HomeMy WebLinkAboutJ-4 Resolution: Dental InsuranceCity of ~Vl idmi ~ard ~ens
1515-200 NW 167~' Street
Miami Gardens, Florida 33169
Aaenda Cover Paae
Date: November 14, 2007
Mayor Shirley Gibson
Vice Mayor Barbara Watson
Councilman Melvin L. Bratton
Councilman Aaron Campbell Jr.
Councilwoman Sharon Pritchett
Councilman Oscar Braynon II
Councilman Andre Williams
Fiscal Impact: No ^ Yes X Public hearing ^ Quasi-Judicial ^
(If yes, explain in Staff Summary) Ordinance ^ Resolution X
Funding Source: Various Departments 1st Reading ^ 2nd Reading ^
ContracUP.O. Requirement: Yes X No^ Advertising requirement: Yes No
Sponsor Name/Department: RFP/RFQ/Bid # 05-06015- Renewal Group Dental
Danny Crew, City Manager Insurance -Blue Cross/Blue Shield
Title
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF MIAMI
GARDENS, FLORIDA, AUTHORIZING A RENEWAL OF THE CITY'S
AGREEMENT WITH BLUE CROSS BLUE SHIELD OF FLORIDA FOR
GROUP DENTAL INSURANCE; PROVIDING FOR THE ADOPTION OF
REPRESENTATIONS; PROVIDING AN EFFECTIVE DATE.
Staff Summarv
The City Council authorized the City Manager to negotiate and execute agreements for
medical, dental and vision coverage for employees and council members and life
insurance for employees on October 11, 2006. Group Dental Insurance was awarded
to Blue Cross Blue Shield of Florida. Funding for health, dental and life insurance is
allocated in various departments for a total of $6,462,211.00.
Analysis:
The City's agent of record McKinley Financial Services, Inc. reviewed the City's renewal
rates from each carrier providing group dental insurance. In the best interest of the City,
they are recommending acceptance of renewing with the existing carrier, Blue Cross
Blue Shield of Florida with no increase for the DMO Plan and 5% increase for PPO
Plan. Renewal notices attached as Exhibit "A"
Recommendation:
J-4) CONSENT AGENDA
RESOLUTION
BLUE CROSS BLUE SHIELD OF
FLORIDA (DENTAL INSURANCE)
We recommend that the City Council approve the attached resolution authorizing the
City Manager to renewal the group dental insurance with Blue Cross Blue Shield of
Florida.
RESOLUTION No. 2007-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF MIAMI
GARDENS, FLORIDA, AUTHORIZING A RENEWAL OF THE CITY'S
AGREEMENT WITH BLUE CROSS BLUE SHIELD OF FLORIDA FOR
GROUP DENTAL INSURANCE; PROVIDING FOR THE ADOPTION OF
REPRESENTATIONS; PROVIDING AN EFFECTIVE DATE.
1 WHEREAS, on October 11, 2006, the City Council authorized the City Manager
2 to negotiate and execute an Agreement with Blue Cross Blue Shield of Florida for group
3 dental insurance, and
4 WHEREAS, the original contract had a renewal provision in it that provided for an
5 additional one year term, but it also provided for a change in the rate, if necessary, and
g WHEREAS, Blue Cross Blue Shield has agreed to renew the existing contract
7 with no increase in the rate that the City is currently paying for the DMO plan, but with a
8 5% increase for the PPO plan, and
g WHEREAS, the City Council would like to authorize the City Manager to take any
10 and all steps necessary to renew the existing Agreement with Blue Cross Blue Shield of
11 Florida,
12 NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY
13 OF MIAMI GARDENS, FLORIDA, AS FOLLOWS:
14 Section 1. ADOPTION OF REPRESENTATIONS: The foregoing Whereas
15 paragraphs are hereby ratified and confirmed as being true, and the same are hereby
16 made a specific part of this Resolution.
