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Item C02 } C.2 `, County of Monroe �y,4 ' �, "tr, BOARD OF COUNTY COMMISSIONERS Mayor Michelle Coldiron,District 2 �1 nff `ll Mayor Pro Tem David Rice,District 4 -Ile Florida Keys Craig Cates,District 1 Eddie Martinez,District 3 w Mike Forster,District 5 County Commission Meeting June 16, 2021 Agenda Item Number: C.2 Agenda Item Summary #8 159 BULK ITEM: Yes DEPARTMENT: Employee Services TIME APPROXIMATE: STAFF CONTACT: Natalie Maddox (305) 292-4450 N/A AGENDA ITEM WORDING: Approval of a resolution approving and establishing the 2022 Wellness Program and funding levels, which includes health and wellness events (lunch and learns, health and wellness fairs, exercise and nutrition classes), wellness exam and age-appropriate screenings with a participation incentive that includes a tobacco cessation plan, community organized event reimbursement (walks, runs, bikes, swims), and Approval of the 2022 Wellness Funding. Also provides for four hours of annual leave to Monroe County BOCC employees and participating Constitutional Officer (Property Appraiser, Court Administration, Land Authority and Clerk of Court) employees who participate in the annual Health & Wellness Fair (minimum participation of biometrics and health coach visit) or visit their personal physician and complete the online Personal Health Assessment. Due to the COVID-19 pandemic, this also allows for Wellness Events to be held online/virtually. ITEM BACKGROUND: The goal of the Wellness Program is to encourage healthy lifestyle choices in the interest of disease prevention and provide opportunities for early detection of illnesses before major medical treatment is required. This contributes to a healthier workforce and seeks to reduce long-term medical and pharmacy claims cost. As part of the County's agreement renewal with Florida Blue in 2018, Florida Blue paid the County a $50,000 wellness contribution upon BOCC approval of the agreement renewal; a $50,000 wellness contribution was made on January 1, 2019, January 1, 2020; January 1, 2021; and is due again on January 1, 2022 and January 1, 2023 per the agreement. The County has implemented programs from 2011-2021 using funds from Florida Blue to encourage health plan enrollees to participate in wellness programs and educational opportunities. The 2022 program includes: All wellness program opportunities will be administered either virtually or onsite, depending upon applicable future safety guidelines for COVID-19. Recurring Events: • Community Organized Event Reimbursement up to $100 annually per enrollee for participation in marathons, walkathons, etc. Packet,Pg. 62 C.2 • Lunch and Learns (Topics will address the top 4 risk areas: Diabetes, BMI, Nutrition, Blood Pressure-Cardio Pulmonary Disease) • Health and Wellness Fairs • Funding of exercise (Yoga, Zumba, etc.) and nutrition classes (healthy cooking, etc.) held at Government Centers (Lower, Middle and Upper Keys) • Wellness Champion Visits/Virtual Presentations by Staff(Will address the top 4 risk areas: Diabetes, BMI, Nutrition, Blood Pressure). Staff will research, design, and present worksite wellness education. Health &Wellness Rewards: • Annual Wellness Exam and Age Appropriate Screenings: Participating employees on the traditional Health Plan will receive $ 25.00 per month ($300 per year)premium discount in 2023. Participating employees on the High Deductible Health Plan with Health Savings Account(HDHP/HSA) will receive $300 deposited into their Health Savings Account in 2022. Employees who attest to tobacco use are included in the ability to earn the employee health insurance premium discount. To be eligible, in addition to the age appropriate screenings required for all participants, those attesting to tobacco use, must voluntarily participate and complete at least one approved tobacco cessation program during the wellness program period of the prior year (November 1, 2021 — October 31, 2022) and submit a certificate or letter of participation/completion from the facilitating program. List of approved tobacco cessation program(s)to be maintained by Employee Benefits and regularly communicated to employees during Wellness Champion visits. • Annual Biometric Screenings and Online Personal Health Assessment: BOCC and participating Constitutional Officer(Property Appraiser, Court Administration, and Land Authority employees (those covered and not covered by the County Health Insurance)who: A. Attend the annual Health Fair and participate in biometric, blood pressure, cholesterol, blood sugar level and body mass index screenings OR B. Visit their personal physician and obtain biometric, blood pressure, cholesterol, blood sugar level and body mass index screenings (on or between the dates of I I/1/21 to 10/31/22) and complete the on-line personal health assessment by 2/1/23. *Will receive 4 hours of personal time off. *Participating employers. ALTERNATE(Virtual): Outlined in Section D of Wellness Program Resolution. Purchases of Goods: • Gato Building Gym — The Gato Fitness Center opened on May 14, 2018. Up to $5,000.00 annually shall be planned for equipment maintenance, repair, and replenishment of fitness center supplies. The table below demonstrates preventive screening participation for 2020. In the attached Preventive Screenings Historical Data,participation during 2016 —2020 can be viewed. 2020 Packet,Pg. 63 C.2 2020 2020 2020 TOTAL Employee Employee EMPLOYERS EMPLOYEES Participation Percentage MC SHERIFF OFFICE 510 144 28% COUNTY CLERK 77 38 49% TAX COLLECTOR 54 21 39% PROPERTY APPRAISER 34 18 53% SUPERVISOR OF ELECTIONS 10 4 40% COURT ADMINISTRATION 21 6 29% LAND AUTHORITY 3 3 100% BOARD OF COUNTY COMMISSIONERS 541 175 32% Total 1250 409 33% Florida Blue reports that the County has spent approximately $2,746,001.00 in claims on Wellness screenings over a 6-year period (October 2014 — September 2020). For the same period Florida Blue estimates that the initiatives of the Wellness Program are approaching a savings to the plan of over 11 million dollars (as cost avoidance). Based on this estimate, every $1.00 spent on Wellness Preventative Screenings saves $6.00 as avoided claims cost. (Attached file: Florida Blue 5-year wellness claims cost and estimated ROI) Florida Blue suggests that the 4 top risk areas for the County are: 