2004-25596 Reso
RESOLUTION NO. 2004-25596
A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF
THE CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE
ADMINISTRATION TO ENTER INTO NEGOTIATIONS, AND IF
SUCCESSFUL, FURTHER AUTHORIZING RENEWAL WITH
HUMANA, THE CITY'S CURRENT PROVIDER OF GROUP
MEDICAL INSURANCE FOR EMPLOYEES, WITH A 4.44%
INCREASE FOR THE HIGH HMO & HIGH PPO AND NO
INCREASE FOR THE POS, LOW HMO AND LOW PPO PLANS,
FOR A ONE-YEAR PERIOD, EFFECTIVE ON OCTOBER 1, 2004,
FOR AN ESTIMATED ANNUAL AMOUNT NOT TO EXCEED
$14,000,000, WITH THE CITY'S OPTION TO RENEW FOR ONE
ADDITIONAL YEAR IF THE ANNUAL COMBINED INCREASE IS
LESS THAN 5%; AUTHORIZING THE ADMINISTRATION TO
RENEW WITH COMPBENEFITS, THE CITY'S CURRENT GROUP
DENTAL PROVIDER FOR EMPLOYEES, FOR A ONE-YEAR
PERIOD, EFFECTIVE ON OCTOBER 1, 2004, WITH NO
PREMIUM INCREASE AND AN ESTIMATED ANNUAL AMOUNT
NOT TO EXCEED $600,000, WITH THE CITY'S OPTION TO
RENEW FOR ONE ADDITIONAL YEAR IF THE ANNUAL
COMBINED INCREASE IS LESS THAN 3%; AUTHORIZING THE
ADMINISTRATION TO RENEW FOR THE YEAR 2004-05 WITH
FRINGE BENEFITS MANAGEMENT COMPANY TO
ADMINISTER THE CITY'S FLEXIBLE SPENDING PROGRAM
AND FOR TWO SUBSEQUENT ONE YEAR PERIODS AT THE
SAME PER-EMPLOYEE MONTHLY ADMINISTRATIVE FEE OF
$4.50, AS PROVIDED IN THE CITY'S CONTRACT WITH FRINGE
BENEFITS MANAGEMENT COMPANY OF OCTOBER 1, 2003;
AUTHORIZING THE ADMINISTRATION TO RENEW FOR THE
YEAR 2004-05 WITH THE COMPREHENSIVE COMPANIES, INC.
TO ADMINISTER THE CITY'S VOLUNTARY BENEFITS
PROGRAM FOR THOSE PLANS OFFERED TO EMPLOYEES AT
NO COST TO THE CITY, AND FOR SUBSEQUENT
CONSECUTIVE ONE YEAR RENEWAL TERMS, UNLESS
OTHERWISE TERMINATED AS PROVIDED IN THE CITY'S
CONTRACT WITH THE COMPREHENSIVE COMPANIES, INC.
OF OCTOBER 1, 2003.
WHEREAS, Humana, the City's eurrent medical plan provider, has offered the City
renewal rates, effective on October 1, 2004, for a one-year period, which are a 4.4% increase for
the high option PPO and POS plans, and no increase for the POS plan and the low option HMO
and PPO plans; and
WHEREAS, CompBenefits, the City's current dental plan provider, has offered renewal
rates, effective on October 1, 2004, for a one-year period, at no increase over the premiums
charged for 2003-2004; and
WHEREAS, Fringe Benefits Management Company, the City's current provider for
flexible spending programs, provided a two-year rate guarantee at the time its contract with the
City was executed in October 2003, and for two subsequent one year periods, at the same per-
employee monthly administrative fee of$4.50 ; and
WHEREAS, The Comprehensive Companies, Inc., the City's current broker for other
voluntary benefit plans that have no cost to the City, was renewed for 2003-2004, with
subsequent one year renewal terms unless otherwise terminated; and
WHEREAS, the Administration recommends that the Mayor and City Commission
authorize the Administration to enter into negotiations and, if successful, authorize renewal with
Humana to provide Group Medical Insurance for employees and retirees, for a one-year period,
effective on October 1, 2004, with the option to renew for one additional year if the combined
renewal increase is less than 5%; authorize renewal with CompBenefits to provide Group Dental
Insurance for employees and retirees, for a one-year period, effective October 1, 2004, at no
increase over the premiums for 2003-2004, with the option to renew for one additional year if the
combined renewal increase is less than 3%; authorize the renewal of the current contract with
Fringe Benefits Management Company, dated October 1, 2003, to provide flexible spending
programs for City employees for a second year, effective October 1, 2004, and for two
subsequent one year periods, as provided in the contract; and authorize the renewal of the current
contract with The Comprehensive Companies, dated October 1, 2003, to provide voluntary
benefit plans, as selected by the City for a second year, effective October 1, 2004, and for
subsequent one year periods unless otherwise terminated; and
WHEREAS, these recommendations were presented to the Group Insurance Board on
June 1,2004 with the Board agreeing with the recommendations ofthe Administration.
