HomeMy WebLinkAboutAmendment No. 2 to the Agreement between the CMB and Health Care Service Corporation, A Mutual Reserve Company and Healthspring Life and Health Insurance Company, Inc. Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21 B03B636138 2_o 23 ^ 32
Docusign Envelope ID.IEEBE18E-1084-46E3-9FEA-94B50F87C820
AMENDMENT NO. 2 TO AGREEMENT
BETWEEN
THE CITY OF MIAMI BEACH, FLORIDA
AND
HEALTH CARE SERVICE CORPORATION, A MUTUAL RESERVE COMPANY
AND
HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.
This Amendment No. 2 ("Amendment")to the Agreement(defined below) is by and between the
CITY OF MIAMI BEACH, FLORIDA (the 'City") a municipal corporation organized and existing
under the laws of the State of Florida, having its principal place of business at 1700 Convention
Center Drive, Miami Beach, Florida 33139, HEALTH CARE SERVICE CORPORATION, A
MUTUAL LEGAL RESERVE COMPANY, an Illinois corporation ("HCSC"), whose principal
address is 300 East Randolph Street, Chicago, Illinois 60601 and HEALTHSPRING LIFE &
HEALTH INSURANCE COMPANY, INC., a Texas corporation, whose principal address is 2800
North Loop West, Houston, Texas 77092 (together with HCSC, collectively, "HealthSpring" "") is
entered into day of , 2025. Any defined terms used but not defined herein
shall have the meaning set forth in the Agreement. MAR 0 2 2026
RECITALS
WHEREAS, on June 28, 2023, the Mayor and City Commission, adopted Resolution No
2023-32624, pursuant to Request for Proposals(RFP) No. 2023-259-WG for Health, Pharmacy,
and Medicare Advantage Plans, authorizing the Administration to negotiate an agreement with
CHLIC, the top- ranked proposer for Health and Pharmacy Plans (Plan A) and Medicare
Advantage Plans (Plan C);
WHEREAS,on or about December 19,2023,the City and Cigna Health and Life Insurance
Company ("CHLIC") executed that certain Employer/Union Group MAPD Agreement for the
Medicare Advantage Plans(Plan C)(as amended by Amendment No. 1, the"Agreement");
WHEREAS, CHLIC subsequently assigned the Agreement to HealthSpring;
WHEREAS, the City and HealthSpring desire to amend the Agreement to bring the terms
of the Agreement into compliance with federal Medicare regulations, to revise a scrivener's error
in the Term, and to update HealthSpring's notice information.
NOW THEREFORE, in consideration of the mutual promises and conditions contained
herein, and other good and valuable consideration, the sufficiency of which is hereby
acknowledged, the City and HealthSpring hereby agree to amend the Agreement as follows:
1. ABOVE RECITALS. The above recitals are true and correct and are incorporated as part
of this Amendment.
2. MODIFICATIONS.
(a) The new plan year will commence January 1, 2026, and continue until December 31,
2026.
(b) The preamble of the Agreement is hereby amended to reflect an effective start date of
January 1, 2024, and an initial expiration date of December 31, 2026(the`Initial Term").
Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21B03B636138
Docusign Envelope ID 1EEBE18E-1084-46E3-9FEA-94850F87C820
(c) Section 26(a) of the Agreement is hereby deleted in its entirety and replaced with the
following:
HealthSpring
Attn: Shelly Tant, Manager—Employer Group Account Management
500 Great Circle Road
Nashville, Tennessee 37228
Shelly Tant( HCSC.crm
With a mailed copy to:
HealthSpring
300 E. Randolph St.
Chicago, Illinois 60601
Attn: DVP Group Medicare Business
(d) Effective January 1, 2026, Exhibit A, 2025 Medicare Advantage Prescription Drug Plan
coverage description, is hereby deleted in its entirety and replaced with Amended Exhibit A,
attached hereto.
