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96-22039 RESORESOLUTION NO. 96-22039 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE MAYOR AND THE CITY CLERK TO EXECUTE A SERVICE AGREEMENT WITH HUMANA HEALTH CARE PLANS TO PROVIDE MANAGED CARE MEDICAL, POINT OF SERVICE, HMO AND MEDICARE SUPPLEMENT PLANS FOR THOSE EMPLOYEES AND RETIREES ELIGIBLE PURSUANT TO CITY OF MIAMI BEACH ORDINANCE NO. 1901 WHEREAS, the City prepared the bid specifications for the Group Managed Care Medical, Point of Service, HMO and Medicare Supplement plans; and WHEREAS, through the competitive bidding process, proposals responding to Invitation to Bid No. 37-95/00 were evaluated by the Human Resources Department; and WHEREAS, upon evaluation thereof, the Human Resources Department recommended that the Group Insurance Board and Health Advisory Committee consider the top two (2) finalists, Humana Health Care Plans and Prudential Health Care System, for the Group Managed Care Medical, Point of Service, HMO and Medicare Supplement plans; and WHEREAS, the Group Insurance Board and Health Advisory Committee, approved entering into negotions with the first ranked proposer, Humana Health Care Plans, with the understanding that if negotiations failed, the Administration had the authority to proceed with negotiations with the second ranked proposer, Prudential Health Care System; and WHEREAS, on June 17, 1996, the Group Insurance Board and Health Advisory Committee recommend the award of Invitation to Bid No. 37-95/00 to Humana Health Care Plan, commencing on October 1, 1996, with a 24 month premium guarantee for the Group Managed Care Medical (PPO), Point of Service and HMO plans, and a 12 month premium guarantee for the Medicare Supplement Plan; and WHEREAS, the Administration has negotiated the attached Service Agreement and recommends approval by the Mayor and City Commission. NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND THE CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and the City Clerk are hereby authorized and directed to execute the attached Service Agreement with Humana Health Care Plans for Group Managed Care Medical, Point of Service, HMO and Medicare Supplement plans for those City employees and retirees eligible pursuant to City of Miami Beach Ordinance No. 1901. ADOPTED this 3rd day of ATTEST: CITY CLERK July ,, 1996. F:\H\$\INS\R&C\H UMARESO.696 CITY OF MIAMI BEACH CITY HALL 1700 CONVENTION CENTER DRIVE MIAMI BEACH FLORIDA 33139 TO: FROM: SUBJECT: Mayor Seymour Gelber and Members of the City Commission DATE: July 3, 1996 Jose Garcia-Pedrosa ~ City Manager t~ ~'!~ A Resolution Approving the Award of Bid No. 37-95/00, City of Miami Beach Group Managed CaYe Medical, Point of Service, HMO and Medicare Supplement Plans to the 1st Ranked Finalist, Humana Health Care Plans, for Fiscal Year 1996/97 and Authorizing the Mayor and the City Clerk to Execute a Service Agreement Between the City of Miami Beach and Humana Health Care Plans ADMINISTRATION RECOMMENDATION: To authorize the award by approving the Resolution and authorizing the execution of the Agreement. CONTRACT AMOUNT AND FUNDING: $5,527,000. (Annual Estimate) Split 50/50 between employee/retiree deductions and City contributions. City contribution funding is available from Budget Accounts of various departments, subject to OMB approval. This estimate is based on the existing number of employees and retirees enrolled in each of the plans. BACKGROUND: The Human Resources Department prepared the b}d specifications for this contract with the bid objectives and benefit changes requested by the Group Insurance Board. The Board is comprised of administrative, employee and retiree representatives. The Group Insurance Board is comprised of the presidents of the American Federation of State, County and Municipal Employees (AFSCME), and the Communications Workers of America (CWA), a retiree representative and three Administration representatives, as well as the Human Resources Director. The Health Advisory Committee is a 13 member City board comprised of individuals from the community who are involved with the health industry. Invitation to Bid No. 37-95/00 was released on January 22, 1996, and bids were received on March 5, 1996. The Human Resources Department evaluated all the bids received and presented a Preliminary Report and Initial Recommendations to the City Administration and the Group Insurance Board on April 4, 1996. On April 15th, the Group Insurance Board and the Health Advisory Committee unanimously voted to negotiate with the top two fmalists: Humana Health Care Plans