2009-27136 ResoRESOLUTION NO. 2009-27136
A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE
CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE CITY TO
ENTER INTO AN AGREEMENT WITH HUMANA INSURANCE
COMPANY AND HUMANA LIFESYNCH FOR THE ADMINISTRATION
OF THE CITY'S GROUP HEALTH (MEDICAL) PLAN AND EMPLOYEE
ASSISTANCE PROGRAM FOR A THREE YEAR PERIOD,
COMMENCING ON JANUARY 1, 2010, AND ENDING ON DECEMBER
31, 2013, FOR A NOT TO EXCEED FEE OF $1,200,000 ANNUALLY,
FOR THE FIRST AND SECOND YEARS, PURSUANT TO THE
REQUEST FOR PROPOSALS ISSUED BY GALLAGHER BENEFITS
SERVICES, THE CITY'S CONSULTANT OF RECORD.
WHEREAS, the City's agreement for its self-funded group health (medical) plan
administrator expires on December 31, 2009; and
WHEREAS, in order to continue providing the self-funded group health (medical)
benefit to the City's employees and retirees, the Administration worked with Gallagher
Benefit Services (Gallagher), the City's consultant of record, to issue a Request for
Proposals (RFP) for the administration of the group health (medical) plan and the City's
Employee Assistance Plan (EAP); and
WHEREAS, on May 8, 2009, Gallagher issued Group Employee Benefits RFP
No. 10-2589 on behalf of the City; and
WHEREAS, in response to this RPF, the seven (7) vendors responded, with six
(6) deemed to be responsive; and
WHEREAS, the proposed administrative fee submitted by Humana, the City's
current provider, was three percent (3%) lower than its current administrative fee, and
was lower than any of the other respondents (37.2% lower than the highest bid, and
4.9% lower than the second most competitive bid) and ;and
WHEREAS, the City's Group Insurance Board (Board) was asked to the make a
recommendation to the City Manager on the renewal of the City's group health
administrator for the medical plans; and
WHEREAS, the final recommendation of the Board was to award the
administration of the City's group health (medical) plan to Humana; and
WHEREAS, the RFP also included a request for Employee Assistance Plan
(EAP) services; and
WHEREAS, after evaluating the respondents, Gallagher recommends that the
management of the City's EAP be awarded to Humana LifeSynch, based on the value of
the benefit provided and the cost; and
WHEREAS, the City Manager has reviewed the recommendations of the Board
and Gallagher and recommends accepting the recommendation of both Gallagher and
the Board, awarding the administration of the City group health (medical) plan to
Humana, and the EAP to Humana LifeSynch.
NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND CITY
COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City
Commission hereby authorize the City to enter into an agreement with Humana
Insurance Company and Humana LifeSynch for the administration of the City's Group
Health (Medical) Plan and Employee Assistance Program for a three year period,
commencing on January 1, 2010, and ending on December 31, 2013, for a not to
exceed fee of $1,200,000 annually, for the first and second years, pursuant to the
Request for Proposals issued by Gallagher Benefits Services, the City's consultant of
record.
PASSED and ADOPTED this 15th day of July , 2009.
ST:
a~ ~a~~c~.-,.
CITY CLERK
Robert Parcher
MA OR
Mattie Herrera Bower
APPROVED AS TO
FORM & LANGUAGE
~ FOR EXECUTION
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Attome D to
T:\AGENDA\2009Uu1y 15\Regular\Medical Benefit Resolution.doc
COMMISSION ITEM SUMMARY
Condensed Title:
A Resolution authorizing the City to enter into an agreement with Humana Insurance Company for the
administration of the City's Group Health (medical) Plan and Employee Assistance Program (EAP).
Intended Outcome Su
• Attract and maintain a quality workforce.
• Ensure ex enditure trends are sustainable over the Ion term.
Supporting Data (Surveys, Environmental Scan, etc.):
I. 2007 Employee Satisfaction Survey
• 68.8% of employees surveyed participate in medical benefits and 69.6% in dental benefits.
• 63.5% of employees surveyed ranked medical benefits as the most important benefit the City offers
II. 2007 Internal Support Functions Survey.
• Overall satisfaction of benefits administration was rated 75.6% as excellent or good combined.
