HomeMy WebLinkAboutCity of Tamarac Resolution R-2022-123 Agreement Renewal with Cigna for Dental InsuranceTemp. Reso. 13857
October 26, 2022
Page 1 of 4
CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R-2022— ]off)
A RESOLUTION OF THE CITY COMMISSION OF THE
CITY OF TAMARAC, FLORIDA, APPROVING THE
RENEWAL OF THE AGREEMENT WITH CIGNA,
AUTHORIZING THE APPROPRIATE CITY OFFICIALS
TO EXECUTE THE AGREEMENT WITH CIGNA
PROVIDING FOR A DENTAL INSURANCE
PROGRAM, AND TO MAKE CERTAIN
MODIFICATIONS TO THE PROGRAM FOR
EMPLOYEES AND RETIREES; PROVIDING FOR THE
CONTINUATION OF THE EXISTING COST
ALLOCATION OF THE DENTAL INSURANCE
PREMIUM BETWEEN THE CITY AND EMPLOYEES;
PROVIDING FOR CONFLICTS; PROVIDING FOR
SEVERABILITY; AND PROVIDING FOR AN
EFFECTIVE DATE.
WHEREAS, the City's dental insurance was awarded to CIGNA effective
January 1, 2018 via Resolution R-2018-144 at its October 24, 2018 meeting, a copy
of such resolution is on file with the City Clerk; and
WHEREAS, the City's dental insurance was renewed with CIGNA effective
January 1, 2021 via Resolution R-2020-113 at its October 28, 2020 meeting, a copy
of such resolution is on file with the City Clerk; and
WHEREAS, the City's contract with CIGNA is scheduled to expire on
December 31, 2022; and
WHEREAS, in the spring of 2022, the City's Human Resources staff worked
with the City's benefit consultant Lockton Companies to negotiate a renewal for
Dental Insurance with CIGNA; and
WHEREAS, CIGNA has guaranteed the renewal rate for a period of one (1)
year effective January 1, 2023 with no changes to the Dental Insurance plan designs
or rates; and
Temp. Reso. 13857
October 26, 2022
Page 2 of 4
WHEREAS, after evaluation of the renewal proposal from CIGNA, the Human
Resources staff, determined that CIGNA continues to provide the most
comprehensive dental insurance program; and
WHEREAS, it is the recommendation of the City Manager and the Director of
Human Resources that the City renew the dental insurance program provided by
CIGNA, subject to any revisions consistent with the benefit plan as may be
negotiated by and between City staff and CIGNA and as approved by the City
Manager and the City Attorney for one (1) plan year effective January 1, 2023; and
WHEREAS, this renewal will result in no premium increase from the 2022
premiums, guaranteed for one (1) year as described in Exhibit A, attached hereto
and made a part hereof; and
WHEREAS, available funds exist in the appropriate Governmental Funds
which are in the approved FY2023 Budget; and
WHEREAS, the City Commission of the City of Tamarac, Florida deems it to
be in the best interest of the business owners, residents, and visitors of the City of
Tamarac to execute the dental insurance contract with CIGNA for dental insurance
for City of Tamarac employees, as outlined in Exhibit A, attached hereto and made
a part hereof, subject to any revisions consistent with the benefit plan as may be
negotiated by and between City staff and CIGNA and as approved by the City
Manager and the City Attorney effective January 1, 2023 for a one (1) year period.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
THE CITY OF TAMARAC, FLORIDA:
SECTION 1: That the foregoing recitals are true and correct and
hereby adopted as the legislative and administrative findings of the City
Commission; all exhibits attached hereto are incorporated herein and made a
specific part of this Resolution.
Temp. Reso. 13857
October 26, 2022
Page 3 of 4
SECTION 2: The Agreement between the City and CIGNA attached
to this Resolution as Exhibit "A", is approved and the appropriate City Officials are
authorized to execute, extend, or renew the Agreement and expend funds in an
amount not to exceed budgeted funds, or as may be amended by City
Commission.
SECTION 3: That the appropriate City officials are hereby authorized
to continue the existing cost allocation of the dental insurance premium between
the City and employees.
SECTION 4: That all resolutions or parts of resolutions in conflict
herewith are hereby repealed to the extent of such conflict.
SECTION 5: That if any clause, section, or other part or application
of this Resolution is held by any court of competent jurisdiction to be
unconstitutional or invalid, in part or application, it shall not affect the validity of the
remaining portions or applications of this Resolution.
"The remainder of this page is left blank intentionally"
Temp. Reso. 13857
October 26, 2022
Page 4 of 4
SECTION 6: This Resolution shall become effective immediately
upon adoption.
