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Item C05
' CM ounty of onroe BOARD OF COUNTY COMMISSIONERS Mayor Heather Carruthers, District 3 Mayor Pro Tem George Neugent, District 2 TheFloridaKeys Danny L. Kolhage, District 1 David Rice, District 4 Sylvia J. Murphy, District 5 County Commission Meeting August 17, 2016 Agenda Item Number: C.5 Agenda Item Summary #1895 BULK ITEM: DEPARTMENT: Yes Employee Services TIME APPROXIMATE:STAFF CONTACT: Maria Fernandez-Gonzalez (305) 292-4448 None. AGENDA ITEM WORDING: Approval of 2016 Blue Options Benefit Booklet for Covered Plan Participants of the Monroe County BOCC Group Health Plan (a.k.a. Plan Document) applicable from January 1, 2016 through December 31, 2016. ITEM BACKGROUND: Changes to the document were to maintain compliance with the Patient Protection & Affordable Care Act (PPACA). Page i: Table of Contents. Deleted Sections 17 (Subrogation) and 18 (Right of Reimbursement). These sections R were moved to Section 19 General Provisions. Claims Processing was Section 19 and will now be in Section 17. R Relationship Between the Parties was Section 20 and now will be Section 18. R Section 21 is now renumbered to Section 19 (General Provisions). R Section 22 is now renumbered to Section 20 (Definitions). R *Page numbers of all the above will also change as noted. R Page 2- Under Preventive Health Services, #4. This language was revised to refer participants R to the Florida Blue website (www.FloridaBlue.com/healthresources) for more detailed information on services covered under the Preventive Services Guide. The services deleted from the Plan Document are still covered but more detailed on the Florida blue website. Current Preventive Services Guide is attached as Exhibit A. Page 2-16: Exclusion. Language regarding exclusion of sterilization procedures and limitations on breast R pumps deleted for PPACA compliance. Both are now covered under PPACA and detailed are outlined in the Preventive Services Guide (Exhibit A). Page 3-4 General Exclusions. #8 language is revised for clarity of coverage in certain circumstances. R 4EGOIX4K ' Added definition of Motor Vehicle Accidents. R Page 5-2 Understanding Your Share of Health Care Expenses. #4 language is deleted. The current plan has no co-payment for Emergency Room R Facility services. The current plan only has a deductible ($100) and co-insurance (25% in-network). Page 8-3 Autism Spectrum Disorder. Deleted wording of Mental Health; and Substance Dependency Services. These R services are now covered under Behavioral Health Services and are located on page 2-4 of the Plan Document. Page 16-1 Coordination of Benefits. Revision of Coordination of Benefits language with regards to establishing the order R in which benefits under the plan will be determined. There is no change to the process and we are only