HomeMy WebLinkAboutPacket 11-06-2003 Special 5:45y of Cape Canaveral
L SPECIAL MEETING
TALL ANNEX
Cape Canaveral, Florida
hursda
mber 6, 2003
x:45 P.M.
Following the 5:30 P.M.
Special Meeting to Certify the General Election Results)
AGENDA
CALL TO ORDER:
CONSIDERATION:
Motion to Approve: Renewal of Group Medical, Dental and Life Insurance.
ADJOURNMENT:
Pursuant to Section 286.1015, Florida Statutes, the City hereby advises the public
that: If a person decides to appeal any decision made by the City Council with
respect to any matter considered at this meeting, that person will need a record of
the proceedings, and for such purpose that person may need to ensure that a
verbatim record of the proceedings is made, which record includes the testimony
and evidence upon which the appeal is to be based. This notice does not
constitute consent by the City for the introduction or admission into evidence of
otherwise inadmissible or irrelevant evidence, nor does it authorize challenges or
appeals not otherwise allowed by law. Persons with disabilities needing assistance
to participate in any of these proceedings should contact the City Clerk's office
(868-1221) 48 hours in advance of the meeting.
105 Polk Avenue • Post Office Box 326 • CaEe Canaveral, FL 32920-0326
\\Cape-nt\cityclerk jt Ik\,,4GENDA\S ECI \20� Ti Council Special Meati Health Benefits R ewal.dce
e ep one: �321A 8d8�1220 • SUNCOM: 982-1220 • FAX: (321) 868-1248
www.myflorida.com/cape • e-mail: ccapecanaveral@cfl.rr.com
Meeting Type: Special
Meeting Date 11-06-03
EPORT
AGENDA
Heading
item
No.
CITY COUNCIL OF THE CITY OF CAPE CANAVERAL
SUBJECT: RENEWAL OF GROUP MEDICAL, DENTAL AND LIFE INSURANCE
DEPT./DIVISION: ADMINISTRATION
Requested Action:
City Council consider the renewal of group medical, dental and life insurance as recommended by the Employee
Review Committee as follows:
Medical — Blue Cross HMO Plan No. 24, 5% decrease to $368.42 per month each employee; no change in coverage
benefits.
Dental — Change to Ameritas PPO, 10% decrease to $24.16 per month each employee.
Group Life — A slight increase of 0.04/1,000 to 0.35/1,000; GE is lowest bid.
Contract renewal date is 12-01-03.
Summary Explanation & Background:
There are (38) employees who participate in the group plan; annual premiums are estimated below:
Annual Medical Premium = $167,999.52 — Represents a 5% decrease and savings of $8,021.04
Annual Dental Premium = $11,016.96 — Represents a 10% decrease and savings of $1,217.52
Annual Group Life Coverage = $5,544.00 — Represents a 13% increase of $636.00
The total renewal premium is $184,560.48. with a savings of $8,602.56. The employees were surveyed about the
use of what was saved. (28) employees requested the $7.32 per pay period be eliminated; (8) employees requested
the savings be escrowed to fund future rate increases.
I recommend approval of group medical, dental and life insurance renewals and that City Council consider the
employees request.
Exhibits Attached:
Renewal correspondence.
City Man Office
Department ADMINISTRATION
moi-----
�/
cap - \mydoc en \council\meeting\2003\11-06-03\insurance.doc
Fn
I BENEFITS, INC. ; FLORIDA B _
7457 ALOMA AVENUE. SUITE 303 • WINTER PARK, FL 32792 •407/679-3800 • Fax 407/679-9001
CITY OF CAPE CANAVERAL
2003 RECOMMENDATIONS
After reviewing our marketing efforts, our recommendations are as follows:
MEDICAL
• Stay with Blue Cross for a 5% decrease over current rates.
DENTAL
• Change to Ameritas for a 10% savings or $1,500 annual savings over current rates
and 44% savings or $6,552 annual savings over renewal rates. Although AIG is
less, their reimbursements out -of -network are not as strong as Ameritas. AIG's
waiting periods are also more stringent for new hires.
GROUP LIFE
• Stay with GE Financial. Although they increased your rates .04/1,000, they are
still the most competitive.
