HomeMy WebLinkAboutCity of Tamarac Resolution R-2022-125 Agreement Renewal with Cigna for Claims, Flexible Spending Plans, EAP, MotivateMe, Voluntary Work-SiteTemp. Reso. 13849
October 26, 2022
Page 1 of 4
CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R-2022 - IA-5
A RESOLUTION OF THE CITY COMMISSION OF
THE CITY OF TAMARAC, FLORIDA, AUTHORIZING
THE APPROPRIATE CITY OFFICIALS TO RENEW
AND EXECUTE AN AGREEMENT WITH CIGNA,
PROVIDING FOR ADMINISTRATIVE SERVICES
FOR CLAIMS AND FLEXIBLE SPENDING PLANS
AND THE EMPLOYEE ASSISTANCE PROGRAM,
THE TELEHEALTH CONNECTION PROGRAM, THE
MOTIVATEME VALUE PROGRAM, THE
VOLUNTARY WORK -SITE BENEFITS PROGRAM,
AND TO MAKE CERTAIN MODIFICATIONS TO THE
HEALTH INSURANCE PROGRAM FOR
EMPLOYEES AND RETIREES; PROVIDING FOR
CONFLICTS; PROVIDING FOR SEVERABILITY;
AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, the City's health insurance was re -structured as a partially self -
insured program effective January 1, 2013; and
WHEREAS, the City Commission approved the renewal of an agreement with
CIGNA to provide Administrative Services for Claims and Flexible Spending
Accounts, and Employee Assistance Plan, and Telehealth Connection Program via
Resolution R-2021-126 at its October 27, 2021 meeting, a copy of such resolution is
on file with the City Clerk; and
WHEREAS, in the spring of 2022, the City's benefit consultant Lockton
Companies reviewed the City's CIGNA agreement and marketed the Voluntary
Work -site Plan for Plan Year 2022; and
WHEREAS, the City desires to renew their contract with Cigna to provide
Administrative Services for Claims and Flexible Spending Accounts, and the
Temp. Reso. 13849
October 26, 2022
Page 2 of 4
Employee Assistance Program, Telehealth Connection Program, MotivateMe Value
Program, and the Voluntary Work -site Benefits Program, and
WHEREAS, the City's Health Insurance Program design will remain
substantially the same with respect to cost sharing, the waiver program, and
premiums; and
WHEREAS, that conditions under which retirees may continue in the City's
health plan until Medicare eligibility, include that they must continue to pay the full
health insurance premium, and that the retiree's ability to opt into the City's health
insurance plan as a retiree may occur only once either (1) upon retirement at
separation of service or (2) at some later time after retirement and separation,
subject to open enrollment or qualifying life change; and
WHEREAS, that eligibility for health insurance and benefit coverage was
extended to employees and their registered domestic partners and their dependents
in a registered Domestic Partnership, and premium rates would be the same as the
rates an employee would pay to add a spouse and/or dependent children to their
coverage, with applicable resulting tax implications; and
WHEREAS, available funds exist in the appropriate Governmental Funds
which are in the approved FY2023 Budget to fund the City's Health Insurance
Program; and
WHEREAS, it is the recommendation of the City Manager, the Director of
Human Resources, and the Director of Financial Services that the City (1) renew the
executed agreement with Cigna for the provision of Administrative Services for
Claims and Flexible Spending Plans, and the Employee Assistance Program,
Telehealth Connection Program, the MotivateMe Value Program, and the Voluntary
Work -site Benefits Program as negotiated, and as amended and approved by the
Temp. Reso. 13849
October 26, 2022
Page 3 of 4
City Manager and the City Attorney effective January 1, 2023; and (2) that the Health
Insurance Program with the changes as described in the Resolution and back-up
documents are implemented effective January 1, 2023; 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 renew and execute such Agreements and approve the changes to the
Health Insurance Program.
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.
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 City's Health Insurance Program design will remain
substantially the same with the addition of the Voluntary Work -life Benefits Program.
SECTION 4: That conditions under which retirees may continue in the City's
health plan include that they must continue to pay the full health insurance premium,
and that the retiree's ability to opt into the City's health insurance plan as a retiree
may occur only once either (1) upon retirement at separation of service or (2) at
Temp. Reso. 13849
October 26, 2022
Page 4 of 4
some later time after retirement and separation, subject to open enrollment or
qualifying life change.
SECTION 5: That all resolutions or parts of resolutions in conflict herewith
are hereby repealed to the extent of such conflict.
SECTION 6: 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.
SECTION 7: This Resolution shall become effective immediately upon
adoption.
PASSED, ADOPTED AND APPROVED this aIOTLday of CC -OD 3I571Z— 2022.
ATTEST:
� z
KIMBERLY ILLON, CMC
CITY CLERK
MICHELLE J. GO EZ
MAYOR
RECORD OF COMMISSION VOTE:
MAYOR GOMEZ: �CS
DIST 1: COMM. BOLTONS
DIST 2: V/M GELIN
DIST 3: COMM. VILLALOBOS yam_
DIST 4: COMM. PLACKO
APPROVED S TO FORM AND LEGAL SUFFICIENCY FOR THE USE AND RELIANCE
OF THE CITAOF TAMARACI ONLY.