and Prudential Health Care System. AGENDA ITEM DATE AWARD OF BID NO. 37-95/00 Page Two July 3, 1996 BACKGROUND: (Continued) On May 13th, representatives from Humana Health Care Plans and Prudential Health Care Systems made presentations to both Boards on their respective companies and bid proposals. As a result, the Health Advisory Committee and Group Insurance Board unanimously voted to negotiate with Humana Health Care Plans with the understanding that if for any reason the Administration failed to reach an agreement with Humana, the Administration was authorized to enter into negotiations with Prudential Health Care Systems. On June 17th, the Health Advisory Committee and the Group Insurance Board voted to recommend awarding the Group Managed Care Medical, Point of Service, HMO and Medicare Supplement Plans to Humana Health Care Plans, commencing October 1, 1996 for a one-year period, with options to renew for four (4) additional one-year periods. A Final Report prepared by the Human Resources Department is attached for City Commission review. ANALYSIS: Invitation to Bid No. 37-95/00 was advertised on January 22, 1996. A pre-bid meeting was held on February 6, 1996, and the bid opening date was March 5, 1996. One hundred-three notices and twenty- eight specification packages were mailed, resulting in nine bid responses. Bids were received from: Av-Med Health Plan CAC/United Health Care Plans of Florida (I) CAC/United Health Care Plans of Florida (II-) Foundation Health Company HIP Health Plan of Florida Humana Health Care Plans ITT Hartford Pharmacy Provider Services Corporation Prudential Health Care System The Human Resources Department evaluated all the bid proposals and it was determined that the following finns did not meet the City's bid specifications, and would not be considered: ITT Hartford - did not offer coverage for all Medicare retirees. Pharmacy Provider Services Corp. - the City was not requesting bids for a stand alone prescription program at this time. Av-Med - provided HMO coverage only (no indemnity/PPO plans quoted). CAC-United Health Care Plans of Florida (II) - provided HMO coverage only (no indemnity/PPO plans quoted). HIP - indicated that PPO coverage would not bc offered to retirees outside the HIP service area. AWARD OF BID NO. 37-95/00 Page Three July 3, 1996 ANALYSIS: (Continued) After careful consideration and review of the remaining proposals, the City Administration recommended that the boards consider the top two (2) finalists, Humana Health Care Plans and Prudential Insurance Company of America. It was determined that Humana Health Care Plans had the best proposal for the employees and retirees of the City of Miami Beach. Humana has the greatest number of hospitals and board certified physicians; better coverage for retirees outside of the South Florida area; higher benefit levels for certain services and 24 months rate guarantee periods for the Group Managed Care Medical, Point of Service and HMO plans. Once Humana was selected as the top finalist, the Group Insurance Board and Health Advisory Committee commenced negotiations with the following agreements reached or clarified, at no additional premium charge: 1) Annual physical exam, including the lab expenses, and an annual prostate exam, will be considered as a covered expense subject to $200 maximum benefit. (PPO plan) 2) Increase the current $34 eyewear credit to a $75 credit. (For all plans) 3) Elective sterilization is to be included as a covered benefit, subject to the annual deductible and co-insurance. (For all plans) 4) PAP Smear test is a covered expense. 5) Established Mail-In program for p~escription drags. Members can purchase up to a three (3) month supply of generic prescription drags via ma/l, subject to a $10 co-payment for each 30 day supply requested. The proposed premium rate increases are as follows (based on our current rates): Managed Care Medical (PPO) Point of Service (POS) Health Maint. Organization (HMO) Medicare Supplement (Gold) = 4% 24 month guarantee = 11% 24 month guarantee = 10% for 1 st 12 month guarantee, and 11% for 2nd 12 month guarantee = 5.7% 12 month guarantee A Service Agreement between the City of Miami Beach and Humana Health Care Plans has been developed to set forth performance standards for the Humana contracts. Representatives from Humana Health Care Plans and the City's Agent of Record are available to answer any questions and provide additional information. AWARD OF BID NO. 37-95/00 Page Four July 3, 1996 CONCLUSION: The Administration recommends that the Mayor and City Commission approve the attached