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Home My Public Portal About18-9532 Avmed Health Plan as the Insurance Provider Sponsored by: City Manager RESOLUTION NO. 18-9532 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 AND METLIFE AS THE PROVIDER FOR THE CITY OF OPA- LOCKA'S DENTAL AND VISION GROUP PLANS, FOR THE BENEFIT YEAR BEGINNING OCTOBER 1,2018 AND EXPIRING SEPTEMBER 30, 2019; PROVIDING FOR INCORPORATION OF RECITALS; PROVIDING FOR AN EFFECTIVE DATE WHEREAS, the City of Opa-locka ("City") 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; and WHEREAS, Staff recommends to renewing with the current health, dental and vision plans; and WHEREAS, the costs associated with renewal of the current health, dental and vision plans are estimated to be $876,357.00 and are subject to change upon employee dependent coverage election; and WHEREAS, the costs are currently included in the proposed budget and are less than the proposed allocated amount; and WHEREAS, the City Commission finds that it is in the best interest of the City to renew its current Avmed Health Plan and its current Metlife Vision and Dental Plans. NOW THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF OPA-LOCKA, FLORIDA: Section 1. RECITALS ADOPTED. The recitals to the preamble herein are incorporated by reference. Section 2. AUTHORIZATION The City Commission of the City of Opa-locka hereby authorizes the City Manager to select Avmed Health Plan as the provider for the City of Opa-locka health plan and Metlife as the provider for the City of Opa-locka's dental and vision group plans, for the benefit year beginning October 1, 2018 and expiring September 30, 2019. Resolution No. 18-9532 Section 3. SCRIVENER'S ERRORS. Sections of this Resolution may be renumbered or re-lettered and corrections of typographical errors which do not affect the intent may be authorized by the City Manager, or the City Manager's designee, without need of public hearing, by filing a corrected copy of same with the City Clerk. Section 4. EFFECTIVE DATE. This Resolution shall take effect immediately upon adoption and is subject to the approval of the Governor or his designee. PASSED AND ADOPTED this 21st day of August, 2018. y a L. Taylor ayor Attest to: Approved as to form and legal sufficiency: Jo.11 a Flores THE BROWN LAW GROUP, LLC Cit• Clerk City Attorney Moved by: Vice Mayor Kelley Seconded by: Commissioner Riley Commissioner Vote: 5-0 Commissioner Holmes: YES Commissioner Riley: YES Commissioner Pigatt: YES Vice Mayor Kelley: YES Mayor Taylor: YES oQp-tOCKa r U _ 0;4 City of Opa-Locka Agenda Cover Memo Department Kierra Ward, MBA Department Director: Director Signature: / ( .Wa Finance Bryan Hamilton FD Signature: Director: Department i City Manager: Newall J. Daughtrey ACM Signature: 11 Commission 08.21.18 Item Type: Resolution s dinanc + ' e Meeting Date: X (EnterXin box) Fiscal Impact: Ordinance Reading: 1st Reading 2nd Reading (EnterXin box) Yes No (EnterXin box) x Public Hearing: Yes No Yes No (EnterXin box) X X Funding (Enter Fund& Advertising Requirement: Yes No Source: Dept) (Enter X in box) % Account#: Ex: 001-218116 Contract/P.O. Yes No RFP/RFQ/Bid#: Required: (EnterXin box) Strategic Plan Yes No Strategic Plan Priority Area: Strategic Plan Obj./Strategy: Related Enhance Organizational J (list the specific objective/strategy this (EnterXin box) Bus.