PROPOSED HEALTH PLAN DESIGN SUMMARY FOR PY 2023 TR13849
EXHIBIT A
Benel'it Hi-hlights
Deductible
Open Access HN10
In Network Only
High Deductible
In Network
Health Plan
Out of Network
Individual/Family
$500/$1,000
$1,500/$3,000
$3,000/$6,000
Coinsurance
$0
10%
30%
Out -of -Pocket Limit
In Network Only
In Network
Out of Network
Individual/Family
$3,000/$6,000
$3,000/$6,000
$6,000/$12,000
Lifetime Maximum
Unlimited
Physician Services
In Network Only
In Network
Out of Network
Primary Care Office Visits
$25
$0
30%
after deductible
Specialist Office Visits
$40
Well Child Care Office Visits
$0
Routine Adult Physical or
Well Woman Exam
$0
Inpatient
$400/admission
after deductible
10%
after deductible
Outpatient Surgery
$150 per visit
afterdeductible
10%
after deductible
Emergency Services
Network Only
In Network
Out of Network
Emergency Room
$300
10%
10%
Urgent Care Center
$50
10%
30%
Convenience Care Clinic
$25
$0
30%
elehealth
$25
$0
N/A
Prescription Drugs (30-Day Supply)
Network Only
In Network
Out of Network
Generic
$10
N/A
Preferred Brand
$35
Non -Preferred Brand
$65
Mail Order - 90-day supply
2.5x copay
OPen Access HMO:
EE Only
Current / Proposed
$707.30
I ER Share
$620.30
ER %
87.70%
EE Share
$87.00
EE %
12.30%
EE+Spouse $1,811.86
$1,351.65
74.60%
$460.21
25.40%
EE + Children $1,570.70
$1,171.74
74.60%
$398.96
25.40%
Family $1,973.24
1 $1,472.04
1 74.60%
1 $501.20
25.40%
EE Only $608.15
$561.93 92.40%
7.60%
$46.22
EE + Spouse
$1,557.87
$1,246.30
80.00%
$311.57
20.00%
EE+Children
$1,350.51
$1,080.41
80.00%
$270.10
20.00%
Family
$1,696.62
$1,357.30
80.00%
$339.32
20.00%
l% _Cigna.
City of Tamarac
Current Plan Renewal - ASO
11112023
ASO Fees and Stop Loss Rates
TR 13849
EXHIBIT B
ASO Fees - Cuffent
OAM
HRA
HDHP
Total
Administrative Service Fees
$
21.82
$
21.82
$
21.82 ####rY###
Network Access Fees
$
18.97
$
18.97
$
18.97 $ 88,552
HRA Fee
$
-
$
4.64
$
- $ 6,069
Total PEPM ASO Fee
$
40.79
$
45.43
$
40.79
Employees
276
109
4
Current Annual Administrative & Access Fees
$
135,096
$
59,422 $
1,958 # ###
•
••
From r12/3112023
Administrative Service Fees
S
21.82
$
21.82
$ 21.82 ######aY#
0.09/o
Network Access Fees
$
18.97
$
18.97
$ 18.97 $ 88.552
0.0%
HRA Fee
$
-
$
4.64
$ - $ 6,069
0.0
Total PEPM ASO Fee
$
40.79
$
45.43
$ 40.79
Employees
276
109
4
Proposed Annual Administrative & Access Fees
$
135,096
$
59,422 $
1,958 #####
0.0%
Stop Loss
rridividual .. Loss
••
Current
$ 103.40
$
103.40
$ 103.40
$ 482,671
Proposed
$ 118 09
$
118.09
$ 118.09
$ 551,244
Lives
276
109
4
Proposed Annual Individual Stop Loss
$ 391,114
$
154,462 $
5,668
ice##
14.2%
' Pooling Point
$ 250,000
'Contract Type
Incurred in 12
' Terminal Liabfky Run -Out Months
24
' Rx Accumulation
Y
' Commissions (Net or %)
Net
Aggregate •. Loss
••HE)HP
s
Total
% Change
Current
$ 16.57
$
16-57
$ 16.57
$ 77,349
Proposed
$ 1736
$
17.36
$ 17.36
$ 81,036
Lives
276
109
4
Proposed Annual Aggregate Stop Loss
$ 57,496
$
22,707 $
833
$ 81,036
4.8 %
'Pooling Point
$ 250,000
' Corridor Amount
118 %
'Contract Type
Paid in 12
' Terminal Liability Run -Out Months
0
`Minimum Attachment Percentage
100%
' Rx Accumulation
Y
' Commissions (Net or %)
Net
Current Total Annual Stop Loss
�#
Proposed Total Annual Stop Loss
12.9%
Date Printed: TO' 12/2022