III. 2008 Environmental Scan
• Motivated and Skilled Workforce turnover rates = 13.86% for 2007 vs. 10.7% for 2006.
Issue:
Should the City enter into an agreement for the administrative services of the City's group health (medical) plan
with Humana and for the City's Employee Assistance Program (EAP) with Humana, LifeS nch?
Item 5ummarv/Recommendation:
The City Code of Ordinances provides for employee health care coverage with the cost of such coverage shared
between the employee and the City. In addition, the collective bargaining agreements of AFSCME, CWA, and
GSA all require the City to provide group health coverage to their members. On January 1, 2009, with one (1)
year left on the City's current group health (medical) contract, the City moved from afully-insured plan to a self-
insured plan. The current administrative service contract with Humana expires on December 31, 2009. In
addition, due to coverage issues with the current Employee Assistance Program (EAP), the Administration
deemed it necessary to explore additional avenues to provide employees with this valuable and important benefit.
At the direction of the City's Administration, Gallagher Benefits Services issued their RFP No.10-2589 on May 8,
2009, requesting proposals for the administration of the City's group health (medical) plan and Employee
Assistance Program (EAP). As a result of this RFP, Gallagher Benefits Services and the City's Group Insurance
Board have recommended renewal of the City's current administrative agreement with Humana and to enter into
an agreement with Humana, LifeSynch for the City's Employee Assistance Program (EAP), both for a period of
three (3) years.
Adviso Board Recommendation:
The Grou Insurance Board recommends this action.
Financial Information:
Source of Amount Account
Funds: 1 $768,000 (not to exceed) 560-1793-000322
Administrative fees for Active Em to ees
2 $432,000 (not to exceed) 560-1793-000322
Administrative fees for Retirees
3
OBPI Total $1,200,000
Financial Impact Summary:
The proposed plan management fees submitted by the incumbent administrator, Humana, are three percent
(3%) lower than the current fees charged to the City, resulting in annual savings of approximately $26,126.52. In
addition, the Humana proposal includes a not to exceed administration fee guarantee, providing the City with
consistent medical plan administration fees through December 31, 2011.
Implementing the recommended change in the City's Employee Assistance Program (EAP) from the Ceridian
Program through Mount Sinai Medical Center to the Humana, LifeSynch program will provide the City with an
annual savings of $4,700 through December 31, 2011. This change in Employee Assistance Program (EAP)
providers also includes a two (2) year rate guarantee, providing the City with a consistent program fees through
December 31, 2011, and better coordination between the EAP services and employees' health insurance
covera a if additional services are needed.
Cit Clerk's Office Le islative Trackin
Sue Radig, Human Resources Administrator I
Si n-Offs•
Department Director Assistant City Manager City Manager
Ramiro Inguanzo,
Human Resources Director ,.--
~~ }~j ~ ,/~ ~ ~~`v ~ A E' A ITEM ~ 1.1..
'~ Y 1 ~/ 1 DATE 7-IS-0
m MIAMIBEACH
City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachFl.gov
COMMISSION MEMORANDUM
TO: Mayor Matti Herrera Bower and Members of the City Commission
FROM: Jorge M. Gonzalez, City Manager
DATE: July 15, 2009
SUBJECT: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI
BEACH, FLORIDA, AUTHORIZING THE CITY TO ENTER INTO AN AGREEMENT WITH
HUMANA INSURANCE COMPANY FOR THE ADMINISTRATION OF THE CITY'S
GROUP HEALTH (MEDICAL) PLAN AND EMPLOYEE ASSISTANCE PROGRAM FORA
THREE YEAR PERIOD, WITH A NOT TO EXCEED FEE OF x1,200,000 ANNUALLY FOR
THE FIRST AND SECOND YEARS, PURSUANT TO THE REQUEST FOR PROPOSALS
ISSUED BY GALLAGHER BENEFITS SERVICES, THE CITY'S CONSULTANT OF
RECORD.
ADMINISTRATION RECOMMENDATION
Adopt the Resolution.
BACKGROUND
Chapter 78, Article II, Sections 78 through 81 of the City Code of Ordinances provide for employee
health care coverage with the cost of such coverage shared between the employee and the City. In
addition, the collective bargaining agreements of the American Federation of State, County and
Municipal Employees (AFSCME), the Communication Workers of America (CWA), and the
Government Supervisors Association (GSA) all require the City to provide group health coverage to
their members. Providing group health coverage to employees enables the City to attract and
maintain a quality workforce, one (1) of the key intended outcomes of the City's Strategic Plan.