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 authorize the Administration to enter into negotiations, and, if successful, further
authorize renewal with Humana, the City's current provider of Group Medical Insurance for
employees and retirees, with a 4.44% increase for the High HMO & High PPO and no increase
for the POS, Low HMO and Low PPO plans, for a one-year period, effective on October 1,
2004, for an estimated annual amount not to exceed $14,000,000, with the City's option to renew
for one additional year if the annual combined increase is less than 5%; authorize the
Administration to renew with CompBenefits, the City's current Group Dental provider for
employees and retirees, for a one-year period, effective on October 1, 2004, with no premium
increase and an estimated annual amount not to exceed $600,000, with the City's option to renew
for one additional year if the annual combined increase is less than 3%; authorize the
Administration to renew for the year 2004-05 with Fringe Benefits Management Company to
administer the City's flexible spending program, and for two subsequent one year periods at the
same per-employee monthly administrative fee of $4.50, as provided in the City's contract with
the Fringe Benefits Management Company of October 1, 2003; and authorize the Administration
to renew for the year 2004-05 with the Comprehensive Companies, Inc. to administer the City's
Voluntary Benefits program for those plans offered to employees at no cost to the City, and for
subsequent consecutive one-year renewal terms, unless otherwise terminated, as provided in the
City's contract with The Comprehensive Companies, Inc. of October 1,2003.
PASSED AND ADOPTED this
9th
day of June
,2004
ATTEST:
~'S~
t CITY CLERK
APPROVED AS TO
fORM & LANGUAGE
& FOR EXECUTION
F:\HUMA\$aII\COMM.RES\Gp Employee Benefits 04-05.doc
CITY OF MIAMI BEACH
COMMISSION'ITEM SUMMARY
m
Condensed Title:
Group Employee Benefits (medical, dental, flexible spending accounts and voluntary benefits) for plan
year beginning October 1, 2004.
Issue:
Should the City renew with Humana for group medical, CompBenefits for group dental, renew the
contract with Fringe Benefits Management Co. for the flexible spending program and renew the
contract with The Comprehensive Companies for voluntary benefits for City employees?
Item Summary/Recommendation:
The City Administration recommends that the Commission accept the recommendations of the
Gallagher Benefits Services, the City's consultant for group health care for employees, and renew
with Humana for medical coverage with a 4.44% increase to the high option PPO and HMO and no
increase for the POS and low option PPO and HMO plans; renew with CompBenefits for dental
coverage with no increase in premium; renew the contract that was executed October 2003 with
Fringe Benefits Management for flexible spending programs for a second year with no increase to the
administrative fee; and renew the contract that was executed October 2003 with the Comprehensive
Companies to provide voluntary benefit programs to employees at no cost to the City.
Advisory Board Recommendation:
The Group Insurance Board agrees with the recommendations of the Administration and Gallagher
Benefit Services.
Financial Information:
Source of
Funds:
~.