"SETTING THE STANDARD FOR EXCELLENCE IN SERVICE'
o fflo rods BIueShield
ofF, �xorida
or. V.e021e1 a..-kVUpjA0c
�m oyr�ro rd � e•pr, �x caw ae �w Ss�ew
d F'�Ylaw .w M•!wM•M lawrd ttN 8W C:4o.
ureq• 4N•b alaea�ba
BlueCare
For Small Groupe
Benefit Summary Plan 24 ( Current Plan)
Benefits frost to You
Emergency Services (Hospital)
Use of emergency rooms and emergency services $50 copay per visit
at contracting hospitals
Use of emergency rooms and emergency services $50 copay per visit
outside of service area or at non -contracting hospitals
Maternity Services
Primary Care Physician office services
$15 copay
Contracting Specialist office services — initial 08 visit only
$25 copay
Certified Nurse Midwife or Midwife
No copay
Inpatient hospital services
$250 per admission
Birthing center services
No copay
Behavioral Health Services
Mental Health Care
$14 preferred generic
• Outpatient visits — 20 per calendar year
$25 copay per visit
• Inpatient facility — 30 days per calendar year
$250 per admission
• Partial hospitalization (2 partial days for 1 inpatient day)
No copay
Substance dependency
• Outpatient visits — 20 per calendar year
$15 copay per visit
• Inpatient hospitalization (detoxification only)
$250 per admission
Infertility Services Not covered
Special Services
Hospice care No copay
Skilled nursing facility— 90 days per calendar year No copay
Horne health care No copay
Ambulance (medically necessary) No copay
Durable medical equipment No copay
Prosthetics and orthotics No copay
13lueCare Rx Pharmacy Program
Retail Pharmacy (includes oral contraceptives)
When prescribed by a contracting physician
$7 preferred generic
and filled at a contracting pharmacy
$20 preferred brand
$35 non -preferred
Mail Order Pharmacy
For your convenience, a 90 -day supply of
$14 preferred generic
maintenance medication is available through the mail
S40 preferred brand
$ 70 non -preferred
Maximum Out-of-pocket $1,500 per covered person
$3,000 per family
Rev. M001 2
B1ueCross BlaeShield
0.9
of Florida
Health Optlons.
BlueCare
For Small Groups
Benefit Summary Plan 24
Care must be received from or arranged by your Health Options contracting Primary Care Physician.
Benefits
Cost to You
Physician Office Services
Primary Care Physician office services $15 copay per visit
Contracting Specialist office services $25 copay per visit
One annual self -referral to contracting GYN for well -woman exam $25 copay per visit
These office services may include.
• Pediatric and well -baby care
• Periodic health evaluation and immunizations
• Other diagnostic services
• Health education
• Professional counseling
(family planning, nutritional, and medical social services)
• Vision and hearing screening
• Family planning services
• In -office surgery
Additional Services (Office or Outpatient Facility)
Allergy testing No copay
Allergy injection, including serum $5 copay per visit
Outpatient physical, speech, cardiac and occupational therapies $5 copay per visit
Diagnostic lab and X-ray No copay
Hospital Services (Inpatient Facility)
Room and board $250 per admission
These Inpatient hospital services may include:
• Anesthesia, use of operating and recovery rooms,
oxygen, drugs and medications
• Intensive Care Unit and other special units
• laboratory and X-ray services
• Inpatient physical, speech, cardiac and occupational therapies
Hospital or Ambulatory Surgical Center (Outpatient Facility)
Outpatient surgical services may include: $100 copay
Anesthesia, use of operating and recovery rooms,
oxygen, drugs and medication, including:
• Hospital or surgical center
• Surgeon's fees
• Outpatient laboratory, X-ray, and other tests.
Rev. W2001
B1neCross BlneShield
0. of Florida
• Health Options.
of fa1W, sn tCyina�,0.l,kpb0pp d Cw 2w• fs•
anrYy S+Y6•M•otUC•4
BiueCare
For Small Groups
Benefit Summary Plan 24
Pre-existing Conditions Limitations
Applies for those not having prior creditable coverage at initial enrollment; group size determines pre-
existing conditions limitations.