Currently, the City provides its active full-time employees and retirees the opportunity to purchase
group health care (medical) coverage. The City's group health plan excludes coverage for members
of the Fraternal Order of Police (FOP) and the International Association of Fire Fighters (IAFF), as
both have their own health trusts and do not participate in the City's Group Health Insurance Plans.
Both the City and the employee/retiree contribute to the cost of this coverage, at different rates, based
on the plan elected by the participant.
Retirees hired prior to March 18, 2006 share equally in the group health cost with the City paying 50%
and the retiree paying 50% of the cost of coverage. However, due to the changes in the Cites pension
system in March 2006, those employees hired after March 18, 2006 will be provided a stipend of $10
a month for each year of service toward their group health costs as retirees. This change in 2006
results in long-term savings to the City overtime.
In 2001, the City recognized that, along with other public and private employers, it was experiencing
significant increases in the cost of health insurance. At that time, the City formed the Group Health
Insurance Task Force, made up of residents and employees, with the objective of developing
July 15, 2009 City Commission Meeting
Selection of a Group Health Insurance Administrator
Page 2 of 7
comprehensive solutions addressing the City's growing challenges in the area of group health
insurance. The Group Health Insurance Task Force was asked to review the City's benefit levels,
plan designs, costs, and coverage, to make recommendations regarding the City's group health care
options consistent with industry standards, and to help reduce the City's spiraling health care costs.
Many of the recommendations made by this Task Force have been implemented, and have provided
the City with some relief in annual premium cost increases. Some of the recommendations that have
been implemented include:
• Conforming the City's benefits plans to industry standards.
• Increase the City share for the standard benefit plans to encourage employee enrollment
(these plans were introduced in 2004).
• Continue City support and premium contribution for dependent group health coverage.
• Change the City contribution for Retiree Group Health to coverage based on years of service.
• Pursue the use of Medicare HMOs and Supplemental Policies for retirees.
In June 2008, the City Commission passed aresolution toimplement aself-insured group health plan.
The City previously provided employee group health coverage through afully-insured group health
plan. Under afully-insured group health plan, the City provides group health care coverage without
any assumption of risk or reward. The City purchased an "off-the-shelf" plan for a set monthly cost,
with the understanding that coverage could not be changed or customized to the group's varying
needs. Monthly premium dollars were paid to the carrier without any City controls on the plan, without
any information flowing back to the City on incurred claims, or without any guarantee that the plan is
providing high quality cost effective benefits to its employees. The carrier built gains (profits) into its
premium costs to guarantee both plan solvency and a return to the plan's investors. The City's only
risk was the steady increase in premium based solely on the group's claim performance for the
previous year - a good claim year resulted in a minimal premium increase for the next plan year;
whereas a bad claim year resulted in a significant premium increase for the next plan year, allowing
the carrier to recoup their losses from the previous year, and earn profit for the new plan year.
By moving to aself-insured group health plan, the City would assume both the plan's risk and its
reward. A monthly administration fee is paid to the plan administrator or third party administrator
(TPA), providing the City with a provider network, claims adjudication and plan administration,
minimizing the carrier's profit. The City is provided access to employee claim information (without any
identifying employee information) to help customize plan benefit design and health and wellness
events. In addition, the incurred claims information can be utilized by the City's benefits consultant to
make the annual actuarial determination of plan premium costs. Excess premium amounts (carrier
profits under afully-insured plan) are retained by the City and used to build the City's plan reserves,
which can be utilized to enhance future benefits, mitigate risk and restructure premium for the City
and employees. In years when the City may incur claims costs greater than the assumed risk, plan
reserves would be available to mitigate the cost impact to the City and its employees. It is important
to note that plan reserves can only be used for health care components, and cannot be used for any
other purposes.
The TPA provides the City with the day-to-day administration of the medical plan benefits, access to
provider networks and provider discounts, claims processing, prescription drug management, detailed
claim and plan utilization reporting, case management, disease management, and wellness
programs. In addition, the plan administrator guarantees the plan's compliance with state and federal
mandates, including the Consolidated Omnibus Budget Reconciliation Act (COBRA) and Health
Insurance Portability and Accountability Act (HIPAA).