Resolution awarding and executing a Service Agreement between the City of Miami Beach and Humana Health Care Plans for a one-year period commencing on October 1, 1996, with options to renew for four (4) additional one-year periods. JGP:RB:TCA:DMR:ses SERVICE AGREEMENT BETWEEN CITY OF MIAMI BEACH AND HUMANA MEDICAL PLAN, INC. & HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. FOR MEDICAL BENEFITS COVERING CITY OF MIAMI BEACH EMPLOYEES, RETIREES AND DEPENDENTS This Agreement, made and entered into this 1st day of October, 1996, by and between the City of Miami Beach, hereinafter referred to as "City" AND Humana Medical Plan, Inc., and Humana Health Insurance Company of Florida, Inc., their successors and assigns, hereinafter referred to as "Humana" WITNESSETH, In consideration of the City awarding Invitation to Bid No. 37-95/00, Group Managed Care Medical, Point of Service, HMO and Medicare Supplement Plans, to Humana, as the top-ranked proposer, for a one (1) year term, and other mutual terms, conditions, promises, covenants and payments hereinafter set forth, the City and Humana agree as follows: o I. PROVISIONS OF AGREEMENT Open Enrollment/Educational Sessions The City will schedule the annual Open Enrollment sessions at various locations and times, and will notify Humana Account Services at least two weeks prior to the first sessions. From one to three other times during the plan year, educational sessions will be conducted again at various locations and times, as agreed by the City and Humana. Humana will provide a representative to conduct benefit presentations at these sessions. HMO. POS and PPO Plans Packets Humana will prepare and distribute by U.S. mail HMO, POS and PPO Plans packets at least two weeks in advance of the commencement of the City's annual Open Enrollment. o an Open Enrollment announcement to be included in each packet, and review information to be included in the packets in advance of printing and distribution. Mailing labels will be provided by the City. Any packets returned for incorrect address will be given to the City administration to send to the employee or retiree. Provider Directories In addition to the HMO, POS and PPO provider directories distributed at Open Enrollment, Humana shall mail to each member a new directory or a list of changes to the previous directory not less than once each calendar quarter. Humana will also notify the City administration in writing of additions, changes or deletions which occur in the interim. Humana must honor all claims for deleted providers until the next directory or list of changes is mailed to the members. HMO and POS Plans members are to be advised by Humana by mail of reassignments to new centers due to cancellation of center contracts. Notification is to be thirty (30) days prior to the reassignment date, or as expeditiously as possible is contract cancellation is effective in less than 30 days. Each calendar quarter, Humana shall provide a list of providers such as home health care, extended care facilities, durable medical equipment, hospice and other such providers contracted with Humana. Each calendar quarter, Humana shall identify the contracted providers for anesthesiology, pathology, radiology, and emergency physician group at each contracted PPO hospital in South Florida Service Area. Also, Humana shall provide assistance to plan members in identifying PPO contracted outpatient facilities billing as hospital facilities. 4. Identification Cards 2 For new enrollees and members with plan or coverage changes, including Open Enrollment, Humana will process the enrollment or change no later than three weeks upon receipt by the Humana Billing office in Louisville, Kentucky. The member is responsible for informing the City Employee Benefits Section of the Human Resources Department. If Humana fails to do so, Humana Account Services must contact providers to arrange for coverage of medical care required. The Account Services representative will be responsible for having the identification card(s) produced and sent to the member. 5. PPO and POS Plans Late Entrants Employees and/or dependent(s) requesting enrollment in the Humana PPO and POS Plans after Open Enrollment has ended or after the 30 day eligibility period will complete the appropriate Enrollment or Change Form, including the Medical Statement. The completed form will be sent by the City to the Humana Billing office for handling. If additional information is required from Humana, Humana will send a written request for any additional information postmarked within two weeks of the application's receipt by the Humana underwriting department as logged in their computer data base. The applicant will have a minimum of six weeks from the date of Humana's request to the date postmarked on the envelope returning the information to Humana. Humana Account Services is to keep the City administration advised of the status of late entrant applicants. 