Item C08C ounty of M onroe
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BOARD OF COUNTY COMMISSIONERS
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Mayor David Rice, District 4
The Florida Key
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Mayor Pro Tem Sylvia J. Murphy, District 5
Danny L. Kolhage, District 1
George Neugent, District 2
Heather Carruthers, District 3
County Commission Meeting
October 17, 2018
Agenda Item Number: C.8
Agenda Item Summary #4741
BULK ITEM: Yes DEPARTMENT: Employee Services
TIME APPROXIMATE: STAFF CONTACT: Bryan Cook (305) 292 -4537
N/A
AGENDA ITEM WORDING: Approval of a resolution approving and establishing the 2019
Wellness Program and funding levels, which includes health and wellness events (lunch and learns,
health and wellness fairs, exercise and nutrition classes), Health Designs, Inc. /Wellness Consultant,
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 2019 Wellness Funding.
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 and
illnesses before major medical treatment is required. This contributes to a healthier workforce and
seeks to reduce long -term claims cost.
As part of the County's agreement renewal with Florida Blue in 2018, Florida Blue will pay the
County a $50,000 wellness contribution for 2018 upon BOCC approval of the agreement renewal; a
$50,000 wellness contribution on January 1, 2019; January 1, 2020; January 1, 2021; January 1,
2022 and January 1, 2023 provided the agreement remains in force. The County has implemented
programs from 2011 -2018 using funds from Florida Blue to encourage health plan enrollees to
participate in wellness programs and educational opportunities.
The 2019 program includes:
Recurring Events:
• Community Organized Event Reimbursement up to $100 annually per enrollee for
participation in marathons, walkathons, etc.
• Lunch and Learns (Topics will address the top 4 risk areas: Diabetes, BMI, Nutrition,
Blood Pressure)
• Health and Wellness Fairs
• Funding of exercise (Yoga, Zumba, etc.) and nutrition classes (healthy cooping, etc.)
held at Government Centers (Lower, Middle and Upper Keys)
• Health Designs Wellness Champion (Will address the top 4 risk areas: Diabetes, BMI,
Nutrition, Blood Pressure)
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
2020. Participating employees on the High Deductible Health Plan with Health Savings
Account (HDHP /HSA) will receive $300 deposited into their Health Savings Account in
2020. 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, 2018 — October 31, 2019) 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
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 11 /l /18 to
10/31/19) and complete the on -line personal health assessment by 2/l/19.
*Will receive 4 hours of personal time off. *Only approved by BOCC, Clerk of Courts,
Land Authority and Property Appraiser for their employees.
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 preventative screening participation. You can see the increase in
participation from 2016 to 2017.
PREVENTxi TWE
SCREENINGS
201.6...
2017
2016
2016 .
2G16 -.
2017
2417
2417
TOTAL
ErnpIoyee
ErnlaIoyee
TOTAL
Ern R.Ioyee
Ern Rloyee
EMPLOYERS
EMPLOYEES
Participation
Percentage
EMPLOYEES
ParL3dpatian
Percentage
Benefltgiven [or particgoation
$25/Month - $SG— Qhyear savings on health
MC SHERIFF OFFICE
532
17
3%
511.
175
34%
Insurance
$25/Month - $SG— Qhyear savings on health
COUNTY CLERK.
73
10
14%
76..
31.
41%
Insurance
$25/Month - $SGQh ear savings on health
TAY COLLECTOR.
52
8
1 15%
53
1 36
68%
Insurance
1PROPERTY
$25 /Month - $Sagh ear savings on health
APPRAISER
38
5
13%
37
21.
57%
Insurance
$25 /Month - $300.'year savings on health
SUPERVISOR OF ELECTIONS
9
4
44%
9-
7
77%
Insurance PLUS- 8 hours time off
$25 /Month - $SO4.'year savings on health
COURT ADMINISTRATION
21
5
14%
22
12
1 55'%
Insurance
$25/ Month- $304h �ear'savings on health
LAND AUTHORITY
3
2
67%
3
5
100%
Insurance
BOARD OF COUNTY
$25/Month - $SG— Qhyear savings on health
OOlMf+tlISS ONER:S
508
59-
12%
524
208...
