Resolution 2025-33602 RESOLUTION NO. z02533602
A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE
CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE
RECOMMENDATION OF THE FINANCE AND ECONNOMIC
RESILIENCY COMMITTEE, MADE AT ITS MARCH 26, 2025 MEETING,
AND DIRECTING THE CITY ADMINISTRATION TO ADD INFERTILITY
TREATMENT AS A NEW BENEFIT AVAILABLE TO PARTICIPANTS OF
THE CITY'S SELF-FUNDED HEALTH PLANS BEGINNING WITH THE
UPCOMING PLAN YEAR STARTING OCTOBER 1, 2025.
WHEREAS, the City of Miami Beach sponsors two self-funded health insurance
plans as a benefit to eligible employees and their dependents; and
WHEREAS, under the current plans, treatment for infertility is not covered; and
W HEREAS, age is the factor that influences fertility the most—the older the couple
the greater the chance of struggling with fertility; and
WHEREAS, whether by choice or because of infertility, Americans are having
fewer children later in life; and
WHEREAS, alternate reproductive therapies, such as invitro fertilization, are
expensive and generally not covered by employer-provided group insurance; and
WHEREAS, employees rely on their places of employment to meet their health
insurance needs; and
WHEREAS, in orderto recruit and retain a quality workforce, benefits have to meet
the needs of the workforce and enhance their quality of life; and
WHEREAS, planning and building a family is a major life event impacting the
emotional, mental, and financial health of a person; and
WHEREAS, struggling with infertility and being unable to afford treatment may
cause emotional and mental anguish to those wishing to build a family; and
WHERAS, providing some level of fertility treatment as a health benefit for
employees is currently under consideration at the federal and state level; and
WHEREAS, adding infertility treatment to the City's self-funded insurance plans
demonstrates a commitment to recruit and retain a quality workforce by contributing to
our employees' personal need to achieve the major life goal of building their families.
NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND CITY
COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA that the Mayor and the City
Commission hereby direct the City Administration to add infertility treatment as a new
benefit available to plan participants of the City's self-funded insurance plans beginning
with the upcoming plan year starting October 1, 2025.
PASSED AND ADOPTED this 13 day of N�Yi ' , 2025.
ATTEST. �"� � �
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Steven Meiner, Mayor
APP. 2 q 2025
Rafael E. Granado, City Clerk i'eE;y,.,
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(sponsored by Commissioner Alex J. Fernandez) _ : ;
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Resolutions -C7 N
MIAMIBEACH
COMMISSION MEMORANDUM
TO: Honorable Mayor and Members of the City Commission
FROM: Enc Carpenler, City Manager
DATE: April 23, 2025
TITLE: A RESOLUTION OF THE MAYOR AND CIN COMMISSION OF THE CIN OF
MIAMI BEACH, FIORIDA, ACCEPTING THE RECOMMENDATION OF THE
FINANCE AND ECONOMIC RESILIENCY COMMITTEE, MADE AT ITS MARCH 26,
2025 MEETING, AND DIRECTING THE CIN ADMINISTRATION TO ADD
INFERTILITY TREATMENT AS A NEW BENEFIT AVAILABLE TO PARTICIPANTS
OF THE CITV'S SELF-FUNDED HEALTH PLANS BEGINNING WITH THE
UPCOMING PLAN VEAR STARTING OCTOBER 1, 2025.
RECOMMENDATION
The Administration recommends enhancing the City's self-funded health plans by providing
coverage for infertility treatments starting the upcoming plan year beginning October 1, 2025 with
the lifetime cap to be discussed as parl o(the fscal year 2026 budget process.
BACKGROUNDIHISTORY
At the February 26, 2025 City Commission meeting, [he Mayor and the Ciry Commission
approved a �eferrel Qtem C4 AL)to the Finance and Economic Resiliency Committee (FERC or
Committee) to diswss adding infeAility as a health insurance beneft to the City's self-funded
health plan. FERC discussed the item at their March 26, 2025 meeting and voted favorebly to
retum the item to Commission for consideretion by the full Commission.
ANALYSIS
The City offers eligible employees and their dependents health insurence through a sel6funded
plan administered by Cigna. As a self-insured plan, it is entirely up to the City to
determine whether antl [o what eztent [o cover infertility Veatment since it bears the full risk of
paying (or the cost of inedical care o! its plan participants as opposed lo paying for coverage
through a fully-insured plan.
