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Home My WebLink AboutCity of Tamarac Resolution R-88-298Temp. Reso. #5213 Revised 10/25 88 1 2 K� 4 5 E:R 20 21 22 23 24 25 26 27 28 29 30 33 34 35 CITY OF TAMARAC, FLORIDA RESOLUTION NO. R-88- cPZ 9 9 A RESOLUTION AWARDING A BID FOR GROUP HEALTH INSURANCE, BID NO. #88-38; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, bids were advertised in the Fort Lauderdale News/Sun Sentinel, a newspaper of general circulation in Broward County on September 29, 1988 and October 6, 1988; and WHEREAS, bids were opened on October 18, 1988; and WHEREAS, Florida League of Cities is the lowest fully responsive and responsible bidder. NOW, THEREFORE, BE IT RESOLVED BY THE COUNCIL OF THE CITY OF TAMARAC, FLORIDA: SECTION 1: That the bid of Florida League of Cities in the following bi-weekly amounts with funds to be taken from various departmental accounts whose employees are in the Florida League of Cities health plan, is HEREBY APPROVED: PAID BY PAID BY CITY EMPLOYEE Single Coverage $41.55 $22.04 Family Coverage $67.15 $118.32 SECTION 2: That the appropriate City officials are hereby authorized to execute any and all contract documents necessary in connection with awarding of this bid. SECTION 3: This Resolution shall become effective immediately upon adoption. PASSED, ADOPTED AND APPROVED this r"� day of 1988. ATTEST: CAROL A. EVANS CITY CLERK I HEREBY CERTIFY that I have approved this RESOLUTION as to form. A _ RI CHARTS DOO CITY ATTORN RECORD OF COUNCIL VOTE MAYOR ABRAMOWITZ DISTRICT 1: C/M ROHR DISTRICT 2: V/M STELZER DISTRICT 3: C/M HOFFMAN DISTRICT 4= C/M BENDER • • Florida Municipal Self -Insurers Fund (Workers' Compensation) • Florida Municipal Liability Self -Insurers Program (Tort Liability) • Florida Municipal Health Trust Fund • Florida Municipal Pension Trust Fund • Florida Municipal Property Self -Insurers Program • First Municipal Loan Program ATTACHMENT 41 0-FLORIIa4 LEAGUE OF -Elam GRO Q P WILLIAM PENV LIFE INSURANCE I- Each Employee - $10, 000 Page 1 kly_;43 Florida League of Cities, Inc. 201 West Park Avenue Post Office Box 1757 Tallahassee, FL 32302-1757 Telephone (904) 222-9684 Suncom 282-5010 Florida League of Cities, Inc. Public Risk Services Division 174 West Comstock Avenue Post Office Box 2026 Winter Park, FL32790-2026 Telephone (407) 740-0210 Suncom 348-6770 2. Life and AD & D benefits reduce by 504 at age 70 with a maximum benefit of $5,000. 3- Additional benefits are available up to $=.000. A health statement is required for anyone requesting $100,000 or more, or any employes age 65 and above. 4. Life and AD & D group benefits are selected by the employer, and individual employees may not alter the amount of coverage- 5- When an employee retires, he/she miay maintain the amount of coverage he/she was eligible for at the time of retirement. Life .77 AD&D Total $ .M/si,000 ATTACHMENT #1 • C� • Florida Municipal Self -Insurers Fund (Workers' Compensation) w Florida Municipal Liability Self -insurers Program (Tort Liability) • Florida Municipal Health Trust Fund • Florida Municipal Pension Trust Fund • Florida Municipal Property Self -Insurers Program • First Municipal Loan Program G R O U P H ,E A L -•T H SCHEDULE OF BENEFITS FLMIDA MUNICIPAL HEALTH TRUST Fly I. LIFETIME MAXIM BENEFIT - $1,000,000 per individual. II. DEDUCTIBLE 1. $200 per individual per calendar year. 2. Maximum $400 per family per calendar year. Page 2 R 0''M Florida League of Cities, Inc. 201 West Park Avenue Post Office Box 1757 Tallahassee, FL 32302-1757 Telephone (904)222-9684 Suncom 282-5010 Florida League of Cities, Inc. Public Risk Services Division 174 West Comstock Avenue Post Office Box 2026 Winter Park, FL 32790-2026 Telephone (407) 740-0210 Suncom 348-6770 Plan pays SIX of the first $5, 000 of eligible and covered experlses per individual per calendar year. 100% is paid thereafter for re- mainder of the calendar year, or up to the lifetime maximum, which- ever occurs first. IV. ELIGIBLE AND COVERED EXPENSES -- subject to calendar year deductible and coinsurance. I. Hospital Roam and Board - Average semiprivate room rate. 2. Inten>'sive Care - Three times average semiprivate room rate. 3. Progressive Care - Up to 1-1/2 times the hospital roan and board benefit if incurred immediately following canfir mant in an intensive care unit. 4. All other eligible chat are paid according to reasonable fee guidelines as evaluated by the Board of Trustee,. 