1) Diabetes 2) Obesity/Body Mass Index (BMI) 3) Cancer 4) Blood Pressure/Cardio-Pulmonary Disease Budget The FY2020 program has an ending balance of$ 116,992.00. The program is scheduled to receive $50,000 from Florida Blue in the first quarter of CY2021,per agreement. Total CY2021 beginning balance: $166,992.00. Recap: Budget The FY2021 program has an ending balance of$ 211,392.14. The program is scheduled to receive $50,000 from Florida Blue in the first quarter of CY2022,per agreement. Total CY2022 beginning balance: $261,392.14. Packet,Pg. 64 C.2 Recap: $ 595K is the cumulative revenue of the program since the beginning, and $ 334K is the cumulative expenses. Using round numbers, $ 595K - $ 334K= $ 261K available to spend in 2022. $ 210,992 minus the $ 44,000 that we plan to spend in 2020 = $166,992 (the 2021 beginning balance). Then, we anticipate spending approximately 50k in 2022 which will take the $261,392.14 down to $211,392.14, which is the forecasted ending balance for 2022. Total expenses for the 2022 program are planned at approximately $ 45,000.00. PREVIOUS RELEVANT BOCC ACTION: Resolution 242-2020 —2021 Wellness Program and Funding Resolution 267-2019 —2020 Wellness Program and Funding Resolution 262-2018 —2019 Wellness Program and Funding Resolution 027-2018 —2018 Wellness Program and Funding Resolution 049-2017 —2017 Wellness Program Resolution 173-2017 —2017 Wellness Program Funding CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATION: Approval DOCUMENTATION: Wellness Resolution for 2022 Resolution 242-2020 2021 Preventive Care Guidelines Wellness Funding 2022 Florida Blue 2014 -Present Wellness Claims Cost& Est ROI 5 18 21 2021 WELLNESS PHYSICIAN FORM Preventive Screenings FINANCIAL IMPACT: Effective Date: l l/1/2021 Expiration Date: 10/31/2022 Total Dollar Value of Contract: N/A Total Cost to County: $45,000.00 estimated Current Year Portion: $45,000.00 estimated Budgeted: Wellness Program Funds Source of Funds: Florida Blue Wellness Contribution,per contract CPI: N/A Indirect Costs: 4 Hours annual leave per employee who participates in the Personal Health Assessment Estimated Ongoing Costs Not Included in above dollar amounts: N/A Packet,Pg. 65 C.2 Revenue Producing: N/A If yes, amount: N/A Grant: N/A County Match: N/A Insurance Required: N/A Additional Details: The program is scheduled to receive $50,000 from Florida Blue in the first quarter of CY2022,per agreement. Total CY2022 beginning balance is expected to be $211,392.14. Total expenses for the 2021 program are planned at approximately $45,000.00. Approximately $ 45,000.00 for the 2022 program to be spent from the existing Wellness Program Budget, and less if expenditures if all or portions of the program are virtual. REVIEWED BY: Bryan Cook Completed 05/28/2021 9:00 AM Natalie Maddox Completed 05/28/2021 9:05 AM Cynthia Hall Completed 06/01/2021 9:25 AM Assistant County Administrator Christine Hurley Skipped 06/01/2021 8:38 AM Purchasing Completed 06/01/2021 9:31 AM Budget and Finance Completed 06/01/2021 4:59 PM Maria Slavik Completed 06/01/2021 5:21 PM Liz Yongue Completed 06/01/2021 5:28 PM Board of County Commissioners Pending 06/16/2021 9:00 AM Packet,Pg. 66 C.2.a RESOLUTION NO. -2021 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA APPROVING AND ESTABLISHING THE CALENDAR YEAR 2022 WELLNESS PROGRAM; REPEALING PRIOR RESOLUTION NO. 242-2020 AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, beginning in 2015, the contract between Blue Cross Blue Shield of Florida ("Florida Blue")and the County,whereby Florida Blue serves as the Administrative Services Only U_ administrator(ASO)for the County's self-insured health insurance plan("Plan")has provided that Florida Blue will contribute an annual amount toward the County's wellness-related initiatives and activities, consisting of $100,000 at execution of the agreement, $75,000 on each of January 11 2016 and January 1, 2017, with additional contributions of $50,000 on January 1, 2018. Upon 0 execution of a renewal contract between Blue Cross Shield of Florida dated September 19, 2018 a and the County, a contribution of $ 50,000 was made toward the County's wellness-related initiatives and activities, and $50,000 was contributed January 2019 and January 2020. $50,000 S was contributed to the County in 2021, and will be contributed in 2022 and 2023,per agreement. N N WHEREAS, currently, the balance of funds contributed by Florida Blue toward wellness N programs shall stand at approximately $ 211,392.14 ("Wellness Fund") for 2021; and 0 WHEREAS, the County has received the results from the personal health assessments 2 completed by the fall 2015, 2016, 2018, 2019, 2020 health fair participants (2017 Health Fair canceled due to Hurricane Irma), and the results indicate that the top four at-risk areas for N participants are diabetes, hypertension/cardio-pulmonary disease, cancer, and obesity; and N WHEREAS, it is in the best interests of Plan participants and the plan that Monroe County 0 adopt a coordinated program designed to improve and promote the health of its Plan participants through early assessments, intervention, education, information, and incentives, particularly targeted against the top four at-risk areas for health fair participants; and WHEREAS, the County desires to use the Wellness Fund on the activities described below. NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY E COMMISSIONERS OF MONROE COUNTY, FLORIDA that: 1. In calendar year 2022,the Monroe County Wellness Program shall consist of the following items, which shall be paid for from the Wellness Funds contributed by Florida Blue pursuant to its contract with Monroe County and the existing Wellness Fund. All such purchases must be finalized within calendar year 2022. Page 1 of 6 Packet,Pg. 67 C.2.a Recurring Events: a. Community Organized Event Reimbursement: All employees covered under the County's health insurance plan are eligible to be reimbursed their registration fees in an amount not to exceed one hundred dollars ($100.00) annually upon presentation of proof that the individual has registered for and has completed community organized foot, bicycle, or swimming race that takes place in the Florida Keys, including but not limited to marathons, triathlons, run/walkathons, and bikeathons. Said requests for reimbursement shall be handled on