17 Section 2. AUTHORIZATION: The City Council of the City of Miami Gardens
18 hereby authorizes the City Manager to take any and all steps necessary to renew that
Page 1
Ft_Lauderdale_268984_1
19 certain Agreement with Blue Cross Blue Shield of Florida for group dental insurance,
20 with no increase in the rate for the DMO plan and with a 5% increase in the PPO plan.
21 Section 3. EFFECTIVE DATE: This Resolution shall take effect immediately
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upon its final passage.
PASSED AND ADOPTED BY THE CITY COUNCIL OF THE CITY OF MIAMI
GARDENS AT ITS REGULAR MEETING HELD ON NOVEMBER _, 2007.
SHIRLEY GIBSON, MAYOR
ATTEST:
RONETTA TAYLOR, CMC, CITY CLERK
Prepared by SONJA KNIGHTON DICKENS, ESQ.
City Attorney
SKD:jIa
SPONSORED BY:
MOVED BY:
VOTE:
Mayor Shirley Gibson (Yes) (No)
Vice Mayor Barbara Watson (Yes) (No)
Councilman Oscar Braynon, II (Yes) (No)
Councilman Melvin L. Bratton (Yes) (No)
Councilman Aaron Campbell (Yes) (No)
Councilman Andre Williams (Yes) (No)
Councilwoman Sharon Pritchett (Yes) (No)
Page 2
Ft_La uderd ale_268984_1
M~~INI.EY FINANCIAL SERV~~ES, INC.
5~}5 North Andre~~~s A~Jenue, ~urt Lauclerd~ile, Ftur-~~a 333a~-3? 15
95q-938-?6b5; Fst~: 974-936•?69~; e-n~~~il: mfsinFc~~~mckinleyinsur~nce cunt
Web Sicc: a~~~~~v.n~cl:inicyinsurance.cnm
Qctoher 12, 2007
City of Mia~i rardens
Taren Kinglee
Human Resources Direcror
1515 167w Street
IVLi.arni Gardens, FL 331b9
Dear Ms T{inglee:
McKinley Financial Services, Inc, is pleased to continue to bave City of Miami Gardens
as our valued clie ew s from each ofth earrie s that~p ov d your Healtb, a.nd Welfare
reviawed your ren
benefits.
Based on conversafions ~with y~u we understand the impartance af making
recommendations that l~ave muiunal financial imPact to the City's budget, the least
disruption and tl~e greatest positive effect an yo~r employees and their families. Taking
rhis into consideration, we are aot makang aay carrier change recommendation. Nor aze
yv~ ~alcing any benefit change recommendations, In the hest interest of the City, we
present the following:
JYIe„ d~cal
Avmed is the medical insurance carrier. Avmed's initial renewal was 13.67% increase
of your current benefiis. AvMed also offered 2 alternatives. The asce~p~tas~cWeItheuesE de
alternatives wot~ld resu.lt in benefit reduction witl~ very little saving . q
that AvMed offer a more reasonab~e renewal. B~sed on these factors: 1) the Gity tenure
urith AvMed is less than one year at the fime fhe renewal was released, 2} the~cl~aims~~
history is not a complete snapshot of the City's performance 3) AvMed truly
Czty as a client and 4) AvMed's retationship with McKinley, AvMed returned with a
sin~le digit renewal of 9.32%. T~is is a little below the State average of 10 -12 percent
renewal increases. Acceptance of the 9•3Z% renewal increase allows the City and its
employees to canti.nue to enjoy the same rich benefits with no change5. ~ t,~
tr~Ek2VIC~ IS UUR SPECIALTYr~
De'ital is aur r~ental carrier. BGBS presented their same two
Blue Cross & Blue Shield (BCBS} ' y
plans with no increase ta the DMO a en wa 8is~5% increase vn tl1 O PO Ptasi.~ough
negotiations with BCBS, the revi
~sinir
20/20 Eyecare Plan is your visio» carrier. This benefit is still in the initiat 2 year ra e
guarantee from the inceptian af the plan and thus, tllere is no increase in cost to the vision
for benefit year 2008.