ANALYSIS
The City's decision to implement the move to self-funding was facilitated by year over year cost
increases to the fully-insured medical plan and the knowledge that our contract with our medical plan
carrier was to expire at the end of the 2009 calendar year. By changing the City's group health
funding mechanism in the 2009 plan year, the City provided itself the opportunity to become familiar
July 15, 2009 City Commission Meeting
Selection of a Group Health insurance Administrator
Page 3 of 7
with the self-funding process under a known plan set-up and payment arrangements. Effective
January 1, 2009 the City's fully-insured agreement with Humana was changed to aself-funded
agreement, with Humana providing the day-to-day administration of the City's medical plan. This
made the transition to self-funding less complex than a change to a new funding mechanism
potentially under a new plan vendor.
A claim analysis completed by Gallagher Benefits Services for the City's self-funded medical plan
reflects an anticipated saving to the City at the of the 2009 plan year of approximately $1.3 million
dollars. This analysis was completed based on the claims paid by the City's current claims
administrator, Humana, through April 30, 2009. It is important to understand that these are projected
cost savings and do not take into consideration the unforeseen catastrophic claim costs that could
impact the final annual savings to the City. These anticipated savings are a testament to the City's
decision to move forward with aself-funded group health plan.
On May 8, 2009 the City's consultant of record, Gallagher Benefits Services (Gallagher), issued their
RFP No. 10-2589 vendor bids for the administration of the City's self-funded group health (medical)
plan and Employee Assistance Program (EAP).
Group Health (Medicall Plan
The following seven (7) vendors responded to Gallagher's RFP for administration of the City's group
health coverage:
• Aetna Healthcare
• AvMed
• Blue Cross Blue Shield of Florida
• CIGNA Healthcare
• Humana Insurance Company
• United Healthcare
• Vista Healthplan
Of these seven (7) vendors, only Vista Healthplan declined to bid as they were not able to quote on all
the items included in the RFP.
The remaining six (6) responding proposals received for the administration of the City's medical plan
were qualified and considered, with each providing their "best and final" proposal. Listed below are
each of these, along with their monthly administrative services fee (the monthly fee the City pays for
each enrolled employee and retiree (participant) per month for the administration of the City's plan,
including, access to providers in the plan's networks, customer service representatives, claims
processing, etc.) and their rate guarantee term:
Plan Administrator Monthly Fee
Per Em to ee/Retiree
Rate Guarantee
Aetna Healthcare $45.93 One 1 ear
AvMed $40.44 Two 2 ear
Blue Cross Blue Shield of
Florida
$61.25
One (1) year
CIGNA Healthcare $51.81 One 1 ear
Humana Insurance Com an $38.44 One 1 ear
United Healthcare $46.57 One 1 ear
Of the six (6) proposals, Humana, the City's current medical plan administrator, provided an
administration fee which was lower than any of the competing respondents (37.2% lower than the
highest bid and 4.9% lower than the second most competitive bid) with a one (1) year rate guarantee
including a second year not to exceed fee for plan administration of $43.57. The following table
demonstrates each vendor's proposed annual administrative fees taking into consideration the City's
July 15, 2009 City Commission Meeting
Selection of a Group Health Insurance Administrator
Page 4 of 7
current enrollment of 1,072 employees and 578 retirees who currently participate in the Cites medical
plans:
Plan Administrator Monthly Fee Per
Employee/Retiree Total Annual
Administration Fee Percent Over Lowest
Proposed Fee
Aetna $45.93 $902,249 19%
AvMed $40.44 $794,403 4.9%
Blue Cross Blue Shield of
Florida
$61.25
$1,203,195
32%
CIGNA Healthcare $51.81 $1,017,756 37.2%
Humana Insurance
Com an
$38.44
$755,115
0%
United Healthcare $46.57 $914,821 21
Gallagher reviewed each proposal for claims administration and network access. The RFP requested
both a duplication of the existing plan benefits and alternative benefit schedules designed to reduce
plan costs. After thorough review, Gallagher has recommended (Attachment A) that the City renew
its medical plan administration with Humana based on the following:
Humana is offering the lowest administrative fee to the City, including a reduction in the
current administrative plan costs
Retaining medical coverage through Humana will cause no disruption in the current
relationships between the plan members (the employees and retirees) and plan providers
The physician and facility discounts provided by Humana, after an analysis by Gallagher of
the of the physician and hospital reimbursement agreements the network providers have with
Humana, revealed the highest provider discounts in the South Florida area.