a"first come first served" basis. Planned cumulative expenditure of two thousand dollars ($2,000.00); if events are held due to COVID-19. All request for reimbursements u must be submitted to the Employee Benefits Department no later than January 9, 2023. b. "Lunch and Learn": (Virtually or onsite, depending upon applicable future safety 0 guidelines for COVID-19) The County's Benefits office will schedule education "lunch and learn" activities throughout the Florida Keys, twice per year, offering presentations on a variety of wellness topics. If onsite, staff will purchase healthy S food items for consumption by active employees who attend and complete scheduled activities. The expenditure of Wellness Funds under this resolution shall N not exceed thirteen dollars ($13.00)per individual per meeting.Planned cumulative expenditure for all Lunch and Learn events is five thousand dollars ($5,000.00); c will be less if virtual. > 0 c. Wellness and Exercise Classes: (Virtually or onsite, depending upon applicable future safety guidelines for COVID-19) Wellness Funds will be used to provide N free wellness, exercise, and nutrition classes for employees and their dependents over age 18 covered under the County's health insurance plan. The classes and 0 events will consist of different types of wellness and exercise, including but not limited to Yoga, Zumba and Pilates, and nutrition/healthy cooking classes. These classes will be held at various County buildings with external instructors. Wellness Funds will be used to compensate the instructors and purchase supplies. The planned cumulative expenditure for Wellness Funds used on all Exercise Classes during CY 2021 is fifteen thousand dollars ($15,000);will be less if virtual d. Annual Health & Wellness Fair: (Virtually or onsite, depending upon applicable future safety guidelines for COVID-19)Each year, Monroe County Benefits office coordinates the Monroe County Health & Wellness Fair. The fair is presented in E three (3) locations (Upper, Middle and Lower Keys/Key West). Any active employees of any of the employers participating in the Plan and their covered dependents over age 18, retirees and their covered dependents over age 18 may attend. Page 2 of 6 Packet,Pg. 68 C.2.a Health Fair and Health Assessment Participation Year Health Fair Participants Online Health Assessment 2015 335 32 2016 369 29 2017 Hurricane Irma- canceled Hurricane Irma- canceled 2018 326 17 U_ 2019 340 9 E 2020 133-Virtual/Online 0 0 CL 2021 will feature a streamlined in person Health & Wellness Fair in September , 2021 with safety precautions for COVID-19. A virtual event will be presented in the event that COVID-19 prohibits an in-person event. Both the streamline and possible virtual Health & Wellness Fair will feature presentations by Monroe County Employee Benefits, Florida Blue, Capital Rx,Delta Dental, VSP, Quantum c (EAP), and Minnesota Life. Wellness Funds will be used to purchase prizes that promote healthy living (i.e., bicycles, fitness trackers, smoothie makers) for participants who attend or participate virtually in annual Health & Wellness Fairs t and complete their Passport to Wellness/virtual minimal requirements. For possible in-person events,there will also be a cost for the use of the facilities where the Health & Wellness Fairs will be held in the lower, middle and upper keys and 0 Wellness Funds will also be used for that purpose. The planned cumulative o expenditure for Wellness Funds used on the Annual Health & Wellness Fair shall be fifteen thousand dollars ($15,000.00); but will be less if held virtually. 0 e. Staff will develop and deliver onsite or virtual Wellness Champion topics to plan participants. Topics will be consistent with top risk factors among participants as identified by Florida Blue. Page 3 of 6 Packet,Pg. 69 C.2.a Employee Participation in Wellness Events: f. To the extent that business operation allows, employees will be allowed to participate in Health & Wellness events, including but not limited to Annual Employee Health & Wellness Fairs and Lunch & Learns that are held during scheduled work hours without the use of vacation, sick or comp time. Employees should attend during normal scheduled work time/hours. Employees voluntarily choosing to attend prior to or after scheduled work hours is not compensable. Health&Wellness Rewards: g. Biometric Screenings: (Virtually or onsite, depending upon applicable future safety guidelines for COVID-19) Four hours of annual leave to Monroe County BOCC employees and participating Constitutional Officer (Property Appraiser, Court Administration, Land Authority and Clerk of Court) employees who participate in the annual Health&Wellness Fair(minimum participation of biometrics and health 0. coach visit) or visit their personal physician and complete the online Personal Health Assessment. Virtual requirements as noted in section D. Leave (above)will be deposited the first payday in April, following the use-it or lose-it date each year. Florida Blue documents participation and provides confirmation data to employee benefits for awarding of annual leave. Annual leave is distributed by employer and is not funded by the Florida Blue annual contribution for wellness initiatives. 0 Participation in the Monroe County Health& Wellness Program is voluntary. 2 h. Annual Wellness Exam and Age Appropriate Screenings: Participating employees on the traditional Health Plan will receive $ 25.00 per month ($300 per year) premium discount in 2023. Participating employees on the High Deductible Health Plan with Health Savings Account(HDHP/HSA) will receive $300 deposited into their Health Savings Account in 2023. This award is not funded by the Florida Blue 0 annual contribution for wellness initiatives; but is reduction in revenue of the o internal service fund and is handled as a ledger entry. To be eligible for the discount (BOCC and participating Constitutional Officer) employees must visit their personal physician for an annual wellness exam and obtain the required age appropriate preventive screenings, determined by staff and specified on the Employee Health Preventive Care — Assessment Acknowledgement Form. In program year ending October 31,2020;416 members completed the screenings and received the reward. i. Traditional Health Plan: Employees paying$50.00 per month for