Basic Life arrd SrippleoietttRl Insrcrurece
Hartfnrd is your basic hfe and supplement insurance carrier. '1'his benefit also had a 2
yeaz rate guarantee upan ~ception. There is n4 increase to the rate for benefit year 2008.
Flexible Sperrdirt~ Accoitnts (Heulil: & Dener:de~rt
BCBS is the administrator far tlus benefit. The contract cast for benefit year 2008 v'nIl
rema.in $6.00 per emplayee per month, no increase.
1t~c,8'ilile~- Services and F'ees
McKinley Pinan~3a1 SeM~~S~ ~c. is your agent of record. McKiniey's services include
an array of hands on assistence to the City and its employees. We value our rela~onship
with the Ciiy and as our stand ~od ees that you are aca 5 oml d ta receiy'Fn,~.vide the
service io the City and its emp y
The City does not have any additiana3 expendiiure from McKinley as yaur agent of
record. ~ur fees are based an a par g.~enefit f lan ye~ w~ receive from the carriers'
rates, This remains true for the 200 P
In cinsing, the benefit package you have is very rich and comgrehensive, This is a
testament ta your efforts and commitin~ of hat you] are da' g~~etro k forwara ta
Gardens. MeKinley is proud to be p
-~x agency af choice.
Floa~..da C~~.nbi~~d I~ife
August 15, 2407
City of Miami ~ardens
Atm: Taren Kangtee
1515 NW 16'7~' St,
Bldg- S - 200
Miami, FL 33169
RE: Grovp Number: 27g20
Ronewal Bffective Date: ]anuarv 1. 20t~8
~eaz Benefits Adminish~ator:
Dental Services Adminishntor
P.O. Box 769569
Roswell, GA 3007b-8223
hie d of Ftoridn, In~n and our BlueDental Care P-~SenesEPl~an es Part of yo lsenefit p ckaga forslour amployees
during this past year..
We are pleased to inform yau that yous B1ueDental Care P-Series Plan rates~i?icrease on your anniversary
datc, 'The rates wil[ be guaraateed for at least another year.
Dgnt~+l Plen• P5220
EmpIoyee Only 514.64
Esnployee + Qne $25.11
Family $37.22
Caverege for subscribers and their depeadents are nutomat~caliy renewed upon eaoh sauual open enrolLnent period
nnless a writtan request for termina6an is subtnittod to FGI..
Tn addition to our printed BlueDental Csre P-Series Perticipating Pravider Direccory, you can viaw our most cunent
Provider nirectory anliue by logging onto wwa.bcbsfl.com. Cliclc an "Provider Directory" in tha wolcome
paragraph, then under "Chaose a Prodvct" scrall down and click on "Denta!- $IueDenSal Care Prepaid P-Series."
Shonld you or your employees have any questions aboui yo~r B1ueDentat Care P-Sorits Plan, ploase caniacc our
~ Member Services Depaztmeni. Member service associates are available Mondny through Friday 8:00 a.m. to 6:00
p m. tatl free at 1-B77-325-3979.
~ We appreciatc your business and look forward to continuing to serve your dent~-1 needs.
~ Sincerely,
I Florida Combined Life
I
cc: McICiiiley Financiat Services, Inc,
i Agent No. 1244Q2FCL
I 545 N Andrews Ave.
; Fort Laudcrdale, FL 33301
i Phona: (30S) 438-2585
M B1ueCcoss B1ueShield
~ `~`~'J of Flari~da
b Y s
i FloAda Combined L11e und its Parant, Htue Ccoaa and 8tua Shletd ut Flotide, .
~ are Independent llcenesos ot tha 9tuo Craos and Blun ShleW Associafion Revised 11/19/03 SG
FLC~RIDA COMBINED LIFE INSURANCE CC~MPANY
Detttrtl Divisio-i
Gollier Building
5011 Gate Parkway
Bvilding 2, Suite 400
jacksonvitle, FL• 32256
904/828-7800
FAX: 904/828-7844
Octaber 12, 2007
Taren KingLee
City ofi Miami Gardens
t 515 NW 167tn Street, Bldg 5-20p
Miami Gardens, FL 33169
RE: Group Palicy Number.
