RESOLUTION 92-20568 • . .
CITY OF MIAMI BEACH
CITY HALL 1700 CONVENTION CENTER DRIVE MIAMI BEACH FLORIDA 33139
OFFICE OF THE CITY MANAGER TELEPHONE: (305) 673-7010
FAX: (305) 673-7782
COMMISSION MEMORANDUM NO. / 392—
Mayor Seymour Gelber and DATE? /22 /92
Members of the City Commission
FROM: Roger M. Car1t n A AL;
City Manager
SUBJECT: AWARD OF BID NO. 101-91/96, CITY OF MIAMI BEACH GROUP
MANAGED CARE MEDICAL, HMO AND MEDICARE SUPPLEMENT PLANS
ADMINISTRATION RECOMMENDATION:
The Administration recommends to the City Commission that our Group
Managed Care Medical and Medicare Supplement Plans be awarded to Humana
Health Insurance Company of Florida, Inc. , and our HMO Plan be awarded
to Humana Medical Plan, Inc. for a one year period commencing October
1, 1992 , with options to renew for four additional one-year periods.
BID AMOUNT AND FUNDING:
$5 , 304 , 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 .
BACKGROUND:
Due to changes in the group insurance market and in the City Commission
and Administration, it appeared to be in the best interest of the City
to solicit bids for the entire group insurance program at this time .
Towers Perrin, the City ' s Benefit Consultant, and the Administration
prepared the bid specifications, with the bid objectives and benefit
changes requested being developed in conjunction with the Group
Insurance Board which is comprised of administration, employee and
retiree representatives .
Invitation to Bid No. 101-91/96 was released on May 14 , 1992 , and bids
were received on June 18 , 1992 .
Towers Perrin evaluated all the bids received and presented a
Preliminary Report - Review of 1992 Bid Proposals and Initial
Recommendations to the City Administration and the Group Insurance
Board on July 10, 1992 . On July 13 , the Group Insurance Board voted
to recommend the award of the bid for Group Managed Care Medical and
Medicare Supplement Plans to Humana Health InsuraAc e Company of
Florida, Inc. and for HMO Plan to Humana Medical Plan, Inc. , commencing
October 1 , 1992 . It is recommended that the awards be for a one year
period, with options to renew for four additional one year periods ,
A Final Report, prepared by Towers Perrin, has been distributed with
the agenda package, for your review.
Jo
Fur a1 APPROVED
V AGENDA
/0, ITEM -
M.�agement and Eu,.get
DATE1L—L.
_ C
df
•
1
AWARD OF BID NO. 101-91/96, CITY OF MIAMI BEACH GROUP MANAGED CARE
MEDICAL, HMO AND MEDICARE SUPPLEMENT PLANS
July 22 , 1992
Page Two
ANALYSIS:
ADVERTISEMENT DATE: May 12 , 1992
PRE-BID MEETING DATE: May 22 , 1992 , 9 : 00 A.M.
BID OPENING DATE: June 18 , 1992 , 4 : 00 P.M.
NOTICES MAILED: Fifty-Four (54 )
SPECIFICATIONS MAILED: Forty-Four (44 )
REPLIES : Fifteen15
( ) , including 1 Non-responsive
bid, and 7 "No Bid" responses
Bids were received from:
AV-MED Health Plan (PPO & HMO)
CAC Ramsey (HMO)
Humana Health Care Plans (PPO, HMO, Medicare Supplement)
ITT Hartford (Medicare Supplement only)
Miami Dade Health Plan (HMO)
PCA Health Plans of Fla . , Inc. (HMO)
Vision Service Plan (Vision care)
Non-Responsive Bid:
Self Funding Administrators, Inc . (no signature on proposal
page)
"No Bide responses:
Addison Financial Services, Inc.
Aetna.
Blue Cross/Blue Shield
Capital American
Colonial Life & Accident Insurance Co.
Family Health Plan, Inc.
Hunt Insurance Group
Towers Perrin evaluated the bids, with the following results.
It was determined that the following firms did not meet the City ' s bid
specifications , and would not be considered:
ITT Hartford - does not offer coverage for all Medicare
retirees
Vision Service Plan - City does not sponsor a stand-alone
vision care program at this time
Proposals from the following companies were not considered because they
were for HMO coverage only (no indemnity/PPO Plans quoted) :
CAC Ramsey
Miami Dade Health Plan
PCA Health Plans of Florida, Inc.
The proposal from AV-MED Health Plan was disqualified because they
indicated that PPO coverage would not be offered to retirees outside
the AV-MED service area .
Humana offered their current program, with no benefit changes at the
current inforce rates for the PPO and HMO plans. The Medicare
Supplement Plan rates are scheduled to increase by 17 . 4% , subject to
Florida Department of Insurance approval .
