HomeMy WebLinkAboutCity of Tamarac Resolution R-2004-243Temp. Reso. #10572 -October 15, 2004
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CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R-2004-.2L{,.3
A RESOLUTION OF THE CITY COMMISSION OF THE
CITY OF TAMARAC, FLORIDA, AUTHORIZING THE
APPROPRIATE CITY OFFICIALS TO RENEW THE
COVERAGE FOR THE CITY'S HEALTH INSURANCE
PROGRAM WITH AETNA US HEALTHCARE FOR THE
PLAN YEAR EFFECTIVE JANUARY 1, 2005; PROVIDING
FOR PREMIUM RATES CHANGES; PROVIDING FOR
THE CONTINUATION OF THE CURRENT COST
ALLOCATION OF THE HEALTH INSURANCE PREMIUM
BETWEEN THE CITY AND EMPLOYEES; PROVIDING
FOR A WAIVER REIMBURSEMENT MAXIMUM;
PROVIDING FOR CONFLICTS; PROVIDING FOR
SEVERABILITY; AND PROVIDING FOR AN EFFECTIVE
DATE.
WHEREAS, the City's contract with Aetna US Healthcare for health insurance
coverage for employees expires on December 31, 2004; and
WHEREAS, Aetna US Healthcare provided premium rates for the renewal of the
City's health insurance plan for 2005; and
WHEREAS, the City has reviewed our experience with Aetna, and determined
that employees were satisfied with Aetna as its insurance provider; and
WHEREAS, the City reviewed the City's plan design and determined that the
current plan design is appropriate and no plan design changes should be made for
2005; and
WHEREAS, City staff has worked with representatives of Aetna U.S Healthcare
to negotiate the most comprehensive and cost effective health plan for the City's
employees and their dependents; and
Temp. Reso. #10572 -October 15, 2004
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WHEREAS, as a result of these negotiations, our overall premium increase is
6.6%. (See Exhibits A, B and C.)
WHEREAS, health insurance rate increases were anticipated and were budgeted
accordingly in the FY 2005 Budget; and
WHEREAS, the City will continue to pay the premium for HMO single coverage in
total, and maintain the current cost allocation on an 80/20 ratio between the City and the
employee for all other coverages so that both the City and the employee bear a portion
of the premium increase; and
WHEREAS, a waiver reimbursement maximum will allow employees who elect to
purchase insurance through their spouse's employer or otherwise independently from
the City to be reimbursed up to a maximum amount equal to 100% of the single HMO
rate and 80% of the family HMO rate for the plan year beginning January 1, 2005; and
WHEREAS, it is the recommendation of the Director of Human Resources and
the City Manager that the City of Tamarac renew the coverage with Aetna US
Healthcare for health insurance for City of Tamarac employees as described in Exhibits
A, B and C subject to any revisions consistent with the benefit plan as negotiated by
and between City staff and Aetna US Healthcare and approved by the City Manager
and the City Attorney effective January 1, 2005; and
WHEREAS, the City Commission of the City of Tamarac, Florida deems it to be
in the best interest of the citizens and residents of the City of Tamarac to renew the
coverage with Aetna US Healthcare for health insurance for City of Tamarac employees
as outlined in Exhibits A, B and C subject to any revisions consistent with the benefit
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Temp. Reso. #10572 -October 15, 2004
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plan as negotiated by and between City staff and Aetna US Healthcare and approved
by the City Manager and the City Attorney effective January 1, 2005.
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.
SECTION 2: That the appropriate City officials are hereby authorized to
renew the coverage with Aetna US Healthcare for health insurance for City of Tamarac
employees as outlined in Exhibits A, B and C subject to any revisions consistent with
the benefit plan as negotiated by and between City staff and Aetna US Healthcare and
approved by the City Manager and the City Attorney effective January 1, 2005.
SECTION 3: That the appropriate City officials hereby authorize _
continued payment of the total cost of the premium for HMO single coverage and
maintain the current cost allocation of the health insurance premium on an 80/20 ratio
between the City and the employee for all other coverage.
SECTION 4: That the appropriate City officials hereby authorize a waiver
reimbursement maximum, to allow employees who elect to purchase insurance
through their spouse's employer or otherwise independently from the City to be
reimbursed up to a maximum amount equal to 100% of the single HMO rate and 80%
of the family HMO rate for the plan year beginning January 1, 2005.