Additionally, maintaining the current administration of the plan with Humana will also help minimize
implementation costs as the City's employees and retirees are familiar with the Humana plan and its
networks, requiring no additional educational materials to be created and distributed.
The City's Group Insurance Board, comprised of employees representing unclassified and classified
employees, met on July 7, 2009 to review and make a recommendation to the City Manager on the
renewal of the City's group health administrator for the medical plans. The Group Insurance Board
included:
• Jose Cruz, Budget Officer, Office of Budget and Performance Improvement
• Georgie Echert, Assistant Director, Finance Department
• John Gresham, Union Representative, Government Supervisors Association (GSA)
• Cliff Leonard, Risk Manager, Human Resources Department
• Richard McKinnon, President, Communication Workers of America (CWA)
• Sue Radig, HR Administrator I Employee Benefits, Human Resources Department
• Perman Terry, President, American Federation of State, County, and Municipal Employees
(AFSCME)
The Group Insurance Board met and reviewed the "best and final" proposals and also addressed the
costs associated with the process of having employees migrate from the Humana plan to an alternate
medical plan. The Group Insurance Board reviewed the proposed plan management fees submitted
by all the plans. Based on the reduction in the administrative fee cost and a second year not to
exceed administrative fee, the final recommendation of the Group Insurance Board was to award the
administration of the City's group health (medical) plan to Humana based the cost savings provided.
The Group Insurance Board's final recommendation is based on Humana's proposed reduction of
three percent (3%) from the current fees paid by the City, resulting in annual savings of approximately
July 15, 2009 City Commission Meeting
Selection of a Group Health Insurance Administrator
Page 5 of 7
$26,126.52 and Humana's second year rate guarantee, providing the City with consistent medical
plan administration fees through December 31, 2011.
Emaloyee Assistance Program (EAP)
In addition, Gallagher's RFP No.10-2589 included a request for Employee Assistance Program (EAP)
services. The City's current EAP provides employees and their family members with telephonic
access to licensed mental health clinicians (24 hours a day, seven (7) days as week), three (3) face-
to-face counseling sessions with licensed mental health clinicians, on-site training services for
employees and management staff, workplace crisis response services and substance abuse
counseling for both voluntary and employer mandated treatment. The program coordinates care with
the patient's medical plan or community service programs if no medical plan benefit is available.
The City's current EAP services are provided through Ceridian by the City's medical services contract
with Mount Sinai Medical Center. Ceridian declined to respond to this RFP. The City has
experienced issues with services from Ceridian since they were contracted approximately nine (9)
months ago. The service issues have been raised with Mount Sinai Medical Center, who has raised
them with Ceridian. Having the services contracted through athird-party with no coordination with the
City's group health (medical) plan provider has proven complicated and inefficient at best. Since the
City was having Gallagher issue an RFP for many other services, it seemed appropriate to take
advantage of the opportunity to see if any efficiencies and cost-savings could be found.
The following six (6) vendors responded to Gallagher's RFP to provide EAP services for the Cites
employees and their dependents:
• Aetna Behavioral Health
• Blue Cross Blue Shield, Corporate Care Works, Inc
• CIGNA Corporation
• Humana, LifeSynch
• MHNet
• Total Employee Assistance and Management, Inc.
The six (6) responding proposals received for the City's EAP were qualified and considered with each
providing their "best and final" proposal. Each EAP vendor provided a proposal indicating their
monthly administration fee (the charge to the City each month for each active employee) to provide
their EAP services, including, access to their network providers and services and the total number of
face-to-face counseling sessions with licensed mental health clinicians. The chart below reflects the
plan administrator, their monthly program fee, the total annual program fee and the face-to-face
counseling session limits:
Plan Administrator Monthly Program Fee
Per Employee Total Annual
Program Fee Face-to-Face
Visit Limit
Aetna Behavioral Health $1.83 $43,392.96 3
Blue Cross Blue Shield,
Cor orate Care Works, Inc.