6. Claims and Correspondence Responses Humana agrees to correspond directly with PPO, POS and HMO members regarding the status of any claims submitted which have not been resolved within 30 days of the date of receipt by Humana. The City administration shall notify Humana of post-30 day claims via claims transmittal forms and copies of claims, or the member may provide notice to Humana in writing with a copy of the claim in question attached. Humana shall respond in writing, or verbally with a follow-up in writing, to the 3 o member (or the City administration, if the member can not be contacted). Information will include the status of the claims, reasons for any delays, and the name and telephone number for a Humana contact person to receive additional information. Responses shall be received by the member (or the City administration, if the member can not be contacted) within 14 calendar days (which includes return mail time) of Humana's receipt of the request. FAILURE TO COMPLY WILL RESULT IN A $100 PER CALENDAR DAY PENALTY TO BE PAID BY HUMANA UPON WRITTEN NOTIFICATION BY THE CITY TO HUMANA. THE AFFECTED MEMBER WILL RECEIVE ONE-HALF OF THE PENALTY, to be applied by the City to the member's healthcare plan premium deduction. This penalty may be waived only by mutual agreement between the City and Humana. "Threatening Letter" Responses Any time a PPO, POS or HMO member receives a letter from a PPO or non-PPO provider threatening legal action, referral to a collection agency or other negative action which could jeopardize the member's credit standing because of Humana's delay or failure to pay claims, Humana shall respond, in writing or verbally with a follow-up in writing, to the member and the City administration with an explanation of the status of any claims submitted within the past 30 days. The City administration shall notify Humana of threatening letter via claims transmittal form and copy of all relevant information available. Humana's response shall include the status of the claims, reason for any delays, and the name and telephone number for a Humana contact person to received additional information. Responses shall be received by the member (or the City administration, if the member can not be contacted) within 14 calendar days (which includes return mail time) of Humana's receipt of the request. FAILURE TO COMPLY WILL RESULT IN A $100 PER CALENDAR DAY PENALTY TO BE PAID BY HUMANA UPON WRITTEN NOTIFICATION BY THE CITY TO HUMANA. THE AFFECTED MEMBER WILL RECEIVE ONE-HALF OF THE PENALTY, to be applied by the City to the member's healthcare plan premium deduction. This penalty may be waived only on a case-by- case basis, by mutual agreement in writing between the o City and Humana. Dedicated Services in Humana Effective October 1, 1996. a o Humana agrees to process PPO Plan claims for City of Miami Beach members, both employees and retirees, in a claims processing unit dedicated exclusively to 'special' (including Service Agreement accounts. Humana will maintain experienced staffing in this claims processing unit to insure timely and accurate processing according to plan benefits. Humana will maintain experienced staffing in this claims processing unit to insure timely and accurate processing according to plan benefits. Humana shall conduct an audit with a random sample of 10% of Medicare primary claims submitted each calendar quarter. A report shall be provided to the City. Humana agrees to place an Account Service Representative within the City of Miami Beach Human Resources Department office on a full-time basis. The representative will be authorized to resolve PPO, POS and HMO problems brought to the Representative to handle. Also, the Representative will be authorized to resolve Gold Plan (Medicare Supplement) claims problems, coordinating activities with the South Florida Representative. Group Medicare The Representative will have a computer terminal on-line with Humana to provide information upon request regarding claims, enrollment and billing. The Representative will also have a toll free 1-800 telephone number in order for retirees who reside outside of the South Florida area may call with service problems. In the event of a change in Representative, the City will be provided