clarifying how it currently works. Page 17-1 Subrogation. Subrogation is now covered in Section 19. Combined with Right of Reimbursement. R No significant changes simplified language. Page 18-1 Right of Reimbursement. Right of Reimbursement is now covered in Section 19. Combined with Subrogation. R No signification changes simplified language. Page 20-4 & 20-14 Definitions. Added definition of Care Coordination and Preventive Services Guide. R Other minor modifications to clarify language throughout the document. PREVIOUS RELEVANT BOCC ACTION: BOCC approvals of the Blue Options Benefit Booklet for Covered Plan Participants of the Monroe County BOCC Group Health Plan (a.k.a. Plan Document): 2013 Plan Document approved November 2012; 2014 Plan Document approved December 20, 2014; 2015 Plan Document approved October 21, 2015. CONTRACT/AGREEMENT CHANGES: Changes STAFF RECOMMENDATION: Approve DOCUMENTATION: 2016 Blue Options Benefit Booklet - red line version.W Exhibit A FINANCIAL IMPACT: Effective Date: Expiration Date: Total Dollar Value of Contract: N/A Total Cost to County: N/A Current Year Portion: N/A 4EGOIX4K ' Budgeted: N/A Source of Funds: N/A CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: If yes, amount: Grant: County Match : Insurance Required: Additional Details: REVIEWED BY: Teresa Aguiar Completed 08/01/2016 5:12 PM Assistant County Administrator Christine Hurley Completed 08/02/2016 9:25 AM Cynthia Hall Completed 08/02/2016 10:17 AM Budget and Finance Skipped 07/25/2016 3:33 PM Maria Slavik Skipped 07/25/2016 3:33 PM Teresa Aguiar Completed 08/02/2016 10:33 AM Kathy Peters Completed 08/02/2016 12:43 PM Board of County Commissioners Pending 08/17/2016 9:00 AM 4EGOIX4K 'E &PYI Options &IRIJMX&SSOPIXJSV'SZIVIH4PER 4EVXMGMTERXWSJ1SRVSI'SYRX] 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ection 11: Termination of Coverage 8IVQMREXMSRSJE'SZIVIH4PER PEWXHE]SJXLI'EPIRHEV=IEVXLEXXLI 4EVXMGMTERX'SZIVEKI 'SZIVIH(ITIRHIRXGLMPHRSPSRKIVQIIXW ER]SJXLIETTPMGEFPIIPMKMFMPMX]VIUYMVIQIRXW %'SZIVIH4PER4EVXMGMTERXWGSZIVEKIYRHIV HEXIWTIGMJMIHF]1SRVSI'SYRX]&3''XLEX 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ection 15: The Effect of Medicare Coverage/Medicare Secondary Payer Provisions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ection 16: Duplication of Coverage Under Other Health Plans/Programs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a) are covered EXLITPERSJXLITEVIRX ;LIR[IGSZIV]SYEWE [LSMWRIMXLIVPEMHSJJRSVVIXMVIH[MPPFI 'SZIVIH(ITIRHIRXERHXLISXLIVTPER or the TVMQEV] GSZIVW]SYEWSXLIVXLEREHITIRHIRX Group Health Plan [I[MPPFIWIGSRHEV] b) FMJXLISXLIVTPERMWRSX 2. the Group WYFNIGXXSXLMWVYPIERHMJEWEVIWYPX ;LIR WYGLTPERHSIWRSXEKVIISRXLISVHIV Health Plan covers [IGSZIV]SYEWE SJFIRIJMXWXLMWTEVEKVETLWLEPPRSX whose HITIRHIRXGLMPHERH]SYVTEVIRXWEVI ETTP] : QEVVMIH RSXWITEVEXIHSVHMZSVGIH ;LIRVYPIWERHEFSZIHSRSX a) EXLITPERSJXLITEVIRX IWXEFPMWLERSVHIV-J]SYLEZIGSRXMRYEXMSR excluding year of [LSWIFMVXLHE] SJFIRIJMXWXLITPER[LMGLLEWGSZIVIH]SY birth QSRXLERHHE]JEPPWIEVPMIVMRXLI XLIPSRKIWXWLEPPFITVMQEV] or ]IEV[MPPFITVMQEV] 8LI+VSYT,IEPXL4PER[MPPRSXGSSVHMREXI b) FMJFSXLTEVIRXWLEZIXLI FIRIJMXWEKEMRWXERMRHIQRMX]X]TITSPMG]ER excluding year of WEQIFMVXLHE] I\GIWWMRWYVERGITSPMG]ETSPMG][MXL birth QSRXLERHHE]ERHXLISXLIVTPER GSZIVEKIPMQMXIHXSWTIGMJMIHMPPRIWWIWSV LEWGSZIVIHSRISJXLITEVIRXWPSRKIV EGGMHIRXWSVE1IHMGEVIWYTTPIQIRXTSPMG] the Group Health Plan XLERYW[I[MPP 6. If you are covered FIWIGSRHEV] a continuation plan YRHIV'3&6%EWE 3. the Group ;LIR VIWYPXSJXLITYVGLEWISJGSZIVEKIEW Health Plan covers [IGSZIV]SYEWE TVSZMHIHYRHIVXLI'SRWSPMHEXIH3QRMFYW HITIRHIRXGLMPH[LSWITEVIRXWEVIRSX &YHKIX6IGSRGMPMEXMSR%GXSJ EW QEVVMIHSVEVIWITEVEXIHSVHMZSVGIH EQIRHIHERHEPWSYRHIVERSXLIVKVSYT TPERXLIJSPPS[MRKSVHIVSJFIRIJMXWETTPMIW a) EMJXLITEVIRX[MXL a) GYWXSH]MWRSXVIQEVVMIHXLITPERSJXLI EJMVWXXLITPERGSZIVMRKXLI TEVIRX[MXLGYWXSH]MWTVMQEV] TIVWSREWERIQTPS]IISVEWXLI IQTPS]IIW(ITIRHIRX ERH b) FMJXLITEVIRX[MXL b) GYWXSH]LEWVIQEVVMIHXLITPERSJXLI FWIGSRHXLIGSZIVEKI TEVIRX[MXLGYWXSH]MWTVMQEV] XLI TYVGLEWIHYRHIVXLITPERGSZIVMRKXLI stepparent's WXITTEVIRX WTPERMW TIVWSREWEJSVQIVIQTPS]IISVEWXLI WIGSRHEV] ERHXLITPERSJXLITEVIRXJSVQIVIQTPS]IIW(ITIRHIRXTVSZMHIH pays EGGSVHMRKXSXLITVSZMWMSRWSJ'3&6% [MXLSYXGYWXSH]MWPEWX 7. ;LIRVYPIWXLVSYKL c) GVIKEVHPIWWSJ[LMGL EFSZIHSRSXIWXEFPMWLERSVHIVSJFIRIJMXW whenever TEVIRXLEWGYWXSH][LIRE XLITPER[LMGLLEWGSZIVIHXLIMRHMZMHYEP GSYVXHIGVIIWTIGMJMIWXLITEVIRX[LSMW XLIPSRKIWXWLEPPFITVMQEV]YRPIWW]SYEVI JMRERGMEPP]VIWTSRWMFPIJSVXLIGLMPH W EKISVSPHIVERHGSZIVIHYRHIV1IHMGEVI LIEPXLGEVII\TIRWIWXLITPERSJXLEX 4EVXW%ERH&-RXLEXGEWIXLMW&SSOPIX[MPP TEVIRXMWEP[E]WQEV] FIWIGSRHEV]XS1IHMGEVI 4. the Group ;LIR -JXLISXLIVTPERHSIWRSXLEZIVYPIWXLEX Health Plan covers [IGSZIV]SYEWE IWXEFPMWLXLIWEQISVHIVSJFIRIJMXWEW HITIRHIRXGLMPHERHXLISXLIVTPERGSZIVW YRHIVXLMW&SSOPIXXLIFIRIJMXWYRHIVXLI is also covered ]SYEWEHITIRHIRXGLMPH SXLIVTPER[MPPFIHIXIVQMRIHTVMQEV]XSXLI under another plan FIRIJMXWYRHIVXLMW&SSOPIX (YTPMGEXMSRSJ'SZIVEKI9RHIV3XLIV,IEPXL4PERW4VSKVEQW 4EGOIX4K 'E 'SSVHMREXMSRSJ;I[MPPRSXGSSVHMREXIFIRIJMXW WLEPPRSXFITIVQMXXIHEKEMRWXERMRHIQRMX]X]TI TSPMG]ERI\GIWWMRWYVERGITSPMG]EWHIJMRIHMR Florida Statutes 7IGXMSRETSPMG][MXL GSZIVEKIPMQMXIHXSWTIGMJMIHMPPRIWWIWSV EGGMHIRXWSVE1IHMGEVI WYTTPIQIRX7YTTPIQIRXTSPMG] 2SR(YTPMGEXMSRSJ+SZIVRQIRX 4VSKVEQWERH;SVOI 'SQTIRWEXMSR 8LIFIRIJMXWYRHIVXLMW&SSOPIXWLEPPRSX 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)QIVKIRG]7IVZMGIWFYXLEZIRSXFIIR EQSRKSXLIV[E]WWMKRMRKER]VIPIEWISJ HMWGLEVKIHJVSQEJEGMPMX]4PIEWIFIWYVI]SYV MRJSVQEXMSRJSVQEXSYVVIUYIWX*EMPYVIF] XVIEXMRK4L]WMGMERGSQTPIXIWXLIETTVSTVMEXI ]SYXSJYPP]GSSTIVEXI[MXLYWQE]VIWYPXMRE JSVQXSMRMXMEXIXLMWVIUYIWXX]TI-J]SYLEZIER] HIRMEPSJXLITIRHMRKGPEMQERH[I[MPPLEZI