40%
Insurance
T+taE
12316
108
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�h '.; ' <, , `�`,
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2016 total participation was 108 of 1236 total eligible employees, or 8.7 %.
2017 total participation was 688 of 1235 eligible employees, or 56 %.
(Attached file: Wellness Preventative Screenings)
Florida Blue reports that the County has spent $1,254,792.39 in claims on Wellness screenings
over a 3 -year period ending September 2017. For the same period Florida Blue estimates that
the initiatives of the Wellness Program saved the plan $7,528,752 (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 3 -year wellness claims cost and estimated ROI)
Florida Blue suggests that the 4 top risk areas for the County are:
1) Diabetes
2) Body Mass Index (BMI)
3) Nutrition
4) Blood Pressure
Budget
The 2018 program has an ending balance of $99,874.97. The program is scheduled to receive
$50,000 from Florida Blue upon execution of the Florida Blue contract renewal, and $50,000 in
the first quarter of CY2019, per agreement. Total 2019 beginning balance: $199,874.97.
Total expenses for the 2019 program are planned at $73,995.00.
PREVIOUS RELEVANT BOCC ACTION:
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 - 2019 v3 - 9 -28 -18 edits
2018 65 + Preventive Care Guidelines -
2018 Adult - Child- Preventive Guidelines
Wellness Program Funding Chart 2019 v2 - 9 -28 -18
2019 WELLNESS PHYSICIAN FORM
Wellness Preventative Screenings
Florida Blue 3 -year wellness claims cost and est ROI
Resolution 027 -2018
FINANCIAL IMPACT:
Effective Date: 11/1/2018
Expiration Date: 12/31/2020
Total Dollar Value of Contract: N/A
Total Cost to County: $73,995.00
Current Year Portion: $73,995.00
Budgeted: Wellness Program Funds
Source of Funds: Florida Blue Wellness Contribution, per contract
CPI:
Indirect Costs: 4 Hours annual leave per employee who participates in the Personal Health
Assessment
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details: The program is scheduled to receive $50,000 from Florida Blue in the
fourth quarter of 2018 and $50,000 in the first quarter of CY2019, per agreement. Total 2019
beginning balance is expected to be: $199,874.97.
Total expenses for the 2018 program are planned at $73,995.00.
Approximately $73,995.00 for the 2019 program to be spent from the existing Wellness Program
Budget
I 11 T/ 1 X117.1.6
Bryan Cook
Completed
Assistant County Administrator Christine
Hurley
10/01/2018
Cynthia Hall
Completed
Budget and Finance
Completed
Maria Slavik
Completed
Kathy Peters
Completed
Board of County Commissioners
Pending
11:45 AM
09/28/2018 4:11 PM
Completed
10/01/2018 12:50 PM
10/02/2018 3:46 PM
10/02/2018 4:05 PM
10/03/2018 10:31 AM
10/17/2018 9:00 AM
RESOLUTION NO. -2018
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA APPROVING AND
ESTABLISHING THE CALENDAR YEAR 2019 WELLNESS
PROGRAM; REPEALING PRIOR RESOLUTION NO. 027 -2018 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 contract between Blue Cross Shield of Florida dated September 19, 2018 and the
County, a contribution of $ 50,000 will made toward the County's wellness - related initiatives and
activities; in addition, $50,000 will be contributed January 2019, 2020, 2021, 2022 and 2023. A
portion of these funds are subject to be repaid to Florida Blue if the county should terminate the
agreement early.
WHEREAS, currently, the balance of funds contributed by Florida Blue toward wellness
programs shall stand at approximately $199,874 ( "Wellness Fund ") for 2019; and
WHEREAS, the County has received the results from the personal health assessments
completed by the fall 2015 and 2016 health fair participants, and the results indicate that the top
four at -risk areas for participants are diabetes, hypertension, cancer and obesity; due to Hurricane
Irma and the cancellation of the health fair, 2017 personal health assessment data is not available,
however, Blue Cross Blue Shield of Florida has provided data that continues to support the noted
top risks for the group; 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
below.
WHEREAS, the County desires to use the Wellness Fund on the activities described
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA that:
In calendar year 2019, 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 2019.
