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Home My WebLink AboutJ-5 Resolution: Medical InsuranceCity of JVliami ~ard~ens 1515-200 NW 167`h 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 1 st Reading ^ 2nd Reading ^ Contract/P.O. Requirement: Yes X No^ Advertising requirement: Yes No Sponsor Name/Department: RFP/RFQ/Bid # 05-06015- Renewal Group Medical Danny Crew, City Manager Insurance - AvMed Health Plans Title A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF MIAMI GARDENS, FLORIDA, AUTHORIZING A RENEWAL OF THE CITY'S AGREEMENT WITH AVMED HEALTH PLANS FOR GROUP MEDICAL INSURANCE; PROVIDING FOR THE ADOPTION OF REPRESENTATIONS; PROVIDING AN EFFECTIVE DATE. Staff Summary 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 Medical Insurance was awarded to AvMed Health Plans. 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 health insurance. In the best interest of the City, they are recommending acceptance of renewing with the existing carrier, AvMed Health Plans, with a slight increase of 9.32% which is below the State average of 10-12 percent renewal increases. Renewal notices attached as Exhibit "A" Recommendation: J-5) CONSENT AGENDA RESOLUTION AVMED HELATH PLANS GROUP MEDICAL INSURANCE We recommend that the City Council approve the attached resolution authorizing the City Manager to renewal the group medical insurance with AvMed Health Plans. 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 AVMED HEALTH PLANS FOR GROUP MEDICAL 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 AvMed Health Plans for group medical 3 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 6 WHEREAS, AvMed has agreed to renew the existing contract with a slight 7 increase of 9.32% over the rate that the City is currently paying, and 8 WHEREAS, the City Council would like to authorize the City Manager to take any 9 and all steps necessary to renew the existing Agreement with AvMed Health Plans, 10 NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY 11 OF MIAMI GARDENS, FLORIDA, AS FOLLOWS: 12 Section 1. ADOPTION OF REPRESENTATIONS: The foregoing Whereas 13 paragraphs are hereby ratified and confirmed as being true, and the same are hereby 14 made a specific part of this Resolution. 15 Section 2. AUTHORIZATION: The City Council of the City of Miami Gardens 16 hereby authorizes the City Manager to take any and all steps necessary to renew that 17 certain Agreement with AvMed Health Plans for group medical insurance, with an 18 increase of 9.32% over the current rate. Page 1 Ft Lauderdale_268979_1 19 Section 3. EFFECTIVE DATE: This Resolution shall take effect immediately 20 upon its final passage. 21 PASSED AND ADOPTED BY THE CITY COUNCIL OF THE CITY OF MIAMI 22 GARDENS AT ITS REGULAR MEETING HELD ON NOVEMBER _, 2007. 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 SHIRLEY GIBSON, MAYOR ATTEST: RONETTA TAYLOR, CMC, CITY CLERK Prepared by SONJA KNIGHTON DICKENS, ESQ. City Attorney SKD:jIa SPONSORED BY: DANNY O. CREW, CITY MANAGER 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 Lauderdale_268979_1 McKINI.EY FINANCIAL SERV~CES, INC. 5~}5 Nurtlt Andre«~s Avenue, Fort Lauderdale, Floi i~ia 33301-3215 95~}-)38-2685~ Faa: 97~F-93S-?69~~ e-m~iil: mfsinFo~tmckinleyinsura»c~.coal WeU Sitc: ~a~~~~~~.mckinlcyinsurance cnm October 12, 2007 City of Miami rardens Tazen Kinglee Human Resources Direcror 1515 I67~' Street Miami Gazdens, FL 33169 Dear Ms T{.inglee: McKinley Financial Serviaes, inc. is pleased to continue to bave City of Miami Gazdens as our valved client. As part ofour responsibility to the City we have received and reviewed your renewals from each of the carriers that provide your Health and Welfare benefits. Based on eonversations ~uvith ynu we understand the irnportance of making