%DECREASE in premium,representing approximately $75,000 savings to the city, without a change in the City's contribution. Dental: Safe Guard is offering a renewal of the current plan with NO CHANGE in the premium rates for the DHMO plan. Met Life is offering a renewal of the current plan with a slight increase of 9.5%in the premium rates for the PPO plan. Aetna refused to quote for the dental insurance because they could not be competitive with the rates. Life: The Standard Life renewal occurred September 1, 2009. The rates will be good for two years,until 2011. July 27, 2009 Mr. Bryan Finnie Acting City Manager City of Opa-Locka 780 Fisherman Street, 4t'' Floor Opa-Locka, Florida 33054 Re: Employee & Dependant Cost Summary for Group Health Plan Dear Mr. Finnie: Enclosed is a spreadsheet comparing costs to the City for employees and dependants coverage based on current coverage and how changes to the percentage coverage for employees and dependants effect those costs. The City currently covers 100% of the employee cost and 75% of dependant coverage cost. The City's current HMO enrollment: 119 (EE), 12 (EE+SP), 9 (EE+CH) & 19 (FAM): total 59 employees. The City's current PPO enrollment is 2 employees. Total enrollment 161 employees. Column#1 is the current AvMed HMO premium for each level of coverage. Column#2 is the City's current benefit coverage covering 100% of employee coverage and 75% for dependants. Column#3 is the cost covering 100% of employee rate and 50% contribution for dependant coverage. Column#4 is the cost covering 100% of employee coverage and 25% for dependant coverage. Column #5 is the cost covering 75% of employee cost and 75% of dependant coverage. Column#6 compares the cost covering 50% of the employee coverage and 50% of dependant coverage. Currently 75% of the City's employee have EE only coverage. Based on that percentage there are little savings to the City in lowering the City's contribution for dependent coverage. The greatest savings will come from introducing new benefit plans with higher deductibles and co-pays. The City can also reduce costs by requiring City employees to share the cost of employee only coverage. The comparison also includes the monthly cost to employees as the percentage of contribution for employees and dependant changes. As previously stated we will review additional options that can reduce costs to the City. This can be accomplished by introducing plans with higher deductibles and higher co-pays which will result in lower premiums. We will be able to review optional plans from AvMed as well as all other insurance carriers. This process can start when AvMed releases the renewal rates in September 2009. I hope you would find this information useful. Let's discuss at your convenience. Sincerely, Charles Charles A. Citrin President enclosures: cc: Dr. Ezekiel Orji Asst. City Manager cc: Sharlene Boyd HR Director cc: Michael Behrman cc: Deborah Citrin August 24, 2009 VIA-E-MAIL(sboyd@opalockafl.gov) Sharlene Boyd, Human Resources Dept Director City of Opa-locka City Hall 780 Fisherman Street Opa-locka, FL 33054 RE: CITY OF OPA-LOCKA(the"City") AV-MED RENEWAL Dear Sharlene: Attached please find the initial renewal proposal for the City. It reflects a 5.4%increase. There are also two(2)alternatives. One reflects no increase,and the other reflects a 6.1%reduction. This would lower the premiums approximately$75,000 per year. It does not affect the employee contribution levels at all. I will ask Av-Med to dig deeper into the benefit should that be the City's continuing desire. Please advise. Very truly yours, CHARLES A. CITRIN President CAC:cmd enclosures cc: Bryan Finney,City Manager,City of Opa-locka with enclosures VIA e-mail (citymanager @opalockafl.gov) Cassandra Joseph, HR Specialist,City of Opa-locka with enclosures VIA e-mail (cjoseph @opalockafl.gov) Deborah B.Citrin VIA e-mail without enclosures Boyd.Opa-locka 10/1/2009 12:55:58 PM Group Name: City of Opa-Locka Effective Date: 11/01/2009 AvMED Agency Name: Citrin Financial&Insurance,Inc. ANS AvMed Representative: Lourdes Abraham EA I. Plan Family: Open Access HMO HM-OA-3422 Plan Name: Existing Plan Network: Benefit Summary: Deductible(Single/Family): $0 00P Max(Individual/Family): $1,500/$3,000 PCP Office Visit: $15 Specialist Office Visit: $25 OP Diagnostic Testing: $25 IP Hospital: $250/Admit OP Surgery: $250 Emergency Room: $75 Urgent Care: $40 Riders: Prescription Drug: AV-LG RX-2x-10/30/50/75/50%-OC-B-08 IP MH 30 Days,$250/Adm: Included OP SA HMO 6 week limit,$50 per wk: Included EToP Rider-1321: Included EToP Rider-3635: Excluded DME Limit from$500 to$2: Included Mammogram Waive Copay/coinsurance: Included IP MH 30 days,$500A/$750A/$750A/40%: Excluded AV-SA-Choice$30$50 40%-08: Excluded MP Numbers: MP39310706 MP34221007 MP52431008 MP13210104 MP35221004 MP15270104 MP21490406 MP32281205 Tier Rates Please initial and date to select this plan: EE $470.55 ES $941.09 