UYIWXMSRWSVGSRGIVRWHYVMRKXLII\XIVREPVIZMI[ RSPMEFMPMX]JSVWYGLGPEMQ TVSGIWWTPIEWIGSRXEGXYWEXXLITLSRIRYQFIV PMWXIHSR]SYV-(GEVHSVZMWMX 4L]WMGEP)\EQMREXMSR [[[ [[402,1486,452,1533][10][,,][Arial]]J [[414,1486,464,1533][10][,,][Arial]]P [[423,1486,510,1533][10][,,][Arial]]SVM [[469,1486,519,1533][10][,,][Arial]]H [[493,1486,543,1533][10][,,][Arial]]E [[516,1486,566,1533][10][,,][Arial]]F [[539,1486,589,1533][10][,,][Arial]]P [[548,1486,598,1533][10][,,][Arial]]Y [[571,1486,621,1533][10][,,][Arial]]I [[594,1486,644,1533][10][,,][Arial]] [[606,1486,656,1533][10][,,][Arial]]G [[627,1486,677,1533][10][,,][Arial]]S [[650,1486,700,1533][10][,,][Arial]]Q [[686,1486,736,1533][10][,,][Arial]] [[698,1486,748,1533][10][,,][Arial]] [[717,1486,767,1533][10][,,][Arial]]= [[744,1486,794,1533][10][,,][Arial]]S [[768,1486,818,1533][10][,,][Arial]]Y [[791,1486,841,1533][10][,,][Arial]] [[802,1486,852,1533][10][,,][Arial]]Q [[838,1486,911,1533][10][,,][Arial]]E] [[881,1486,931,1533][10][,,][Arial]] [[891,1486,941,1533][10][,,][Arial]]W [[912,1486,962,1533][10][,,][Arial]]Y [[935,1486,985,1533][10][,,][Arial]]F [[958,1486,1008,1533][10][,,][Arial]]Q [[995,1486,1045,1533][10][,,][Arial]]M [[1004,1486,1054,1533][10][,,][Arial]]X [[1015,1486,1065,1533][10][,,][Arial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ection 2018: Relationship Between the Parties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ection 2119: General Provisions %GGIWWXS-RJSVQEXMSR'SQTPMERGI[MXL7XEXIERH*IHIVEP 0E[WERH6IKYPEXMSRW &'&7*ERH1SRVSI'SYRX]&3''LEZIXLI VMKLXXSVIGIMZIJVSQ]SYERHER]LIEPXLGEVI 8LIXIVQWSJGSZIVEKIERHFIRIJMXWXSFI 4VSZMHIVVIRHIVMRK7IVZMGIWXS]SYMRJSVQEXMSR TVSZMHIHYRHIVXLMW&IRIJMX&SSOPIXWLEPPFI XLEXMWVIEWSREFP]RIGIWWEV]EWHIXIVQMRIHF] HIIQIHXSLEZIFIIRQSHMJMIHERHWLEPPFI &'&7*ERH1SRVSI'SYRX]&3''MRSVHIVXS MRXIVTVIXIHWSEWXSGSQTP][MXLETTPMGEFPIWXEXI EHQMRMWXIVXLIGSZIVEKIERHFIRIJMXWTVSZMHIH SVJIHIVEPPE[WERHVIKYPEXMSRWHIEPMRK[MXL WYFNIGXXSEPPETTPMGEFPIGSRJMHIRXMEPMX] FIRIJMXWIPMKMFMPMX]IRVSPPQIRXXIVQMREXMSRSV VIUYMVIQIRXWPMWXIHFIPS[&]EGGITXMRK SXLIVVMKLXWERHHYXMIW GSZIVEKI]SYEYXLSVM^IIZIV]LIEPXLGEVI 'SRJMHIRXMEPMX] 4VSZMHIV[LSVIRHIVW7IVZMGIWXS]SYXS HMWGPSWIXS&'&7*ERH1SRVSI'SYRX]&3'' )\GITXEWSXLIV[MWIWTIGMJMGEPP]TVSZMHIHLIVIMR SVXSEJJMPMEXIHIRXMXMIWYTSRVIUYIWXEPPJEGXW ERHI\GITXEWQE]FIVIUYMVIHMRSVHIVJSVYWXS VIGSVHWERHVITSVXWTIVXEMRMRKXS]SYVGEVI EHQMRMWXIVGSZIVEKIERHFIRIJMXWWTIGMJMG XVIEXQIRXERHTL]WMGEPSVQIRXEP'SRHMXMSRERH QIHMGEPMRJSVQEXMSRGSRGIVRMRK]SYVIGIMZIHF] XSTIVQMX&'&7*ERHSV1SRVSI'SYRX] 4VSZMHIVWWLEPPFIOITXGSRJMHIRXMEPF]YWMR GST]ER]WYGLVIGSVHWERHVITSVXWWS GSRJSVQMX][MXLETTPMGEFPIPE[7YGLMRJSVQEXMSR SFXEMRIH QE]FIHMWGPSWIHXSXLMVHTEVXMIWJSVYWIMR GSRRIGXMSR[MXLFSREJMHIQIHMGEPVIWIEVGLERH 6MKLXXS6IGIMZI2IGIWWEV] IHYGEXMSRSVEWVIEWSREFP]RIGIWWEV]MR -RJSVQEXMSR 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