7,308,000.00
Ci Clerk's Office Le islative Trackin :
Mayra Diaz Buttacavoli
F:\HUMA\$a1~.SUMMARY\sl.JTlmary-gp employee benefits 04-05.doc
AGENDA ITEM
DATE
R7D
r; -f--<Je-(
CITY OF MIAMI BEACH
CITY HALL 1700 CONVENTION CENTER DRIVE MIAMI BEACH. FLORIDA 33139
www.miamibeachfl.gov
To:
From:
Subject:
COMMISSION MEMORANDUM
Mayor David Dermer and
Members of the City Commission
Jorge M. Gonzalez \ . /'
City Manager a ~
Date: 6/09/04
A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY
OF MIAMI BEACH, FLORIDA, AUTHORIZING THE ADMINISTRATION TO
ENTER INTO NEGOTIATIONS, AND IF SUCCESSFUL, FURTHER
AUTHORIZING RENEWAL WITH HUMANA, THE CITY'S CURRENT
PROVIDER OF GROUP MEDICAL INSURANCE FOR EMPLOYEES, WITH
A 4.44% INCREASE FOR THE HIGH HMO & HIGH PPO AND NO
INCREASE FOR THE POS, LOW HMO AND LOW PPO PLANS, FOR A
ONE.YEAR PERIOD, EFFECTIV~ ON OCTOBER 1, 2004, FOR AN
ESTIMATED ANNUAL AMOUNT NOT TO EXCEED $14,000,000, WITH
THE CITY'S OPTION TO RENEW FOR ONE ADDITIONAL YEAR IF THE
ANNUAL COMBINED INCREASE IS LESS THAN 5%; AUTHORIZING THE
ADMINISTRATION TO RENEW WITH COMPBENEFITS, THE CITY'S
CURRENT GROUP DENTAL PROVIDER FOR EMPLOYEES, FOR A ONE-
YEAR PERIOD, EFFECTIVE ON OCTOBER 1, 2004, WITH NO PREMIUM
INCREASE AND AN ESTIMATED ANNUAL AMOUNT NOT TO EXCEED
$600,000, WITH THE CITY'S OPTION TO RENEW FOR ONE ADDITIONAL
YEAR IF THE ANNUAL COMBINED INCREASE IS LESS THAN 3%;
AUTHORIZING THE ADMINISTRATION TO RENEW FOR THE YEAR 2004-
05 WITH FRINGE BENEFITS MANAGEMENT COMPANY TO ADMINISTER
THE CITY'S FLEXIBLE SPENDING PROGRAM AND FOR TWO
SUBSEQUENT ONE YEAR PERIODS AT THE SAME PER.EMPLOYEE
MONTHLY ADMINISTRATIVE FEE OF $4.50, AS PROVIDED IN THE
CITY'S CONTRACT WITH THE FRINGE BENEFITS MANAGEMENT
COMPANY OF OCTOBER 1, 2003; AUTHORIZING THE
ADMINISTRATION TO RENEW FOR THE YEAR 2004-05 WITH THE
COMPREHENSIVE COMPANIES, INC. TO ADMINISTER THE CITY'S
VOLUNTARY BENEFITS PROGRAM FOR THOSE PLANS OFFERED TO
EMPLOYEES AT NO COST TO THE CITY, AND FOR SUBSEQUENT
CONSECUTIVE ONE YEAR RENEWAL TERMS, UNLESS OTHERWISE
TERMINATED AS PROVIDED IN THE CITY'S CONTRACT WITH THE
COMPREHENSIVE COMPANIES, INC. OF OCTOBER 1, 2003.
ADMINISTRATION RECOMMENDATION:
Adopt the Resolution.
ANALYSIS:
MEDICAL:
Humana, the City's current provider of Group Medical Insurance for its employees and
retirees, has offered renewal rates of 4.44% for the High Option HMO and PPO and no
increase for the POS and Low Option HMO and PPO, resulting in a straight line
percentage increase of 1.78%. This is a minimal increase in light of the upward trends that
continue to affect health insurance, with the nationwide averages being between 10 and
14%. The Administration recommends accepting the renewal rates offered and continuing
with the plan options and contribution percentages established and approved by
Commission for the plan year effective October 1, 2003. The High Option plans are
available at a contribution rate by the City of 50%. The Low Option plans are available to
Unclassified, Others, and GSA at a contribution level of 75% for employee coverage and
60% for family coverage. Participation in the Low plans by members of C.W.A. and
AF.S.C.M.E. are subject to negotiation. When the new HMO and PPO low option plans
were introduced for the October 1, 2002 plan year, C.W.A. and AF.S.C.M.E. declined to
offer these plans to their members. The attached chart (Attachment A) indicates the new
monthly premiums for employees covered under the City's medical plan.
The City estimates that it will contribute an additional $ 553,000.00 to the Fraternal Order
of Police Health Trust for fiscal year 2004-05 and approximately $370,000.00 to the Florida
Fire Fighters Insurance Trust Fund as a result of this years successful negotiation with the
F.O.P. and the I.A.F.F.