SECTION 5: That all resolutions or parts of resolutions in conflict
herewith are hereby repealed to the extent of such conflict.
Temp. Reso. #10572 -October 15, 2004
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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 27t" day of October, 2004.
JOE SCHREIBER
MAYOR
ATTEST:
RECORD OF COMMISS ON VOTE:
MARION SW NSON, CMC MAYOR SCHREIBER
CITY CLERK DIST 1: COMM. PORTN
DIST 2: COMM. FLANSBAUM-TALABISCO
DIST 3: V/M SULTANOF
DIST 4: COMM. ROBERTS
I HEREBY CERTIFY that
I have approved this
RESOLUTION as to form.
MITCHELL S. 19
CITY ATTORN
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�Aetna
September 16, 2004
Maria Swanson
City of Tamarac
7525 Pine Island Road
Tamarac, FI. 33321
Re: Medical Renewal
Dear Maria:
EXHIBIT A
Joy Fenton
Account Manager
8201 Peters Road,
Plantation, Florida 33324
Tel 954-382-4292
Fax 954-3882-8200 or 954-382-8104
Our underwriting department has completed the financial analysis of your group's Medical and Dental
Insurance in connection with the 1/1/05 renewal period.
The following factors are among those taken into consideration in determining your premium rates for the
coming plan year:
• Your benefit plan design
• Changes in the size of your group and the ages of the group members
• Changes in medical trend
• Experience of your group
Based on this analysis we have determined the future costs of your health insurance coverage. The
resulting changes are displayed on your enclosed rate sheets.
Benefit plan design is an integral part of controlling costs and utilization. Aetna, Inc. has a full portfolio of
products and benefit options designed to help control future health care costs. As your Account Manager, I
will be pleased to consult with both you and your broker to evaluate your current benefit program.
Thank you for your business and it's been our pleasure to provide healthcare benefits to your employees
and their covered dependents. We look forward to continue doing business with you.
6y P. Fenton
Account Manager
EXHIBIT B
Aetna Inc.
Additional Financial Information
City of Tamarac PH Number: 809520
Effective January 1, 2005 Group Number: 264234
The quotation presented in this package is based on the assumptions outlined below. We reserve the right to add
charges, make adjustments to the charges shown and make other adjustments to the quotation if there are
deviations from these assumptions. If additional information related to this quotation is made available to Aetna at
a later date, we reserve the right to revise this quotation based upon analysis of that information. We reserve the
right to withdraw any portion of this quotation that relates to new plans or extension of existing plans to new
locations. We have made every effort to include information in a manner that reflects existing and expected
business practices for the policy period that you have chosen. However, nearly all of the matters addressed in
this rating are dynamic and subject to change before or after the effective date.
Prior to finalizing rates and open enrollment occurring, City of Tamarac will provide Aetna with full disclosure of
open enrollment materials, including employee contribution rates for all plan options, eligibility definitions for all
plans (retiree, part-time employees), and other carrier plan designs for all sites where our insured product is
offered.
The quoted rates are valid for a twelve-month period commencing January 1, 2005. Where required oy state law,
a change in the final filed and approved premium rates may result in an increase or decrease to the quoted rates.
Rates may also be changed due to a change in the factors bearing on the risk we assume:
1. Employer contributes at least 50% of the total cost at each rate tier. In addition, where Aetna is offered as an
option, the contribution strategy does not favor other health product offerings over the Aetna plans. The
monthly employee contribution for the Aetna HMO versus the cost of other plan offerings in the same location
is not greater than $20 for a single rate, or $60 for a family rate. Failure to meet these requirements may
result in termination or non -renewal.
2. At least 75% of eligible employees participate in the employer's plan, or at least 50% when excluding those
providing proof of enrollment in a spouse's plan. Failure to meet this requirement may result in termination or
non -renewal. If fewer than five employees enroll in the Aetna plan in any one site, we may charge an
additional administrative fee.
3. The demographic and/or geographic mix of the enrolled group in any site with at least 100 enrolled
subscribers does not change during the term in a way that in our discretion would increase the per capita
premium by more than 5% versus that assumed when developing final rates.
4. The plan of benefits will be extended to all groups included in our current eligibility files. Our rates assume
that coverage will not be extended to any additional groups of employees without additional information and
underwriting approval and that the total groups of employees will not increase or decrease by more than 10%
in any site with at least 100 enrolled subscribers.