&Economic Dev item will address) Public Safety Quality of Education Qual.of Life&City Image Communication C7 Sponsor Name City Manager Department: City Manager Thou u Title: Authorizing the City Manager to renew the contract with AvMed, and MetLife for the Medical, dental and vision insurance for the employees. Staff ;:mary: It is in the best interest of the City to renew the contracts with AvMed,and Metlife for the City Benefit providers. Prowsed Action: Staff recommends approval. Attachment: J`,,s.LOCh� COX OS% Mom. onnt Memorandum TO: Mayor Myra L.Taylor Vice-Mayor Joseph Kelley Commissioner Timothy Holmes Commissioner Matthew Pigatt Commissioner John Riley , FROM: Newall Daughtrey,Acting-City Manager , �� DATE: August 18, 2018 RE: Proposed Health,Dental,Vision Carrier for Fiscal Year 2018/2019. 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, 2018 EXPIRING SEPTEMBER 30,2019. 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$876,357, 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 1,2018- September 30,2019 Legislative History: Resolution NO. Recommendation(s): This approval is based on staff's analysis of the proposed services, providers, and costs. Additionally, the City is proposing to renew the agreement with AvMed and MetLife for the FY 2018-19 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 a richer plan design with AvMed at an increased rate of 4.96 to the current rate. This plan will provide out of pocket financial relief to the employees as primarily the copayments are reduced, the primary physician from$40 to$25 and the specialist from$80 to $45.See attached plan design. Metlife provided a rate pass for the renewal of the dental and vision insurance with no increase. Attachments: Plan design and Insurance Bid Results PREPARED BY: Kierra Ward,MBA Human Resources Director os Lock(a; fi u ' 4 ry e City of Opa-locka Kierra Ward,MBA Office: 305-953-2815 Human Resources Director Email: kward @opalockafl.gov MEMORANDUM To: Newall Daughtrey,Acting-City Manager From: Kierra Ward,Human Resources Director Re: Benefit Renewal Analysis &Recommendation Date: August 18,2018 Staff has been.working with Sapoznik to assess the current benefits offered to City Employees to plan for Open enrollment, and explore opportunities to enhance the current plan to reduce the out of pocket expenses for the employees. Analysis: Staff met with Sapoznik on Thursday, August 16th, to review the final negotiated rates received from AvMed and the proposed plan offer from United HealthcarefUHC.The quotes that were received from United Healthcare is for a plan identical to the current plan being offered by AvMed with a 4.99% increase. Due to this years' objective to enhance the plan design, the opportunity of enhancement is being afforded by AvMed at a 4.96% increase is more feasible. The City has been receiving health insurance with AvMed for four(4) years and has built an outstanding working relationship with their Customer Service and Account representatives. Although there is one open large medical claim that is unfavorable for the City,however AvMed managed to offer a renewal enhanced plan below industry trend. Industry trend is usually a 10% annual increase. Final Recommendation: The Human Resources Department recommends the renewal of benefits with AvMed for the enhanced plan design(Plan HMO-OA)because it has been proven that the continuity of business has allowed the Claims experience to improve through the implementation of employee education provided by AvMed and Sapoznik. The employees are familiar with AvMed, its network and the plan structure.The customer service provided by AvMed via member services to employees directly and internally to staff has been highly exceptional, and it is evident that continuing the business relationship with AvMed has been beneficial to meeting budgetary objectives as it relates to affordability of Human Resources Department•780 Fisherman Street 4'"floor,Opa-locka,FL 33054+(305)953-2815 annual premiums. The final negotiated renewal is less than what was anticipated