(e) Effective January 1, 2026, Exhibit B, Cigna Healthcare Medicare Advantage Prescription
Drug (MAPD)Group Administrative Guidelines is hereby deleted in its entirety and replaced with
Amended Exhibit B, attached hereto.
3. OTHER PRESCRIPTION DRUG COVERAGE/OTHER HEALTH INSURANCE. Client
acknowledges and agrees that to the extent that Client elects a plan benefit design that includes
or incorporates other prescription drug coverage benefits, as that term is defined at 42 C.F.R.
423 464(f), such other prescription drug coverage benefits may be provided in certain states by
an affiliated or unaffiliated insurer or health maintenance organization in conjunction with the
Medicare Part D benefits that are offered by HealthSpring in such states.
4. RATIFICATION Except as amended herein, all other terms and conditions of the
Agreement shall remain unchanged and in full force and effect. In the event there is a conflict
between the provisions of this Amendment and the Agreement,the provisions of this Amendment
shall govern.
THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK.
Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21803B636138
Docusign Envelope ID:1EEBE18E-1084-46E3-9FEA-94B50F37C820
IN WITNESS WHEREOF,the parties hereto have caused this Amendment to be executed
by their appropriate officials, as of the date first entered above.
FOR CITY: CITY OF MIAMI BEACH, FLORIDA
ATTEST:
C&Y by: 41
rwat(, Gram,44 By
Ra ae1 A3ranado, City Clerk Eric T. Carpente City Manager
Date: 3/2/2026 I 8:38 Esr
FOR HEALTHSPRING HEALTHSPRING LIFE& HEALTH
INSURANCE COMPANY, INC.
ATTEST:
;
Z),zeataA Wy
Y\
By:
Signature
Deborah Mills
Name: Name: Stephen Harris
Title: Sr Executive Assistant President,Government Markets
Title:
Date: 12/29/2025
HEALTH CARE SERVICE CORPORATION,
A MUTUAL LEGAL RESERVE COMPANY
ATTEST:
PEA:N4A7 By: :i...
Signature
Name: Deborah Mills Name: Stephen Harris
Title: Sr Executive Assistant Title: President,Government Markets
Date: 12/29/2025
APPROVED AS TO
FORM & LANGUAGE
& FOR EXECUTION
t k kt, _- 1?IzzI2c
„-„City Attorney • Date
Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21B03B636138
Docusign Envelope ID:1EEBE18E-1084-46E3-9FEA-94850F87C820
AMENDED EXHIBIT A
MEDICARE ADVANTAGE PRESCRIPTION DRUG PLAN COVERAGE DESCRIPTION
(to be attached)
4
Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21803B636138
Docusign Envelope ID:1EEBE18E-1084-46E3-9FEA-94B50F87C820
AMENDED EXHIBIT B
GROUP ADMINISTRATIVE GUIDELINES
(to be attached)
Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21B03B636138
Docusign Envelope ID:1EEBE18E-1084-46E3-9FEA-94B50F67C820
Attachment C
Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21B03B636138
Docusign Envelope ID:1EEBE18E-1084-46E3-9FEA-94B50F87C820
DecoSion Envelope ID:9FDtFBA1-AE68-46F6-88F9-E31DFIC5DA72
b;P111'I,OVftlt/UNIUN G'ItQUP MAI'u AGREEMENT
This Employer/Union(hoop Medicare Advantage Prescription Drug("MA PO")Agreement(hereinafter
"AY,rcement")is by and between C'i)tna I lentil'and Life hx unmce Company and(lc allhSpnia((Life&Health
hiaurance Company.Inc.(collectively retcnrd to us"Cigna")and City of Miami Itau:h("Group"),and is
effective as from manual I,2.024 through 1)a:e lher 3I.2.021.