16-E0374-00
Renewai Date: Jan«ary 1, 2Q08
Dear Ms. KingLee:
Thank you far aa~ for 9ou4ogro p Dentaldinsuran er be efitsmpWe va[ue y~oueas a~customer aind
Shield of Flori , Y
appreciate your business.
Yaur Group Dentai Insurance Plan is about to renew. We have compieted o~ar annual review of
your coverage with FCL, taking into account a vari~ty of factors that affect rate development.
After careful c~nsideration and anafysis, we have estabfished your renewa! rates for fhe next plan
year. Your current and renewal rates ere shawn below The renewai rates will take effect on your
renewal date and are guaranteed for fhe foilowing 12 months, subject to the terms and conditions
of your group contract.
Current Rates New Rates
$ 33 40 ~ 35 a7
Employee 63.89 $ 67 08
Emplayee + 1 Dependent ~ 1 Q3.64 $ t 08 82
Employee + 2 or Mare Dep ~
We look forward to continuing our relationship weil into the future Should you have any questions
regarding this letter please contact your local Bfue Cross and Blue Shield sales representative or
telephone our office at 1-800-477-3738 ext. 87818
Sincerely,
Amy Cain
Group Dental Underwriting
cc: McKinley Financial, AOR
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~!$y O'~ ~9~~~ ~~~`~~'~S
Current Period (Cur} = January 07 to Jone 07
CEient Service Representative - Blnnca Hcrnandez
Phm~e Nunsbcr - 3US..G71.5-~37 x=Cr17U
Medical Director- Edwin Rodriguez MD
Pl~une Numbcr-95J-AG=.2SZU ~7G233
7!~
~
H~ A ~-r H P L A N S
Emptayees by Contract Type as a Percent af Totai
Percent of
~ Employee only
{{ Empioyee + spouse
iti Employee + chitd
tV Empfoyee + children
v Empioyee + spouse + child(ren)
Curren4
Average #
Total
Empfoyees
Current Current
100 75 $%
6 4.5%
t ti 8.3%
g 4 5%
g B.8%
______.---
132
lus Dependents by Contract Type as a Percent of Total
Emptoyees p Average # Percent of
Members Total
• Cu-" rrent- Current
100 52.4%
~ Employee onfy t3 6 8%
il Employee + spouse 22 11 5%
ip Employee + chifd 20 10.5%
iV Empioyee + chiidren ~ 18.8%
v Employee + spause + child{ren) _
_ ~ 9 -
Average Contract Size 1.45
Current
.n^°' ~.w~r
~~ ~
•c ~,~,~
~-- =--
I~ 1~~
6.8°/. 71.5%
IV
.::-.>:;.;::::: ~D.S%
V
18 8%
Page 2 of 6 Empiayer Graup Reporting
RvMed NeafEh Pians Confidentia!
Percent Employees 6y Age Band
Age 7ota! Female
Cur BOB Male
Cur B~B
Rn Cur BOB
<21 0 8°!0 0 7% 0 0% Q.7%
0 8% 0.7%
21-30 32.8% 14 9% 19 9°/a 15 8% 12 9% 19 0%
16 6% 24 5%
31-40 32.?% 24 3% 16 Q% 24 1%
6% B B% 29 3%
29 11 5°!0 29.8%
.
41-50 20.3%
51-64 13,5% 28 1% 4 5°l0 27 9% 9 0% 28. 3%
2
8%
65+ 0.0% 2.5% 0.0% 2.2% .