Page 1 of 5
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). All request for reimbursements must be submitted to the Employee
Benefits Department no later than January 11, 2020.
b. "Lunch and Learn": 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. Staff will purchase healthy food items
for consumption by active employees who attend and complete scheduled
activities. The expenditure of Wellness Funds under this resolution shall 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. Wellness and Exercise Classes: Wellness Funds will be used to provide 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 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
2019 is twenty thousand dollars ($20,000.00).
d. Annual Health & Wellness Fair: Each year, Monroe County Benefits office
coordinates the Monroe County Health & Wellness Fair. The fair is presented in
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. In 2015, 335 employees attended the Annual Health & Wellness Fair; an
additional 32 employees filled out the on -line preventive health assessment. In
2016, 369 employees attended the Annual Health & Wellness Fair; an additional
29 employees filled out the on -line preventive health assessment. Even though the
2017 Annual Health & Wellness Fairs were cancelled due to the impact of
Hurricane Irma, as of September 4, 2017 (3 weeks prior to events), the reservations
to attend the events were over 50% filled; indicating that participation was on track
for its highest level to date. In 2018, 326 employees attended the Annual Health
& Wellness Fair; on -line preventive health assessment will remain open through
November 9, 2018 for those members who were unable to attend the fair. The
Annual Health & Wellness Fair is a great opportunity to obtain basic diagnostic
Page 2 of 5
tests at no cost, as well as to obtain a flu vaccine and other health and wellness
information from the County's health plan vendors. Wellness Funds will be used
to purchase prizes that promote healthy living (i.e., bicycles, fitness trackers,
smoothie makers) for participants who attend one of the Health & Wellness Fairs
and complete their Passport to Wellness. 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 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).
e. Health Designs, Inc./ Wellness Champion: Wellness Funds will also be used to pay
for a consultant with expertise in health benefits, to serve as a Wellness Champion.
The consultant shall serve as an extension of Monroe County Benefits staff and
shall be an advocate to explain features of the Monroe County Wellness program,
provide Wellness topic presentations, and provide health and benefit information
to employees of the BOCC and the constitutional officers who are members of the
Monroe County health plan. The consultant will be visiting at least 50 locations at
which the employees are employed, in Upper, Middle and Lower Keys, on at least
a quarterly basis. In calendar year 2019, approximately $ 26,995 in Wellness Funds
will be spent on Health Designs. The program and contract for this program ends
June 30, 2019, and will be reviewed by Employee Benefits staff for renewal or bid.
An amount of $26,995 shall be allocated for this item in the CY 2019 Wellness
Program.
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: 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. Leave will be deposited the first payday in April, following the
use -it or lose -it date each year. Florida Blue documents participation and provides
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. Participation in the Monroe County Health & Wellness Program is
voluntary.
Page 3 of 5
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 2020. Participating employees on the High Deductible Health
Plan with Health Savings Account (HDHP /HSA) will receive $300 deposited into
their Health Savings Account in 2020. 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
Employee Health Preventive Care — Assessment Acknowledgement Form. In
program year ending October 31, 2017 (extended to November 22, 2017) and with
the impact of Hurricane Irma, 466 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 $300
deposited into their Health Savings Account. These funds are direct
deposited into the employee's HSA each payday by their respective
participating employer /payroll.
Employees who attest to tobacco use are included in the ability to earn the employee
health insurance premium discount (Traditional Health Plan) or contribution to
HSA (High Deductible Health Plan with Health Savings Account). To be eligible,
in addition to the age appropriate screenings required for all participants, those
attesting to tobacco use, must voluntarily participate and complete at least one
approved tobacco cessation program (programs vary in length) during the wellness
program period of the prior year (November 1, 2018 — October 31, 2019) and
submit a certificate or letter of participation /completion from the facilitating
program. No -cost cessation programs are offered throughout Monroe County and
South Florida by various organizations. Employee Benefits Staff will maintain and
regularly communicate a list of approved tobacco cessation program(s). Employees
inside or outside of Monroe County who are interested in another tobacco cessation
program not listed may submit the program name and contact information in
writing to the Benefits Administrator or Employee Services Director for eligibility
review. Employees must receive approval of other tobacco cessation programs in
advance in order for participation in those programs to qualify the employee for the
premium discount or HSA deposit. Envision Rx Options, Monroe County's
prescription plan provider also supports tobacco cessation and covers tobacco
cessation products (patch, gum, Rx). Employees are not limited in the number of
Page 4 of 5
attempts to become tobacco free during a calendar year. Participation in wellness
and cessation programs are completely voluntary.