EN $894.04 Initials Date FA $1,458.69 *These are Final Rates. Date Printed:08/20/2009 *This is a partial list of benefits,limitations,and exclusions.Refer to group contract for a complete listing of Quote Reference#:68086- - benefits,limitations,and exclusions. *Specific qualifications are detailed in the attached"Underwriting Assumptions&Caveats"document. *Group-Specific Underwriting Assumptions/Contingencies:Not applicable Page 2 of 2 RtTi Group Name: City of Opa-Locka Effective Date: 11/01/2009 r: Agency Name: Citrin Financial&Insurance,Inc. HI AI "1' II PC ANS AvMed Representative: Lourdes Abraham Plan Family: Open Access HMO P HM-OA-3422 Plan Name: Existing Plan Network: Benefit Summary: Deductible(Single/Family): $0 OOP Max(Individual/Family): $1,500/$3,000 PCP Office Visit: $15 Specialist Office Visit: $25 OP Diagnostic Testing: $25 IP Hospital: $250/Admit OP Surgery: $250 Emergency Room: $75 Urgent Care: $40 Riders: Prescription Drup: $20/40/60/75/50%0C-2X-B IP MH 30 Days,$250/Adm: Included OP SA HMO 6 week limit,$50 per wk: Included EToP Rider-1321: Included EToP Rider-3635: Excluded DME Limit from$500 to$2: Included Mammogram Waive Copay/coinsurance: Included IP MH 30 days,$500A/$750A/$750A/40%: Excluded AV-SA-Choice$30$50 40%-08: Excluded MP Numbers: MP39310706 MP34221007 MP40141007 MP13210104 MP35221004 MP15270104 MP21490406 MP32281205 Tier Rates Please initial and date to select this plan: EE $458.22 ES $916.45 EN $870.63 Initials Date FA $1,420.50 These are Final Rates. Date Printed: 08/20/2009 This is a partial list of benefits,limitations,and exclusions.Refer to group contract for a complete listing of Quote Reference#:68086- - benefits,limitations,and exclusions. Specific qualifications are detailed in the attached"Underwriting Assumptions&Caveats"document. Group-Specific Underwriting Assumptions/Contingencies:Not applicable Page 2 of 2 (1+1. 14 Group Name: City of Opa-Locka Effective Date: 11/01/2009 AVMED Agency Name: Citrin Financial&Insurance,Inc. H a A [ 1` A 1 A N S AvMed Representative: Lourdes Abraham Plan Family: Open Access HMO HM-OA-5228 Plan Name: Proposed Plan Network: Benefit Summary: Deductible(Single/Family): $250/$750 00P Max(Individual/Family): $750/$1,500 PCP Office Visit: $10 Specialist Office Visit: $20 OP Diagnostic Testing: 10%After Deductible IP Hospital: $150/Admit OP Surgery: $150 Emergency Room: $75 Urgent Care: $40 par/$60 non-par Riders: Prescription Drug: $20/40/60/75/50%0C-2X-B IP MH 30 Days,$100/Adm: Included OP SA HMO 6 week limit,$50 per wk: Included EToP Rider-1321: Included EToP Rider-3635: Excluded DME Limit from$500 to$2: Included Mammogram Waive Copay/coinsurance: Included IP MH 30 days,$500A/$750A/$750A/40%: Excluded AV-SA-Choice$30$50 40%-08: Excluded MP Numbers: MP52280109 MP36470308 MP39310706 MP40141007 MP13210104 MP35.201004 MP15270104 MP21490406 MP32281205 Tier Rates Please initial and date to select this plan: EE $419.20 ES $838.41 EN $796.49 Initials Date FA $1,299.53 *These are Final Rates. Date Printed:08/20/2009 *This is a partial list of benefits,limitations,and exclusions.Refer to group contract for a complete listing of Quote Reference#:68086- - benefits,limitations,and exclusions. *Specific qualifications are detailed in the attached"Underwriting Assumptions&Caveats"document. *Group-Specific Underwriting Assumptions/Contingencies:Not applicable Page 1 of 2 Group Name: City of Opa-Locks Effective Date: 11/01/2009 AVMED Agency Name: Citrin Financial&Insurance,Inc. — — — -- — — AvMed Representative: Lourdes Abraham H t: A 1. r H P t A N 4 Plan Family: Choice Plan Name: CH-CH-3996 Existing Plan Network: Choice PHCS Non Network Benefit Summary: Deductible(Single/Family): $0/$0 $250/$750 $500/$1,500 OOP Max(Individual/Family): $2,500/$5,000 $3,500/$7,000 $5,000/$10,000 PCP Office Visit: $15 $25 40%UCR Specialist Office Visit: $30 $50 40%UCR* OP Diagnostic Testing: 10% 20% 40%UCR IP Hospital: $500/Admit $750/Admit 40%UCR OP Surgery: 10% 20% 40%UCR Emergency Room: $100 $150 $200 Urgent Care: $40 $60 $60 Riders: Prescription Drug: $20/40/60/75/50%0C-2X-B IP MH 30 Days,$250/Adm: Excluded OP SA HMO 6 week limit,$50 per wk: Excluded EToP Rider-1321: Excluded EToP Rider-3635: Included DME Limit from$500 to$2: Excluded Mammogram Waive Copay/coinsurance: Excluded IP MH 30 days,$500A1$750A/$750A/40%: Included AV-SA-Choice$30$50 40%-08: Included MP Numbers: MP39961008 MP40141007 MP36351204 MP36331008 MP36391008 Tier Rates Please initial and date to select this plan: EE $522.61 ES $1,045.23 EN $992.97 Initials Date FA $1,620.11 These are Final Rates. Date Printed: 08/20/2009 *This is a partial list of benefits,limitations,and exclusions.Refer to group contract for a complete listing of Quote Reference#: 68086- - benefits,limitations,and exclusions. Specific qualifications are detailed in the attached"Underwriting Assumptions&Caveats"document. *Group-Specific Underwriting Assumptions/Contingencies:Not applicable Page 