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Home My WebLink AboutCity of Tamarac Resolution R-2016-116Temp. Reso. 12867 October 10, 2016 Page 1 of 4 CITY OF TAMARAC, FLORIDA RESOLUTION NO. R-2016- 116 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 TO EXERCISE THE SECOND OF TWO (2) ONE (1) YEAR RENEWAL OPTIONS EFFECTIVE JANUARY 1, 2017 THROUGH DECEMBER 31, 2017, PROVIDING FOR ADMINISTRATIVE SERVICES FOR CLAIMS AND FLEXIBLE SPENDING PLANS AND THE EMPLOYEE ASSISTANCE PROGRAM AND TELEHEALTH CONNECTION 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 awarded a three (3) year contract with CIGNA with two (2) one year renewals, to provide Administrative Services for Claims and Flexible Spending Accounts, and an Employee Assistance Plan via Resolution R-2012-126 at its November 14, 2012 meeting, a copy of such resolution is on file with the City Clerk; and WHEREAS, the City desires to renew the contract with CIGNA to provide Administrative Services for Claims and Flexible Spending Accounts, and the Employee Assistance Program, and Telehealth Connection Program, and Temp. Reso. 12867 October 10, 2016 Page 2 of 4 WHEREAS, the City's Health Insurance Program design will remain substantially the same with respect to cost sharing, waiver program, and will include some plan adjustments, including an increase in premiums, co -pays, deductibles and annual out-of-pocket maximums, and certain modifications to the CIGNA program -wide prescription and specialty drug programs; 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, available funds exist in the appropriate Governmental Funds which are in the approved FY2017 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 and Telehealth as negotiated, and as amended and approved by the City Manager and the City Attorney effective January 1, 2017, and (2) that the Health Insurance Program with the changes as described in the Resolution and back-up documents are implemented effective January 1, 2017; and WHEREAS, the City Commission has deemed it to be in the best interest of the health, safety and welfare of citizens and residents of the City of Tamarac Temp. Reso. 12867 October 10, 2016 Page 3 of 4 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 "WHEREAS" clauses are hereby ratified and confirmed as being true and correct and are hereby made a specific part of this Resolution. All exhibits attached hereto are incorporated herein and made a specific part of this Resolution. SECTION 2: That the appropriate City officials are hereby authorized to renew the executed contract documents with CIGNA, attached as Exhibit 1, for the provision of Administrative Services for Claims and Flexible Spending Plans, the Employee Assistance Program, and Telehealth Connection Program. SECTION 3: That the City's Health Insurance Program design will remain substantially the same with some plan adjustments, including an increase in premiums, co -pays, deductibles and annual out-of-pocket maximums, and certain modifications to the prescription and specialty drug programs. 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 some later time after retirement and separation, subject to open enrollment or qualifying life change. Temp. Reso. 12867 October 10, 2016 Page 4 of 4 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 8: This Resolution shall become effective immediately upon adoption. PASSED, ADOPTED AND APPROVED this v`6 day of Zvull 2016. HARRY DRESSLER MAYOR ATTEST: PATRICIA TEUFELOCIVIC CITY CLERK RECORD OF COMMISSION VOTE: MAYOR DRESSLER DIST 1: COMM. BUSHNELL DIST 2: COMM. GOMEZ DIST 3: VICE MAYOR GLASSER DIST 4: COMM. PLACKO I HEREBY CERTIFY THAT I HAVE APPROVED THIS RESOLUTION AS TO FORM W'v) SAWUEL S. GOR CITY ATTORNEY 1 1 n EXHIBIT 1 _Yfr_ City of Tamarac Current Plan Renewal - ASO 11112017 ASO Fees and Stop Loss Rates ASO Fees - Current Medical Vision Total Administrative Service Fees $ 17.88 $ 73,594 Network Access Fees $ 21.10 $ 86,848 Total PEPM ASO Fee $ 38.98 $ 0.37 Employees 343 Current Annual Administrative & Access Fees $ 160,442 $ $ 160,442 