WI Uiltl•:AS.Cigna has contracted with the Centeno for Medicare&Medicaid Services("('MS")under the
Social Security Act as amended by the Medicate:Prescrtplion Drug,improvement and Modernization Act of
21101 and by the Inflation Reduction Act c112072 acid Ihn Affordable Care.At and as Wilber regald,ed by ihr
Medicate Advantage liciielii flan Nall Rules contained in 42 CFR 422("MA PI)Find Rules")mid the
Medicare Prescription Drug fienelit Plan Final Rules contained in 42 Cflt hart 423("POP final Rules")hi
opennc:an MAPI)Phut.and offer cmpinyet/union-only grasp MA PI)Flaps;and
Wo IF Ito?AS.CMS'contract acklendum with Cigna((anpioyer/Union-Only(in+ulp Acklendwn)requires that
Cigna obtain written agreements from catch employer or union with whk:h it contracts for ontpinyerhutam.emty
group MAPf1 plans.nod that such agreements Contain certain(elms and provisions,as set forth below:and
WI Il Rf:AS,Gnaw wishes Cigna to provide and Cigna wishes to offer to Group an enpploycrimrwn-only
group MAPI)(hereinafter mortared to as the"Plan")fee MA IV eligible individuals in accordance with this
Agisslmicnt;and
NOW, fUERITORE,in consideration of the annual promises and covenants cootnuted herein.it is hereby
nhteccl as follows:
I :l_erc>Z. this Agreement is effective as of the
14llective bate set forth above and shall ,I. upon telminalt(tl oaf C1((na's contract with
Continue in clThet for an initial term of three (MS;or
(3)years. llteudter,this Agreement uuty be a:. upon any other data mutually agreeable to
renewed for Iwo(2)additional there(3)yam the Group'au'Cigna.
terms provided that Cigna mash tiroup mulu;lll,,
ague:on the trinis of such renewal.atom's ' Se'TYIct.Cigna shall provide ravcrai,r in
City Manager shall be authorized to execute accordance with applicable Federal haw,Ilw
all renewal terms under Ibis Age:comnl. MAPI)final Kolas.P1)1)hued Riles,the
Notwithshmding the foregoing,this I nipkayerilhlicin.Only(hoop Adckenduru mid
Agreement may be terminated ut any time im the I'vale-nee of Coverage issued by Cigna to
accurcbuteae with Section 2 below. On or about those MAPI)eligible individuals who.are
Ibe anniversary of each contract lain,Cigna eligible for and manned iu(iroup's flan
may request.and the City Manager may ("I'urollec-r"),as tolkrws•
:approve,a cast ailjustment WNW on
documented cosi increases liter the following a. Cigna shall(r oyale the flan In('lgna's
corn nici year.Six-exhibit A servicx area an utilising a pmvidca network,
phanuucy nclvuik and forntulu'y that
'Ii<mtinutiyn.'1•hia Agreement will 1C111111.11tle erect the requirements of its
upon the earlier of any of die following lmployer/t anon-Only(Mimi Addendum
with CMS (See 42('FR 422 Subpart C.
a. 1hr dune dud(sloop tea inmates its('pun, Ilit'Aledieal r Rhruuged Care Manual
("111M(::M"),('h.9,Section 40.1,and 41
b. the date runup fails Cf It 423.12(1,and(lie Medicare
uecaickmec with Section 4 benzin. Prescription Drug Benefit A1;unual
("PllliM"),('h. la,Section 210R0
c. .i any lime,upon thirty(30)days'prim
ea mini melee by on.:patty t,+'he mite': h t'utaaa shall provide Groan taini(kcs
a
Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21B03B636138
Docusign Envelope ID IEEBE18E-1084-46E3-9FEA-94B50F87C820
M I A M I BEACH ,. rllt = #z": •
u.•
23-259-02 Amendment No.1-Medicare Advantage Plan(Plan C)
Amendment No.2-Medicare Advantage Plan(Plan C)
HealthSpring Life&Health Insurance Company,Inc. Human Resources
Blenj- VAN ♦ :. ��IiT'".�''J:':� -':. � ,�.....: :�..IfYILIl.!ITIi..l_�.7M7P.. ,+ti'tt71. ...