recommendations that have mini.mal financial impact to the City's budget, the least disrup6on and the greatest positive effect on yo~r employees and theiz fanulies. Taking this into cansideration, we are not makang any carrier change recommendation. Nor are vye making any benefit change recommendations, In the best interest af the City, we present the following: llfedicul Avmed is the medical insurance carrier. Avmed's initial renewal was 13.67% increase of your current benefiis. AvMed also offered 2 alternatives. The acceptance either of the alternatives wat~fd resuIt in benefit reduction with very litCle savings. Thus, we requested that AvMed offer a more reasonabte renewal. Based on these factors: 1) the City tenure with AvMed is less than one year at the time tlie renewal was released, 2} the claims Iusiory is not a complete snapshot of the City's performance 3) AvMed truly values the City as a client and 4) AvMed's relationship with McKinley, AvMed returned with a single digit renewal of 9.32%. This is a little below tl~e State average of 10 -12 percent renewal inareases. Acceptance of the 9.32% renewal increase allows the City and its employees to cantinue to enjay the same rich benefits with no changes. ,. ~~~ `rSERVICE IS ~UR SPECIALTY" Dental Blue Gross & Blue 5hield (BCBS} is your denta.i carrier, BCBS presented their same two plans with no increase to the DMO and an 8.8% increase to the PPO Plan. Through negotiations witli BCBS, the revised renewai is 5% increase on the PPO Plan. ~sio~r 20/20 Eyecare Plan is your vision carrier. This benefit is still in the initia[ 2 year rate gt~arantee from the inception of the plan and thus, there is no increase in cost tv the vision for benefit year 2008. Basic Life atrd S:rnnlenie~ttal I~:srcrarrce Hartford is your basic Iife and supplement insurance carrier. This benefit also had a 2 year rate guarantee upnn inception. There is no increase to t(~e rate for benefit year 2008, FlPxible Spendi~t~Accorne~s (A'eal~lr & Dene~rdent) BC'BS is the acliniiustrator ft~r this benefit. The contract cast for benefit year 2Q~8 will remain $6.00 per employee per month, no i.ncrease, Mc,B'i-tlev Services and F'ees McKinley Financial Services, Ine. is your agent of record. McI{in[ey's services include an array of hauds on assistance to the City and its employees. We value our relationship with the City and as our standazd of daing business we will continue to provide the service io the City and its employees that you are acaustamed to receivi.n~, The City does not have any additional expenditure fr~m McKiz~ley as yaur agent of record. C)ur fees are based on a percentage of premiums we receive &om the cazriers' rakes, This remains true for the 20Q8 benefit plan year. In closing, fihe benefit package you bave is very rich and comprehensive. Tlus is a testament to yaur efforts and commitment to the emplayees of and citizens of Miami Gardens. McKinley is praud to be a part of what you are daing. We look forward to -ur agency of choice. Florida Ca~nbined I.ife August IS, 2007 City of Miami Cardens Atm: Tarea ISingiee 1515 NW 167~` St, Bldg. 5 - 200 Miami, FL 33169 ftE: Graup Niunber: 27 Rancwa.l Effective Aate: lanuarv 1. 2008 Dear Benefits Admiaistrator: Dental Services Adminishator P.O. Box 769569 Roswell, GA 30076-8223 Thank you for selecting Florida Combined Life Ins~uance Company, Inc, (FCL,), a subsidiary of Btua Cross Blue 5hietd of FIoridn, Ina., and our BlueDentsl Care P-Series Plan as part of your benefit package for your amployees during this pasC ycar,. We are pieased to inform yau that yow B1ueDental Care P-Series Plan rakes will aat increase on your ans~iversary date. Tho rates wi3[ be guaranteed for at least another year. Dental Plan: PS220 Employee Only ~14.60 Employee + One $25.11 Family $37.22 Covarage for subscrbers and their dependents are automaticstly renewed upon esch anaual open enroflmant period un2ess a writtan request for terminatian is submitted to FCL. In additfon to our printed BlueDental Care P-Series Participating Provider Directory, you can view our most c~urent Provider Airectary online by logging onto www.bcbsfl.com. Click on "Provider D'uecWry" in tho walcome paragta~h, then tmder "Chaose a Product" scroll down and click on "Derita!