0.0%
The fabie shows the per~entage af inernhers by age range The vatue is bold it
ercent of inembers to lhe hook-of-
the absolute difference batween yaur p
business is greater than or equal to 1 5°h in the curtent repoAing period
Percent of Empioyees by "Age Band" by Gender
Female Employees
Employees
<zt
2i-30
37-00
41 •50
67-64
fi6+
32 8%
32 7%
These charts compare curtent reponing period's'Age Bands' & Gender as a percent of toial employee membership
Page 3 of 6 Employer Group Reporting
AvMed Health Plans Confidenfiai
rn~~ r,(~~t3~e^'~s;'~. ~,'r~ ~ ~r~~- ~ . . ~ .
i ~ ~ke, ~~~e.~~.~.c- tis -
~ ~ ' ~,.+ ,~`~~~~ ~ ~_L.. -.. . .. ~
tn this seco'n s atushwi hin~the AvMed Netwo k bAdd t onalfy, a~li tyof youagroup's Tap 10~Health Care
Participat
Providers ranked by tota} amount paid is provided. This list shows where your members requinng
heaith care are getting the care they need
Paid Medical Claims on a Per {Utember Per iVfonth (PtUiPM) basis.
Current Reporting Period
Submitted
Amount Total PaEd Paid °/e
of Total Paid % 6f
Submfried
Service pmount AIlownd
DyOs 51 ~ q ~q $73 2t 562 &8 48 8°/a 52 3%
%
59 93 S5 34 54 64 3 6% 46 8
Emergency $67 56 516.77 516 71 13 0% 24 7°Jo
HOSPilel 57 59 53 13 53 D4 2 4°/a 40 1%
Olher
Outpatienl
5131 14
315 to
S1A 93
~S Z
~
PCP
518 48
58 85
58 02 o 43.4%
Spectaiists 9 ~
~4
s ~
4 31 1%
Tolal 413
3
~ 1
1
~ S 28 50 0
a
100
5119 74 573 21 562 68 48 B°/ 52 3%
OfUgS
59 93
55 34 54 64 3 6% 48 8%
Emergency 567 56 516 77 S16 71 13 0% 24 7°h
Hosprial S4 78 51 33 51 29 1 0°~ 27 0°/u
Olher
Outpatlent
5131 14
515 10
514 83
~ S~o
ao o°~
P~P 5~3 27 gg p6 SS 30
$ cielists 2 S
' 94 7% 30 4%
Tatai ~4D0
2 t
34
S1 5721 65
SO OD SD 00 50 OD 0 0% p 0%
QNgs
9D 00
50.00
50 00 p 0°l0 0 0%
Emergency
SO 00
50 00 o Do,o 0 0°h
~psP~~~ SD 00 51 75 1 4% 62 5%
Other S2 BO $1 80
50 00 p pa~ o o°k
Outpatient SO DO 50 00 52 72 /e
2 1° 52 2%
PCP 55 21 52 79
57
52 52,38 ~
1.9/0 50.1°h
Speclaifsts 54.75 • 58 BS 5.3% 53.7%
Totai 5'12 76 57 16
The tehies ebove Ilst paid medical costs on a pmpm besfs Costs are grouped by Major service typas The "Total" block contains all
gerv~oes The "Par' &"Nonpat" separate charges by provider partfclpaUon status CapltaGon costs are not included in this paid repori.
page 4 of 6 Employer Group Repo~ting
AvMed Healfh Pians Confidential
Current Pertod
Partlolpatfng
Nan-Partlcipaling
Current Period 7op 10 Hospitals
Ranked on Paid Amount
°/a of 7otal Running
Rank Provider Name Pafd Hosp TotaE
0 Drugs
^ Emergency
^ Hospital
o Other
^ Dutpatient
o PCP
^ Speeialists
The pie charts iflustrate the
percentage af services by
"Major Service Type"..
Additional detail is provided
by shawing services by
parficipation status.