5. Maternity - Treated same as any other condition. ATTACHMENT #1 Page3 P- iS- W i F1 CRIDA M.NICIPAL HEALTH TRUST R10 SCHED1-JLE OF BENEFITS - Page Two 6. Second Surgical Opinions are covered and eligible eases. 7. Chiropractic Care - Plan pays the reasonable fees for chiroprac- tic services. 8. Outpatient Registered Physical Therapist Care - Plan pays up to a maximum benefit of $2,000 per individual per calendar year, for all reasonable fees. 9- TM7, Ossecus Surgery and Impacted Teeth Benefit - The reasonable fee charged by hospital, dentists, or physicians for the treat- ment of temporal mandibular joint dysfunction, osseeus surgery and/or impacted teeth are eligible for benefits up to a lifetime maximum of $1,500 for all services related to these conditions. Only one $1,500 lifetime benefit can be provided. 10. Alcohol and Drug Abuse Benefits - Benefits for the treatment of alcoholism, alcohol abuse, drug abuse, or injuries or sickness related to such abuse and/or consumption, is limited to a life- time maximum of $2,000. 11- Hospice Care Benefit - Plan pays for routine home care, and con- tincus home care subject to a maximum of $5,000 for a maximum period of six (6) months. Plan pays for inpatient resaite care subject to a maximum of $10,000 for a maximum period r-f six (6) months. Hospice care can only be approved once for a partici- pant. 12. Convalescent Care Facility Benefit - If a participant is confined in a convalescent cars facility or extended care faci.�ity immedi- ately following a hospital confinement, the Plan will provide a benefit of up to $75 per day for each day of confinement, not to exceed fourteen (14) days. 13. Skilled Nursing Care - Plan pays up to a maximum lifetime benefit of $10.000 per individual, for reasonable fees of a registered graduate nurse or of a licensed practical nurse, when ordered by a physician. 14. Mental and Nervous Condition Services - Plan pays up to a maximum lifetime benefit of $25,000 per individual, and a math calert- dar year benefit of $5,000 per individual. Services include the reasonable fees for inpatient and outpatient physician, psychia- trist, psychologist, and hospital charges- ATTACHMENT #1 Page 4 �- gS 0 0 0 FLORIDA MUNICIPAL HEALTH TRUST RjD SCHMA.E OF BENEFITS - Page Than 15. Well Child Care Benefits - Charges by a physician for Periodic examinations, immunizations and laboratory tests rot'required for treatment of illness or injury, are covered for eligible dependents from birth until age 16. V- SUPPLEMENTAL ACCIDENT SENEF17S Plan pays 100% of the first $300 - Not subject to deductible - Pro- vided treatment is within ninety (9o) days of accidental injury. - VI. OUTPATIENT SURGERY BENEFIT 1- Arthroscxpic knee surgery. 2. Breast Biopsy. 3. D & C (Dilation & Curettage). 4. T & A (Tonsillectomy & Adenoidactcmry). S. Cataract extraction. 6- Laser eye surgery for glaucoma or retinal detachment. 7. Buniorectcmies. B- Uapar0scOpic tubal ligations. 9. [ystoscopies. 10. TYmpanostanies with tune insertion. 11. Simple he orrhoiderctcmy procedures_ VII. OUTPATIENT PRE -ADMISSION LT[RY AND RADIOLOGY TESTING BENEFIT Plan pays 100% of the reaso mble fees, not subject to the calendar Year deductible, for outpatient pre-acknission testing. Testing must be ordered by a Physician and conducted within seven (7) days Prior to an inpatient hospital con irrment. VIII. OIAQ4MTIC X-RAY, LABQRATCRY AND PATHOLOGY SERVICES BENEFIT Plan Pays 100% of the reasonable fees, not subject to the calendar Year deductible, for outpatient hospital and physician charges up to a $100 benefit per individual Per calendar year. IX. BIRTHING CENTER BENEFIT Plan Pays 100% of the reason&ble fees, not subject to the calendar Year deductible, for services rendered within twenty-four-(24) hours • of delivery, UP to a mwdm m benefit of $1,000 per delivery. attachment # 1 Page 5 K- $ Y 2.9 8 W 11 FLORIDA MUNICIPAL HEALTH TRUST FUND SCHMLL.E OF BENEFITS - Page Four X. NCN!-EMERGENCY M 40ATCRY SECOND SLRGICAL OPINION BENEFIT Plan requirem that a :second surgical opinion be obtained for the following surgical proceaures in all non -emergency situations: 1. Cholecystectomy (excision of the gallbladder). 2. Hysterectomy (removal of uterus). Z. Knee surgery (any surgical procedure involving the knee). 4. Mastectomy (excision of the breast). 