with a resume of the proposed representative ' s qualifications and experience. Should the Representative be scheduled to be absent from the office more than three (3) consecutive business days, telephone calls to the Representative will be rerouted to the Account Services Analyst under the supervision of the Account Services Supervisor. Humana of Miami Beach offices determined necessary by both parties. Humana agrees to provide ready access to a Utilization Specialist to assist HMO, POS and PPO members with medical issues including PPO and POS prior authorizations, PPO and POS pre -admission certifications, PPO and POS length of stay issues and discharge planning; HMO and POS referrals, access to HMO and POS primary care physicians, and obtaining authorizations for emergency and outpatient care. Access for employees and retirees will be via the in-house Service Representative. HMO, POS and PPO Plans - Changes in Benefits When Humana changes a plan benefit, the City administration shall be notified at least 60 days prior to the proposed effective date of the change. All changes must be agreed to by the City administration at least 30 days prior to the actual implementation date. All plan members must be notified by announcement mailed to their home addresses at least 15 days prior to implementation, once such change has been agreed to by the City administration. FAILURE TO COMPLY WILL RESULT IN A $100 PENALTY PER MEMBER ADVERSELY AFFECTED, TO BE PAID BY HUMANA UPON WRITTEN NOTIFICATION BY THE CITY TO HUMANA. EACH AFFECTED MEMBER WILL RECEIVE ONE-HALF OF THE PENALTY, to be applied by the City to the member's healthcare plan premium deduction. ALSO, AN EXCEPTION WILL BE REQUESTED AND APPROVED TO PROVIDE THE BENEFIT AT THE PREVIOUS LEVEL UNTIL THE CHANGE IS APPROVED BY THE CITY ADMINISTRATION AND NOTIFICATION PROVIDED TO THE PLAN MEMBERS. 10. HMO and POS Plan Physician Appointments Humana guarantees that all "emergency" medical care required by covered City members will be available within 24 hours of notification by the covered member or his representative (i.e. family member, friend, hospital or other provider) to one of the following Humana offices: Pre-admission Review/Prior Authorization in Louisville, Kentucky at 800) 523-0023; Customer Services at Miami, Florida at 800) 521-4882 or (305) 623-2400; or the member's primary care physician office or, if after office hours, the physician's answering service. Further, Humana guarantees that each covered City member requiring "urgent" medical care due to illness or injury (but not considered an "emergency") will be able to secure an appointment and have treatment provided by a 7 Primary Care Physician or, if deemed medically necessary (and authorized by the patient's HMO and POS Center), a specialist within 72 hours (including weekends and/or observed Federal holidays) of notification by the covered member or his representative (i.e. family member, friend, or a City Employee Benefits representative). Notification shall be to the member's Humana primary care Physician's office or, if after hours, the physician's answering service; or Customer Services in Miami, Florida at (800) 521-4882 or (305) 623-2400. FAILURE TO COMPLY WILL RESULT IN A $100 PER CALENDAR DAY PENALTY TO BE PAID BY HUMANA UPON WRITTEN NOTIFICATION BY THE CITY TO HUMANA. THE AFFECTED MEMBER WILL RECEIVE ONE-HALF OF THE PENALTY, to be applied by the City to the member's healthcare plan premium deduction. ALSO, AN EXCEPTION WILL BE REQUESTED BY THE CITY AND APPROVED BY HUMANA TO PROVIDE PLAN BENEFITS FOR THE FOLLOWING: (a) ONE EMERGENCY ROOM OR OFFICE VISIT (INCLUDING MEDICALLY NECESSARY SERVICES SUCH AS TESTS AND/OR PROCEDURES) FOR "EMERGENCY" SERVICES INCURRED BY THE MEMBER IF "EMERGENCY" SERVICES WERE NOT AVAILABLE BY THE END OF THE 24 HOUR PERIOD. HUMANA'S PENALTY WOULD BE LIMITED TO $100 (ONE CALENDAR DAY). (b) ONE OFFICE VISIT FOR "URGENT" SERVICES (INCLUDING MEDICALLY NECESSARY SERVICES SUCH AS TESTS AND/OR PROCEDURES) INCURRED BY THE MEMBER IF "URGENT" SERVICES WERE NOT PROVIDED BY THE END OF THE 72 HOUR PERIOD. HUMANA'S PENALTY WOULD BE LIMITED TO $100 (ONE CALENDAR DAY). Humana agrees that any covered City member requiring specialty care shall be referred to an appropriate specialist and have treatment provided within two (2) weeks of the Primary Care Physician visit if the patient's health and well-being would be compromised by a delay in specialty care beyond the two (2) week period. Otherwise, specialty care shall be provided within four (4) weeks of the Primary Care Physician visit. If an appropriate