1 of 2 Page 1 of 4 Deborah Citrin From: Brett-Diaz, Nickesha T [Brett-DiazN @aetna.com] Sent: Thursday, October 01, 2009 2:52 PM To: 'Marla A. Peed' Cc: 'deborah @citrinfinancial.com'; Jacqueline Howard Subject: RE: City of Opa Locka - Deborah Citrin/Citrin Financial Our GI underwriter reviewed this RFP and has decided to decline due to the high participation of police/fire employees. Please contact me if you should have any questions. Thank you, Nickesha T. Brett-Diaz(BRETT) Sales Support Consultant(Dental, Life, Disability) 1060 Maitland Center Commons, Suite 405, Maitland, FL 32751 tel: 352-343-0665 fax:860-262-7680 email:brett-diazn @aetna.com x From: Marla A. Peed [mailto:MarlaP @benefitmall.com] Sent: Thursday, October 01, 2009 1:35 PM To: Brett-Diaz, Nickesha T Cc: 'deborah @citrinfinancial.com'; Jacqueline Howard Subject: FW: City of Opa Locka - Deborah Citrin/Citrin Financial Brett Deborah is calling asking if we are getting these quotes. Please let me know when we should expect a quote. Thanks Please call should you have any questions. Sincerely, Marla A. Peed Broker Sale Rep Benefitmall 6750 N. Andrews Ave. Ste 125 Fort Lauderdale, FL 33309 954-771-2915 x 1005 Fax 954-771-6264 1(/2/2009 Metropolitan Life Insurance Company Customer Service Center 4150 N Mulberry Drive, Suite 300 Kansas City, MO 64116 - }(rye' ,5 ' vk t'4' xyj i 2i% August 21, 2009 BENEFITS ADMINISTRATOR CITY OF OPA-LOCKA 780 FISHERMAN ST 4TH FLOOR OPA-LOCKA, FL 33054 Re: Customer#05723320 Dear Benefits Administrator: We have completed our annual renewal evaluation of your group coverage with MetLife. Our analysis takes into consideration a variety of elements that include overall industry trends in claims incidence, shifts in employee composition as well as other financial or premium related issues that have a bearing on our cost structure. After careful consideration of the above factors, we have established our pricing for the upcoming policy year. Following are both your current and renewal rates, which will be effective on November 1, 2009. Coverage Current Rates Renewal Rates Rate Basis DENTAL $33.680 $36.880 Employee $68.050 $74.510 Employee + Spouse $70.210 $76.880 Employee + Child(ren) $111.350 $121.930 Family Billing statements on and after November 1, 2009 will reflect the renewal rates. Rates are guaranteed for 12 months subject to the terms, conditions and provisions of your group insurance policy. Any additional coverages not specifically mentioned in this letter that are active at the time of the renewal will have their rates continued through the coming year. It is our expressed intent to provide the best possible relationship of benefit costs to the products we provide to your group. Please be assured that our analysis has been completed with this in mind. We appreciate the opportunity to provide your employee benefits and look forward to continuing our relationship. If you have any questions regarding our assessment, please do not hesitate to contact us at 800 ASK-4-MET. Sincerely, MetLife Renewal Underwriting cc: CHARLES A CITRIN TAMPA REGIONAL SALES OFFICE Aetna Barry Noorigian 1060 Maitland Center Commons Account Executive yV Blvd. (407) 618-2348 Suite 405 E-mail: NoorigianB @aetna.com Maitland, FL 32751 September 17, 2009 Karen Rogowski Sales Administrative Assistant BenefitMall Re: City of Opa Locka Dear Karen, We have received your request for a dental proposal on the above named prospect. Aetna uses underwriting guidelines to determine whether or not each potential prospect will be eligible for group insurance. Based on the information provided, we are unable to quote this prospect due to the fact that we would not be competitive. Thank you for your time and consideration. Sincerely, Barry Noorigian Account Executive Dear SafeGuard Agent...this is a copy of your client's renewal letter which will be sent out within the next 30 days. July 1, 2009 Citrin Financial & Insurance, Inc. 300 71st street, Suite 300 Miami Beach, FL 33141-3075 Re: Plan Renewal for your Client: City of Opa-Locka-275726 Dear Valued Client: We would like to take this opportunity to thank you for your continued participation in the SafeGuard®benefit program chosen by your organization. We know you want your benefits to provide value at a monthly cost that is fair and appropriate and the SafeGuard program you have chosen does that. And the plan value is increased to an even greater degree by access to one of the largest networks of healthcare professionals in your state. You made the right choice when you chose SafeGuard. This letter is your renewal notification and constitutes an amendment to the SafeGuard Group Contract for Prepaid Services and Acceptance Agreement for your SafeGuard benefit program. Please retain this copy for your files. The term of this amendment begins on the renewal date, for the term noted below. The first billing statement of your new contract term will reflect the rates