Purchases of Goods:
i. Gato Building Gym: In CY 2017, county staff was authorized to expend up to
Ninety- thousand dollars ($ 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. Up to $5000.00 annually shall be
planned for equipment maintenance, repair, and replenishment of fitness center
supplies.
Use of 2019 Wellness Funds among categories:
Employee Services may reassign 2019 funds among the wellness program categories, based on
under or over utilization, in order to manage the needs of the specified program.
2. Resolution No.027 -2018 is inconsistent with this resolution and are hereby repealed.
3. This resolution shall take effect upon adoption.
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 2018.
Mayor David Rice
Mayor Pro Tern Sylvia Murphy
Commissioner Danny Kolhage
Commissioner George Neugent
Commissioner Heather Carruthers
(SEAL)
ATTEST:
KEVIN MADOK, Clerk
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
La
Deputy Clerk
LN
Mayor
Page 5 of 5
Preventive Care Guldellnesfor Cage 65+
C.8.b
N V §,
Schedule an Annual Wellness Visitor your Welcome to Medicare Preventive Visit with your doctor to
discuss preventive screenings and the flu vaccine. Before you go, make sure that your Medicare plan
benefits cover these services.
Routine Health Guide
Annual Wellness and Routine Checkup
Welcome to Medicare Preventive Visit
Obesity Screening: Diet /Physical Activity /BMI Counseling
Vision Exam, Glaucoma Screening and Dental Exam
R ecommended Diagnostic Checkups Screening for At-Risk Patients
Abdominal Aortic Aneurysm (AAA) Check
One -time screening in a lifetime:
Discuss with you...doctor **
Annually for ages 55 -80; with a 30 -pack
Lung Cancer Screening and Counseling
per year smoker history, current smoker
or those who have quit smoking within
the past 15 years
High Blood Pressure (hypertension)
Annually
Diabetic Screening, Blood Sugar, Hemoglobin Al C,
Annually
Retinal Eye Exam, Kidney Function, Blood Pressure
Every 24 months or more often if
Osteoporosis
medically necessary, discuss with your
doctor
Ages 50 -75; Screening Colonoscopy
every 10 years, FOBT (Fecal occult
Colorectal Cancer Screening and Counseling*
blood test) every year or FIT -DNA every
2 years, CT colonography every 5 years
or Sigmoidoscopy every 5 years
HIV and other Sexually Transmitted Infections (STIs)
Annually; discuss with your doctor
Screening & Counseling
........ ......... ......... ......... ......... ......... ......... .........
Cholesterol Screening
Once every 5 years; more frequently if
at risk; discuss with your doctor.
Prostate Cancer Screening (Men only)
Discuss with your doctor
Mammogram (Women only)
Once every 5 years; more frequently if
at risk; discuss with your doctor
Pap Test /Pelvic Exam (Women only)
Once every 5 years; more frequently if
at risk; discuss with your doctor
Skin Cancer Screening. Early detection of cutaneous
melanoma, basal cell cancer, or squamous cell skin cancer Discuss with your doctor
in the adult aeneral population.
Hearing Test I Discuss with vour doctor
Screen /Counseling: Depression, Obesity, Tobacco, Every visit, or as indicated by
Alcohol and Substance Abuse your doctor
Fall Risk/Unintentional Injury/Domestic Violence Every visit, or as indicated by
Prevention /Urinary Problems your doctor
Medication List (including over - the - counter & vitamins) Every visit, or as indicated by
for potential interactions your doctor
Advance Directives: Living Will Annually, discuss with your doctor
Immunizations (Routine Recommendations)
Hepatitis B, Hepatitis C Virus (HCV) Infection
Screening and Varicella (Chickenpox)
Discuss with your doctor
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A A u _ 'ag 1 � � �� ;Fels c er - Be sure to review your plan benefits to determine your costs for these services.
Annual Wellness and Routine Check -up Annually
Obesity Screening: Diet /Physical Activity /BMI Counseling Annually
Vision and Dental Exam (These services may not be covered by your medical Annually: Discuss with your doctor
benefits plan. Check your plan documents.)
