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2009-185-1131 - Medical Insurance Coverage 1515 NW 167 Street, Building 5 Suite 200 Miami Gardens, Florida 33169 City of Miami Gardens Agenda Cover Memo Council Meeting Date: October 14, 2009 Item Type: (Enter X in box) Resolution Ordinance Other X Fiscal Impact: (Enter X in box) Yes No Ordinance Reading: (Enter X in box) 1st Reading 2nd Reading X Public Hearing: (Enter X in box) Yes No Yes No X Funding Source: Various Departments Advertising Requirement: (Enter X in box) Yes No X Contract/P.O. Required: (Enter X in box) Yes No RFP/RFQ/Bid #: RFP#0506015Renewal Medical InsuranceAvMed Health Plans X Sponsor Name Dr. Danny Crew Department: Human Resources Department Short Title: A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF MIAMI GARDENS, FLORIDA, AUTHORIZING THE CITY MANAGER TO EXECUTE A RENEWAL OF MEDICAL INSURANCE COVERAGE WITH AVMED HEALTH PLANS; PROVIDING FOR THE ADOPTION OF REPRESENTATIONS; PROVIDING AN EFFECTIVE DATE Staff Summary: Background The City Council authorized the City Manager to negotiate and execute agreements for medical, dental, dental, vision, flexible spending, and life coverage for employees and council members on October 11, 2006. Medical insurance was awarded to Avmed Health Plans. Funding for medical, dental, vision, flexible spending, and life insurance is allocated in various departments for a total of $3,442,662. The City’s agent of record McKinley Financial Services, Inc. and staff reviewed the proposed 8.6% renewal rate increase and was able to negotiate a reduced rate increase of 6.34%, which is below the state average renewal increase of 10%. Renewal notice attached as Exhibit A. Proposed Action: That the City Council approve the attached resolution authorizing the City Manager to renew medical insurance with AvMed Health Plans. ITEM J-9) CONSENT AGENDA RESOLUTION Renewal with AvMed Health Plans 1515 NW 167 Street, Building 5 Suite 200 Miami Gardens, Florida 33169 Attachment: Exhibit A: Avmed Medical Financial Analysis ‐3 Year Period 3410 HMO 3410 HMO 3410 HMO In-Network Out-of Network In-Network Out-of Network In-Network Out-of Network DEDUCTIBLE 0 $500/$1,500 $500/$1,500 0 0 $500/$1,500 0 0 $500/$1,500 COINSURANCE 100% 100% 30% 100% 100% 30% 100% 100% 30% OUT OF POCKET MAXIMUM $1,500/$3,000 $1,500/$3,00 0 $3,000/$6,000 $1,500/$3,000 $1,500/$3,000 $3,000/$6,000 $1,500/$3,000 $1,500/$3,000 $3,000/$6,000 PCP/SPC $10 $10 30% aft Ded $10 $10 30% aft Ded $10 $10 30% aft Ded IP HOSPITAL $0 $0 30% aft Ded $0 $0 30% aft Ded $0 $0 30% aft Ded OP SURGERY $0 $0 30% aft Ded $0 $0 30% aft Ded $0 $0 30% aft Ded MRI, CAT SCAN, PET SCAN $25 $25 30% aft Ded $25 $25 30% aft Ded $25 $25 30% aft Ded EMERGENCY /URGENT CARE $75 /$40 $75 /$40 $75 /$40 $75 /$40 $75 /$40 $75 /$40 $75 /$40 $75 /$40 $75 /$40 PRESCRIPTION $10/$20/$30 $10/$20/$30 Not Covered $10/$20/$30 $10/$20/$30 Not Covered $10/$20/$30 $10/$20/$30 Not Covered City of Miami Gardens Effective 1/1/2010 Medical Financial Analysis -3 Year Period3410-40 POS 2009 3410-40 POS 2008 3410-40 POS 2010 (REVISED) Fully Insured Rates Employee Only $451.61 $424.32 $400.66 Employee & Spouse $858.06 $806.77 $761.26 Employee & Family $1,219.34 $1,146.46 $1,081.78 % Change Year over Year Todate there has not been any carrier or benefit changes.Renewals consistently under 10% 6.02% $447.98 $851.17 $1,209.56 $477.54 6.35% 9.32% $907.32 $1,289.35 $507.21 $963.69 $1,369.45 Medical Financial Analysis 9-5-07