indicated below. Effective Renewal Date: November 1, 2009 Term of Agreement: October 31, 2010 Contract Term: 12 Months SGXM185A Current Rate Renewal Rates Employee Only $11.68 $11.68 Employee+Spouse $20.44 $20.44 Employee+Child(ren) $24.53 $24.53 Employee+ Family $34.46 $34.46 If you have any questions or would like additional information, please contact me. I will be happy to assist you. Sincerely, Christine Gregory (813)393-5806 Group Name: City of Opa-Locka , J s Effective Date: 11/01/2009 s A ED gency Name: Citrin Financial&Insurance,Inc. H 1 A I T AvMed Representative: Lourdes Abraham FAITH P L A N S Plan Family: Choice Plan Name: CH-CH-3996 Existing Plan Network: Choice PHCS Non Network Benefit Summary: Deductible(Single/Family): $0/$0 $250/$750 $500/$1,500 OOP Max(Individual/Family): $2,500/$5,000 $3,500/$7,000 $5,000/$10,000 PCP Office Visit: $15 $25 40%UCR Specialist Office Visit: $30 $50 40%UCR* OP Diagnostic Testing: 10% 20% 40%UCR IP Hospital: $500/Admit $750/Admit 40%UCR OP Surgery: 10% 20% 40%UCR Emergency Room: $100 $150 $200 Urgent Care: $40 $60 $60 Riders: Prescription Drug: AV-LG RX-2x-10/30/50/75/50%-OC-B-08 IP MH 30 Days,$250/Adm: Excluded OP SA HMO 6 week limit,$50 per wk: Excluded EToP Rider-1321: Excluded EToP Rider-3635: Included DME Limit from$500 to$2: Excluded Mammogram Waive Copay/coinsurance: Excluded IP MH 30 days,$500A/$750A/$750A/40%: Included AV-SA-Choice$30$50 40%-08: Included MP Numbers: MP39961008 MP52431008 MP36351204 MP36331008 MP36391008 Tier Rates Please initial and date to select this plan: EE $534.94 ES $1,069.87 EN $1,016.38 Initials Date FA $1,658.30 These are Final Rates. Date Printed: 08/20/2009 *This is a partial list of benefits,limitations,and exclusions.Refer to group contract for a complete listing of Quote Reference#: 68086- - benefits,limitations,and exclusions. *Specific qualifications are detailed in the attached"Underwriting Assumptions&Caveats"document. *Group-Specific Underwriting Assumptions/Contingencies:Not applicable Page 1 of 2 Group Name: City of Opa-Locks Effective Date: 11/01/2009 V:1‘ Agency Name: Citrin Financial&Insurance,Inc. HE A L T H P L A N S AvMed Representative: Lourdes Abraham Plan Family: Choice CH-CH-3996 Plan Name: Existing Plan Network: Choice PHCS Non Network Benefit Summary: Deductible(Single/Family): $0/$0 $250/$750 $500/$1,500 00P Max(Individual/Family): $2,500/$5,000 $3,500/$7,000 $5,000/$10,000 PCP Office Visit: $15 $25 40%UCR Specialist Office Visit: $30 $50 40%UCR* OP Diagnostic Testing: 10% 20% 40%UCR IP Hospital: $500/Admit $750/Admit 40%UCR OP Surgery: 10% 20% 40%UCR Emergency Room: $100 $150 $200 Urgent Care: $40 $60 $60 Riders: Prescription Drug: $20/40/60/75/50%0C-2X-B IP MH 30 Days,$250/Adm: Excluded OP SA HMO 6 week limit,$50 per wk: Excluded EToP Rider-1321: Excluded EToP Rider-3635: Included DME Limit from$500 to$2: Excluded Mammogram Waive Copay/coinsurance: Excluded IP MH 30 days,$500A/$750A/$750A/40%: Included AV-SA-Choice$30$50 40%-08: Included MP Numbers: MP39961008 MP40141007 MP36351204 MP36331008 MP36391008 Tier Rates Please initial and date to select this plan: EE $522.61 ES $1,045.23 EN $992.97 Initials Date FA $1,620.11 *These are Final Rates. Date Printed:08/20/2009 *This is a partial list of benefits,limitations,and exclusions.Refer to group contract for a complete listing of Quote Reference#:68086- - benefits,limitations,and exclusions. *Specific qualifications are detailed in the attached"Underwriting Assumptions&Caveats"document. *Group-Specific Underwriting Assumptions/Contingencies:Not applicable Page 1 of 2 Group Name: City of Opa-Locka Effective Date: 11/01/2009 AvMED Agency Name: Citrin Financial&Insurance,Inc. H E A L l" H PL A N S AvMed Representative: Lourdes Abraham Plan Family: Choice Plan Name: CH-CH-5233 Proposed Plan Network: Choice PHCS Non Network Benefit Summary: Deductible(Single/Family): $01$0 $250/$750 $500/$1,500 00P Max(Individual/Family): $2,500/$5,000 $3,500/$7,000 $5,000/$10,000 PCP Office Visit: $20 $25 40%after Ded Specialist Office Visit: $40 $50 40%after Ded OP Diagnostic Testing: 15% 20% 40%UCR IP Hospital: $500/Admit $750/Admit 40%UCR OP Surgery: 15% 20% 40%UCR Emergency Room: $100 $150 $200 Urgent Care: $40 $60 $60 Riders: Prescription Drug: $20/40/60175/50%0C-2X-B IP MH 30 Days,$100/Adm: Excluded OP SA HMO 6 week limit,$50 per wk: Excluded EToP Rider-1321: Excluded EToP Rider-3635: Included DME Limit from$500 to$2: Excluded Mammogram Waive Copay/coinsurance: Excluded IP MH 30 days,$500A1$750A/$750A/40%: Included AV-SA-Choice$30$50 40%-08: Included MP Numbers: MP52330109 MP40141007 MP36351204 MP36331008 MP36391008 Tier Rates Please initial and date to select this plan: EE $498.00 ES $996.00 EN $946.20 Initials Date FA $1,543.80 *These are Final Rates. Date Printed: 08/20/2009 *This is a partial list of benefits,limitations,and exclusions.Refer to group contract for a complete listing of Quote Reference#:68086- - benefits,limitations,and