Presently, [he City's health plan does no� cover infertiliry Ireatment once a diagnosis of infertiliry
is made.
Prior to the diagnosis of infertility, Ihe plan will cover trealment for underly�ng medical
conditions. There are numerous medical conditions[hat may be Ihe underlying cause of infertility
which if treated may resWt in conception. The plan would cover these undedying conditions as
any other illness.
Once a diagnosis of infertility is made. Ihe plan will no[ cover tes[ing performed specifically to
identi(y the cause ot infertility, [reatmen[ or procedures pertormed speci(cally to restore (ertility,
or assistive reproductive trea�ments such as intrauterine insemina[ion QUI), invitro fertilization
QVFj, embryo transfer, or gamele (sperm and ova) in-vivo fertilizalion (GIFTI, to list a few. The
plan def nes infertility as
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• the inability of opposite-sez partners lo achieve conceplion a([er at least one year of
unprolected intercourse;
• the inabilily of opposite-sex partners to achieve conception afler six months o(
unprotec[ed intercourse, when lhe female partner trying to conceive is age 35 or
older,
. the inability of a woman, with or without an opposite-sex partner. to achieve
conception after at least six �self-funded] Vials o( medically supervised artificial
insemination over a one-year period.
Costs of Addina Benef[to Plan
In response lo[he city's inquiry a6out adding in(ertility heatment benefts, CIGNA, lhe third-party
adminisVator, proposes the below changes to amend the City's plan:
• Testing performed specifcally to determine lhe cause of in(ertility.
• Treatment and/or procedures peRormed specifically to res�ore tertility (i.e.,
procedures to wrrect an infertility condition)
• Artifcial/Intrau[erine Inseminalion (IUI)
• In-viho fertilization (IVF)
• GIFT (gamete inha(allopian transfer)
. ZIFT (zygote inhafalloplan Iransfer)
. Cryopreservation (upon requesq
• $20.000 Li(etime Maaimum, including infertiliry specialrylinjeclable drugs
I(the Commission so desires to amend �he city s health pian and approves a budget inclusive of
these cosls, Ihe plan description can be amended and participants notified of Ihe change in
benefits. perhaps as early as August 2025 open enroliment for this upcoming plan year starting
Oc�ober 1, 2025. There is no other known fiscal, regulatory, or administrative requiremen�s that
would impede the provision of these benefit enhancemenis by the next fiscal year.
FISCAL IMPACT STATEMENT
The inclusion of this beneft is projected lo cosl the plan between t% and 2°/ of claims plus 3%
over[he individual stop loss rate tor an estimated cost to Ihe plan of$579,000. The appropnation
for the inc�eased costs to the plan would be made through the FY 26 budget process.
Does this Ordinance reouire a Business Imoad Estimate?
(FOR ORDINANCES ONLV)
If applicable, Ihe Businasa Impact Estimate(BIE)was published on:
See BIE at: https:llwww.miamibeachfl.qovlcity-halllcitvclerk/meetino-noticesl
FINANCIAL INFORMATION
The Citys heal[h insurance is funded in [he 1791 Risk Benefits Fund and has suFficient reserves
ro mver [he cosc of enhanung[he benefi[.
CONCLUSION
The Commission should discuss and consider enhancing the Ciry's health benefit to include
infertility trealmenls and ihe fiscal impact on lhe city's self-funded plan to round oul the bene(t
with a more comprehensive health plan to meet the needs of its workforce.
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Aoolicable Area
Citywide
Is this a "Residents Riaht to Know" item. Is this item related to a G.O. Bond
pursuant to CiN Code Section 2-177 Praiect7
No No
Was this Aaenda Item initialiv requested bv a lobbvist which as defined in Code Sec 2381
includes a orincioal enaailed in 1o66vino7 No
If so, specify the name of lobbyis[(s) and principal(s):
Deoartment
Human Resources
SDOfISOfIS�
Commissioner Alex Fernandez
Co-soonsorls)
Condensed Title
Accept ReclAdd Infertility Tealment to City'S Self-funded Insurance Plans. (Fernandez) HR
Previous Action IFor Citv Clerk Use Oniv1
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