R11-069
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I RESOLUTION NO. R11-0lutt
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4 A RESOLUTION OF THE CITY COMMISSION OF
5 BOYNTON BEACH, FLORIDA, APPROVING
6 RENEWAL OF THE VISION PLAN WITH HUMANA
7 COMP BENEFITS FOR A PERIOD OF TWO YEARS
8 FROM OCTOBER 1, 2011 TO SEPTEMBER 30, 2013;
9 AND PROVIDING AN EFFECTIVE DATE.
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12 WHEREAS, on August 4, 2009, the City Commission of the City of Boynton Beach
13 awarded a Provider Agreement via Resolution 09-109 to Humana "CompBenefits" for a
14 vision plan; and
15 WHEREAS, the Provider Agreement approved by the City Commission provided for
16 three (3) additional one (1) year extensions; and
17 WHEREAS, on July 20, 2010, the City Commission approved renewal of the Vision
18 Plan with Humana ComBenefits for a period of one year at the same terms, conditions and
19 rates as allowed by the Provider Agreement; and
20 WHEREAS, Humana CompBenefits has extended the renewal offer for the remaining
21 two (2) additional renewal periods with a reduction in rates of 2% for the period October 1,
22 2011 to September 30, 2013; and
23 WHEREAS, the City Commission of the City of Boynton Beach, upon
24 recommendation of staff, deems it to be in the best interests of the residents and citizens of the
25 I City of Boynton Beach to approve the two year renewal of the Provider Agreement with
26 Humana CompBenefits vision plan commencing October 1, 2011 to September 30,2013 for
27 all city employees.
28 I NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
S:\CA\RESO\Agreements\Reso - Vision Health Benefits 2011-13.doc
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I THE CITY OF BOYNTON BEACH, FLORIDA, THAT:
2 Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed
3 as being true and correct and are hereby made a specific part of this Resolution upon adoption
4 hereof.
5 Section 2. The City Commission of the City of Boynton Beach, Florida does
6 hereby approve the two year renewal of a Provider Agreement with Humana CompBenefits
7 vision plan commencing October 1,2011 through September 30, 2013, for all city employees,
8 a copy of the Provider Agreement is attached hereto as Exhibit "A".
9 Section 3. That this Resolution shall become effective immediately upon passage.
10 PASSED AND ADOPTED this S .t-h day of July 2011.
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12 CITY.PF BOYNTON BEACH, FLORIDA
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ts\Reso - V ision Health Benefits 2011-13 .doc
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PROVIDER AGREEMENT FOR
"FULLY INSURED VISION PLAN"
THIS AGREEMENT is entered into between the City of Boynton Beach, hereinafter referred to
as "the City", and Humana ComoBenefits (Vision Plan) , hereinafter referred to as "the
Provider", in consideration of the mutual benefits, terms, and conditions hereinafter specified.
\. PROJECT DESIGNATION. The Provider is retained by the City to perform PROVIDER
services in connection with the project designated.
2. SCOPE OF SERVICES. Provider agrees to perform the services, identified on Exhibit "A"
attached hereto and incorporated herein by reference, including the provision of all labor,
materials, equipment and supplies. No modifications will be made to the original scope of
work without the written approval of the City Manager or his designee.
3. TIME FOR PERFORMANCE. Work under this agreement shall commence upon the giving
of written notice by the City to the Provider to proceed. Provider shall perform all services
and provide all work product required pursuant to this agreement.
4. TERM: October 1, 2011 through September 30, 2013 .
5. PAYMENT. The Consultant shall be paid by the Provider/City for completed work and for
services rendered under this agreement as follows:
Monthly basis per eligible employee and dependent for vision coverage invoiced by
Provider.
6. OWNERSHIP AND USE OF DOCUMENTS. All documents, drawings, specifications and
other materials produced by the Provider in connection with the services rendered under this
Agreement shall be the property of the City whether the project for which they are made is
executed or not. The Provider shall be permitted to retain copies, including reproducible
copies, of drawings and specifications for information, reference and use in connection with
Provider's endeavors.
7. COMPLIANCE WITH LAWS. Provider shall, in performing the services contemplated by
this Agreement, faithfully observe and comply with all federal, state and local laws,
ordinances and regulations that are applicable to the services to be rendered under this
agreement.
8. INDEMNIFICA TION. Provider shall indemnify, defend and hold harmless the City, its
offices, agents and employees, from and against any and all claims, losses or liability, or any
portion thereof, including attorneys fees and costs, arising from injury or death to persons,
including injuries, sickness, disease or death to Provider's own employees, or damage to
property occasioned by a negligent act, omission or failure of the Provider.