DENTAL:
CompBenefits, the City's current provider of Group Dental Plans for its employees and
retirees, has offered renewal rates at no increase over the premiums established in the
contract effective October 1, 2003. The Administration recommends renewal with
CompBenefits.
The City offers a Dental HMO and a Dental PPO, contributing 50% towards the premium.
Last year the City added a third plan - the Elite 400 - that is another PPO and available to
the groups Unclassified, Others and GSA. Members of the Fraternal Order of Police will
have the option of enrolling in the Elite plan this year (IAFF members have their own
coverage as part of their Trust). This plan provides higher benefits to employees, at a
higher cost. The City contributes 50% of the premium of the base PPO and employees
"buy up" if they wish to participate in this plan. Participation in the Elite 400 by members
of C.W.A. and AF.S.C.M.E. is subject to negotiation. The attached chart (Attachment A)
indicates the monthly premiums.
FLEXIBLE SPENDING PROGRAM:
The City currently has a flexible spending program for members of the groups Unclassified
and Others. This program offers a medical spending account and/or a dependant care
account that allows employees to set aside pre-tax dollars, on a fiscal year basis, to assist
with healthcare expenses not covered under their health insurance and dependant care
related expenses as defined by the IRS. As a result of successful bargaining with F.O.P.,
I.A.F.F. and G.SA, this program will be offered to these groups.
October 1, 2003 a contract was established with Fringe Benefits Management Company to
administer the plans for a monthly per individual fee of $4.50 and for two subsequent one
year periods at the same per-employee monthly administrative fee. Forthe last two years,
and again this year, the City will pay this monthly administrative fee. The Administration
recommends continuing the current contract with Fringe Benefits Management Co.
VOLUNTARY BENEFITS:
The City currently offers several voluntary benefit plans to employees. These plans are
fully paid for by the employee; however the City allows the premiums to be payroll
deducted.
October 1, 2003 a contract was established with The Comprehensive Companies, Inc. to
administer the City's voluntary benefit program for the year, allowing subsequent
consecutive one year terms unless otherwise terminated as provided in the contract. The
City will continue to review various voluntary benefits and offer those that it feels are
valuable to its employees. The Administration recommends continuing the contract with
The Comprehensive Companies.
SUMMARY:
The City Administration recommends that the Commission accept the recommendations of
the Gallagher Benefits Services, the City's consultant for group health care for employees,
the recommendation of the Group Insurance Board, and renew with Humana for medical
coverage with a 4.44% increase to the high option PPO and HMO and no increase for the
POS and low option PPO and HMO plans; renew with CompBenefits for dental coverage
with no increase in premium; continue the contract that was executed October 2003 with
Fringe Benefits Management for flexible spending programs for a second year with no
administrative fee increase; and continue the contract that was executed October 2003
with the Comprehensive Companies to provide voluntary benefit programs to employees at
no cost to the City
JMG:MDB:ph
F:\HUMA\$aII\COfJld.f.EMGroup Employee Benefts04-05-memo.doc
MONTHLY RATES FOR GROUP EMPLOYEE MEDICAL AND DENTAL INSURANCE
OCTOBER 1, 2004
EMPLOYEE MONTHLY RATES FOR MEDICAL INSURANCE--
CURRENT RATEI NEW RATE
(THRU IlI3O/04t EFFECTIVE 1011104
MONTHLY MONTHLY
HIGH OPTION HMO HIGH OPTION HIIO CITY COST TOTAL PREMIUM
EMPLOYEE (50%) $167.96 EMPLOYEE (50%) $17542 $ 175.43 $ 350.85
FAMilY (50%) $416.33 FAMilY (50%) $434.81 $ 434.82 $ 869.63
POS POS
EMPLOYEE (50%) $215.88 EMPLOYEE (50%) $215.88 $ 215.88 $ 43176
FAMilY (50%) $535.65 FAMilY (50%) $535.65 1 $ 535.66 $ 1,071.31
I.