premiums will be reduced to$25.00 and those paying$75.00 per month for premiums will be reduced to $50.00 per month. These discounts are administered on the employee direct deposit pay statements or pay checks. ii. High Deductible Health Plan with Health Savings Account(HDHP/HSA): Employees on this plan pay zero in premiums, so a monthly discount does not apply. Instead employees on the HDHP/HSA will receive $300 deposited into their Health Savings Account. These funds are direct Page 4 of 6 Packet,Pg. 70 C.2.a deposited into the employee's HSA each payday by their respective participating employer/payroll. Employees who attest to tobacco use are included in the ability to earn the employee health insurance premium discount (Traditional Health Plan) or contribution to HSA (High Deductible Health Plan with Health Savings Account). To be eligible, in addition to the age appropriate screenings required for all participants, those attesting to tobacco use, must voluntarily participate and complete at least one approved tobacco cessation program (programs vary in length) during the wellness program period of the prior year (November 1, 2021 — October 31, 2022) and submit a certificate or letter of participation/completion from the facilitating u program. No-cost cessation programs are offered throughout Monroe County and South Florida by various organizations. Employee Benefits Staff will maintain and regularly communicate a list of approved tobacco cessation program(s). Employees inside or outside of Monroe County who are interested in another tobacco cessation 0 program not listed may submit the program name and contact information in c. writing to the Benefits Administrator or Employee Services Director for eligibility review. Employees must receive approval of other tobacco cessation programs in S advance in order for participation in those programs to qualify the employee for the premium discount or HSA deposit. Monroe County's prescription plan provider also supports tobacco cessation and covers tobacco cessation products (patches, gum, Rx). Employees are not limited in the number of attempts to become tobacco c free during a calendar year. Participation in wellness and cessation programs are completely voluntary. Purchases of Goods: N i. Gato Building Gym: Up to $5000.00 annually shall be planned for equipment maintenance, repair, and replenishment of fitness center supplies. 0 Beginning November 1, 2019, the Gato Building Gym will be open to health plan participants, spouses, and covered dependents age 18 and over. Since inception of the gym, the facility was only available to health plan participants. This change increases the fitness opportunities for additional covered plan participants. In 2017, county staff was authorized to spend up to Ninety-thousand dollars ($ 90,000.00) in calendar year 2017 as part of the County's Wellness Program in order to create a gym in the Gato Building(Gato Building Gym). The Gato Building Gym shall be open to all employees and retirees in Monroe County Board of County Commissioners ("BOCC"), Monroe County Land Authority, and the constitutional officers (Property Appraiser, Supervisor of Elections, Clerk of court, Tax collector and Sheriff) who are participants in the Monroe County health plan ("Employees and Retirees"). The County shall purchase and have ownership of the equipment. County staff shall establish reasonable rules for use of the gym, including but not limited to hours of operation, and may condition use of the gym on execution of documents by the gym users waiving and releasing the County from any liability for the voluntary activity. The Gato Fitness Center opened on May 14, 2018. Page 5 of 6 Packet Pg. 71 C.2.a Use of 2020 Wellness Funds among categories: j. Employee Services may reassign funds among the wellness program categories, based on under or over utilization, in order to meet demand and manage the needs of the specified programs. _ 2. Resolution No. 242-2020 is inconsistent with this resolution and is repealed on October 31, 2021. 3. This resolution shall take effect on November 1, 2021. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the day of 2021. CL Mayor Michelle Coldiron Mayor Pro Tem David Rice Commissioner Craig Cates _ c„ Commissioner Eddie Martinez Commissioner Mike Forester (SEAL) ATTEST: BOARD OF COUNTY COMMISSIONERS N KEVIN MADOK, Clerk OF MONROE COUNTY,FLORIDA `CD ~ cv 0 By: By: C As Deputy Clerk Mayor 0 Page 6 of 6 Packet,Pg. 72 C.2.b RESOLUTION NO. 242 -2020 A RESOLUTION OF THE BOARD OF COUNTY COMNUSSIONERS OF MONROE COUNTY, FLORIDA APPROVING AND ESTABLISHING THE CALENDAR YEAR 2021 WELLNESS PROGRAM; REPEALING PRIOR RESOLUTION NO. 267-2019 AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, beginning in 2015, the contract between Blue Cross Blue Shield of Florida ("Florida Blue")and the County,whereby Florida Blue serves as the Administrative Services Only administrator(ASO)for the County's self-insured health insurance plan("Plan")has provided that Florida Blue will contribute an annual amount toward the County's wellness-related initiatives and activities, consisting of$100,000 at execution of the agreement, $75,000 on each of January 1, 2016 and January 1, 2017, with additional contributions of$50,000 on January 1, 2018. Upon execution of a renewal contract between Blue Cross Shield of Florida dated September 19, 2018CD and the County, a contribution of $ 50,000 was made toward the County's wellness-related CL initiatives and activities, and $50,000 was contributed January 2019 and January 2020. $50,000 Ch is due to be contributed to the County in January of 2021, 2022 and 2023,per agreement; and WHEREAS,currently, the balance of funds contributed by Florida Blue toward wellness programs shall stand at approximately$ 116,992.00 ("Wellness Fund") for 2020; and CD 4- WHEREAS, the County has received the results from the personal health assessments o completed by the fall 2015, 2016, 2018, 2019 health fair participants (2017 Health Fair canceled due to Hurricane Irma), and the results indicate that the top four at-risk areas for participants are diabetes, hypertension/cardio-pulmonary disease, cancer, and obesity; and WHEREAS,it is in the best interests of Plan participants and the plan that Monroe County adopt a coordinated program designed to improve and promote the health of