PA-I
9. INSURANCE. The Provider shall secure and maintain in force throughout the duration of
this contract comprehensive general liability insurance with a minimum coverage of
$1,000,000 per occurrence and $1,000,000 aggregate for personal injury; and $1,000,000 per
occurrence/aggregate for property damage, and professional liability insurance in the amount
of $1 ,000,000 per occurrence to 2 million aggregate with defense costs in addition to limits.
Said general liability policy shall name the City of Boynton Beach as an additional named
insured and shall include a provision prohibiting cancellation of said policy except upon
thirty (30) days prior written notice to the City. Certificates of coverage as required by this
section shall be delivered to the City within fifteen (15) days of execution of this agreement.
10. INDEPENDENT CONTRACTOR. The Provider and the City agree that the Provider is an
independent contractor with respect to the services provided pursuant to this agreement.
Nothing in this agreement shall be considered to create the relationship of employer and
employee between the parties hereto. Neither Provider nor any employee of Provider shall
be entitled to any benefits accorded City employees by virtue of the services provided under
this agreement. The City shall not be responsible for withholding or otherwise deducting
federal income tax or social security or for contributing to the state industrial insurance
program, otherwise assuming the duties of an employer with respect to Provider, or any
employee of Provider.
11. COVENANT AGAINST CONTINGENT FEES. The Provider warrants that he has not
employed or retained any company or person, other than a bonafide employee working solely
for the Provider, to solicit or secure this contract, and that he has not paid or agreed to pay
any company or person, other than a bonafide employee working solely for the Provider, any
fee, commission, percentage, brokerage fee, gifts, or any other consideration contingent upon
or resulting from the award or making of this contract.
For breach or violation of this warranty, the City shall have the right to annul this contract
without liability or, in its discretion to deduct from the contract price or consideration, or
otherwise recover, the full amount of such fee, commission, percentage, brokerage fee, gift,
or contingent fee.
12. DISCRIMINATION PROHIBITED. The Provider, with regard to the work performed by it
under this agreement, will not discriminate on the grounds of race, color, national origin,
religion, creed, age, sex or the presence of any physical or sensory handicap in the selection
and retention of employees or procurement of materials or suppl ies.
13 ASSIGNMENT. The Provider shall not sublet or assign any of the services covered by this
Agreement without the express consent of the City.
14. NON-WAIVER. Waiver by the City of any provision of this Agreement or any time
limitation provided for in this Agreement shall not constitute a waiver of any other provision.
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16. NOTICES. Notices to the City of Boynton Beach shall be sent to the following address:
City of Boynton Beach
ATTN: Patricia Sholos
P.O. Box 310
Boynton Beach, FL 33425-0310
Notices to Provider shall be sent to the following address:
Humana Health Insurance Company of Florida, Inc.
ATTN: Jackie Martinez-Sancho
Director of Account Management
3401 S.W. 160th Avenue, Bldg. A, 2nd Floor
Miramar, FL 33027
17. INTEGRATED AGREEMENT. This agreement, together with attachments or addenda,
represents the entire and integrated agreement between the City and the Provider and
supersedes all prior negotiations, representations, or agreements written or oral. This
agreement may be amended only by written instrument signed by both City and Provider.
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DATED this L day of ,20~.
CITY OF BOYNTON BEACH COMPBENEFITS COMPANY
d~tI~,&~-
Ci anager
Attest! Authenticated: VICE PRESIDENT
Title
~tn.P~ (Corporate Seal)
C ty CI k
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Approved as to Form: Attest/Authenticated:
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Office Secret ry JOAN O. LENAHAN
VP & CORPORATE SECRETARY
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"EXHIBIT A"
. SCOPE OF SERVICES
PA-5
EXHIBIT A SCOPE OF SERVICES VISION CARE PLAN
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Visit a nonparticipating
Vision care services Visit a partlclpilltlng provider provider
------..------ -,.._._.~ --~~- _._-~ ----_. - - --_..- .-----.- +-.----"-----.--------- - -_._-,- ----,-----
Exam with dilation as necessary 100% after copay $35 allowance
--'--~-'--'-' --- - -~.. --- ------.. --- -- --_.~-- ___.__.._ .__.,'~_._r~ __~ .___ _____.____ _____ ._____
Le nses
. Single vision 100% after copay $25 allowance
. Bifocal 100% after copay $40 allowance
. Trifocal 100% after copay $60 allowance
..______..___ __. -0_-"'- __ ------ ".---.- .-
Frames $45 wholesale frame allowance $45 retail allowance
________._____ ._ ___.__ __,.___,._ _. __ ~. ~________'_L____._________________..__ _______ _
Contact IlInst!ls
. Elective (conventional and disposable) $105 Contact lens allowance $105 Contact lens allowance
. Medically necessary 100% $210 allowance
-'- .__.._--_..._._---~--~--- --' --~--- -..- -- - ----- --.- -.-----.---.-.-.----..---- -
Frequency (based on date of service)
. Examination Once every 12 months
. Lenses or contact lenses Once every 12 months
. Fra me Once every 24 months
--..---.-- _.-.------------_._--- _._----- .".- - -,"- --_._- ."_.-.--~--- -~
Exam/material copay $10/$0
----------.-- .... --_.~ --.---.- ~----------' --.--- ----
WhDlesale frame allowance* $90-$135 approximate retail value
-.--.-..--._--_. . -~-_.