Marla Alpizar'V yr 2/20/2026 I 2:04 EST Mark Taxis "',-•••• 2/22/2026 I 10:29 EST
X Type I-Contract,amendment,change order,or task order resulting from a procurement-Issued competitive solicitation.
Type 2-Any other contract,amendment,change order,or task order that does not result from a procurement-issued competitive solicitation.
Type 3-Independent Contractor Agreement(ICA) Type 6-Tenant Agreement
Type 4-Grant agreements with the City as the recipient Type 7-Inter-governmental agency agreement
Type 5-Grant agreements with the City as the grantor Type 8-Other:
�MIAM�Yy�$1�!tlt3�iCt�tifi
On June 28,2023,the Mayor and City Commission adopted Resolution No.2023-32624,pursuant to RFP No.2023-259-WG,authorizing
the Administration to negotiate an agreement with Cigna Health and life Insurance Company(hereinafter referred to as"CHLIC'),the
top-ranked proposer for Health and Pharmacy Plans(Plan A)and Medicare Advantage Plans(Plan C).The Resolution also included
authorization to negotiate Plan B-Pharmacy Benefits Only.
On October 1,2023,the City and CHLIC entered into an agreement to provide administrative services exclusively for the City's self-
funded health and dental plans,as well as pharmacy benefits(PlansA and B).On or about December 19,2023,the parties also executed
a second Agreement titled the Employer/Union Group MAPD Agreement,specifically for a Medicare Advantage Prescription Drug Plan
(Plan C). I he contract between Cigna and the City for an MAPD plan included no rate increases during Plan Year 20Th and a S%rate
increase during Plan Year 2026.
Amendment No.1(see Attachment A)
The purpose of Amendment No.I is to reflect the change in providers from CHLIC to HealthSpring,and to update the Plan's coverages
and rates(Exhibit A)and the administration guidelines(Exhibit B)for the plan year starting on January 1,2025,and ending on December
31, 2025. On November 5, 2024, Health Care Service Corporation "HCSC" completed its acquisition of HealthSpring Life& Health
Insurance Company("HealthSpring"),with HealthSpring remaining as the surviving entity responsible for Plan C.The City consented to
the assignment of the Plan C contract from Cigna to HCSC and HealthSpring.Additionally,HCSC/HealthSpring and the City agreed to
amend the Agreement to reflect the Medicare Advantage Plan Coverage Description,including rates,and Administration Guidelines for
the contract plan year starting January 1,2025,and ending December 31,2025.There was no rate increase for the 2025 plan year,
consistent with the initial award to Cigna.Amendment No 1 and the Consent of Assignment were agreed upon contemporaneously;
however, the City only signed the Consent to Assignment on October 31, 2025. Amendment No. 1 is presented for signature to
memorialize the parties'Agreement and to ensure compliance with Medicare regulations.
Amendment No.2(see Attachment B1
The purpose of Amendment No.2 is to update the Plan's coverages and rates(Exhibit A)and the administration guidelines(Exhibit B)
for the plan year starting January 1,2026,and ending December 31,2026.Amendment No.2 also proposes to increase rates by 5%or
$10,844.64 above last year's rate.The rate increase was not passed through to part cipants.It was paid for by the City.
The Centers for Medicare Services(CMS)requires providers of Medicare Advantage Plans—such as HealthSpring in this case—to report
contract details to employer groups.This includes plan specifics,benefit structures,and enrollment figures.The preamble to the original
agreement with Cigna states that"CMS's"contract addendum with Cigna(Employer/Union-Only Group Addendum)requires that Cigna
obtain written agreements from each employer or union it contracts with for employer/union-only grnlrp MAPD plans These
agreements must include certain terms and provisions,as outlined below."Exhibit A of the initial MAPD agreement with Cigna outlines
the plan coverage and rates,while Exhibit B describes the administration guidelines.Amendment No.2 updates the exhibits for the
2026 plan year
Amendment No.2 proposes a rate increase of five percent(5%),as shown in the"2025 Retiree Rates-Tier A&B Pension Retirees"
table.From October 2023 to October 2024,the CPI-U for medical care in the Miami-Fort Lauderdale-West Palm Beach region rose by
3.5%,while rates remained unchanged for 2025.Additionally,from August 2024 to August 2025,the CPI-U increased by 3.8%,bringing
the cumulative increase over two years to 7.3%.Based on these figures,the Human Resources Department considers the proposed five
percent(5%)rate adjustment fair and reasonable.