Select Exclusions and Limitations
The following is a partial listing of services that are excluded from coverage under the Group Master
Plan. For a complete listing please refer to the Group Master Plan.
• All services not specifically listed In the Covered Services section of your Certificate of Coverage or
in any rider or endorsement, unless such services are specifically required by state or federal law
• Elective cosmetic surgery
• Hearing aids or eyeglasses, dental care, or oral appliances
• Physical for insurance, licensing, school or recreational purposes
• Elective abortions
• Workers' compensation
• Complementary and Alternative Healing Methods (CAM)
The copayments are the responsibility of the covered persons and must be paid to the provider at time
service is rendered.
Should it become necessary, a grievance procedure is available to all covered persons, as detailed in
the Group Master Plan.
Health care services must be provided or authorized by your Primary Care Physician. Additional
information related to access to providers can be found in the Provider Directory. This summary is only
a partial description of the many benefits and services covered by Health Options, the HMO subsidiary
of Blue Cross and Blue Shield of Florida, inc. These benefits apply only to groups of 50 or fewer
employees. Health Options, inc. and Blue Cross and Blue Shield of Florida, Inc. are independent
licensees of the Blue Cross and Blue Shield Association. This does not constitute a contract. For a
complete description of benefits and exclusions, please see Health Options Group Master Plan 863110;
its terms prevail.
Rev. 912001
TOTAL P.04
City of Cape Canaveral
PLAN HIGHLIGHT
Effective Date 12/01/2003
Dental Plan 1 - PLAN I
Coinsurance (Plan Pays)
Participating
Non -Participating
Dentist
Dentist
Preventive Procedures................................................................100%...................................90%
Cleanings, Exams, Space Maintainers, Fluoride for
Children(under age 19), X -Rays, Other Procedures
BasicProcedures...........................................................................80%......................................80%
Fillings, Anesthesia, Oral Surgery, Sealants, Root
Canals (In -Panel), Gum Disease (In -Panel), Other
Procedures
MajorProcedures.........................................................................50%......................................40%
Crowns, Dentures, Bridges, Onlays, Root Canals
(Out -Of -Panel), Gum Disease (Out -Of -Panel), Other
Procedures
OrthodontiaProcedures.............................................................50%......................................50%
Deductible Amounts
Preventive Procedures
Deductible Waived for Preventive ......................
Basic and Major Procedures
Cal. Year -Per Person -3 Family Max :.................
Orthodontia Procedures - Lifetime .......................
Maximum
Preventive, Basic and Major Procedures
.......$0 ........................................$0
........$50 .......................................$50
.........$100 .....................................$100
CalendarYear -Per Person.....................................................$1000...................................$1000
Orthodontia Procedures
Lifetime -Per Person.................................................................$1000...................................$1000
Proposed Rates
Employee
Employee & Family
ALLOWANCE TABLE
Preventive Procedures
Basic Procedures
Major Procedures
Orthodontia Procedures
Dental Rates With Orthodontia
Adult & Child
$24.16
70.16
IN PANEL
Negotiated Fee
Negotiated Fee
Negotiated Fee
UCR
This form is a benefit highlight, not a certificate of insurance.
OUT OF PANEL
UCR at 90%
UCR at 90%
UCR at 90%
UCR
O
w
cdtn
p
O
O
Cd
O O
� b
O 00 N
yVy.�
U
tri
conw
M_
j ti
x
O
'~
V1
(Z
Nr 6R
yN3
6N4
tn�'-
-
cd
bNl9
64
U
x
0
0
i'
L1r
V
C)
p
C14
N W M C" ^ y
e�
�p 03
N
�
6M9 r— 6�4 69 69
'
N
6s
..
69
.�.
69Cd
U
os
U
u:•
O
N N00
U
4
C>
�
,00
SS
6R C�
y •ir
b9
N.