its Plan participants through early assessments, intervention, education, information, and incentives, particularly targeted against the top four at-risk areas for health fair participants; and 0 WHEREAS, the County desires to use the Wellness Fund on the activities described below. NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY e COMMISSIONERS OF MONROE COUNTY, FLORIDA that: 1. In calendar year 2021,the Monroe County Wellness Program shall consist of the following items, which shall be paid for from the Wellness Funds contributed by Florida Blue pursuant to its contract with Monroe County and the existing Wellness Fund. All such purchases must be finalized within calendar year 2021. Page 1 of 6 Packet,Pg. 73 C.2.b Recurring Events: a. Community Organized Event Reimbursement: All employees covered under the County's health insurance plan are eligible to be reimbursed their registration fees in an amount not to exceed one hundred dollars($100.00) annually upon presentation of proof that the individual has registered for and has completed community organized foot,bicycle, or swimming race that takes place in the Florida Keys, including but not limited to marathons,triathlons, runlwalkathons, and bikeathons. Said requests for reimbursement shall be handled on a"first come first served" basis. Planned cumulative expenditure of two thousand dollars ($2,000.00); if events are held due to COVID-19. All request for reimbursements must be submitted to the Employee Benefits Department no later than January 11, 2022. b. "Lunch and Learn": (Virtually or onsite, depending upon applicable future safety E guidelines for COVID-19) The County's Benefits office will schedule education "lunch and learn" activities throughout the Florida Keys, twice per year, offeringCL presentations on a variety of wellness topics. If onsite, staff will purchase healthy y food items for consumption by active employees who attend and complete scheduled activities. The expenditure of Wellness Funds under this resolution shall a, not exceed thirteen dollars($13.00)per individual per meeting.Planned cumulative expenditure for all Lunch and Learn events is five thousand dollars ($5,000.00); CD N will be less if virtual. 0 c. Wellness and Exercise Classes: (Virtually or onsite, depending upon applicable future safety guidelines for COVID-19) Wellness Funds will be used to provide free wellness, exercise, and nutrition classes for employees and their dependents W over age 18 covered under the County's health insurance plan. The classes and events will consist of different types of wellness and exercise, including but not limited to Yoga, Zumba and Pilates, and nutrition/healthy cooking classes. These classes will be held at various County buildings with external instructors. Wellness Funds will be used to compensate the instructors and purchase supplies. The planned cumulative expenditure for Wellness Funds used on all Exercise Classes during CY 2021 is fifteen thousand dollars($15,000);will be less if virtual. d. Annual Health & Wellness Fair: (Virtually or onsite, depending upon applicable future safety guidelines for COVID-19) Each year,Monroe County Benefits office coordinates the Monroe County Health & Wellness Fair. The fair is presented in e three (3) locations (Upper, Middle and Lower Keys/Key West). Any active employees of any of the employers participating in the Plan and their covered dependents over age 18, retirees and their covered dependents over age 18 may attend. Page 2 of G Packet,Pg. 74 C.2.b Health Fair and Health Assessment Participation Year Health Fair Participants Online Health Assessment 2015 335 32 2016 369 29 2017 Hurricane Irma-canceled Hurricane Irma-canceled 2018 326 17 2019 340 9 2020 will feature a first ever Virtual Health & Wellness Fair October 5, 2020 — o October 11, 2020. Presentations by Monroe County Employee Benefits, Florida CL Blue, Capital Rx, Delta Dental,VSP,Quantum(EAP), and Minnesota Life will be available to plan participants on the Monroe County website and will be accessible 24 hours per day. All presentations are less than 15 minutes. No pre-registration will be required,but attendance will be tracked based on presentations viewed by each individual. The online personal health assessment will provide participants with a printed health assessment and the opportunity to voluntarily speak with a health coach and request additional health support from the Florida Blue Next Steps Programs. Minimum participation to be eligible for Health&Wellness prizes will be the completion of the online health assessment and viewing the Employee Assistance Program presentation. Wellness Funds will be used to purchase prizes �-- that promote healthy living (i.e., bicycles, fitness trackers, smoothie makers) for participants who attend or participate virtually in annual Health & Wellness Fairs and complete their Passport to Wellness/virtual minimal requirements. For possible in-person events,there will also be a cost for the use of the facilities where the Health& Wellness Fairs will be held in the lower, middle and upper keys and o Wellness Funds will also be used for that purpose. The planned cumulative expenditure for Wellness Funds used on the Annual Health & Wellness Fair shall be fifteen thousand dollars($15,000.00);but will be less if held virtually. e. Due to the COVID-19 pandemic, the County suspended the services of Health Designs, Inc., who provided Wellness Champion visits at various County and Constitutional Offices and Facilities. This reduced the Wellness Program budget expense by $45,000 annually. Due to the ongoing uncertainty of the COVID-19 pandemic, in lieu of restarting Health Designs, Inc. onsite services, staff will themselves research and deliver onsite or virtual Wellness Champion topics to plan participants. Page 3 of 6 Packet,Pg. 75 C.2.b Employee Participation in Wellness Events: f. To the extent that business operation allows, employees will be allowed to participate in Health & Wellness events, including but not limited to Annual Employee Health & Wellness Fairs and Lunch & Learns that are held during scheduled work hours without the use of vacation, sick or comp time. Employees should attend during normal scheduled work time/hours. Employees voluntarily choosing to attend prior to or after scheduled work hours is not compensable. Health& Wellness