R06-134
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RESOLUTION NO. R06- j :3'"
A RESOLUTION OF THE CITY COMMISSION OF
BOYNTON BEACH, FLORIDA, AUTHORIZING THE
RENEWAL OF EMPLOYEE BENEFITS AND
PREMIUMS FOR FISCAL YEAR 2006-07 WITH BLUE
CROSSIBLUE SHIELD OF FLORIDA, METLIFE,
JEFFERSON-PILOT, AND VISIONCARE
INCORPORATED; AND PROVIDING AN EFFECTIVE
DATE.
WHEREAS, the City Commission of the City of Boynton Beach, upon
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recommendation of staff, deems it to be in the best interests of the residents and citizens of the
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City of Boynton Beach to approve the renewal benefits and premiums for 2006-2007 health
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insurance and life insurance coverage with Blue Cross/Blue Shield of Florida medical plan,
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MetLife dental plan, Jefferson-Pilot (Lincoln Financial Group) life and disability plan and the
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Vision Care Incorporated plan, for all city employees.
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NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
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THE CITY OF BOYNTON BEACH, FLORIDA, THAT:
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Section 1.
The foregoing "Whereas" clauses are hereby ratified and confirmed
24 as being true and correct and are hereby made a specific part of this Resolution upon adoption
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Section 2.
Upon recommendation of staff, the City Commission of the City of
27 Boynton Beach, Florida does hereby approve the renewal benefits and premiums for 2006-
28 2007 Health and Life Insurance coverage with Blue Cross/Blue Shield of Florida medical
29 plan, MetLife dental plan, Jefferson-Pilot (Lincoln Financial Group) life and disability plan
S:\CA \RESO\Agreements\renewal health benefits 2006-07.doc
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and the Vision Care Incorporated plan.
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Section 3.
That this Resolution shall become effective immediately upon passage.
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PASSED AND ADOPTED this ~ day of August, 2006.
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22 ATTEST:
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CITY OF BOYNTON BEACH, FLORIDA
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S:\CA\RESO\Agreements\renewal health benefits 2006-07.doc
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EXHIBIT A
City of Boynton Beach Insurance Committee Recommendation
To the City Commission for the 2006-2007 Group Insurance Renewal
The recommendation from the insurance committee is based on the City's negotiated renewal offers
from Blue Cross/ Blue Shield of Florida medical plan, Metlife dental plan, Jefferson-Pilot (Lincoln
Financial Group) life and disability plan and the Vision Care Incorporated Plan.
Life/Accidental Death & Dismemberment (AD&D) and Lone: Term Disability Insurance
The recommendation is to renew the Jefferson-Pilot (Lincoln Financial Group) life and disability
insurance and the Vision Care Incorporated Plan coverage with no change in benefits or rates.
Dental Plan
The recommendation is to renew the Metlife dental plan with the addition of coverage for dental
implants and no change in rates.
Medical Plan
Employees:
The recommendation is to renew the Blue Cross/Blue Shield of Florida health insurance plans for
employees with no change in benefits. This is a 10.7% rate increase to the City.
Dependents:
The committee is very sensitive to minimizing the cost of health insurance coverage for dependents so
rates don't become so expensive that city employees cannot afford to cover their families
· The committee recommends a more progressive approach where the respective health plans have
"unblended" dependent increases as follows:
o 10.5% increase for HMO coverage
o 44.6% increase for Blue Choice PPO coverage
o -1.0% rate decrease for Blue Options PPO coverage.
S:\HR\Jnsurance Committee\Insurance Committee\FY20062007 Insurance Committee Recommendationsa.doc
EXHIBIT B
CITY OF BOYNTON BEACH: BLUE CROSS BENEFIT COMPARISON
HMO Plan 1
PPO Plan 101 NS
BlueOptions 1748NS
Provider Network
BlueCare
BlueChoice
Network Blue
Maximum Benefit
Unlimited
$5,000,000
$5,000,000
BASIC CARE (office visits. blood tests. diaanostic tests. physicals. prescriptions-this is all 70%+ of insureds will receive)
Open Access to PCP/Spec? No Yes Yes
Test Approval Required? Yes No No
1M, GP, FP, Ped OV Copay $5 ded uctible/coinsu rance $5
Specialist OV Copay $5 deductible/coinsu rance $5
Mammogram Copay $0 coinsurance $0
Adult Wellness Physical Maximum unlimited not covered $250
Independent Clinical Lab Co pay $0 ded ucti ble/coinsu rance $0
Ind Diagnostic Testing Fac Copay $0 ded uctible/coinsu rance $0
Prescription Copays $5/15/30 ded uctible/co ins u rance $5/15/30
PHYSICIAN SERVICES RECEIVED OUTSIDE OF THE PHYSICIANS OFFICE (suraeons. IP visit. ER. Anesthesia. Radioloay. Patholoay)
Calendar Year Deductible (individual) $0 $300 $0 in network/$500 out of network
Calendar Year Deductible (family) $0 $600 $0 in network/$1500 out of network
Coinsurance % you pay (in network) 0% 10% of negotiated fee 0% of negotiated fee
Coinsurance % you pay (out of network) 100% 30% + balance billing 40% + balance billing
in excess of allowance in excess of allowance
HOSPITAL SERVICES (Varies by Hospital under BlueOptions - Option 1 Hospital 1 Option 2 Hospital 1 Option 3 Hospital)
Inpatient Copay 1 admit $ 0 ded uctible/coinsu rance $0/5001750
Outpatient Surgery 1 Test Copay $ 0 d ed uctible/coinsu rance $0/2001300
Emergency Room Services Copay $50 ded uctible/coinsu rance $50
Amb 1 DME 1 HHC 1 Injectable Drug $ 0 ded uctible/co insu rance deductible/coinsu rance
Therapy Copay 1 Benefit Maximum $0, 60 days ded/coins, $2500/yr ded/coins, $2500/yr
MAXIMUM OUT OF POCKET EXPENSE ON COVERED CHARGES/CALENDAR YEAR{protection from unbudaetable medical expenses)
Ded 1 Coins 1 Non-Rx Copays
$1500
$1800
In network lout of network
$1500 1 $3000
Blue Choice non-participating provider benefits access the Blue Cross Traditional network to access its pre-negotiated fees and no
balance-billing provisions with providers that do not participate in Blue Choice.
BlueOptions non-participating provider benefits access the Blue Cross Traditional networks to access their pre-negotiated fees and no
balance-billing provisions with providers that do not participate in Network Blue.
Expenses with providers who are not under any contract with BCBSFL are subject to the BCBSFL "MAP" (Maximum Allowable
Payment), which is lower than actual charges. Also, members are subject to balance billing from non-participating providers.
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