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03/13/2001 Special MINUTES OF THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 2001/73 Special Meeting Board of County Commissioners Tuesday, March 13,2001 Marathon, Florida A Special Meeting of the Monroe County Board of County Commissioners convened at 9:00 A.M., on the above date at the Marathon Government Center. Present and answering to roll call were Commissioner Charles "Sonny" McCoy, Commissioner Murray Nelson, Commissioner Dixie Spehar, and Mayor George Neugent. Commissioner Nora Williams arrived later in the meeting. Also present were Danny L. Kolhage, Clerk; James Roberts, County Administrator; Suzanne Hutton, Assistant County Attorney; County Staff, members of the press and radio; and the general public. All stood for the Invocation and Pledge of Allegiance. ADDmONS, CORRECTIONS, DELETIONS There were no Additions, Corrections, or Deletions made to the Agenda. COUNTY ADMINISTRATOR County Administrator James Roberts and Administrative Services Director Sheila Barker discussed with the Board Monroe County employees and retirees group benefits and approval as appropriate as per resolution. Representatives from Keys Physician Hospital Alliance (KPHA), Walgreens Health Initiatives (WHP), and Gallagher Bassett made presentations to the Board. The following individuals addressed the Board: Gwen Rodriguez, Leonard H. Knowles, Andy McBroom, representing the International Association of Firefighters, Local #3909; Mary Tucker, Mary Wingate, Susan Hawxhurst, Judi Angels, Tom Brazil, representing the Fraternal Order of Police, Lodge #38; and Bob Voss, representing the Fraternal Order of Police. The following Monroe County' Constitutional Officers also addressed the Board: Property Appraiser, Ervin A. Higgs; Supervisor of Elections, Harry Sawyer; Sheriff Richard D. Roth; and Clerk of Court, Danny L. Kolhage. After Board discussion, motion was made by Commissioner Nelson and seconded by Commissioner Spehar to accept the following recommendations: 2. Implementation of Emergency Room Visit deductible of$75 per visit. Implementation date is October 1, 2001. At present, there is a tendency for employees and dependents to utilize the emergency room for non-emergency situations rather than going to a personal physician or a clinic. The Administration concurs. 03/13/01 10. 14. 15. 2001/74 5. Begin two-stage approach on examining other options for health coverage. Phase one: Work with consultant on what plans are available and what would be the range of options we would have from self-insurance to fully funded plan and/or a mixed plan. Phase two: Refine our range of options and RFP for providers. The recommended time for implementation would be ASAP. The Administration concurs and feels that the state health benefits program should be considered if eligibility for Monroe County is passed by the state legislature. 6. Secure National wrap around network and eliminate out-of-network exclusion. This means that retirees and dependents who live around the country will have the benefit of in-network expenses rather than out-of-network expenses. The Administration concurs. 8. Limit Chiropractic visits per calendar year from 60 to 30. The Administration concurs. 9. Limit Massage Therapy visits per calendar year to 15. The Administration concurs. Limit Acupuncture Treatments per year to 15. The Administration concurs. 11. Vision Benefits - return to "no more than one complete visual examination, including refraction, during any two calendar years. At present, the benefit is available for each calendar year. The Administration concurs. Acordia to process claims under Medicare guidelines regarding unbundling of charges. The Administration concurs. This will reduce the possibility for providers to charge full fees for two services when both rely upon the same basic procedures. The rates for dependent health premiums should be increased $10 per pay period to help cover the deficit between health care costs and dependent premium contributions. This will change the deduction per pay period from $100 for one dependent to $110 and from $120 for two or more to $130. Mayor Neugent read a letter from Commissioner Williams concerning changes to the Group Insurance Plan. Roll call vote was unanimous. Motion was made by Commissioner Nelson and seconded by Commissioner Spehar to accept the following recommendation: 1. Employees hired on or after October 1, 2001 would not be eligible for free or reduced coverage upon satisfYing Florida Retirement System requirements. Employees hired on or after October 1, 2001 would have to pay full premium rate 03/13/01 2001/75 upon retirement (whatever that rate is at the time.) At present, retirees do not contribute toward the cost of health insurance. The Administration concurs. Motion carried unanimously. Motion was made by Commissioner Spehar and seconded by Mayor Neugent to not approve the following recommendation: 3. Implement a charge for all current retirees and all employees employed by the county prior to October 1, 2001, upon their satisfying all retirement requirements. The charge should be $100 per month for their insurance. Group Insurance will assist all retirees who do not claim their Retiree Health Insurance Subsidy from the FRS with the process to obtain it. Implementation date of October 1, 2001. (The amount of the subsidy is based on service credit at retirement, $5 for each year of service, with a minimum monthly subsidy of$50 and a maximum of$150. The County pays FRS for Insurance Subsidy.) The Administration concurs but is willing to consider a different amount commensurate with the amount received by retirees to assist with the provision of health insurance. Roll call vote was taken with the following results: Commissioner