PASSED, ADOPTED AND APPROVED this o26 day of C)C7b(3G�Q— 2022.
ATTEST:
KIMBERLY, DILLON, CMC
CITY CLERK
ga�a 1Z
MICHELLE J. GOMEZ
MAYOR
RECORD OF COMMISSION VOTE:
MAYOR GOMEZ: jc—�-s
DIST 1: COMM. BOLTON
DIST 2: V/M GELIN 91—ss6p T
DIST 3: COMM. VILLALOBOS
DIST 4: COMM. PLACKO
APPROVED AS TO FORM AND LEGAL SUFFICIENCY FOR THE USE AND RELIANCE
OF THE CITY OF TAMARAC dINLY.
JOHN R. ffVIN, JR.
CITY ATTORNEY
TR 13857
EXHIBIT A
Cigna Healthcare Financial Exhibit for:
CITY OF TAMARAC
Effective Date: January 01, 2023
PAGE 1 OF 3
Cigna.
This is a summary of benefits for your dental plan.
All deductibles, plan maximums, and service specific maximums (dollar and occurrence) cross accumulate between in and out of network.
Your DPPO plan allows you to see any licensed dentist, but using an in -network dentist may minimize your out-of-pocket expenses.
Plan Design I Total Cigna DPPO I Out -of -Network
Calendar Year Maximum
(Class I, 11, III Expenses) $2000. Class I Applies $2000, Class I Applies
Calendar Year Deductible
Per Individual
$50
$100
Per Family
$150
$300
Class I Expenses - Preventive & Diagnostic Care
Oral Exams
100%, No Deductible
80%, No Deductible
Cleanings
Routine X-rays
Fluoride Application
Sealants
Space Maintainers (limited to non -orthodontic treatment)
Non -Routine X-rays
Class II Expenses - Basic Restorative Care
Emergency Care to Relieve Pain
80%, After Deductible
50%, After Deductible
Fillings
Oral Surgery - Simple Extractions
Oral Surgery - All Except Simple Extraction
Surgical Extraction of Impacted Teeth
Anesthetics
Minor Periodontics
Major Periodontics
Root Canal Therapy / Endodontics
Relines, Rebases, and Adjustments
Repairs - Dentures
Brush Biopsy
Class III Expenses - Major Restorative Care
Repairs - Bridges, Crowns, and Inlays
60%, After Deductible
50%, After Deductible
Crowns/Inlays/Onlays
Stainless Steel/Resin Crowns
Dentures
Bridges
Class IV Expenses - Orthodontia
Coverage for Eligible Children and Adults
Lifetime Maximum
50%, No Ortho Deductible
$1000
50%, No Ortho Deductible
$1000
Based on Maximum Allowable Charge
Dental Plan Reimbursement Levels Based on Contracted Fees Standard schedule (for location of
service rendered).
Additional Member Responsibility in
Yes, the difference between the
None
member's dentist's billed charges and
excess Of Coinsurance
the dental Ian reimbursement level"-
Student/Dependent Age 26126
P0010 Network. Prepared by Underwriting
Cigna Healthcare Financial Exhibit for:
CITY OF TAMARAC
TR 13857
EXHIBIT A yy�
PAGE 2 OF 3
Cigna
Effective Date: January 01, 2023
Cigna Dental PPO / Indemnity Exclusions and Limitations:
Procedure
Exclusions & Limitations
Exams
Two per calendar year
Prophylaxis (cleanings)
Two per calendar year
Fluoride
1 per calendar year for people under 19
X-Rays (routine)
Bitewings: 2 per calendar year
X-Rays (non -routine)
Full mouth: 1 every 3 calendar years. Parwrex: 1 every 3 calendar years
Cone Beams
Not covered
Model
Payable only when in conjunction with Ortho workup
Minor Perio (non -surgical)
Various limitations depending on the service
Perio Surgery
Various limitations depending on the service
Crowns and Inlays
Replacement every 5 years
Prosthesis over Implants
1 per 5 years if unserviceable and cannot be repaired. Benefits are based on the amount
payable for non -precious metals. No porcelain or whiteltooth colored material on molar crowns or
bridges.
Bridges
Replacement every 5 years
Dentures and Partials
Replacement every 5 years
Relines, Rebases
Covered if more than 6 months after installation
Adjustments
Covered if more than 6 months after installation
Repairs - Bridges
Reviewed if more than once
Repairs - Dentures
Reviewed if more than once
Sealants
Limited to posterior tooth_ One treatment per tooth every three years up to age 14
Space Maintainers
Limited to non -Orthodontic treatment No frequency limit for participants under age 19.