- B1ueDental Care Prepaid P-Series." Shauld you or your employees have any questions about your BlueDental Care P-Series Plan, please cantact our Member Services Pepartment. Member service associates aze availabte Mondny through Friday 8:00 a.m. to 6:00 p,m_ toil free at 1-677-325-3979, We appreciate your business and look forward to wntinuing to serve yoiu dentnl naeds. Sincerety, Florida Combined Life cc: McICiriley Financial Services, Inc. Agent No, 120402FCL 545 N Andrews Ave. Fort Lauflcrdale, FL 33301 Phone: (305) 938-2585 ~ ~ B1ueCcoss B1ueSlueld .~ ~ of Florida b 0 FloAdn Cam~tned Ute nrM its Pararrt, Blue Croaa arxl 8fua 5hield ol Flwida, are Indepsndent llcenesas o1 ths 8tuo Craos and eluo ShieW Associaiioa Revised 11119/03 SG FLC~RIDA COMBINED LIFE INSURANCE C~MPANY DentRl Division (;,ollier BuiIding 5011 Gate Parkway [3uilding 2, Suite 400 Jacksonville, FL• 32256 904/828-7800 FAX: 904/828-7844 October 12, 2007 Taren KingLee City of Miami Gardens 1515 NW 167~h Street, B(dg 5-20A Miami Gardens, FL 33169 RE: Group Policy Number. 15-E0374-00 Dear Ms.. KingLee: Renewai Qate: Jan«ary 1, 2Q08 Thank you for choosing Flarida Gambined Life Insurance Campany, an affiliate of Blue Cross Blue Shield of Fforida, for your group Dental Insurance benefits We value you as a customer and apprecia#e your business Your Group Dental Insurance Plan is about to renew. We have completed our annual review of your coverage with FCL, taking into account a variety of factors that affect rate development. After careful consideration and analysis, we have established your renewal rates for the next plan year Your current and renewal rates are shown below The renewaf rates will take effect on your renewaf date and are guaranteed for the following 12 months, subject to the terms and conditions of your group contract. Current Rates New Rates Employee $ 33 40 $ 35 07 Employee + 1 Dependent $ 63 89 $ 67 08 Empioyee + 2 or More Dep $ 1 Q3 64 $ 108 82 We look forward to continuing our relationship well into the future Should you have any questions regarding this letter please contact your local Blue Crass and Blue Shield sales representative or telephone our o~ce at 1-800-477-3736 ext. 87818 Sincerely, Amy Cain Group dental Underwriting cc: McKinley Financial, AOR ~' \° ~' o ~-3 ^3 ~l ~-3 -~ Ir! rrf trl '=f H n7 trl trl n~ f~ n ~~~ ~~ 6 e s a ~ = ~ ~ a a ~ ~ st7 n m n~ vv v C n vrog ~ o o % a 0 0 0 0 0 0 ~ ~ w ~«., ~~ ~.+, C- o o~ 9v ? e ~ ~~ W fi~ O ~ ~ ~ ~ ~ ~~ ke fi O " b ° ~ r ~-n cn °' o '~ ~ o ~ ° 8 9 8 ~ ~ `e c.a ~ ro ~e v ~ ° p ° .a ~ ° ~ ~ n ~ ~ .c ~' ~ " '~ `~ " ~ n ~ °i ° ° • 3 ~ o c ` ' ^ ro p ~ ~ -e b Cm ~ ~~ C~ ~ , » .. . .. . ':1 'TJ n~ ro 8 ~ 3 ~ N ~ ~I '-. ~ v A _ ~ I + 4I.1 ~ h •+ 00 ~J .~. Q~ N -~ O j lr ~. ~. ~ ~n ~ ~ N ~ W ~ ~ ~ v~ W ~ ~ ~ ~ ~ ~ sa ~ ornw O~ . ~ W W W W A N i~ ~~ UI ~ V ~~O O '. I ~ b+ ~"~ N W IJ .~-~ 00 ~ ~ ~I l!~ t. ~. A ~ N O ~ I~~,= N Oo -~ ~ W N ~ tJ ,p N ~ r.~ o 3a ~ W ~ Vl N Vl N ~ ~ lsl a~9 ~ O ~ A' O N A IR• ln ~ t. w ~D ~ .,1 W ~D W ~+ ~ N W J ~ 00 ~ ~J ~ .P ~ I .r N W O~ 0. ~ .+ n 00 . .. p ~ ~ ~ 40 ~ "~ j ~, N J LJ y O 0 ~. i A O o y ~+ o d ~ ~ ~ ~ r v + A ~p ~. 