exclusions. *Specific qualifications are detailed in the attached"Underwriting Assumptions&Caveats"document. *Group-Specific Underwriting Assumptions/Contingencies:Not applicable Page 2 of 2 Page 1 of 4 Deborah Citrin From: Brett-Diaz, Nickesha T[Brett-DiazN @aetna.com] Sent: Thursday, October 01, 2009 2:52 PM To: 'Marla A. Peed' Cc: 'deborah @citrinfinancial.com'; Jacqueline Howard Subject: RE: City of Opa Locka - Deborah Citrin/Citrin Financial Our GI underwriter reviewed this RFP and has decided to decline due to the high participation of police/fire employees. Please contact me if you should have any questions. Thank you, Nickesha T. Brett-Diaz(BRETT) Sales Support Consultant(Dental, Life, Disability) 1060 Maitland Center Commons, Suite 405, Maitland, FL 32751 tel: 352-343-0665 fax: 860-262-7680 email: brett-diazn @aetna.com x From: Marla A. Peed [mailto:MarlaP @benefitmall.com] Sent: Thursday, October 01, 2009 1:35 PM To: Brett-Diaz, Nickesha T Cc: 'deborah @citrinfinancial.com'; Jacqueline Howard Subject: FW: City of Opa Locka - Deborah Citrin/Citrin Financial Brett Deborah is calling asking if we are getting these quotes. Please let me know when we should expect a quote. Thanks Please call should you have any questions. Sincerely, Marla A. Peed Broker Sale Rep Benefitmall 6750 N. Andrews Ave. Ste 125 Fort Lauderdale,FL 33309 954-771-2915 x 1005 Fax 954-771-6264 10/2/2009 Metropolitan Life Insurance Company Customer Service Center 4150 N Mulberry Drive,Suite 300 Kansas City, MO 64116 • (R' August 21, 2009 BENEFITS ADMINISTRATOR CITY OF OPA-LOCKA 780 FISHERMAN ST 4TH FLOOR OPA-LOCKA, FL 33054 Re: Customer#05723320 Dear Benefits Administrator: We have completed our annual renewal evaluation of your group coverage with MetLife. Our analysis takes into consideration a variety of elements that include overall industry trends in claims incidence, shifts in employee composition as well as other financial or premium related issues that have a bearing on our cost structure. After careful consideration of the above factors, we have established our pricing for the upcoming policy year. Following are both your current and renewal rates, which will be effective on November 1, 2009. Coverage Current Rates Renewal Rates Rate Basis DENTAL $33.680 $36.880 Employee $68.050 $74.510 Employee + Spouse $70.210 $76.880 Employee + Child(ren) $111.350 $121.930 Family Billing statements on and after November 1, 2009 will reflect the renewal rates. Rates are guaranteed for 12 months subject to the terms, conditions and provisions of your group insurance policy. Any additional coverages not specifically mentioned in this letter that are active at the time of the renewal will have their rates continued through the coming year. It is our expressed intent to provide the best possible relationship of benefit costs to the products we provide to your group. Please be assured that our analysis has been completed with this in mind. We appreciate the opportunity to provide your employee benefits and look forward to continuing our relationship. If you have any questions regarding our assessment, please do not hesitate to contact us at 800 ASK-4-MET. Sincerely, MetLife Renewal Underwriting cc: CHARLES A CITRIN TAMPA REGIONAL SALES OFFICE Dear SafeGuard Agent...this is a copy of your client's renewal letter which will be sent out within the next 30 days. July 1, 2009 Citrin Financial & Insurance, Inc. 300 71St street, Suite 300 Miami Beach, FL 33141-3075 Re: Plan Renewal for your Client: City of Opa-Locka-275726 Dear Valued Client: We would like to take this opportunity to thank you for your continued participation in the SafeGuard®benefit program chosen by your organization. We know you want your benefits to provide value at a monthly cost that is fair and appropriate and the SafeGuard program you have chosen does that. And the plan value is increased to an even greater degree by access to one of the largest networks of healthcare professionals in your state. You made the right choice when you chose SafeGuard. This letter is your renewal notification and constitutes an amendment to the SafeGuard Group Contract for Prepaid Services and Acceptance Agreement for your SafeGuard benefit program. Please retain this copy for your files. The term of this amendment begins on the renewal date, for the term noted below. The first billing statement of your new contract term will reflect the rates indicated below. Effective Renewal Date: November 1, 2009 Term of Agreement: October 31, 2010 Contract Term: 12 Months SGXM185A Current Rate Renewal Rates Employee Only $11.68 $11.68 Employee+Spouse $20.44 $20.44 Employee+Child(ren) $24.53 $24.53 Employee+ Family $34.46 $34.46 If you have any questions or would like additional information, please contact me. I will be happy to assist you. Sincerely, Christine Gregory (813)393-5806 Aetna Barry Noorigian 1060 Maitland Center Commons Account Executive k Blvd. (407) 