Alternate Benefit
When more than one covered Dental Service could provide suitable treatment based on common dental
standards, Cigna HealthCare will determine the covered Dental Service on which payment will be based and the expenses
that will be included as Covered Expenses.
Missing Tooth Provision The amount payable is 50 % of the amount otherwise payable until insured for a specified time period; thereafter, considered a Class III expense
Late Entrant Limit 50 % coverage on Class III and IV (if applicable) for 12 months
Pre -Treatment Review Available on a voluntary basis when extensive work in excess of $200 is proposed
Benefit Exclusions:
Services performed primarily for cosmetic reasons
` Replacement of a lost or stolen appliance
Replacement of a bridge or denture within five years following the date of its original installation
Replacement of a bridge or denture which can be made useable according to accepted dental standards
` Procedures, appliances or restorations, other than full dentures, whose main purpose is to change vertical dimension,
diagnose or treat conditions of TMJ, stabilize periodontally involved teeth, or restore occlusion
Veneers of porcelain or acrylic materials on crowns or pontics on or replacing the upper and lower first, second and third molars
Bite registrations; precision or semi -precision attachments; splinting; Surgical implant of any type
Instruction for plaque control, oral hygiene and diet
Dental services that do not meet common dental standards
Services that are deemed to be medical services
Services and supplies received from a hospital
` Charges which the person is not legally required to pay
` Charges made by a hospital which performs services for the U.S. Government if the charges are directly related to a condition
connected to a military service
Experimental or investigational procedures and treatments
Any injury resulting from, or in the course of, any employment for wage or profit
` Any sickness covered under any workers' compensation or sinnlar law
Charges in excess of the reasonable and customary allowances
' To the extent that payment is unlawful where the person resides when the expenses are incurred;
' Procedures performed by a Dentist who is a member of the covered persons family (covered persons family is limited to a spouse,
siblings, parents, children, grandparents, and the spouses siblings and parents);
For charges which would not have been made if the person had no insurance; For charges for unnecessary care, treatment or surgery;
To the extent that you or any of your Dependents is in any way paid or entitled to payment for those expenses by or through a public
program, other Ulan Medicaid;
` To the extent that benefits are paid or payable for Vase expenses under the mandatory part of any auto insurance policy written to
comply with a'no-faulr insurance law or an uninsured motorist insurance law. Cigna HealthCare will take
into account arty adjustment option chosen under such part by you or arty one of your Dependents.
In addition, these benefits will be reduced so that the total payment will not be more than 100% of Ire charge made for the Dental
Service if benefits are provided for that service under this plan and any medical expense plan or prepaid treatment program sponsored
or made available by your Employer_
In Texas, the insured dental product offered by CGLIC and CHLIC is referred to as the Cigna Dental Choice Plan, and this plan uldizes the national Cigna Dental PPO network.
—Charges are based upon an independent third party organization that is the industry standard. Percentile data is based upon the thirdearly organization's aggregated industrywide claims data
This benefit summary hightighls some of the berefts available under the proposed plan. A complete description regarding the terns of
coverage, exclusions and lirmtations, including legislated benefits, will be provided in your insurance certificate orplan description.
Benefits are insured and/or administered by Cigna Health Care.
Did you know that most of Cgna's dental plans include the Cigna Dental Oral Health Integration Program? This program was designed to address research that supports the association
of oral health to overall health and provides reimbursement of copays or coinsurance for customers with qualifying medical conditions for program eligible procedures. Additionally,
registered program members can access articles on behavioral conditions that impact oral health.
Cigna is a registered service mark, and the "Tree of Life' logo is a service mark, of Ggna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries.
Ad products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance
Company, Cigna Health and Life Insurance Company, Cigna HealthCare of Connecticut. Inc., and Cigna Dental Health, Inc. and its subsidiaries.
Prepared by Underwriting
Cigna DPPO Network (P0010)
Cigna Healthcare Financial Exhibit for:
CITY OF TAMARAC
Effective Date: January 01, 2023
Plan Cost Summary - Rates
TR 13857
EXHIBIT A
PAGE 3 OF 3
Cigna.
Total Enrollment
Current
Renewal
Cigna Rates
PPO
Plan 1
Monthly Total
Employee
Emp + Dep
Emp + Family
68
27
41
$40.11
$80.91
$135.92
$40.11
$80.91
$135.92
1 $10,484.77
$10,484.77
RenewalChangej
0.00%
Total Enrollment
Current
Renewal
Cigna Rates
Dental Care Access
Employee
86
$18.26
$18.26
P41VX
Emp + Dep
50
$31.97
$31.97
Emp + Family
77
$50.23
$50.23
Monthly Total
$7,036.57
$7,036.57
Renewal Chan a
0.0000
Account #:3336651 10/111202212W PM