HIGH OPTION PPO HIGH OPTION PPO
EMPLOYEE (50%) $342.06 EMPLOYEE (50%) $357.25 $ 357.26 $ 714.51
FAMilY (50%) $839.24 FAMilY (50%) $876.50 $ 876.51 $ 1,753.01
lOW OPTION HMO LOW OPTION HMO
EMPLOYEE (35%) $77.58 EMPLOYEE (25%) $77.58 $ 232.74 $ 310.32
FAMilY (50%) $307.00 FAMilY (40%) $307.00 $ 462.15 $ 769.15
LOW OPTION PPO LOW OPTION PPO
EMPLOYEE (35%) $151,63 EMPLOYEE (25%) $151.63 $ 454.88 $ 606.51
FAMilY (50%) $592.40 FAMilY (40%) $592.40 $ 895.66 $ 1,488.06
MONTHLY RATES FOR DENTAL INSURANCE
CURRENT RATE Rate
10101/03.9130/04 10101104.9/30105
DMO (50%) DMO (50%)
Employee $5.05 Employee $5.08 $ 5.08 $ 10.16
Employee + 1 $9.48 Employee + 1 $9.48 $ 9.48 $ 18.96
Family $12.33 Family $12.33 $ 12.33 $ 24.66
PPO (50%) PPO (50%)
Employee $11.35 Employee $1135 $ 11.35 $ 22.70
Employee + 1 $21.89 Employee + 1 $21.89 $ 21.89 $ 43.78
Family $33.55 Family $33.55 $ 33.55 $ 67.10
.
PPO ELITE 400 PPO ELITE 400(buy up from PPO amI.)
Employee $18.23 Employee $18.23 $ 11.35 $ 29,58
Employee + 1 $35.15 Employee + 1 $35.15 $ 21,89 $ 57,04
Family $53.87 Family $53.87 $ 33.55 $ 87.42
ATTACHMENT A
F:\HUMA\$all\GROUPINS\OPEN-ENR\OPEN -04\MONTHL Y MED-DENT for 04-05 reso.xls
~."'...
.,
Gallagher Benefit Services, Jne.
A Subsidiary of Arthur J. Gallagher & Co.
April 20, 2004
Ms. Pat Hipple, Human Resources Administrator
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
Re: Medical, Dental & Flex Plan Renewals
Dear Pat,
Gallager Benefit Services recommends the City renew with Humana effective October I,
2004, maintaining the existing five plans with an increase of 4.44% applied to the High
Option plans and no change in rates to the Low Option Plans. The addition of alternate
plans and the inclusion of drug formularies continue to reflect in improved experience in
a time of medical and drug inflation in the mid to high teens.
CompBenefits, the City's dental carrier has agreed to continue the current three dental
offerings at current rates and we recommend renewal. The inclusion of a third plan
during the last renewal, prohibited CompBenefits from offering a multi-year rate
guarantee. With six months of experience now available, we will continue to negotiate a
multi year contract.
The Flexible Spending Account manager, Fringe Benefit is renewing the second year of a
two year rate guarantee.
We appreciate the opportunity to work with the City and it's staff and we wil be happy to
answer any questions that ay arise.
Richard G. Schell
Area Vice Preside
One Boca Place
2255 Glades Road, Suite 400 E
Boca Raton, FL 33431
561.995,6706
Fax 561.995.6708
www.aj9.COm
J( HUMANA,~
J "
"..