31
•
AWARD OF BID NO. 101-91/96, CITY OF MIAMI BEACH GROUP MANAGED CARE
MEDICAL, HMO AND MEDICARE SUPPLEMENT PLANS
July 22 , 1992
Page Three
ANALYSIS (Continued) :
With Humana remaining as the only viable bidder, the Group Insurance
Board commenced negotiations. The following agreements were reached:
Rate increases for 10/1/93-9/ 30/94 plan year are guaranteed
not to exceed a maximum of 8% for HMO and 11% for PPO
(negotiated down by the Board from Humana ' s first offer of
12% and 15% respectively)
Reasonable and customary reimbursement levels for services
incurred by out-of-area retirees will be established within
5% of the 90th percentile of the HIAA database
CONCLUSION:
Because Humana remained the only viable bidder, and because a
reasonable agreement was negotiated, the Group Insurance Board voted
to recommend awarding the bid to Humana, and the Administration concurs
with that decision.
(v,
RMC:EJD: j f
•
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 is an agreement, made and entered into this 1st day of
October , 1992 , 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. 101-91/96: Group Managed Care Medical, HMO and Medicare
Supplement Plans to Humana for a one (1) year term and the mutual
terms, conditions, promises, covenants and payments hereinafter set
•
forth, the City and Humana agree as follows:
I. PROVISIONS OF AGREEMENT
1. 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.
4
2 . HMO and PPO Plans Packets
Humana will prepare and distribute by U.S. mail HMO and
PPO Plans packets at least two weeks in advance of the
commencement of the City's annual Open Enrollment. The
City administration will assist in the development of 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.
3 . Provider Directories
In addition to the HMO and PPO provider directories
distributed at Open Enrollment, Humana shall mail to each
1
• • '
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 Plan 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 (3 0) days
prior to the reassignment date, or as expeditiously as
possible if contract cancellation is effective in less
- - than 3u 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
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 group insurance section of the Personnel 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 Plan Late Entrants
Employees and/or dependent(s) requesting enrollment in
the Humana PPO Plan 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
2
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 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
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.
7 . "Threatening Letter" Responses
Any time a PPO 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
3
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 City and Humana.
8. Dedicated Servic.'s in Humana
Effective October 1, 1992 .
a. 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.
Effective November 1, 1992 , a random
sample of 10% of Medicare primary claims
submitted each calendar quarter shall be
audited. A report shall be provided to
the City.
b. Humana agrees to place a Service
Representative within the City of Miami
Beach Personnel Department office on a
full-time basis. The Representative will
be authorized to resolve PPO 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 Group
Medicare Representative.
The Representative will have a computer
terminal on-line with Humana to provide
information upon request regarding
claims, enrollment and billing.
In the event of a change in
Representatives, the City will be
provided with a resume of the proposed
representative ' s qualifications and
experience.
4
•
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 shall
arrange for periodic visits to the City
of Miami Beach office as determined
necessary by both parties.
c. Humana agrees to provide ready access to
a Utilization Specialist to assist HMO
and PPO members with medical issues
including PPO prior authorizations, PPO
pre-admission certifications, PPO length
of stay issues and discharge planning;
HMO referrals, access to HMO primary care
physicians, and obtaining authorizations
for emergency and outpatient care.
Access for employees and retirees will be
via the in-house Service Representative.
9 . HMO 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 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:
Preadmission 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
5
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
Primary Care Physician or, if deemed medically necessary
(and authorized by the patient's HMO 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 Group Insurance 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 Center, Humana shall arrange for treatment to be
6
•
•
•
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 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 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, 1992 and terminate
September 30, 1993 . The City administration and Humana have the
option to renew this Agreement annually upon mutual consent.
7
A
III. PERFORMANCE OF SERVICE NOTIFICATION
Humana shall receive notices regarding performance of service
addressed to the following:
Rahila Khan, Account Services Manager
Humana Health Care Plans
3400 Lakeside Drive
Miramar, Florida 33027
Telephone: (3 05) 626-5216
The City administration shall receive notices regarding performance
of service addressed to the following:
•
• Dee Martinez, Employee Benefits Coordinator
Personnel Department
City of Miami Beach
1700 Convention Center Drive
Miami Beach, FL 33139
Telephone: (305) 673-7526
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
All provisions contained within this Agreement, the City of Miami
Beach Invitation to Bid No. 101-91/96 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:
8
This Agreement
Humana ' s Bid Response
City of Miami Beach Invitation to Bid No. 101-91/96
The City administration and Humana recognize that in order to
comply with applicable state laws that 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
this Agreement, Humana' s Bid Response and City of Miami Beach
Invitation to Bid No. 101-91/96. -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. 101-91/96 and Humana 's Bid Response.
9
IN WITNESS WHEREOF, the parties have made and executed this
Agreement on the respective dates under each signature:
CITY OF MIAMI BEACH
BY:
Mayor
CITY OF MIAMI BEACH
Attest:
City Clerk
Approved
4'4;1 o form by the
City Atto ey' Office
2
BY: /4.--/
J .�/ V4,1
HUMANA HEALTH CARE PLANS
HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.
CORPORATE SEAL) -°'
77:77"-t1 ef
BY: Executive Director
DATE:
i2 I ici. 1a2
HUMANA MEDICAL PLAN, INC.
CORPORATE SEAL)
BY: /—` (--- IA17) . Executive Director
DATE:
121 z..
qz-zusly
ORIGINAL
RESOLUTION NO. 9/20568
Bid award No. 101-91/96, C.M.B. Group
Managed Care Medical,HMO and Medicare
Supplement Plans.