specialist is not contracted by the patient's HMO and POS Center, Humana shall arrange for treatment to be provided within the time frames and guidelines set forth above in this paragraph. FAILURE TO COMPLY WILL RESULT IN A $100 PER CALENDAR DAY PENALTY (UNTIL IN COMPLIANCE OR AS NOTED BELOW), TO BE PAID BY HUMANA UPON WRITTEN NOTIFICATION BY THE CITY TO HLrMA_NA. THE AFFECTED MEMBER WILL RECEIVE ONE-HALF OF THE PENALTY, to be applied by the City to the member's healthcare plan premium deduction. ALSO, AN EXCEPTION WILL BE REQUESTED BY THE CITY AND APPROVED BY HUMANA TO PROVIDE PLAN BENEFITS FOR THE FOLLOWING: (a) ONE OFFICE VISIT FOR SPECIALTY SERVICES (INCLUDING MEDICALLY NECESSARY SERVICES SUCH AS TESTS AND/OR PROCEDURES) INCURRED BY THE MEMBER IF SPECIALTY SERVICES WERE NOT PROVIDED BY THE END OF THE TWO (2) WEEK PERIOD, IF THE PATIENT'S HEALTH AND WELL-BEING WOULD BE COMPROMISED BY A FURTHER DELAY. HUMANA'S PENALTY WOULD BE LIMITED TO $100 TIMES THE NUMBER OF CALENDAR DAYS FROM THE END OF THE TWO (2) WEEK PERIOD UNTIL THE DATE OF THE SPECIALTY VISIT. (b) ONE OFFICE VISIT FOR SPECIALTY SERVICES (INCLUDING MEDICALLY NECESSARY SERVICES SUCH AS TESTS AND/OR PROCEDURES) INCURRED BY THE MEMBER IF SPECIALTY SERVICES WERE NOT PROVIDED BY THE END OF THE FOUR (4) WEEK PERIOD. HUMANA'S PENALTY WOULD BE LIMITED TO $100 TIMES THE NUMBER OF CALENDAR DAYS FROM THE END OF THE FOUR (4) WEEK PERIOD UNTIL THE DATE OF THE SPECIALTY VISIT. II. TERM OF AGREEMENT This Agreement shall commence on October 1, 1996 and terminate September 30, 1997. The City administration and Humana have the option to renew this Agreement annually upon mutual consent. III. PERFORMANCE OF SERVICE NOTIFICATION Humana shall receive notices regarding performance of service addressed to the following: Sandrea Silvera, Account Services Director Humana Health Care Plans 3400 Lakeside Drive Miramar, Florida 33027 Telephone: (305) 626-5216 The City administration shall receive notices regarding performance of service addressed to the following: Dee Martinez Ravelo, Employee Benefits Coordinator Human Resources Department City of Miami Beach 1700 Convention Center Drive Miami Beach, FL 33139 Telephone: (305) 673-7000 Ext. 6540 10 IV. PAYMENT OF PENALTIES Any time penalties are incurred by Humana pursuant to the terms of the Agreement, the City administration will submit a written invoice to Humana detailing the dates, City member names, identification numbers and alleged performance failures. Humana must agree to or dispute these penalties within 20 days of receipt. If Humana agrees that the penalty is justified, Humana will acknowledge the penalty and inform the City administration in writing within 10 days of the decision. Humana will pay these agreed-to penalty amounts to the City administration within the following 30 days. If Humana does not agree that the penalty is justified, Humana will inform the City administration in writing within 10 days of the decision. A meeting between the City administration and Humana will be held within 30 days to resolve the alleged penalty through negotiations. V. ENTIRE AGREEMENT Ail provisions contained within this Agreement, the City of Miami Beach Invitation to Bid No. 37-95/00, and Humana's Bid Response represent all the terms and conditions agreed to by the City administration and Humana. In the event of a discrepancy between these documents, the order of priority of the documents shall be as follows: 1) This Agreement; 2) Humana's Bid Response; 3) City of Miami Beach Invitation to Bid No. 37-95/00. The City administration and Humana recognize that in order to comply with applicable State laws, Humana must file a document with the State of Florida Department of Insurance setting forth the benefits and coverage to be provided by Humana under the terms of 11 this Agreement, Humana's Bid Response and City of Miami Beach Invitation to Bid No. 37-95/00. The City administration and Humana acknowledge that the document to be provided to the State is not a full and accurate representation of the terms and conditions as set forth in this Agreement, City of Miami Beach Invitation to Bid No. 37-95/00 and Humana's Bid Response. 12 IN WITNESS WHEREOF, the parties have made and executed this Agreement on the respective dates under each signature: CITY OF MIAMI BEACH Attest: City Clerk CITY OF MIAMI BEACH B . %3 ~'(-~ Mayor LEGAL HUMANA HEALTH CARE PLANS (CORPORATE SEAL) HUMANA HEALTH INSURANCE COMPANY OF FL, INC. Vice President Fi. Market Operations (CORPORATE SEAL) HUMANA MEDICAL PLAN, INC. Nar~e and~T/~t le DATE: -7/! / / Vice President Market Operations 13