Renewal Underwriting Decision
Marketing Exhibit
Case Name: City of Miami Beach
Affiliation/Customer Number: B0156, B0636, 60355, 64298,64637, 65311, 98346, N1323
Products: HMO, PPO & POS
Market: South Florida
Effective Date: 10/1/2004
Mar1<eting Representative: Bhan Garnson
Broker: Galla9her, Richards, Shell
Plan Summary and Rates
Group number: 98346,64637, 80636, 80156
Plan option: High HMO. Plan 021304
Employee Only
Employee + Family
Total Employees:
Total Members:
Current Rates
S 335.93
S 832.66
Breakout
426
~
806
1742
Group number: 80156
Plan option: Low HMO - Plan 02127
Employee Only
Employee + Family
Total Employees:
Total Members:
Current Rates
S 310.32
S 769.15
Group number: 60355
Plan option: P~S . Plan 14/438
Employee Only
Employee + Family
Total Employees:'
Total Members:
Current Rates
S 431,76
$ 1,071.31
Breakout
78
29
107
183
Breakout
25
33
58
119
Group number: 65311,64298
Plan option: High PPO . Plan 061782
Employee Only
Employee + Family
Total Employees:'
Total Members:
Current Rates
S 684,13
$ 1,678.49
Breakout
305
194
499
773
Group number: N1323
Plan option: Low PPO . Plan 181783
Employee Only
Employee + Family
Total Employees:'
I otal MemCers:
Current Rates
S 606,51
$ 1,488,06
Breakout
44
24
68
101
Renewal Action
4.44%
Renewal Rates
$ 350.85
$ 869.63
Renewal Action
0,00%
Renewal Rates
$ 310.32
$ 769.15
Renewal Action
0.00%
Renewal Rates
$ 431.76
$ 1,071.31
Renewal Action
4.44%
Renewal Rates
$ 714.51
$ 1,753.01
Renewal Action
0.00%
Renewal Rates
$ 606.51
$ 1,488.06
. A portion of the single/family population above qualifies for Medicare carve-out rales as provided below:
2/12/2004
MEMORANDUM OF UNDERSTANDING (MOU)
AND
AGREEMENT
BETWEEN
COMPBENEFITS CORPORATION
AND
CITY OF MIAMI BEACH, FLORIDA
FOR GROUP EMPLOYEE DENTAL PLANS
FROM OCTOBER 1, 2004 TO SEPTEMBER 30, 2005
It is hereby understood and agreed by the undersigned parties this 2 '-frrt day of
A;Jlavs1 , 2004 that CompBenefits Corporation, a Georgia Corporation having its
principal offices at 100 Mansell Ct. E Ste. 400, Roswell, Georgia (CompBenefits), and the City
of Miami Beach, Florida (City), shall enter into a mutual agreement to provide dental plans to
eligible employees of the City of Miami Beach.
It is agreed that CompBenefits, as the successful proposer pursuant to the City of Miami Beach
Request for Proposals No. 23-02/03 for Group Employee Benefits - Dental Plans (the RFP), and
Commission Resolution 2004-25596, authorizing the renewal for plan year October 1, 2004
through September 30, 2005, with no increase in premiums which are incorporated by reference
hereto, will provide the City with the following:
1. A Triple Choice Dental Benefits Program, which consists of a Network Based
(DHMO) Dental Care Plan through CompBenefits (CSI50), a PPO Dental Plan
underwritten by Security Life Insurance Company of America and CompBenefits
Insurance Company (SLV-PPO), and an Indemnity Dental Plan underwritten by
CompBenefits Insurance Company (EC400). The following are the monthly rates
for 2004/05 that are herein guaranteed by CompBenefits to continue for the plan
year October 1,2004 through September 30, 2005:
Managed Care Dental Plan:
CS150
Employee Only
Employee + One
Employee + Family
$10.16
$18.96
$24.66
1
PPO Dental Plan:
SLV-PPO
Employee Only
Employee + One
Employee + Family
$22.70
$43.78
$67.10
Indemnitv Dental Plan:
EC400
Employee Only
Employee + One
Employee + Family
$29.58
$57.04
$87.42
2. Brochures and all marketing materials necessary for emollment.
3. A current list ofCompBenefits Preferred Providers for all work locations
4. A Preferred Provider Network reasonably suitable for handling the
employee/patient flow.
5. Employee Identification Cards to be mailed to the employee's residence.
6. Employee Certificate of Benefits to be mailed to the employee's residence.
7. Ample supplies of applications and marketing materials for all new full-time City
employees.
8. Coordination with management during on-site emollment when possible by
CompBenefits personnel where permitted.
9. Verification of all emolled employees to be supplied to the group as requested (by
CompBenefits) upon fifteen (15) days written notification.
10. Terminated employees will have the right to convert to an individual network
based dental care plan.
11. Expeditious handling and judicious settlement of all claims for indemnity benefits
from the CompBenefits Office.
12. Managed Care (DHMO) Dental Plan Rates and benefits are for the Plan Year,
October 1'\ 2004 through September 30th, 2005. PPO (SLV-80) Dental Plan
Rates and benefits are for the Plan Year, October 1 '\ 2004 through September
30th, 2005. The Indemnity (EC400) Dental Plan Rates and benefits are for the Plan
Year, October 1'\ 2004 through September 30th, 2005.
