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Ordinance 81-22794 ORDINANCE NO. 81-2279 AN ORDINANCE AMENDING SECTION 2.55 OF "THE CODE OF THE CITY OF MIAMI BEACH, FLORIDA" ESTABLISHING CONTRIBUTIONS BY EMPLOYEES AND THE CITY TO HEALTH MAINTENANCE ORGANIZA- TIONS FOR MEDICAL AND HOSPITALIZATION COVERAGE, PROVIDING FOR SEVERABILITY, PRO- VIDING FOR EFFECTIVE DATE. BE IT ORDAINED BY THE CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA: SECTION 1. That Section 2.55 of "The Code of the City of Miami Beach, Florida," be amended as follows: I. Group Health Insurance (a) MEMBER: The contribution of a member shall be one-half of the costs of the benefits provided for in his agreement, as such costs are determined by the board. (b) CITY: The contribution of the City on behalf of the members shall be one-half of the cost of the benefits provided for in the agreements as such costs are determined by the board, but not to exceed thfee hutidfed f-ifty four hundred fifty dollars per year for an agreement covering a member only, nor to exceed n4 a hendfed twenty-€4ve one thousand two hundred fifty dollars per year for agreements covering a member and his family. The City shall continue to contribute at the same rate for members who are absent on authorized leave, sickness or military service and shall contribute at the same rate on behalf of retirants who elect to continue their agreements and pensioners who elect to become members of the plan. The board shall ascertain annually the total amount of contribution to be made by the City on behalf of members of this plan and shall certify such amount together with an estimate of administrative costs to the City Manager for his review, recommendation and submission to the City Council for its approval and inclusion in the annual budget. PAGE 1 I. Group Health Insurance (Continued) (c) The contribution of those employees, retirants, pensioners and dependents age sixty-five and over, eligible for Medicare benefits and who are members of the City employees' benefit plan shall be one-half the cost of the benefits provided for in the City employees' benefit plan for those employees, retirants, pensioners and dependents age sixty-five and over, eligible for Medicare benefits as such costs are determined by the governing board, plus one-half the cost of the contribution for Medicare benefits, but in no event shall such total contribution exceed the contribution of members of the City employees' benefit plan who are not eligible for Medicare benefits and have a similar agreement for individual membership or for a family basis. (d) The contribution of the City on behalf of the members of the City employees' benefit plan age sixty-five and over and eligible for Medicare benefits shall be one-half the costs of the benefits provided for in the agreements as such costs are determined by the governing board plus one-half the cost of contribution for Medicare benefits but in no event shall the total of such contribution by the City exceed the amount of contribution respectively for any other agreements under the City employees' benefit plan which covers members only who are not eligible for Medicare benefits or which covers members and their families, none of whom are eligible for Medicare benefits. (e) Whenever a husband and wife are both members of the plan, and either has an agreement with the plan providing for benefits on a family basis, and either is making contributions for the same, then the other spouse shall not be required to contribute to the plan. Any members believing they qualify under this provision shall file a notice with PAGE 2 I. Group Health Insurance (Continued) the Personnel Director on a form prescribed by him. Such notice shall be signed by both husband and wife and shall indicate from which spouse's pay contruibutions are to be deducted. Such notice shall become effective as of the first day of the first pay period following the date of the election, subject to review by the governing board, which shall disallow any election which it finds to be improper. Thereafter contributions shall be made as provided in the notice, provided further, that there shall be no refund of any contributions made prior to the effective date of any notice. II. Health Maintenance Organization (HMO) (a) MEMBER: The contribution of a member shall be the difference between the dollar amount paid by the City and the HMO rate. (b) CITY: The cost to the City shall be the same dollar cost as paid to the group insurance carrier. The cost is not to exceed four hundred dollars per year for an agreement covering a member only, nor to exceed one thousand one hundred twenty dollars per year for agreements covering a member and his family. 1. The City contribute members authorized military contribute behalf of continue pensioners shall at the who are leave, service continue to same rate for absent on sickness or and shall at the same rate on retirants who elect to their agreements and who elect to become members of the plan. The board shall ascertain annually the total amount of contribution to be made by the City on behalf of members of this plan and shall certify such amount together with an estimate of administrative costs to the City Manager for his review, recommendation and submission to the City Council for its approval and inclusion in the annual budget. PAGE 3 II. Health Maintenance Organization (HMO) (Continued) (c) The contribution of those employees, retirants, pensioners and dependents age sixty-five and over, eligible for Medicare benefits and who are members of the City employees' benefit plan shall be the difference between the dollar amount paid by the City and the HMO rate for those employees, retirants, pensioners and dependents age sixty-five and over, eligible for Medicare benefits as such costs are determined by the governing board, plus one-half the cost of the contribution for Medicare benefits, but in no event shall such total contribution exceed the contribution of members of the City employees' benefit plan who are not eligible for Medicare benefits and have a similar agreement for individual membership or for a family basis. (d) The contribution of the City on behalf of the members of the City employees' benefit plan age sixty-five and over and eligible for Medicare benefits shall be the same dollar cost as paid to the group insurance carrier as such costs are determined by the governing board plus one-half the cost of contribution for Medicare benefits but in no event shall the total of such contribution by the City exceed the amount of contribution respectively for any other agreements under the City employees' benefit plan which covers members only who are not eligible for Medicare benefits or which covers members and their families, none of whom are eligible for Medicare benefits. (e) Whenever a husband and wife are both members of the plan, and either has an agreement with the plan providing for benefits on a family basis, and either is making contributions for the same, then the other spouse shall not be required to contribute to the plan. Any members believing they qualify under this provision shall file a notice with the Personnel Director on a form prescribed by him. Such notice shall be signed by both husband and wife and shall indicate from which spouse's pay contributions are to be deducted. Such notice shall become effective as of the PAGE 4 II. Health Maintenance Organization (HMO) (Continued) first day of the first pay period following the date of the election, subject to review by the governing board, which shall disallow any election which it finds to be improper. Thereafter contributions shall be made as provided in the notice, provided further, that there shall be no refund of any contributions made prior to the effective date of any notice. SECTION 2. That all ordinances or parts of ordinances in conflict herewith be and the same are hereby repealed. SECTION 3 This ordinance shall become effective as of November 1, 1981. PASSED AND ADOPTED this Attest: //</.1"%,L'Ae City Cle 16th day of 1st Reading - September 2, 1981 2nd Reading - September 16, 1981 Words stftiek thfetdgh are deleted. Words underlined are added. September FORM APPROVED LE AL DEPT. Gy Date l 0044 PAGE 5 cu 0 a), $-( H O 0 4-1 R. 4) N [: H rn cd cd • 0 {-J N a) •-4 N 4J 0. •ri 0 Z CO 0 cti .0 H •r1 Z • 4-J 'b H 0 .0 0 .n�`° 34 21 zU 4-1) 0:1 6 0 •r' Z - 0 0 0 • P G T 0 41 •r4 0 U 44 •r1 v U) cd 1-1 0 +1 •ri V) d 4i w 0 cC R$ N coverage,