$1.60
$37,939.20
3
CIGNA Corporation $1.47 $34,856.64 3
Humana, LifeSynch $1.35 $32,011.20 5
MHNet $2.29 $54,300.48 3
T
t
l E
l $1.50 $35,568.00 3
o
a
mp
oyee Assistance
and Management
Inc. $2.05 $40,508.00 3
, $2.65 $62,599.68 3
Total Employee Assistance and Management, Inc. provided fees for three plans, each providing (3)
face-to-face visits but with different service and coverage levels in each plan.
July 15, 2009 City Commission Meeting
Selection of a Group Health Insurance Administrator
Page 6 of 7
In addition, each respondent proposed unlimited telephonic consultations, web access to educational
materials and non-clinical services. All the respondents indicated they were able to direct employees
and their family members to licensed therapists when necessary, however, only Humana, LifeSynch
program was able to guarantee direct referral to mental health counselors who are members of the
Humana Medical Plan provider networks, providing continued treatment through the medical plan with
the same therapist as provided by through the EAP benefit if required. In addition, the majority of
patient issues can usually be resolved in three (3) to five (5) counseling sessions. These sessions,
provided within the EAP benefit, not the employee's health care plan, helps to reduce medical costs
for the City.
Gallagher reviewed each proposal for cost, benefits provided and medical plan integration based on
recent changes in the Federal Benefits Law impacting Mental Health Parity and the need for group
medical plans to provide the same coverage of mental and nervous conditions as they do for any
other illness or injury. After thorough review, Gallagher has recommended (Attachment A) the City
enter into an Employee Assistance Plan (EAP) agreement with Humana, LifeSynch for the City based
on the following:
Improved benefits based on an increase in face-to-face visits with licensed mental health
clinicians
Low cost relative to the benefits provided
Medical plan savings opportunity as a result of common vendor coordination for the treatment
of mental and nervous conditions between Humana (the City's proposed medical plan
administrator) and Humana, LifeSynch
The Group Insurance Board also recommended the management of the City's Employee Assistance
Program (EAP) be awarded to Humana, LifeSynch based on the value of the benefit provided and the
cost.
FINANCIAL IMPACT
The proposed fees submitted by Humana, the incumbent and recommended medical plan
administrator, are three percent (3%) lower than the current administrative fee charged to the City,
reducing the current annual fees of approximately $781,241.88 to approximately $755,115.36,
resulting in an annual savings to the City of approximately $26,126.52. This $755,115.36 in
administration fees is based on the current number of plan participants (1,072 employees and 578
retirees). If all eligible employees and retirees were to elect group health coverage, the amount paid
by the City would be approximately $1.2 million.
Humana has also provided the City with a two (2) year rate guarantee which will ensure a consistent
cost for the administration of the medical plan through December 31, 2011. The Humana proposal
includes a contract term of three (3) years, with a rate guarantee of two (2) years and not for the third
and final year of the contract. However, the Administration will include in the final agreement the
same early termination provision included in the current Humana Account Services Agreement. This
early termination provision provides the City the opportunity to terminate the agreement, with ninety
(90) days written notice to Humana, should the City become dissatisfied with the plan's performance,
services or requested increases in costs for year three (3).
The recommended change in the City's Employee Assistance Program to Humana, LifeSynch will
also result in an annual savings to the City. The proposed annual fees submitted by Humana,
LifeSynch of $32,011.20 are lower than Mount Sinai Medical Center's current annual fees of
approximately $36,753.60, resulting in an annual savings to the City of approximately $4,700.
Humana, LifeSynch has also provided the City with a two (2) year rate guarantee, providing the City a
consistent cost for the EAP benefit through December 31, 2011.
July 15, 2Q09 City Commission Meeting
Selection of a Group Health Insurance Administrator
Page 7 of 7
CONCLUSION
The Administration has reviewed the recommendations ofthe Group Insurance Board and Gallagher
Benefits Services and recommends awarding the administration of the City's group health (medical)
plan to Humana and the Employee Assistance Program (EAP) to Humana, LifeSynch.
Attachment A
Gallagher Benefits Services
Letter of Recommendation
,""°~~ Gallagher Benefit Services, Inc. --- ------------------------_- -
June 30, 2009 A Subsidiary of Arthur J. Gallagher t~ Co.