0~ W J A ~ tW+ I.G l.n IJ U d U1 ~ ~1 O 4 ~ W ~1 4 ~ f 5 ~~~~~~~ _ ~ ~~~~~ ~°~~.i~ - ~~ ~ ~ City of N10ami Ga~-dens Cvrrent Periad (Cur) = Janunry 07 to June 07 C(ient Service Representative - Bl~nca Hernandez Phonr Numbcr - 3US.G71..Sa37 xZG170 Medieal Direetor- Gdwin Rodriguez MD Pl~onc Numbcr-95A dG3.2S20 s7G233 ~ f>I H L A E. 7 H P L A N S Empfoyees by Contract Type as a Percent of Total Average # Percent of Employees 7otal Current Current i Employee only 1(JO 75 8% II Empioyee + spouse 6 4.5% III Employee + child >> B 3~~ tV Employee + children 6 4 5% ~ Employee + spouse + ch91d(ren) 9 6.8% 132 Current Employees plus Dependents by Contract Type as a Percent of Total Average # Percent of Members Tota! Current Current I Emp(oyee only 100 52 4% 1) Employee + spouse 13 6 8% ill Employee + child 22 11 5% IV Employee + children 20 10.5% V Employee + spouse + child(ren) 36 18.8% 191 Average Contract Size 1,45 Current ~~y ~~~°~r,:, ~.. ~.~ s~ ,~~~ u m 6.8% 11.5Yo IV ' 10 b% V 18.8% AvMed Health Plans Canfidential Page 2 of 6 Employer Group Reporting Percent Employees by Age Band Age 7otal Female Male Rn Cur BOB Cur BOB Cur BOB <21 0 8% 0 7% 0 0% 0.7% 0 8% 0.7% 21-30 32.8% 14 9% i 9 9% 15 8% 12 9% 14 0% 31-40 32.7°l0 24 3°/a 16 0% 241 % 16 $% 24 5% 41-50 20,3°/a 29.6% 8 8% 29 3% 11 5% 29.8% 51-64 13,5% 28 1% 4 5% 27 9% 9 0% 28, 3% 65+ 0.0% 2.5% 0.0% 2.2%-_-- - 0.0% 2.8% 'fhe teWe shows ihe percentage of inembers by age range The vaWe is Cold if the absolute dffference between your percenl of inembers to the book-of- business is greater lhan or equal io 1 5°~ in the cuRent reporting period Percent of Employees by "Age Band" by Gender Employees Female EmpEoyees <zt 21-90 31 ~40 41 •50 b7-fi4 66+ These charts compare curtent reporiing period's'Age Bands' 8 Gender as a percent of total employee membershlp AvMed Health Plans Cor~fdential Page 3 of 6 Employer Group Reporting ~ ~ ~~ ~,~~~~"' 1 ~~~ ~ a~~,~ r: ~~ ` ' " o r ~a ~ s u. ~~`"^ +,?a~ ~ u ....... ....... . .. . . in this section we show yoar groups utilization by Major Service Type and Health Care Provider Participation status within the AvMed Network Additiona-ly, a list of your graup's Top 10 Health Care Providers ranked by total amount paid is provided This list shows where your members requiring healEh care are getting the care they need Paid Medical Claims on a Per Member Per Month (PMPMj basis. Current Reporting Period Servfce Submitted Amount Total Patd Pa~d °/ Paid % at en,nunf e~lnwwd of Tetal Subm3tted DN9S - ___ 5114 74 573 21 562 &B 48 8% 52 3% Emergency 59 93 S5 34 S4 64 3 6% 48 8% Hospital S67 56 516.77 51871 13 0% 24 7% O(h2f 57 59 53 13 53 04 2 4°/a 40 1°/n Outpatienl 513114 5151D S1493 116% 114% PCP $78.48 58 85 58 02 6 2% 43 4% SpeciSliSlS 558.95 519.26 $18.47 14.4% 31.3% Tola) Sa1339 51A167 572850 1000% 311% , ~rugs 5119 74 S73 21 $62 68 48 8°/ 52 3% Emergency S8 93 S5 34 S4 64 3 6% 46 B% Hospilal S67 56 516 77 S16 77 13 0% 24 7°h Olher 94 78 51 33 S1 29 1 o°h 27 0% Outpetient S13114 51510 5t493 116°h 114% PCP 513 27 56 OB S5 30 4 1°/n 40 0°h 5 cialists 554.20 516.68 $76.09 12.5°h 29.7'Yo Tolel S4D0 62 5134 51 5121 65 94 7% 30 4% 0lUgs SO 00 SD 00 SO 00 0 0% 0 0% Emergency SO 00 SD 00 50.00 0 O~o 0 0% Hospitat SO 00 50 00 50 00 0 0% 0 D°k Olher 52 80 51 80 S 1 75 1 A% 62 5% Oulpatient SO 00 50 00 50 00 0 0% 0 0°k PCP 55 21 52 79 52 72 2 1% 52 2% S cialists 54,75 52.57 52.38 1.9% 50,1°h Total S12 76 S~ 16 SB 85 5 3% 53 7% The tables ebove Ilst paid medical costs on a pmpm besls Costs are gtouped by Major service types The -Total" block contains ell servirss The "Pat" 8'Nonpar' separate charges by ptovider particlpaUon status Capitafion costs are not included in this paid repari AvMed Health Pians Confidential Page 4 of 6 Employer Group Reporting Curreni Period Non-Part)cipating Current Period Top 10 Hospitals Ranked on Pald Amount Rank Provider Name % of Total Running Pafd Hosp Total ~ Drugs ^ Emergency ^ Hospital 0 Other ^ Outpatient ~ PCP ^ Specialists The pie cha~ts illustrate the percentage of services by "Major Service Type°. Additional detail is provided by showing services by participation status 1 Memorlal Hospital-West 56.5°k 56 5% This table ranks the Top 10 Hospitals by total pald 2 Memorial Hospilal Mlramar 28 1°k 82 6% amount In the curren~ 3 Jackson North Medical Cenler 9 3% gi 90~o period A column disptays the amount as a 4 Westside Regional Medicai Center 8 1°k 100 0% percentage of total paid ~ hospital claims The last wlumn is a running total 6 ofthe percentage paid of 7 total paid Paid amounts reflec! faciiity Gaims 8 only 9 10 AvMed Health Plans ConfidentMal Page 5 of 6 Employer Group Reporting This seciion provides a summary view of your group's cost and utilization information Key utilization measures are stated in per t00Q ratias in order to annualize the data for comparison with the book of business Monthly key financial measures are also shown Key Utiltzation Statistics Curr sos Inpatient Admissions11,Q00 Members 84 67 Days of Inpatient Gare/i,00d Members 178 273 Average Length of Stay 2 13 4 1 ERIUC Claims/i,AQO Members 358 295 Number Scripts/1000 Members 9,970 9,973 Number Scriptsl1000 Employees 14,346 20,088 Key Measures hy Month Dollar Amounts in Thousands Current Jan Feb Mar Apr May Jun Premium S56 $61 ~62 564 569 $71 Medical 518 ~12 $20 525 S37 $23 Rx $17 ~12 ~12 $t1 ~10 $9 Capitation' S2 52 ~2 $2 52 $2 MM 165 182 184 19i 207 212 This table lists the monthly premium. claims (medl~ai, pharmaey, 8 capilation). and membership The premium. Wc. Capftation. & membership are posfed ~ rea!•time months 7he medical Gaims are posted w~en they are pald (paid monlh) • Capitation doliars are estimated as provider contrects chenge (hroughout ihe year This section describes your group's Pharmacy costs on a per employee and per member basis Prescription Drug Summary Current Paid per Member per Month ($PMPM} $62 68 Paid per Employee per Month ($PEPM) $90 19 Copay % of Total AIlowed 14.0% Average Monthly CoPay per Claimant $15 76 Generic Scripts / 10(?0 Members 5,269 Brand Scripts / 1D00 Members 4,554 Generic Paid as % of Total 8 8% Brand Paid as % of 7otal gi ~% AvMed Health Pians Confidential Page 6 of 6 Employer Group Reporting Pa~;e 1 ~f 2 Taren Kingiee From: Doretta Green (dgreen.mckinieyins@gmail com] Sent: Monday, Sepfember 17, 2007 1:11 PM To: Taren Kinglee Subject: Re: Renewai Rates The L,ife and Vision Rates are not to change, they were under a 2 yr rate guarantee from what I understand. I am waiting for confirmation from the carriei°s on these. I will follow baclc up with BCBS to see if tliey have released the Spending account rates. On 9/17/07, Taren Kinglee <tkinglee~miamigardens-fl.~ov> wrote: Doret#a, I just realized that when you came by last week I was not present with renewal rates for HartFord, McKinley, 20/20 EyeCare vr 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 publrc entrty subject to Chapter 1 f 9 of fhe Florfda Statutes concerning public records. Email messages are covered under such laws and thus s~bject fo disclosure. AI1 E-mails sent and ~ received are caputred by our servers and kepf as a public record.. ` Confrdentia! Notice: This Emai! communication and any attachments may coniain confidentia! and priviledged ' information for fhe use of the desrgnated recipient(sJ named above.. !f you are not the intended receipisnt, you are hereby not~ed fhat you have received fhis communication in error and thaf any review, disclosure, dissemrnation, disfribution or copying of if or its contents is prohibrfed. If yau have received this communicaflon in error, please nofify the sender immediately by replying to this message and delefing it from your computer. Thank you 9/17/2007