Network Access Fees $ 21.10 $ 86,848 0.0% Total PEPM ASO Fee $ 38.98 $ 0.37 Employees 343 - Proposed Annual Administrative & Access Fees $ 160,442 $ - $ 160,442 0.0% Stop Loss lindividual Stop Loss Current Medical Total $ 106.17 $ 436,996 % Change Proposed $ 106.17 $ 436,996 Lives 343 Proposed Annual Individual Stop Loss $ 436,996 $ 436,996 0.0% * Pooling Point $ 150,000 • Contract Type Paid Rx Accumulation Y Commissions (Net or %) Net Aggregate Stop Loss Medical Total % Change Current $ 10.76 $ 44,288 Proposed $ 10.76 $ 44,288 Lives 343 Proposed Annual Aggregate Stop Loss $ 44,288 $ 44,288 0.0% " Pooling Point $ 150,000 ' Corridor Amount 118% Contract Type Paid • Minimum Attachment Percentage 100% Rx Accumulation Y Commissions (Net or %) Net Current Total Annual Stop Loss $ 481,284 Proposed Total Annual Stop Loss $ 481,2841 0.0% l Date Printed: 10/1112016 1 ��Cigna, City of Tamarac Current Plan Renewal - ASO 1/1/2017 Total Adjusted Annual Calms x Corridor • E 4,494,875 1 S 259,188 ti $90.163 11 % S 211,754 118% 5 82,229 118% 118% 118% Projected Claims with Conidor $5.303,953 Minimum Attachment Percentage 100% Protected Illustrative Minimum Attachment Pant S5.303.953 Projected Lives 343 26 23 294 Projected MomhN Deductible Factors E 980.26 S 341.00 S 905.33 $ 351.56 $949.89 $ 338.32 Pro acted Combined M 1 321.26 S 1256.89 1 288.21 Current Minimum Attachment Point S 4.835,977 Current Caddo, 118% Current Monthly Deductible Factor $1.240.47 $ 1 167.00 $1.195.16 DFIn 6.51 % 7.70 % 7. % The minimum attachment point for the current contract year is the greater of (1) the sum of each mooth's number of employees multiplied by the Monthly Deductible Factors) a (2) Me Minimum Attachment Point. For illustrative purposes, the Minimum Attachment PoK included in the total claim spend with cornda for the current year, has been calculated with the current months enrollment times the current Monthly Deduotbe Factor($). raw Prima: tat nf$01$ TR 12867 ATTACHMENT A City of Tamarac 2017 Proposed UUNA heann benent bummar HMO/OAPIN POS/OAP1 PP0/0AP2 Benefits Highlights In Network Only In Network Out of Network In Network i Out of Network Deductible Single $300 $350 $1,000 $600 $2,000 Family $600 $700 $2,000 $1,200 $4,000 Coinsurance $0 0% 20% 10% 1 30% Out -of -Pocket Limit _ Single $2,000 $2,500 $4,500 $2 500 $4,500 _ Family $4,000 $5,000 $9,000 $5 000 $9,000 Lifetime Maximum Unlimited Unlimited _ Unlimited Physician Services Open Access Open Access PCP Office Visits _ $25 $25 after deductible $30 30% after deductible Specialist Visits S p $40 $40 20 /0 after deductible $40 after deductible Preventive Care 3 Well Child Care $0 $0 20% after deductible $0 30% i after deductible Routine Adult Physical $0 $0 20% after deductible $0 30% after deductible Exam i 20% $0 30% Well Woman/GYN Exam $0 $0 '• after deductible i after deductible _ Hospital Services (includes Mental Health &':Substance Abuse) _ ... c _ $400 $500 $500 & 20% _ $500 & 10% $900 & 30% Inpatient per admission per admission per admission deductible per admission after deductible per admission after deductible after deductible after deductible _ after _ $150 $250 20% $250 & 10% 30% Outpatient Surgery per visit p after deductible per visit after deductible I after deductible per visit after deductible - - after deductible i - Emergency Services i Emergency Room $300 $350 $350 $350 -- + $350 - - - Urgent Care Center $75 $75 $75 $75 $75 Convenience Care Clinic $25 $25 $25 $25 $25 Telehealth $25 $25 n/a $25 n/a Other Health Care - ! Facilities/Services Advanced Radiology Imaging $50 after deductible $50 after deductible 20% after deductible $50 & 10% after deductible 30% after deductible Vision Benefit $25 $25 Up to $45 $25 Up to $45 Exam every 12 months every 12 months reimbursement every 12 months reimbursement Prescription Drugs Retail - 30 day supply Generic $10 $10 $10 Preferred Brand $35 $35 $35 Non -Preferred Brand $65 $65 $65 Mail Order - 90 day 2.5x copay 2.5x copay 2.5x copay supply 012412016 PROPOSED: THIS BENEFIT SUMMARY IS FOR ILLUSTRATION PURPOSES ONLY.