Ramiro Inguanzo, Human Resources Director
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
Re: Employee Benefits Recommendations
Dear Mr. Inguanzo,
At the City of Miami Beach's request, we released Request for Proposals (RFP's) for all
City employee benefits including Medical, Dental, Life, Accidental Death and
Dismemberment, Voluntary and Dependent Life, Statutory Accidental Death and
Dismemberment, Employee Assistance Program, Vision, Short and Long Term
Disability. A vendor list has been provided illustrating what carriers were supplied the
RFP's and those that responded by product (See exhibit A). Recommendations will be
discussed briefly below.
Medical proposals were requested for claims administration and network access. We
requested both duplication of existing benefits and alternate benefit schedules. Responses
were received from the incumbent carrier Humana, AvMed, Cigna Healthcare, Aetna
United and Blue Cross & Blue Shield of Florida. We recommend renewal with Humana
based on the following:
1) Humana offered the lowest administrative fee's to the City including a reduction
of current costs
2) Retaining Humana will cause no disruption to member provider relations
3) Physician and hospital reimbursement analysis revealed Humana's strong South
Florida discounts
Life and Accidental Death and Dismemberment Request for Proposal resulted in thirteen
responses including the incumbent carrier, Standard. Short listing and continued
negotiations results in the recommendation of Hartford Life for the Basic Life and
AD&D, Dependent Life, Retiree Life and Voluntary Life. Reasons are as follows:
1) Lowest Basic Life, AD&D and Retiree cost to City and employees
2) Thirty six month rate guarantee
Statutory Accidental Death and Dismemberment Benefit Request for Proposal resulted in
two responses, the incumbent Hartford Life and Ace USA. We recommend renewal with
Hartford.
1) Hartford offered lowest cost including a 25% reduction in current annual
premium
2) No change to current benefits
3) Three year rate guarantee
One Boca Place
2255 Glades Road, Suite 400 E
Boca Raton, FL 33431
561.995.6706
Fax 561.995.6708
www.ajg.com
9 ~~~
i '~~.
Currently Dental coverage (Indemnity/PPO and DMO) are purchased by the City on a
fully insured basis for the DMO and self insured for the Indemnity and PPO. In addition
to the incumbent response from Comp Benefits, eight addition proposals were received.
We recommend awarding MetLife the fully insured DMO plan and self funding the
Indemnity/PPO dental coverage. Factors supporting this recommendation are as follows:
DMO
1) MetLife offered lowest DMO cost (16% reduction annually) while
improving benefits to members
2) Large network of general dentists, Periodontists, Endodontic and
Orthodontists.
3) Two year rate guarantee.
Indemnity/PPO
1) Lowest annual administrative fee's
2) Improved benefits to participating members
3) Thirty six month rate guarantee
The Employee Assistance Program is currently provided by Ceridian. Six additional
proposals were received and reviewed for cost, benefits provided and Medical Plan
integration opportunities resulting from the recent Federal Benefits Law changes
impacting Mental Health Parity. Humana is the recommended vendor for the following
reasons:
1) Improved benefits via increased face to face visits
2) Low cost relative to benefits provided
3) Medical plan savings opportunity as a result of common vendor coordination
The Vision benefits Request for Proposal resulted in eight responses. Similar to the
Dental benefits, both fully insured and self insured proposals were received. We are again
recommending this benefit be self funded based on the low claims risk and trend
predictability. EyeMed is the recommended vendor based upon:
1) Lowest administrative services fee
2) Comprehensive exam and hardware benefits
3) Large tri-county provider network
Short and Long Term Disability Benefits RFP's responses were evaluated by vendors
offering both coverage's. For continuity of coverage and a seamless transition from short
term to long term disability, the objective is to provide continuity of coverage and a
seamless transition from short to long term disability with no disruption due to
differences in disability definition, medical evaluation and benefits offered. Unum is the
recommended carrier.
1) Minimal participation requirement and no termination feature
2) Low overall cost
3) Family Medical Leave Act administration for all employees
4) Twenty four month rate guarantee for Long Term Disability and FMLA
Administration
i ~~~
6
We appreciate the opportunity to work with the City and staff and would be happy to
answer any questions you may have.
Sincerely,
Richard G. Schell
Area Vice Preside