618-2348 Suite 405 E-mail: NoorigianB @aetna.com Maitland, FL 32751 September 17, 2009 Karen Rogowski Sales Administrative Assistant BenefitMall Re: City of Opa Locka Dear Karen, We have received your request for a dental proposal on the above named prospect. Aetna uses underwriting guidelines to determine whether or not each potential prospect will be eligible for group insurance. Based on the information provided, we are unable to quote this prospect due to the fact that we would not be competitive. Thank you for your time and consideration. Sincerely, Barry Noorigian Account Executive Sponsored by: City Manager RESOLUTION NO. 0 8-7 3 6 9 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA, AUTHORIZING THE CITY MANAGER TO SELECT Avmed AS THE CITY'S HEALTH INSURANCE CARRIER AND MetLife AS THE CITY'S DENTAL INSURANCE CARRIER FOR THE PLAN YEAR BEGINNING NOVEMBER 1, 2008 THROUGH OCTOBER 31,2009. WHEREAS,the City Commission of the City of Opa-locka("City Commission")adopted Resolution 05-6780, appointing Citrin Financial Insurance, Inc., ("Citrin") as the Agent of Record for the City of Opa-locka ("City"); and WHEREAS,Citrin,on behalf of the City's Human Resources and Finance Department,has received annual group health plan comparisons and rate proposals for the City's upcoming plan coverage year beginning November 1, 2008 through October 31, 2009; and WHEREAS,after reviewing the group health plan comparisons and rate proposals received from the various providers,the City Manager recommends selecting AvMed as the health insurance carrier and MetLife as the dental insurance carrier for the upcoming plan coverage year beginning November 1, 2008 through October 31, 2009; and WHEREAS, the City Commission desires to select a health insurance carrier and dental insurance carrier for the City for the plan year beginning November 1, 2008 through October 31, 2009. NOW,THEREFORE,BE IT DULY RESOLVED BY THE CITY COMMISSION OF THE CITY OF OPA-LOCKA,FLORIDA: Section 1. The recitals to the preamble herein are incorporated by reference. Resolution No. 08—7 3 6 9 Section 2. The City Commission of the City of Opa-locka hereby authorizes the City Manager to select AvMed as the health insurance carrier for the City and MetLi fe as the dental insurance carrier for the City for the plan year beginning November 1,2008 through October 31, 2009. Section 3. This resolution shall take effect immediately upon adoption. PASSED AND ADOPTED this 8 day of OCTOBER , 2008. • EPHL. 'L ,,EY MAYOR Attest: Approved as to form and legal sufficiency: ■ �j Debor. S. Irby :urn••ette N s-Weeks City Clerk --- '' Attorney Moved by: JOHNSON Seconded by: MILLER Commission Vote: 5—0 Commissioner Tydus: YES Commissioner Holmes: YES Commissioner Miller: YES Vice-Mayor Johnson: YES Mayor Kelley: YES City of Opa-locka City Commission Agenda Item Request DATE: September 29,2008 TO: Jannie R.Beverly,City Manager FROMIPHONE: Sharlene Boyd/305.953.2815 DEPARTMENT: Human Resources Director PREPARED BY: Sharlene Boyd TITLE OF AGENDA ITEM: HEALTH AND DENTAL CARE BENEFITS CARRIER CHANGE FOR 2008/2009 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF OPA-LOCKA,FLORIDA authorizing the City Manager to select_ as the City's health carrier and as the City's dental carrier for the plan coverage year beginning November 1, 2008 through October 31, 2009. REPORT IN BRIEF: Staff has reviewed the plan comparisons and rate proposals submitted by the City's Agent of Record (Citrin Financial & Insurance, Inc). Several companies submitted proposals to the Agent of Record for the upcoming plan year. Based on that information, Staff recommends AvMed as the health carrier, and MetLife as the dental carrier for the City's health and dental benefits. PREVIOUS ACTIONS: Resolutions#98-5965,#98-5966 and#05-6780 CONCURRENCES: N/A FISCAL IMPACT: Has request been budgeted? Yes If yes,expected cost: $1,453,571.16 Account Name: Budgeted per Department Account Number: If no.amount needed: What account will funds be appropriated from: RECOMMENDATI.ON(S): Commission Approval ATTACHMENT(S): Departmental Memo,Resolutions#98-5965, #98-5966 and#05-6780, Health Carrier Comparison and Rate Proposals. Sponsored by: City Manager JUN 2 5 iuUB Resolution No. 05-6780 '. A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA, APPOINTING CITRIN FINANCIAL INSURANCE, INC. AS THE AGENT OF RECORD FOR THE CITY OF OPA-LOCKA,FLORIDA WHEREAS, the City solicited a Request for Qualifications,(RFQ)on May 22,2005,for an Agent of Record; and WHEREAS, the City received five(5) responses to the RFQ; and WHEREAS, on June 23,2005 the Selection Committee conducted interviews for the Agent of Record with scores tabulated as follows: Benefits Design Resources,Inc. 136 Citrin Financial Insurance Inc. 135 A&A Underwriters 82 Duetra Robinson 58 Billy Cowins 47 ; and WHEREAS, the City Commission is of the opinion that Citrin Financial Insurance,Inc. is best qualified to serve in the