5. Aetna plan designs cannot be significantly different from any other plan offering if the differences have the
potential to create for adverse selection. (For example, Aetna will offer Advanced Reproductive Technology
(ART) benefits only if all other competing options also offer ART at a similar coverage level).
6. Aetna reserves the right to reallocate the premium rate ratios due to changes in the composition of the
enrolled census by more than 10%. Aetna assumes that rate tier structure and rate ratios for the Aetna plans
are the same as for any competitor plans offered in the same location.
Aetna Inc.
Additional Financial Information
City of Tamarac I PH Number: 809520
Effective January 1, 2005 Group Number: 264234
7. Any changes in the plan of benefits offered, claim payment requirements, procedures, or account structures
initiated by City of Tamarac or required because of legislative or regulatory action may result in a rate
revision.
8. Retirees comprise less than 10% of the enrolled group. If this plan is offered as an option to another plan and
if pre-65 retirees will be offered Aetna coverage, pre-65 retirees must be eligible for coverage from all other
competing benefit plans.
9. Cobra enrollment is less than 10% of the enrolled group.
10. Effective with your 01 /01 /2005 Renewal package of benefits is the addition of MedQuerysm program at no
additional cost to all Medical products and sites when Pharmacy is also offered (with the exception of HMO -
based products located in California). The program offering will focus on a subset of the membership (those
members age 35 and over) where we believe the greatest opportunities exist for intervention, improvement,
and savings. MedQuerySA° alerts physicians to opportunities for improved care by applying state-of-the-art
clinical algorithms to the medical information derived from claims, pharmacy claims, laboratory reports and
demographic information. This technology generates specific recommendations applicable to a specific
individual and delivers these recommendations to the treating physician.
11. Aetna is excluding coverage for bariatric surgery as treatment for morbid obesity from our base medical plans.
Aetna is making available buy -up coverage at either the inpatient hospital coverage level or at a 50% member
cost sharing with or without a lifetime maximum benefit. This renewal does not include coverage for bariatric
surgery and has been priced accordingly. Note that this quote is contingent upon appropriate regulatory filing
approvals to exclude this benefit. We will communicate any changes in the covered benefits resulting from
this approval process prior to finalizing your enrollment materials and any increase in the rate, if regulatory
approval to exclude the benefit is not obtained. If you are interested in pursuing a buy -up quote, please
contact your Account executive.
HMO Renewal/Proposed Rates
City of Tamarac
Effective January 1, 2005
Policyholder Number - US264234
• This exhibit outlines your renewal/proposed rates effective January 1, 2005.
• Please refer to the Financial Conditions and Plan Design Exhibits for an outline of the level of benefits
quoted, as well as the terms and conditions of this proposal.
FL - Northern FL01
Coverage Categories
Current/Assumed
Em to ees
Current Rates
Proposed/
Renewal Rates
Chan e
Em to ee Onl _
.
Employee + Family
-- 1_
0
_$326.90
$847.90
$346.51 --------
$898.77
..._ ....
Monthly Total
1
$326.90
$346.51
6.00%
FL- uth Miami FL04
Coverage Categories
Current/Assumed
Employees.
Current Rates
Proposed/
Renewal Rates
%
Change
Employee 0
Employee + Family
140
172
$326.90---
$847.90
_ $346.51
$898.77
Monthly Total
312
$191,604.80
$203101.09
6.00%
Cu
FL - South (Miami
Current Rates I Renewal Rates
Employe Only --.7.,
[Employee + Family-15 $954.20 -$7 011.45
Monthly Total 1 22 $17 176.00 1 $18,206.56 6.00%
Current Proposed
Employees Premium Premium % Chan e
Monthly Totals 335 209,107.70 221,654.17 6.00%
(Page 1 of 1)
Summary of Monthly Billing Rates
City of Tamarac
PH NO 809520
• Proposed rates are effective January 1, 2005 through January 1, 2006.
Rate Comparison
Annual
Annual
Existing
Premium at
Proposed
Premium at
Lives
Rates
Current Rates
Rates
Proposed Rates
^
PPO
Single Employee 8 $
445.69
$42,786
$ 501.40
$48,134
Family 19 $
1,085.23
$247,432
$ 1,220.88
$278,361
27
$290,219
$326,495
TOTAL ANNUAL PREMIUM (PPO) $290,219 $326,496
Renewal Increase 12.5%