Rewards: `6 g. Biometric Screenings: (Virtually or onsite,depending upon applicable future safety guidelines for COVID-19) Four hours of annual leave to Monroe County BOCC employees and participating Constitutional Officer (Property Appraiser, Court Administration, Land Authority and Clerk of Court) employees who participate in the annual Health&Wellness Fair(minimum participation of biometrics and health coach visit) or visit their personal physician and complete the online Personal Health Assessment.Virtual requirements as noted in section D. Leave(above)will Ch 0. be deposited the first payday in April,following the use-it or lose-it date each year. Florida Blue documents participation and provides confirmation data to employee S benefits for awarding of annual leave. Annual leave is distributed by employer and is not funded by the Florida Blue annual contribution for wellness initiatives. Participation in the Monroe County Health&Wellness Program is voluntary. 0 h. Annual Wellness Exam and Age Appropriate Screenings: Participating employees on the traditional Health Plan will receive $ 25.00 per month ($300 per year) premium discount in 2022. Participating employees on the High Deductible Health Plan with Health Savings Account(HDHPIHSA) will receive$300 deposited into their Health Savings Account in 2022.This award is not funded by the Florida Blue annual contribution for wellness initiatives; but is reduction in revenue of the internal service fund and is handled as a ledger entry. To be eligible for the discount (BOCC and participating Constitutional Officer) employees must visit their personal physician for an annual wellness exam and obtain the required age appropriate preventive screenings, determined by staff and specified on the y Employee Health Preventive Care — Assessment Acknowledgement Form. In program year ending October 31,2019;480 members completed the screenings and received the reward. i. Traditional Health Plan: Employees paying$50.00 per month for premiums will be reduced to$25.00 and those paying$75.00 per month for premiums will be reduced to $50.00 per month. These discounts are administered on the employee direct deposit pay statements or pay checks. ii. High Deductible Health Plan with Health Savings Account (HDHPIHSA): Employees on this plan pay zero in premiums, so a monthly discount does not apply. Instead employees on the HDHPIHSA will receive $300 deposited into their Health Savings Account. These funds are direct Page 4 of 6 Packet,Pg. 76 C.2.b deposited into the employee's HSA each payday by their respective participating employer/payroll. Employees who attest to tobacco use are included in the ability to earn the employee health insurance premium discount (Traditional Health Plan) or contribution to HSA(High Deductible Health Plan with Health Savings Account). To be eligible, in addition to the age appropriate screenings required for all participants, those attesting to tobacco use, must voluntarily participate and complete at least one approved tobacco cessation program(programs vary in length)during the wellness program period of the prior year (November 1, 2020 — October 31, 2021) and submit a certificate or letter of participation/completion from the facilitating program. No-cost cessation programs are offered throughout Monroe County and South Florida by various organizations. Employee Benefits Staff will maintain and regularly communicate a list of approved tobacco cessation program(s).Employees inside or outside of Monroe County who are interested in another tobacco cessation E program not listed may submit the program name and contact information in writing to the Benefits Administrator or Employee Services Director for eligibility CL review. Employees must receive approval of other tobacco cessation programs in y advance in order for participation in those programs to qualify the employee for the premium discount or HSA deposit. Monroe County's prescription plan provider , also supports tobacco cessation and covers tobacco cessation products (patches, gum,Rx). Employees are not limited in the number of attempts to become tobacco free during a calendar year. Participation in wellness and cessation programs are 0 completely voluntary. Purchases of Goods: i. Gato Building Gym: Up to $5000.00 annually shall be planned for equipment maintenance, repair, and replenishment of fitness center supplies. N Beginning November 1, 2019,the Gato Building Gym will be open to health plan participants, spouses, and covered dependents age 18 and over. Since inception of the gym, the facility was only available to health plan participants. This change increases the fitness opportunities for additional covered plan participants. y In 2017, county staff was authorized to spend up to Ninety-thousand dollars ($ 90,000.00) in calendar year 2017 as part of the County's Wellness Program in order to create a gym in the Gato Building(Cato Building Gym). The Gato Building Gym shall be open to all employees and retirees in Monroe County Board of County Commissioners ("BDCC"), Monroe County Land Authority, and the constitutional officers(Property Appraiser,Supervisor of Elections,Clerk of court,Tax collector and Sheriff) who are participants in the Monroe County health plan ("Employees and Retirees"). The County shall purchase and have ownership of the equipment. County staff shall establish reasonable rules for use of the gym, including but not limited to hours of operation, and may condition use of the gym on execution of documents by the gym users waiving and releasing the County from any liability for the voluntary activity. The Gato Fitness Center opened on May 14,2018. Page 5 of Packet,Pg. 77 C.2.b Use of 2020 Wellness Funds among categories: j. Employee Services may reassign funds among the wellness program categories, based on under or over utilization, in order to meet demand and manage the needs of the specified programs. 2. Resolution No. 267-2019 is inconsistent with this resolution and is repealed on October 31, _ 2020. 3. This resolution shall take effect on November 1,2020. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, E Florida,at a regular meeting of said Board held on the 1 th day of Se tember 2020. 