and is favorable to the objectives set forth in the proposed budget for FY 18-19 It is also being recommended that the City renews with MetLife insurance as our extended business relationship has resulted in the City's receipt of a rate pass for the second consecutive year for vison, HMO and PPO dental plans (0% increase). Human Resources Department 0780 Fisherman Street 4"'floor:Opa-locka,FL 33054•(305)953-2815 nik46. City Of Opa Locka WHERE HEALTH BENEFITS October 1, 2018 AvMed - Alternate Carrier Name AvMed AvMed Plan Name HMO OA 6357 HMO OA Network Access In Network Only In Network Only Deductible Deductible $5500/$11000 $5000/$10000 Member Co-Insurance 0% 20% Max Benefits . _ Out of Pocket Maximum $6350/$12700 $6850/$13700 Lifetime max Unlimited Unlimited Physician Office Services Physician $40 $25 Specialist $80 $45 Preventive Care Covered 100% Covered 100% Diagnostic Services,, Partic Labs:Covered 100% Partic Labs:Covered 100% Independent Clinical Lab Indp: $75 Ind 25 All Other: $150 After Ded p' $ , RI,MRA,CT&PET Scans Indp:$400 Indp:$250 All Other $600 After Ded All Other:$500 R and,Urgent Care, y Emergency Room $600 $500 Urgent Care $50/$35 $75/$25 Outpatient&;.Inpatient Services `. .` , Outpatient Surgery ASC:$750 Ambulatory Surgical Center/Hospital Hosp:$900 After Ded 20%After Ded Inpatient Hospital $750 After Ded 20%After Ded Provider Services Inpatient Hospital 0%After Ded 20%After Ded Pharml cy'Services. Presci 1ption $20/75/50%/50%/50% $20/40/75;50%/50%After Ded Premium Breakdown Current Negotiated Negotiated Employee 87 $390.23 $421.84 $415.96 $409.59 Employee/Spouse 11 $780.46 $843.68 $831.92 $819.18 Employee/Child(ren) 12 $741.44 $801.50 $790.33 $778.22 Employee/Family 15 $1,209.71 $1,307.71 $1,289.48 $1,269.72 Comments 125 Current 8.10% 6.59% 4.96% Monthly Total $89,578.00 $75,214.21 $74,165.80 $73,029.75 - Quotes are based on the census received.Rates could he 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 9:14 AM express permission. 8/15/2018 • City Of Opa Locka October 1, 2018 WHERE HEALTH BENEFITS NHP //(„IC Carrier Name I ` r AvvMeed �+ NHP Plan Name HMO 6357 HMO OA FOVQ M Network Access In Network Only In Network Only Deductible Deductible $5500/$11000 $5500/$11000 Member Co-Insurance 0% 0% Max Benetltis Out of Pocket Maximum $6350/$12700 $6350/$12700 Lifetime max Unlimited Unlimited Physician.Oftice Services_ : !, , Physician $40 $40 Specialist $80 $80 Preventive Care Covered 100% Covered 100% Diagnostic•Services Partic Labs:Covered 100% Independent Clinical Lab Indp:$75 Covered 100% All Other:$150 After Ded MRI,MRA,CT&PET Scans Indp 400 $400 All Other::$$600 After Ded t ER and Urgent.Care i Emergency Room $600 $600 Urgent Care $50/$35 $50 Outpatient,&inpatient?Services Outpatient Surgery ASC:$750 $750 Ambulatory Surgical Center/Hospital Hosp:$900 After Ded Inpatient Hospital $750 After Ded $750 After Ded Provider Services inpatient Hospital 0%After Ded 0%After Ded Pharmacy Sertices - Prescription $20/75/50%/50%/50% $10/50/20%/20% Premium Breakdown Current Negotiated Employee 87 $390.23 $421.84 $409.69 Employee/Spouse 11 $780.46 $843.68 _ $819.38 Employee/Child(ren) 12 $741.44 $801.50 $778.41 Employee/Family 15 $1,209.71 _ $1,307.71 $1,270.04 Comments 125 Current 8.10% 4.99% Monthly Total $69,578.00 $75,214.21 $73,047.73 "NHP Coverage Area:Broward,Charlotte,Citrus,Collier,DeSoto,Flagler,Glades,Hardee,Hendry,Hernando,Highlands,Hillsborough,Indian River,Lake,Lee, Martin,Miami-Dade,Okeechobee,Orange,Osceola,Palm Beach,Pasco,Pinellas,Polk,Sarasota,Seminole,St.Lucie,Summter, Volusia." 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 COG 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 9:14 AM express permission. 8/15/2018