In addition to aligning with market trends,the proposed increase adheres to the terms outlined in the initial agreement between CHLIC
and the City The Medicare Advantage Plan(MAPD)Agreement,Section] -Term, states that"on or about the anniversary of each
contract term,Cigna may request,and the City Manager may approve,a cost adjustment based upon documented cost increases for
Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21B03B636138
Docusign Envelope ID•1EEBE18E-1084.46E3-9FEA-94B50F87C820
the following contract year"(see Attachment C).Furthermore,Exhibit A to the initial MAPD agreement specifies that"rates include:
0%2025 Rate Guarantee;5%2026 Rate Cap."
Under Section 9,"Modification of Agreement,"any changes to the Agreement must be made in writing and signed by an authorized
representative from each party.Based on the justification herein and pursuant to the authority granted by Section 9,"Modification of
Agreement."Accordingly,this item requests the City Manager's signature on the attached Amendments(No. 1 and No. 2)to the
Agreement between the city of Miami Beach, Florida, and Health Care Service Corporation, a Mutual Reserve Company, and
HealthSpring Life&Health Insurance Company,Inc. —
—
tl1r ► _ A2nwail Peflo$• ' `Taw1 erne(Or giiia t'gem`. 3
January 1,2024-December 31,2026 2 additional 3-year terms January 1,2024-December 31,2032
•iS ^'r..rMv�.Yr.^Y.CCL'iri%a✓SLis.T�..�71Lv w _SI! ns rt :.. _ -..- ...
Grant Funded: MI® X Nor�.y ,C— State I Federal II Other:
4 4r a i,- �i I-V. 4isiii.0,17VUr-rC ,�,,
AnNatxieC. _ . , .. . AcoAUAt. RUulre.E►1han4eme r
'� .�- - ' Yes X No
1 $10,844.64 City Increase' -S60-1 795-000 3 7 5-1 3-4 1 5-5 92-00-00-04
(2025:$145,998.72 Past)
(2026:$156,843.36 Proposed)
'Nc budgetary increase to the retiree portion.
1.For contracts longer than five years,contact the Procurement Department.2.Attach any supporting explanation needed.3.Budget
approval indicates approval for the current fiscal year only.Future years are subject to City Commission approval of the annual
adopted operating budget.
City Commission Approved: I X Yes No Resolution No.: CC Agenda Item No.: CC Meeting Date:
2023-32624 R7 W October 18,2023
If no,explain why CC approval is not required:
Legal Form Approved: I X (Yes 1 1 No J If no,explain below why form approval is not necessary:
Procurement: Grants: N/A
Kristy Bada —".". 2/11/2026 I 5:56 ES"
,—/C" 1
Budget Analyst: Information N/A
I ims 2/20/2026 I 9:32 EST Technology
Yelina Iglesias [
Budget Director:
Tameka Otto Stewart ...... 2/20/2026 19:58 ES1
Risk Management:
'°""°' Fleet& N/A
Marc Cheva ier Facilities:
Human Resources: N/A Reviewed by: 2/11/2026 I 10:45 EST
Monica Garcia `ML
Reviewed by:
Theresa Buigas —«11' 2/11/2026 1 10:59 EST
fk•S/)5
Docusign Envelope ID:DB049CA2-06A9-4087-95FE-21 B03B636138
Docusign Envelope ID:1EEBE18E-1084-46E3-9FEA-94B50F87C820
Attachment B