5. Prostatectomy (excision of the prostate gland). b. Spinal or vertebral surgery (any surgical procedure involving the spine or vertebra). Xf a second surgical opinion is not obtained, the Plan will only pay 5C% of the reasonaole fee for charges related to the surgery rather than the normal reimbursement. XI. HCSPITAL BILL SOLE-ALDIT BENEFIT As a result of hospital billing errors and overcharges. the Plan erx=rages employees to review all hospital bills. If an emloyee identifies a non --accounting error and the hospital corrects the overbilling, the Plan will provide a payment directly to the employee in the amount of fifty percent (50%) of the savings (the total dollar difference between the original bill and the revised bill). This benefit is limited to a maximum of $1,000. XII. PRE-EXISTING CONDITIONS A pre-efdsting condition is an injury, sickness or pregnancy, or any condition related to that injury, sickness or pregnancy, for which a participant i ived diagnosis, treatment, medical advice or incurred eacenses within ninety (90) days prior to the effective date of Coverage3. Benefits will be limited to $500 for w<per es incurred for or in connection with a pre-existing condition unless the expenses are incurred at the expiration of: 1. a ninety (90) day period while this Plan is in force, during which a participant has not received diagnosis, treatment, or medical i.cal advice and has not incurred expenses in correction with that injury, sickness, or pregnancy; or ATTACHMENT #1 Page 6 W FLORIDA MUNICIPAL HEALTH TRUST FUND SCHEDULE OF BENEFITS - Page Five 2. a one year period during which a participant is continuously covered. NONE: This clause applies to all employer grcxps of nine (9) or less participating employees. For employer groups with ten (10) or more participating employees, this clause applies to employees and their dependents only after the initial enrollment and effective date of this Plan, or those employees or dependants who were not previously covered by the employ- er's group health plan. This Schedule of Benefits is made a part of, and is subject to, they conditions and limitations set forth in the Plan of Benefits adopted by the Board of Trustees. HEALTH RATES: Employee Medical $137.77 Dependent Medical Family Total $401.85 MATERNITY IS INCLUDED • r� ATTACHMENT 01 Page 7 +z ` � 0 v?-Cty r LJ 0 • Florida Municipal Self -Insurers Florida League of Cities, Inc. Fund (Workers' Compensation) 201 West Park Avenue Post Office Box 1757 • Florida Municipal Liability a—&�I� Tallahassee, FL 32302-1757 Self -Insurers Program Telephone (904) 222-9684 (Tort Liability) Suncom 282-5010 �E � �� • Florida Municipal Health Trust Fund — soM W W _ _ _ = Florida League of Cities, Inc. • Florida Municipal Pension —� = = — Public Risk Services Division 174 West Comstock Avenue Trust Fund — Post Office Box 2026 • Florida Municipal Property Winter Park, FL 32790-2026 Telephone (407) 740-0210 Self -Insurers Program Suncom 348-6770 • First Municipal Loan Program GR-Q4LP_ DE„NTAL SCHEDULE OF BENEFITS FLORIDA MUNICIPAL HEALTH TRUST Flab AL QffiE BENF.EIT Lifetime Maximum Benefit - Unlimited Calendar Year Maximum Benefit - $1,000 per individual % MARy F] 9ENERAL _CARE ,$ERNICFS I. Examinations and recall services, Check-ups and cleaning of teeth 2. Palliative treatment 3. Endodontic treatment 4. Space maintainers 5. X-rays 6. Oral surgery 7. Periodontal treatment 8. Normal extraction of teeth 9. Silver and synthetic permanent fillings, crowns and jackets 10. Fixed bridges consisting of crowns or jackets 11. Dentures and removable bridges TIBLE $50 per individual per calendar year. Maximum two (2) per family. Plan pays 80% of first $1,250 of eligible eDq3enses per calendar year. Employee Dental $13.00 Dependent Dental $19,50 Family Dental $32.50 MTHODQNTIC CgRE BENEFIT Lifetime Maximum Benefit - $1,000 per individual. MMIARY..OF 0BM12MT 9 CARE I. Diagnostic procedures 2. Appliances for tooth guidance and control of harmful habits 3. Retention appliances 4. Comprehensive treatment with freed and removable appliances for correction of malocclusion in permanent, primary and mined dentition S. Orthodontic treatment must begin prior to attainment of age 19 for dependents. LIFETIME DEDUCTIBLE $50 per individual. QU Plan pays 50% of first $2,000 of eligible 6KAvm s per individual in their lifetime. Employee Dental $15.00 Dependant Dental Family Dental $37.50 This Schedule of Benefits is made a part of, and is subject to, the conditions and limitations set forth in the plan of Benefits adopted by the Board of Trustees. 100% PARTICIPIATION REWIRED