McCoy Yes Commissioner Nelson No Commissioner Spehar Yes Mayor Neugent No Motion failed. Motion was made by Commissioner Nelson and seconded by Commissioner McCoy to change the policy requiring the retirees to reimburse the county for health insurance coverage in the amount that they receive from the Florida Retirement System as a supplement to their retirement for that purpose. Roll call vote was taken with the following results: Commissioner McCoy Yes Commissioner Nelson Yes Commissioner Spehar No Mayor Neugent Yes Motion carried. Motion was made by Commissioner McCoy and seconded by Commissioner Nelson to approve the following Resolution approving the recommendations 1 & 3, as approved above. (This Resolution is reconsidered and approved in a different format later in the meeting.) Roll call vote was taken with the following results: 03/13/01 2001/76 Commissioner McCoy Commissioner Nelson Commissioner Spehar Mayor Neugent Yes Yes No Yes Motion carried. Gwen Rodriguez, Leonard H. Knowles, and Susan Hawxhurst addressed the Board. Motion was made by Commissioner McCoy and seconded by Mayor Neugent to reconsider the previous Resolution. Mr. Roberts also addressed the Board. Roll call vote was unanimous. After discussion, motion was made by Commissioner McCoy and seconded by Commissioner Nelson to adopt the following Resolution which approves Recommendation #1 only. Motion carried unanimously. RESOLUTION NO. 119-2001 Said Resolution is incorporated herein by reference. Motion was made by Commissioner McCoy and seconded by Commissioner Nelson to approve the recommendation from Walgreens Health Initiatives - Retail: $10 for generic, $20 brand, $35 non-preferred brands. Via mail: $25 for generic, $50 brand, $87.50 non-preferred brands for 90 day supply. Implementation date of October 1, 2001. Motion carried unanimously. Motion was made by Commissioner Nelson and seconded by Commissioner Spehar to approve the following recommendation: 7. Increase out of Network disincentive from 10% to 5e% 30% . Since a reduced cost of network services will be available in most areas of the country and since almost all plan participants will be able to take advantage of it, there is little need to go outside of network. Plan members who go outside the network for personal reasons, thereby costing the County more money, should pay a higher percentage. The Administration concurs. Roll call vote was unanimous. Motion was made by Commissioner McCoy and seconded by Commissioner Spehar to refer the following recommendations to the Administrator: 12. Increase yearly deductible from $200 to $300 per individual and from $400 to $1000 per family. The Administration concurs. 13. At present, covered individuals are responsible for 20% of health care costs on a total cost of$lO,OOO. Thereafter, the plan pays 100%. Recommendation is to change the base limit to $20,000. The Administration concurs. 03/13/01 2001/77 During discussion, the motion was withdrawn. Motion was then made by Commissioner Nelson and seconded by Commissioner McCoy to approve the following recommendation, as modified: 12. Increase yearly deductible from $200 to $300 per individual and from $400 to $1000 $600 per family. Roll call vote was taken with the following results: Commissioner McCoy Yes Commissioner Nelson Yes Commissioner Spehar No Mayor Neugent Yes Motion carried. Motion was made by Commissioner Nelson and seconded by Commissioner McCoy to approve recommendation #13 above, as modified by leaving it at the $10,000 limit at the present, but to increase it 10% per year until the limit reaches $20,000. Commissioner Williams enters the meeting. Roll call vote was unanimous. Motion was made by Commissioner Spehar and seconded by Commissioner Williams directing Staff to issue a Request for Proposals (RFP) for a Cafeteria Plan for Group Health Insurance which could include both the self insurance version as well as an outside provider. Roll call vote was unanimous. COMMISSIONERS' ITEMS Motion was made by Commissioner Williams and seconded by Commissioner Spehar to open the agenda. Motion carried unanimous. Motion was made by Mayor Neugent and seconded by Commissioner Williams to add Agenda item D 1 concerning the approval of revisions to the Memorandum of Agreement between Monroe County and the Florida Fish and Wildlife Conservation Commission. Motion carried unanimously. Marine Resources Director, George Garrett addressed the Board. Commissioner McCoy excused himself from the meeting. Motion was made by Commissioner Williams and seconded by Commissioner Nelson granting approval and authorizing execution of the item. Roll call vote was unanimous. GROWTH MANAGEMENT Motion was made by Commissioner Williams and seconded by Commissioner Nelson granting approval for the transfer of one buildable from William Adams to Monroe County by Warranty Deed, Permit Number 00-3-2846 for property described as Lot 18, Block 15, Eden Pines Colony, Big Pine Key. The applicant receiving a dwelling unit allocation award for the year ending July 13, 2001, has filed the document in accordance with Ordinance No 47-1999. Motion carried unanimously. 03/13/01 2001/78 COUNTY ADMINISTRATOR Mr. Roberts addressed the Board. Motion was made by Commissioner Williams and seconded by Commissioner Spehar to table discussion of issues that will be part of the proposed Fiscal Year 2002 Budget with guidelines from the Board of County Commissioners concerning how they wish to approach these issues, to the meeting of March 22,2001 in Marathon. Motion carried unanimously. There being no further business to come before the Board, the meeting was adjourned. Danny L. Kolhage, Clerk and ex-officio Clerk to the Board of County Commissioners Monroe County, Florida -Sk~ C. /J)p;A~ Isabel C. DeSantis, Deputy Clerk