1
Memorial Hospitai-West 56.5°k 56 5% This table ranks the Top
~o Hospisais by totai pa~d
2 Memorlal Hospitai Miramar 26 1°~ 82 6°k
, amount In the current
period A column
3 Jaokson North MediCal Cenlel' 91 9
~o
g 3'~0 dispiays the amount as a
4
Westside Regional Medical Center g ~% 1 pp 0% percentage of lotai paid
hagp~~~ claims 7he las~
5 cotumn Is a running total
at the percentege paid of
6 total paid Paid amounis
~ renecl taci~iy claims
only
8
9
10
Page 5 of 6 Employer Group Reporting
AvMed Heaith Ptans Confidentiai
7his section provides a summary view of your group's cost and utilization information Key utilization
measures are stated in per 1000 ratias in order to annualize the data for comparison with the book of
business Monthly key financiai measures are aiso shown
Key Utilization 3tatistics Curr g~g
InpatientAdmissions/1,~00 Members
84 ~7
Days of Inpalient Gare/1,00d Members 179 273
Average Length of Stay
2 ~3 41
295
ERlUC Claims/1,Q00 Members 358
Number Scripts/1000 Members 9 g70 g,973
Number Scriptslt00Q Employees ~4,346 20,088
Key Measures 6y Manth
Dollar Amounts in Thousands
Current Jan Feb Nlar Apr May Jun
~~~
Premium 556 $61 ~62 564
525 569
~37 S23
Medical 51B
517 ~12
~12 $20
$12 St1 S10 $9
Rx
Capiiation' 191 207 Z~iz
MM ifi5 182 184
This table lisls the monthly premfum. claims (mediaal, phartnaey, & capilation). and membership The premium CRx•i atiofn dol ars
membership are posted ~ real•time monihs The medical otaims are posted when lhey are paid {paid monlh) ' P
are esUmated as provider coniracts change Ihroughout ihe year
,..~mber basis.
This seciion describes your group's Pharmacy costs on a per emp~~y~~ ~~ ~~ r~•
Prescription Drug Summary
Current
paid per Member per Month ($PMPM) $~z ~
Paid per Employee per Month (~PEPM) $~~ 19
Copay % of Totai Allowed
14.0°!0
q~erage Monthiy CoPay per Claimant $~5 7s
Generic Scripts / 10Q0 Members
5,289
Brand Scripts / 1Q00 Members
4,554
Generic Paid as % of Total
B 8%
Brand Paid as % of Total
91 0%
Page 6 of 6 Empfoyer Group Reporting
AvMed Fiealth Plans Confidentiel
Page 1 of 2
Taren Kinglee
From: Doretta Green [dgreen.mckinieyins@gmail.com]
Sent: Monday, September 17, 2007 1:11 PM
~o; Taren Kinglee
Subject: Re: Renewa{ Rates
The L,ife and Vision Rates are not to change, they were under a 2 yr i~ate guarantee fram what I
understand. I am waiting for confirmation from the carriei•s on these.
I will follow baclc up with BCBS to see if they have released the Spending account rates.
On 9/17/07, Taren ~inglee <tlcin~lee~miami~ardens-fl.~ov> wrote:
Doretta,
I just reafized that when you came by last week I was not present with renewal rates far Hartford, McKinley,
20/20 EyeCare ar BlueCross (flexible spending). Please advise
; Taren Kinglee
Human Resources/Risk Director
City of Miami Gardens
1515 N.W. 167 Street, Building 5-200
Miami Gardens, Florida 33169
` 305-622-8030
305-622-8265 Fax
'. The City of Miami Gardens is a public enlity subject to Chapier 1 f9 of fhe Florida Statufes concerning public
records. Email messages are ca g 5 and kept as arpublrc reco d, subject to disclosure. A!1 E-mails sent and
~: received are caputred by our serv
Canfidential Notice: This Emai! communicafio en f s named above..t !f you a~ernat fhe intended re~ ~'preln~~ °
informahon for the use of the designated rec~p f 1
are hereby not~ed fhaf you~hc~ve !n ~of it~o~ifs ~an ents Is~prohrbtedr If you have received ~hisr~ommunication
dissemination, disttibufion pY 9
in error, please notify the sender immediatel.y by replying to fhrs message and delefing it from your compu er.
Thank you
9/17/2067