2
13. The Indemnity (EC400) Dental Plan will be offered to the unclassified employees,
the group listed as "Others", the Government Supervisors Association (G.S.A.),
the Fraternal Order of Police, and other groups as determined by the City
Administration. Unions must collectively bargain for the benefit.
14. Domestic partners are eligible for coverage.
Performance Standards
CompBenefits agrees to the performance guarantees below:
1. Account Management - a dedicated Service Representative - Account Manager
will be assigned to the City of Miami Beach. The Account Manager will be
responsible for communicating with the Human Resources Administrative Office
and their personnel. If a member concern escalates to the Human Resources
Administrative Offices, the Account Manager will be involved in solving the
problem.
2. Customer Service - Delivery of the Identification Cards
3. Member Services Telephone Response Time
A. Satisfactory response Time - 90% within 60 seconds
B. Satisfactory Abandon Rate - 5% or less
4. Claims Accuracy and Turn Around Time
A. Accuracy rate to include both procedural and financial accuracy of
93% subject to the receipt of complete and necessary documents
B. Turnaround time - 100% of all clean claims will be processed within
30 days.
5. Quality Assurance - Quality Assurance Consultants follow up and work closely
with providers and their staffs to achieve and maintain compliance with
CompBenefits Quality Assurance recommendations.
Termination of Al!:reement bv the City:
The City has the right to terminate this Agreement without cause and/for its convenience by
providing thirty (30) days prior written notice to CompBenefits. Said termination will be
effective as ofthe date specified by the City in such written termination notice.
Termination bv ComuBenefits:
DHMO - CompBenefits has the right to terminate this Agreement by providing one hundred and
twenty (120) days prior written notice to the City. However, for non-payment of premium,
CompBenefits has the right of thirty-one (31) days prior written notice.
PPO/Indemnitv - CompBenefits has the right to terminate this Agreement by providing one
hundred and twenty (120) days prior written notice. However, for non-payment of premium,
CompBenefits has the right of thirty-one (31) days prior written notice.
3
Notices
All communications relating to the day-to-day activities shall be exchanged between the Project
Manager/Account Representative appointed by CompBenefits and the Project Manager
designated by the City. CompBenefit's Project Manager and the City's Project Manager shall be
designated no later than the commencement date of the Agreement or October 1, 2004.
All other notices and communications in writing required or permitted hereunder may be
delivered personally to the representatives of CompBenefits and the City listed below or may be
mailed by registered mail, postage prepaid (or airmailed if addressed to an address outside of the
city of dispatch).
Until changed by notice in writing, all such notices and communications shall be addressed as
follow:
TO PROVIDER: CompBenefits Corporation
Ken MacDougall, Vice President of Sales and Marketing
100 Mansell Ct. E Ste. 400
Roswell, Georgia, 30076
1-800-295-6279
305-269-2132 Fax
E-mail: kmacdoua@compbenefits.com
TO CITY: City of Miami Beach, Fl.
Mayra D, Buttacavoli, Director of Human Resources & Risk Management
1700 Convention Center Drive, 3rd Floor
Miami Beach, Fl. 33139
305-673-7000 ext 6469
..
305-673-7529
E-mail: mayrabuttacavoli@miamibeachfl.gov
Notices hereunder shall be effective if delivered personally, on delivery; if mailed to an address
in the city of dispatch, on the day following the date mailed; and if mailed to an address outside
the city of dispatch on the seventh day following the date mailed.
LITIGATION JURISDICTIONNENUE
This Agreement shall be governed by and construed according to the laws of the State of
Florida. This Agreement shall be enforceable in Miami-Dade County, Florida, and if legal
action is necessary by either party with respect to the enforcement of any or all of the terms or
conditions herein, exclusive venue for the enforcement of same shall lie in Miami-Dade
County, Florida.
4
BY ENTEREING INTO THE AGREEMENT, CITY AND COMPBENEFITS EXPRESSLY
WANE ANY RIGHTS EITHER PARTY MAY HAVE TO A TRIAL BY JURY OF ANY
CNIL LITIGATION RELATED TO, OR RISING OUT OF, THIS AGREEMENT.
Signed and agreed this 2"f1'~ day of -AuiA.\J~1 , 2004.
Beach, Florida
Attest:
~~ POA~
CIty Clerk
F:\HUMA \$alllBenefits\CompBenefits-Dental\Jetterofunderstanding 2004 to 200S.doc
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