The cont~ct lens i1l1owilnce applies to professional services (evaluation and
Contact lens allowance fitting fee) and materials. M~mbers receille a 15% discount on professIonal
services. The discount for professional services is allallable for 12 months alter
---.--- -_.. -- ..... .-.-.--...-- the covered eve eKam. "-. --_._-
Lasik and PRK
Members receive substantial reductions when procedures are done by network providers.
Members can expect to pay no more than $1,800 per eye for conventional Lasik procedures and $2,300 per eye for
custom Lasik or they can use designated TLC Vision Lasik Advantage Centers that have the following fixed prices:
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. Conventional Lasik $895 per eye
. Custom Lasil< $1,295 pee eye
. Custom Laslk with IntraLase $1,895 per eye
___ _k_'___~,,__,_ .-- _u ----
How does the wholesale frame allowance work?
Benefits include a wholesale frame allowance. If the wholesale cost exceeds the frame allowance, members pay twice
the wholesale difference. They never pay ful! retail.
._...~T~______________ ____
. Retail costs may differ and are based On two to three times the wholesale cost. Actuai savings may vary.
AdditiDnal plan discDunts
. Members receive additional fixed copayments on lens options including: anti-reflective and
scratch-resistant coatings,
. Members also receive a 20% retail discount on a second pair of eyeglasses. This discount is available for 12
months after the covered eye exam and available tllrough the VCP network provider who sold the initial pair
of eyeglasses.
. After copay, standard polycarbonate available at no charge for dependents less than 19 years old.
Proprietary to Humana Insurance Company 3
HUMANA~
Specialty BCIl~fits
May 2, 2011
City of Boynton Beach
Attn: Renee Schindler
5550 Glades Road, Suite 500
Boca Raton, FL 33431
Dear Mrs. Schindler:
Since 2004, I-Iumana/CompBenefits has been offering the City of Boynton Beach employees and
their families high quality vision and dental coverage. To this end, we are pleased to present the
dental and vision renewal for the City of Boynton Beach. We are offering to renew the vision
plan at a 2% reduction in current premiums guaranteed for two years. The dental renewal is a
slight increase to current premiums with a rate cap guarantee of 7% for the second year.
Vision Plan Current rates Renewal Rates Guarantee
Employee $3.92 $3.84 10/112011-9/30/2013
Family $16.94 $16.60
Dental PPO Current rates Renewal rates Guarantee
Employee $29.71 $32.64 1011 /20 11-9/30/20 13
7% rate cap for year two
Family $83.11 $91.32
Please feel free to contact me should you have any questions.
Sincerely,
Mo Estevez
HUMANA/CompBenefits
The City of Boynton Beach
City Clerk's Office
100 E BOYNTON BEACH BLVD
BOYNTON BEACH FL 33435
(561) 742-6060
FAX: (561) 742-6090
e-mail: prainitoj@bbfl.us
www.boynton-beach.org
MEMORANDUM
TO: Tim Howard
Deputy Director of Finance
FROM: Janet M. Prainito, MMC
City Clerk
DATE: July 6, 2011
SUBJECT: R11-069 Provider Agreement for Fully Insured Vision Plan
Attached for your handling is the original agreement mentioned above and a copy of
the Resolution. Once the document has been executed, please return the original to
the City Clerk’s Office for further processing.
Please contact me if there are any questions. Thank you.
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Attachments (2)
(1 Agreement & Resolution)
C: Central File
S:\CC\WP\AFTER COMMISSION\Departmental Transmittals\2011\Tim Howard R11-069 Humana compBenefits Vision
Plan.doc
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