0 CL Mayor Heather Carruthers y v, Mayor Pro Tem Michelle Coldiron y Commissioner Craig Cates , • Commissioner David Rice Y-Q e Commissioner Sylvia Murphy IQ 0 > 2 ATTEST: BOARD OF COUNTY COMMISSIONERS KEVIN MADOK,Cl rk OF MONROE CO NTY LORIDA W ca Cv By: By: CD As Deputy Clerk ay N C7 0 1 L COO aC- rn V U Approved as to form and content: _r a� Monroe County Attorney's Office ❑igitally signed by Cynthia L.Hall Dw cn=Cynthia L-Hall,o=Mon roe County MCC,ou,emaikhall- ,r Cynthia@monroelounty-fl.gov, r-Us Date:2020.09.10 12!3421-04r00' Page 6 of 6 Packet,Pg. 78 (Buipunj PuB wBJBOJd SSOUJIGM10 I nOi ) s ll p!n!D ejeo GA14UGAGJdL :4u8wg3B44 _ U, 0 s p N 6 O c ) p a s R N > p +� p Q) + N O � a O a O c � � a p a cm � O in V lz c= •- c O N co � a fta � a .> O O O O Q)) O cc O i N II _ LL t1 O V O cQ Q) —� 0O 0 V O ,� U LJJ C = a o 0 a > > > ra Q� N O O u + > + a OJ ±' N tC " w;; tC v a,ti P AY v + O .� IL co N (o Q) M s u O Q) .^_ m (� N p o N 0 � '+ p C N C Q� + N N � v LL > N g Q C O O s a■�a■o t h C7 QQ O LL E O E N o U + O O s N V O6 O a ca LL > O O v N • • • • • • # U U 0 C7 0 + co a a U o c O i Ln m cm ® rya - o ui N O t CD n w E �a E ? o n E 0 E c o O + cm cm Ln ■ O O > O cm M0- + + O w >. 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Grand Prize bike 2015 $306.99 Marriott Beachside Room Rental 2016 $2,278.96' Lunch&Learns 2016.1 $1 561.96 (n Lunch&Learns 2016.2 $1 529.00 Travel Reimbursement MM&NM $90.63 Travel Reimbursement Benefits Team Fairs 2019 + $350.00' Travel Reibursement Benefits Team Fair 2020-Virtual $0.00 Health Fair Supplies/Prizes 2016 $854.99 Passport Postcard Print&Mail $1 843.02 Hotel Room Health Fair 2016 $129.001 Health Fair Snacks/Waters 2016 $71.24 tr ��fi t�n�ir� be'��526`1{7` Health Designs added labs 2016 $2 383.65 Race Reimbursement 2012 $579.70 Race Reimbursement 2013 $610.80 Race Reimbursement 2014 $260.60 Race Reimbursement 2015 $182.07 Race Reimbursement 2016 $80.00 Packet,Pg. 81 Race Reimbursement 2017 $288.00 Race Reimbursement 2018 $286.63 Race Reimbursement 2019 $325.00 Race Reimbursemetn 2020 $237.00 Grand Prize Bikes 3 2016 $760.98' Lunch and Learn#1 water and boxed lunches 2017 $1 531.39 Lunch and Learn#2 water and boxed lunches 2017 $1 354.00 Lunch and Learn water and boxed lunches 2018 $972.96' Lunch&Lean-2019/2020-Virtual $0.00 Gym Equipment Sheriff lnterlocal Agreement)2017 $35 269.54 Gym Equipment Gato Building) $36 899.11 Gym Equipment Gato Building) $298.45 G m Equipment&Su lies 2019/2020 $659 00 St�r<d Ytk/�rlfs�ett�ila,��'�7 �,,, ai' f\�� \ t stiifiit Si nlIENW r�«v r� i4 St�r<d 1'tk/�t1c��t > E Travel and Per Diem MM for Lunch and Learns 2017&2018 $276.66' CD C Travel and Per Diem NM Wellness Champion Visits 2017 $199.28 CL Wellness Meeting 6/14/17 Lunch Reimbursement NM $62.81i (n Other Phone and Postage(Wellness Info Mailings)2017 $733.54 � 1lUellness�h�rta icarl H'ffalth Deli`ns 2tl17 $20 fa93.�t�; � CN CD 1lUellness hrta icarl H'eolth Desi ns 2tl18 $39 996`'Ot 1lUellnes`s' hr >`ion'. F l'ea[th Deli `ns'2tl1 N Wellness' liairi 1�r7': Health Desi'' el"ris r20t� Nc�v:L019 3iane 202{t ` $33 75U=(t0 Ballroom Rentals&Hotel Room Health Fair 2018 $7 122.49 > Ballroom Rentals&Hotel Room Health Fair 2019 $6 944.00' Ballroom Rentals&Hotel Room Health Fair 2020-Virtual $0.001 Health and Wellness Fair Invitation mailing 2017 $1 718.40' CN N Health and Wellness Fair Invitation mailing 2018 $1 530.50' CD N Health and Wellness Fair Invitation mailing and event posters 2019 $1 990.00' Health and Wellness Fair Mailin wand Event Posters-2020 Estimated $1 990.00' Health Fair Prizes 2018 from 2017,door phzes and Grandprizes) $1,919.81' Health Fair Prizes 2019 door prizes and Grandprizes) $1 629.00 w Health Fair Prizes 2020-Virtual $600.52 Reusable signs for health fairs 2019 $776.86 Health Designs added labs 2018 $2 500.00' �. Health Designs added labs 2019 $3 500.00' Sum of Expenses to date $333,607.86 2021 Wellness Program Available Funds $261 392.14 2022 Planned Events: Resolution Expenditures Virtually or onsite,depending upon applicable future safety guidelines for COVID-19; events held virtually will incur less expense. Community Organized Event Reimbursement Walks/Bikes/Swims $2 000.00 Lunch and Learn $5 000.00 Exercise Classes $15 000.00 Annual Health& Wellness Fair $15 000.001 Packet,Pg. 82 1lUelln s`s Gh' r `iiti,Vtsits`b, staff 2#�1'`I�:f?t' Purchases of Goods: 03M awl M ON ON Sum of Planned Expenses for 2022 $44,000.00 Expected Program Balance for 12/31/22 $217,392.14 Wellness Funding Recap $545,000-$333,000=$211,000 available to spend in 2020. $ 210,992 minus the$44,000 planned spending in 2020=$166,992(the beginning balance). Then spending—$50K in 2021 which will take the$166,992 down to $ 116,992,which is the forecasted ending balance for 2021. CU L. CD L. CL Cn Cn cv cv CD cv 4- 0 0 cv cv CD cv CD Cn Cn U Packet,Pg. 83 C.2.e MONROE COUNTY BOCC-B0611 Summary of Wellness/Cancer Preventive Screenings Incurred: 10/01/2014-09/30/2020 Report Date: 05/13/2021 Report contains Florida Blue proprietary St confidential information � OCT14-SEPT15 ADULT WELLNESS EXAM 460 775,874.34 BREAST CANCER SCREENING 262 $98, cb 808.22 CERVICAL CANCER SCREENING 62 $3,513.06 CL Ch COLORECTAL CANCER SCREENIN 160 $174,612.79 OCT14-SEPT15 Total $352,808.41 OCT15-SEPT16 ADULT WELLNESS EXAM 530 $87,987.02 BREAST CANCER SCREENING 302 $139,858.10 cv CD CERVICAL CANCER SCREENING 58 $3,443.90 COLORECTAL CANCER SCREENIN 182 $240,353.24 OCT15-SEPT16 Total $471,642.26 > OCT16-SEPT17 ADULT WELLNESS EXAM 556 $95,435.33 BREAST CANCER SCREENING 304 $145,250.46 CERVICAL CANCER SCREENING 62 $3,344.61 COLORECTAL CANCER SCREENIN 152 $186,311.32 OCT16-SEPT17 Total $430,341.72 LO OCT17-SEPT18 ADULT WELLNESS EXAM 664 $117,101.28 BREAST CANCER SCREENING 305 $116,041.77 CERVICAL CANCER SCREENING 74 $1,975.15 (n COLORECTAL CANCER SCREENIN 145 $249,016.75 LU 06 OCT17-SEPT18 Total $484,134.95 y OCT18-SEPT19 ADULT WELLNESS EXAM 668 $119,039.32 BREAST CANCER SCREENING 287 $136,410.16 (n CERVICAL CANCER SCREENING 53 $2,131.33 COLORECTAL CANCER SCREENIN 176 $287,797.47 OCT18-SEPT19 Total $545,378.28 OCT19-SEPT20 ADULT WELLNESS EXAM 593 $111,080.84 BREAST CANCER SCREENING 272 $137,900.28 CERVICAL CANCER SCREENING 44 $1,766.95 COLORECTAL CANCER SCREENIN 117 $210,947.49 y OCT19-SEPT20 Total $461,695.56CL Grand Total $2,746,001.18 CD cv Packet,Pg. 84 County of Monroe VP The Florida Keys Employee Health Preventive Care-Assessment Acknowledgment Form Passport to Wellness Year 