capacity of Agent of Record. NOW,THEREFORE,BE IT DULY RESOLVED BY THE CITY 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 hereby appoints Citrin Financial Insurance,Inc.to serve as Agent of Record. Resolution No. Section 3. The City Manager is hereby further authorized to enter into and execute an agreement with Citrin Financial Insurance,Inc. in a form acceptable to the City Attorney, PASSED AND ADOPTED this 27th day of July , 2005. L 6314 MA.Y Attest to: Approved as to form and legal sufficiency: ,. ._ .iN�ht<i if CITY CLERK C' Y 0 I 242.1.A5 Moved by: Commissioner Holmes Second by: Commissioner Johnson Commission Vote: 4-0 Commissioner Holmes: YES Commissioner Tydus: NOT PRESENT Commissioner Johnson: YES Vice-Mayor Pinder: YES Mayor Kelley: YES Resolunonl Agreement with Benefits Design Resources,inc-7-35 • RESOLUTION NO. 98-5965 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA, AUTHORIZING THE CITY MANAGER TO ENTER INTO A CONTRACT WITH NUMANA. FOR GROUP ljEziy,gitis 'F r. V RAGE FOR THE EMPLOYEES OF THE CITY OF OPA-LOCKA. WHEREAS; the City of Opa-locka has accepted numerous proposals for employee group health Insurance coverage from various health maintenance organizations for review by the City Commission; and WHEREAS; the summary of those benefits and their associated cost are Included as part of this resolution as exhibit "A"; and WHEREAS; the present contract with Av-Med to supply group health Insurance coverage will expire as of September 30, 1998. NOW, THEREFORE, BE IT DULY RESOLVED BY THE CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA THAT: Section 1: The City Manager is authorized to enter into a contract between HUMANA and the City of Opa-locks for group health insurance. PASSED AND ADOPTED THIS 28TH day of SEPTE :ER 19 _ •:� est: ♦A' ay...r City Clerk _ Approved as to form nd egal su#ficlenf� red Commission Vote: 4-0 By: sir. Moved by: COMMISSIONER HOLMES Ity a ttorney Seconded by: COMMISSIONER TAYLOR Date: /ter ! 0 f Commissioner Miller: YES Vice Mayor Allen: YES Commissioner Taylor: YES Commissioner Holmes: YES Mayor Ingram: NOT PRESENT RESOLUTION NO. 98'5966 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA, AUTHORIZIJ,Ox.•.T MANAGER TO ENTER INTO A CONTRACT WITH!OHS DENTAL FOR COMPREHENSIVE DENTAL COVERAGE FOR THE E -GYE•ES OF THE CITY OF OPA-LOCKA. WHEREAS; the City Manager has accepted proposals received for comprehensive dental coverage for the city's employees; and WHEREAS; the summary of benefits and their associated cost are included as part of this resolution as exhibit"A"; and WHEREAS; a recommendation is hereby made by the Manager for OHS-DENTAL to provide the city's employees with their Managed Dental Care Plan. NOW, THEREFORE, BE IT DULY RESOLVED BY THE CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA THAT: Section 1: The City Manager is authorized to enter into a contract between OHS-DENTAL and the City of Opa-locka for group dental coverage. PASSED AND ADOPTED THIS 28TH day of SEP,EMBER 4998. ' t#eSt: 1 •• r e ..r� Approved as # arm and legal City Clerk sufficiency: Commission Vote: •4-0 By: e/rtififejl., -6-44/�( ,( Moved by: COMMISSIONER HOLMES ity Attorney Seconded by: COMMISSIONER TAYLOR Date: l�c,ir,r T I Vice Mayor Allen: YES Commissioner Miller: YES Commissioner Holmes: YES Commissioner Taylor: YES Mayor Ingram: NOT PRESENT N r- 0 0 to c r • - ham, • p vn'i 7 `Ji -a 1 r(y En ry MEMORANDUM co To: Janie R. Beverly, City Manager From: Ezekiel Orji Ph.D., Asst. City Manager/Finance Director P Date: September 26,2008 Re: Health & Dental Benefits Carrier Change It is my recommendation that the City select AvMed to be its health carrier,and MetLife to be its dental carrier. Humana is the City's current health & dental carrier and has provided a renewal rate proposal that will increase the health cost 20.78% per employee. Given the current economy,this is an increase that the City can not absorb, nor is it a cost that we can consider passing on to our employees. Health Benefit The City received a variety of different carriers to quote the health benefits. AvMed which is very close to the current coverage levels that we have with Humana came in at a proposed cost increase of only 4% per employee for the HMO plan and 29.5% reduction in the POS choice option plan. The AvMed plan is an open access plan which means there are no requirements for referrals to be issued by the primary care physician or specialist. Dental Benefit The City received a variety of different carriers to quote the dental benefits. The current dental carrier is through Humana which has received the dental coverage through Safeguard with no increase in premiums.However,Safeguard was bought out by MetLife,so Hunmana's dental that has been quoted would now be covered by CompBenefits. MetLife gave a proposal for the same Safeguard dental coverage that we currently have at a 6.2% reduced rate. It is .nay recommendation that the City select MetLife