69Cd
sUr
V U
U
Cd
C)
„-, N
N ^' cd
0
O
M
o~O OO
Oen \ y
' ' N Q
Q:
O
p
M [� V
69 69 69
V
a
N
N-•
N
O
N
69
69
69
tn
cG
U
T
O
C
U
Mco
Mco
67
OM
000 00
�
to
O
V7
Ln �
M W 00 � -
bq 6�9 64 0
C14r� N
to
.--�
�
69
69
Cd En
N
69
U d"
cs
U "G
cl
rA
cs ca
C6 U V = U
vciA
b
bol
u
�
;
'
�
0
0
�'
� = % •v y v
F
�
�
c
.°ter
.°� ° � ai
rA 4.0
a0 dCd zl
O
O
c
a
O
Z
o
oZ
o
O
O
V-)
p
c
\
o\
Vo
O
N
00
vG1i
N
i
E.9
O
C*l
oC
N
64Q
^'
.,^
6e
00O
O
iG
«S
O
C
0
0
0
p0
Z
Z
Z
Z
O
t
O
OM
ff)
CN
O
O
p
V)
O
o
0
0
69
M
M
M
N
N
i
Cl)
C
O
p
C>
p
p
b9
O
O
O
O
O
64
O
O
O
a
O
c,
o
z
a
Z
a
Z
s
Z
O
oMo
opo
00
o
o
•Q
O
�.
o
O
o
\
\
\
N
M
M
N
(�
vi
N
vj
'L
A .-.
5�R
bq
O
(5\
o
to
d
o
..
64
Ncf�
V,
c�
r.
b4
o
o
\
0
00
xa
O
0
0
0
p
oN
O
p0
Z
Z
Z
Z
N
p�
o
r0+
p
��.
0
0
o
N
�,
M
M
i
N
rV
N
O1
M
O
(Sr
64
ys
-
'osO
Cl
O
\
tn
O•
\
•
69
6M�
[�
_
69
64
CO
6
O
O
+O
w
a
p.,
Cs.
a
00
O
Z
2
Z
Z
"
oMo
N
�
cn
0�
0
i
�.f'.
O�
tr)—
O
o
o
-,,oN
M
M
1
N
�
-:t
'
C,
6969
r+
O
p�
p
V)
O
Ln
6's
4E S 14
Vl
O�
--
p
o
00
Ca
?CD
o
C
U
j
X
m
ccs
b
>
U
U
C
O
O
U
U
a
Q
w
Q
a
C�
O
O
W
G�
w
c`-;
a
U
�,
¢
00 -0 v�
O
O
00
o
c
o
¢
MN
N
M
M
'C7
it
C
to
p
O
p
p
O
M
Cl)
U
M
M
\O
00
N O
>0
_
fios
6s
m
i.. En
i
c cl O 'O
O
0
U
cn O Q w
.. b b O
0
N
N
N
*: en
O
p
V
N
o
p 'C O�
c.. cd
p'
Off+
�_
O
o
o
M
M
N
NLn
1
�_
y rn O
cs.
69
69
O
p kn
o
69
69
6a
64
V
0
0
0
�z
^3
C>
rn
\C,-.
o N
v
U 0 En
Wt 0
En
A
O
O
cd
o(A
..
q:
o
pa.
pO
0
N}
psi;
00
o
U
QV0v3w
cc" `
CD
o
00
z
z
O
0
0
0
0
cn
M
M
i
N
Mu
-d Z .�
e
59
69
000
ci'
-
C,4
b9
00_
64
y
00
O
O
0 �
A
o
.
-�D.o
o`
`^
N
tS o > cd a r4 c
'O
o
CN C-0 ��, �
y O
`-'
O
O
O�
'°
M
r
O
O\
000
1103
0 3 0 on
p
In
cn
00
N
O
N
N
�
z C •
fr
a
a
69
6A
64
O
C\69
O
N
O
�-.
'� co
a°
p
o
>w ot7; >
V N � 4r � •�
N O y N 0
t/�
o O O V
KLn
Y
O
3
0
0 �. 3
-v
�'
w
C*Q
O O
a
�-
H
%)
.^.
.: c1 ,.
U O 3 00 0
a-^
m
❑
cl
.,
C
W
U
0
cs
W
w
w
U
W
cs
w
�¢
U
a.
a
w¢
a
m
0
0
w
w
w
c.
A
Ir/