2021 Services provided between: 11/1/2020 through 10/31/21 Discount Period: 1/1/2022-12/31/2022 Employee Name: Age: _ (Please Print) Male: Female: EMPLOYER: (Please Print) Physician Name: (Please Print) Completion Date: Physician Acknowledgement: My signature below indicates that the following tests,assessments,clinicals indicated,pertain to CD C the employee identified above,have been measured, if I deemed appropriate.The results of which have been reviewed with the CL employee in accordance with established treatment protocols. y Biometrics Information: Check if Recommended tests (Not required) if applicable at com leted Physician's discretion: N Wellness checkup/Physical Comprehensive Metabolic Panel (CPT Codes 80053, 10 84436, 84479) The below can be done at the County's annual Vitamin B health fair or with your personal physician: 0. Height/Weight CBC < Blood Pressure: Systolic/Diastolic CMP '✓ Cholesterol : LDL/HDL/Tri I cerides TSH Blood Sugar Level Bilirubin screening Body Mass Index BMI HBA1c if diagnosed diabetic Required Preventive Screenings discussed with Physician. If screening is recommended and done at a different office (such as a hospital), proof of procedure/visit with name of patient �- and date of procedure must be attached to this form. CL Mammogram: Annually at ages 40+ OR Not required at this time (age, screening given within past year, etc.) CN Pap Test/Pelvic Exam: Women age 21-65 every 3 years or women age 30-65 Pap Test/HPV combined every 5 year: N Ages 65+discuss with doctor OR Not required at this time. _Date Last Completed: Screening for Colorectal Cancer: Ages 50-75 with either a colonoscopy,fecal occult blood test or sigmoidoscopy OR Not required at this time Date Last Completed: Pagel Of 2 Approved BOCC 2/21/18 Packet,Pg. 85 Abdominal Aortic Aneurysm Check: One-time men ages 65-75 who have ever smoked or history of AAA OR Not required at this time Date Last Completed: Lung Cancer Screening: Ages 55-80; 30 pack smoker history, current smoker/quit within past 15 years OR Not required at this time Date Last Completed: Bone Mineral Density Screening and prescribed medication for osteoporosis: Women beginning 65+ and in younger women who have increased risk OR Not required at this time Date Last Completed: Prostate Cancer Screening: Discuss with doctor Skin Cancer Screening: Discuss with doctor HIV and other Sexually Transmitted Infections (STIs): Discuss with Doctor Doctor: I have given the patient the results of these tests and the employee has been counseled on the results and CL necessary follow up to prevent further health issues: y Physician Signature: Date: cv Physician Address: cv Physician Phone #: o Please give patient a copy of this form,completed by physician and mail completed,signed form to: Monroe County Employee Benefits Office Gato Building,2nd Floor, Room 268 '✓ 1100 Simonton Street Key West,FL 33040 EMPLOYEE SIGN BELOW: I hereby certify that I do not currently use tobacco products and agree to remain tobacco free while participating in the Wellness Program. Tobacco products are defined as cigarettes, cigars, pipe tobacco, chewing tobacco, snuff, dip, CL electronic or e-cigarettes that contain nicotine or any other product that contains tobacco or nicotine. Nicotine replacement products such as gum and patches are also considered tobacco products. I further understand that I may LU be subject to testing to verify non-use of tobacco products. A refusal to submit to a test is considered "positive" for tobacco use. LU I hereby certify that I currently use tobacco products, and have completed a qualified tobacco cessation program during the wellness program period and have attached a copy of documentation verifying my participation cv (certificate/letter). Tobacco products are defined as cigarettes, cigars, pipe tobacco, chewing tobacco, snuff, dip, electronic or e-cigarettes that contain nicotine or any other product that contains tobacco or nicotine. NOTE: *Original assessment form completed by physician must be submitted to Monroe County Employee Benefits Office along U with any proofs of age appropriate screenings. DO NOT email or fax. *If COVID-19 safety measures are recommended,clear and legible email/fax submissions as above will be accepted. Employee Name Employee Signature Date Submitted to County on: Date Received by Employee Services Employee Name/Signature: Date: Page 2 of 2 Approved BOCC 2/21/18 Packet,Pg. 86 PREVENTATI1 2016 2016 2016 TOTAL 2016 Employee Employee EMPLOYERS EMPLOYEES Participation Percentage MC SHERIFF OFFICE 532 17 3% COUNTY CLERK 73 10 14% TAX COLLECTOR 52 8 15% 0 PROPERTY APPRAISER 38 5 13% CL ch S SUPERVISOR OF ELECTIONS 9 4 44% N CD COURT ADMINISTRATION 21 3 14% 0 LAND AUTHORITY 3 2 67% BOARD OF COUNTY COMMISSIONERS 508 59 12% N Total 1236 108 9% 2020 CL 2020 2020 TOTAL 2020 Employee Employee EMPLOYERS EMPLOYEES Participation Percentage MC SHERIFF OFFICE 510 144 28% COUNTY CLERK 77 38 49% TAX COLLECTOR 54 21 39% PROPERTY APPRAISER 34 18 53% SUPERVISOR OF ELECTIONS 10 4 40% COURT ADMINISTRATION 1 21 1 6 1 29% Packet,Pg. 87 LAND AUTHORITY 3 3 100% BOARD OF COUNTY COMMISSIONERS 541 175 32% Total 11250 409 33% L. CD 0 L. CL ch S N N CD 4- 0 CL Packet,Pg. 88 VE SCREENINGS 2017 2018 2017 TOTAL 2017 Employee 2017 Employee 2018 TOTAL 2018 Employee EMPLOYEES Participation Percentage EMPLOYEES Participation 511 175 34% 520 169 76 31 41% 80 41 53 36 68% 53 22 0 37 21 57% 38 22 CL S 9 7 77% 8 7 N N 22 12 55% 22 6 0 3 3 100% 4 4 524 208 40% 520 209 N 1245 480 CL Packet,Pg. 89 0 CL cv cv CD cv 4- 0 0 CD CL Packet,Pg. 90 2019 2019 2018 Employee 2019 Employee 2019 TOTAL Participatio Employee Percentage EMPLOYEES n Percentage 33% 499 137 27% 50% 71 48 67% 42% 54 27 50% 0 60% 38 22' 60% CL Ch S 90% 8 7 90% CN CD 30% 21 " 9 45% CN 0 100% 3 3 100% 2 40% 520 226 43% 39% 1214 479 39% CL Packet,Pg. 91 0 CL Ch S cv cv CD cv 4- 0 0 CD CL Packet,Pg. 92 Benefit given for participation $25/Month -$300/year savings on health insurance $25/Month -$300/year savings on health insurance $25/Month -$300/year savings on health insurance $25/Month -$300/year savings on health 0 insurance $25/Month -$300/year savings on health insurance PLUS 8 hours time off $25/Month -$300/year savings on health insurance 0 $25/Month -$300/year savings on health insurance $25/Month -$300/year savings on health insurance N Packet,Pg. 93