to be it's dental carrier and retain the Safeguard coverage at the proposed 6.2% reduced rate. The attached reflects the carriers that provided quotes to the City. Open enrollment will be conducted in October; with benefit coverage's beginning November 1,2008 through October 31,2009. Attachment Citrin Financial at Insurance, inc. • • Insurance & Pensions 1 . - CHARLES A. CITRIN f President E-moil:cacitrin @unitedplonners-com 0,10001.1..,,A,A:00)%kist.k‘ 6 C September 17,2008 SMteiti-1903c;9'gg1.24 + 041144 418/.579.92 + Sharlene Boyd 19 453,571.16 G+ Human Resources Director City of Opa-Locka City Hall 780 Fisherman Street Opa-Locka,FL 33054 Re: City of Opa-Locka Employee Benefits Renewal Proposal:November 2008 • Dear Sharlene: • Medical: Humana,the City's current health insurance carrier,as well as Neighborhood Health Partnership, Cigna Healthcare, Blue Cross Blue Shield,Vista Healthplans and AvMed Health Plans offered to quote on the City's group health plan.Aetna declined to quote based on a review of claims. Human'a's renewal quote on the current plan increased the yearly premium 20.78%per employee. We requested and received alternate plans from Humana which will lower the premium increase by 11.4%to 14.6%per employee,but increase co-payments. Vista offered optional plans for the City that would increase the yearly premium 2.5%to 9%per employee.Vista plans are Open Access plans and increases co-payments. AvMed offered optional plans for the City that would increase the yearly premium 2.5%to 4% per employee.AvMed plans are Open,Access plans and could reduce co-payments • Neighborhood Health Partnership's quote could reduce the yearly premium 2%per employee. The NHP plan increases co-payments. Cigna Healthcare's quote increases the yearly premium 15.5%per employee. The Cigna plan included yearly deductibles and actually increases co-payments. Blue Cross Blue Shield's quote increases the yearly premium 12.5%to 14.5%per employee. The i BCBS plan increases certain co-payments. 300 77 st Street, Suite 300, Miami Beach, A. 33141.3038 Tel: 305.861.0999 Fax:305.867.0032 Registered Representative Offering Securities through United Planners'Financial Services of America Member NASD-SIPC City of Opa-Locka Employee Benefits Renewal Proposal:November 2008 Dental: Humana's renewal quote on the current dental plan has no increase in premium. The following companies also submitted dental quotes:United Healthcare,Blue Cross Blue Shield,Cigna,MetLife, Delta Dental and the Ameritas Group. Please refer to the attached booklet for all quotes,quote comparisons, complete summary of plan benefits&letters of decline. We thank you and your staff for their assistance and again and we thank you for your trust. Please know we are available for any questions. Sinc rely, - Charles A. Citrin President cc:Michael Behrman • • Citrin Financial $ insurance. 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Fully-insured renewal summary r - City of Opa Locka Group or Affiliation #806640 Renewal date: December 1,2008 Your current'and renewal dental-rates Plan description Coverage type Enrollment Current rata Monthly Renewal rate Monthly • premium premium Plan 1 PPO 100/90/50 In-network,80/80/50 out-of- Employee 8 533.78 $270 533.78 S270 network periodontics/endodontics In Basle, Employee&Spouse 2 _ 571.75 $144 $71.75 $144 51500 annual maximum$50 krnetwork Employes&Child(ren) 2 572.76 5146 572.78 $146 deductible.550 out-of-network deductible; Family 1 5177.2/ 5117 $117.21 — 3117 deductible werved on preventive:child only orthodontia with 31000 lifetime maximum • Total 13 5678- 3676 Plan 2 ' Prepaid 5G 185A Employee 79 31248 _ 5984• $12.48 - $984 Employee&Spouse 13 521,81 5284 521.81 $264 Employee&Child(ren) 16 $26.79 $429 526.79 5429 . Family 16 536.76 5588 336.76 5588 Total _ 124 _ $2,285 $2,285 i Your cost-saving alternatives Proposed Monthly • HumanaDental is commited to Plan description Coverage type rates premium' addressing the link between oral and overall health through Plan 1 member education and Prepaid CS 150 Employee 314.50 31,262 targeted benefits. Employee&Spouse $29.07 $436 • Employee d.Chedtren) 526.53 5478 : Family 545.01 3765 You also receive: Total $2,940 EyeMed vision discount program,where you and your employees can save money with more than 40,000 providers at 20.000 locations nationwide including optometrist's,ophthalmologists. opticians and LensCrafters.. Brush Up,a free newsletter with articles about dental health and benents 'Monthly Premium for etterr.a; quotes uses total enrollment Members receive it free with their • explanation Of benefits. Access anytime to dental benefits - information through our automated Information line(1.800-233-4013)and T f r Humana0enial.COm. H �'prtt'sait Ui'nse'Jii:ss ANA tn`.rmacinn is Intended for the recipient only and is not to be distributed- This privileged and confidential information Is proprietary to HumanaDental 1n.vrei;e Cnmoerr,.