Abdominal Aortic Aneurysm (AAA) Check
One -time screenina for aces 65 to 75 who have ever smoked or have a familv history of AAA
Bone Mineral Density Screening and prescribed medication for Women beginning at age 65 or older; and in younger women who have an increased risk
Osteoporosis
Cholesterol Screening Age 35 +; Age 20 -35 at risk Annually: All Men; Age 45 +; Age 20 -45 at riskAnnually: All
Women
Colorectal Cancer Screening and Counseling Age 50 -75; Colonoscopy or fecal occult blood test orsigmoiclosco
Mammogram Annually at age 40.
Pap Test /Pelvic Exam Women age 21 -65 should have Pap Test every 3 years or women age 30 -65 should have
Pap Test /HPV combined testinq every 5 years; Aqes 65 +: Discuss with your doctor.
HIV and other Sexually Transmitted Infections (STIs) Screening and As indicated by history and /or symptoms. Discuss with your doctor behavioral risks
Counseling
Lung Cancer Screening and Counseling Ages 55 -80; 30 pack smoker history, current smoker/ quit within past 15 years
Prostate Cancer Screening Discuss with your doctor
Skin Cancer Screenina Discuss with vour doctor
Screen /Counseling: Depression, Obesity, Tobacco, Alcohol, Substance Every visit, or as indicated by your doctor
Abuse and Preg
Fall Risk /Unintentional Injury /Domestic Violence Prevention /Seat Discuss exercise, home safety and vitamin D supplementation with your doctor
Belt Use
Medication List (including over-the-counter and vitamins) for Every visit, or as indicated by your doctor
p otential interactions
Advance Directives /Living Will Annuallv
Tetanus, Diphtheria, Pertussis (Td/Tda) Ages 19 +: Tdap vaccine once, then a Td booster every 10 years
Flu (Influenza) Annually during flu season
Pneumococcal Ages 19 -64: if riskfactors are present; Ages 65 +: 1 -2 doses (per CDC); Ages 50 +:1 dose
PCV13 and PPSV23 (Florida Blue Benefits)
Shingles (Zoster) Aqes 60 +: 1 dose (per CDC); Ages 50 +:1 dose (Florida Blue Benefits)
Haemophilus InfluenzaeType b (HIB) Hepatitis A, Hepatitis B, Ages 19 +: if risk factors are present
Meningococcal
Human Papillomavirus (HPV), Measles /Mumps /Rubella (MMR), Physician recommendation based on past immunization or medical history
Varicella (Chickenpox) & Hepatitis C (HCV) Infection Screening
*Some immunizations are contraindicated for certain conditions, discuss with your doctor.
oe
C.8.c
In the . urs -un: of "iealt
Get a Flu Vaccine every year CIL
to prevent illness and related
hospitalizations.
1 0 'ire hei helia:
Ca� l l
Customer Service
1- 800 -FLA -BLUE (1- 800 - 352 -25
TTY/T D D Ca I 1 711
Care Consultant Team
1- 888 - 476 -2227
24 -Hour Nurseline
1- 877 - 789 -2583
Go to floridablue.com
VI)')t a ii =''di`i l L'Z 'fe't°
Go to floridabluecenters.com f
locations or call 1- 877 - 352 -5830
Sources: These guidelines are recommendati
from the organizations listed below and wei
not developed by Florida Blue.
www.ahrq.gov
www.cdc.gov
Get your annual wellness exam
.
to review your overall health an(
keep follow -up visits with your
doctor.
-o
Find out if you are at risk for hea
conditions such as diabetes.
Get your vaccines, preventive
W
'-
screenings and labs.
o
Human Papillomavirus (HPV)
CL
vaccine 3 dose series is
recommended for men and
c
women ages 19 through 26 yea
not previously vaccinated prior
age 13.
r
Talk with your doctor about the
medications and over - the -courr
o
vitamins you are taking to reduc
side effects and interactions.
Get a Flu Vaccine every year CIL
to prevent illness and related
hospitalizations.
1 0 'ire hei helia:
Ca� l l
Customer Service
1- 800 -FLA -BLUE (1- 800 - 352 -25
TTY/T D D Ca I 1 711
Care Consultant Team
1- 888 - 476 -2227
24 -Hour Nurseline
1- 877 - 789 -2583
Go to floridablue.com
VI)')t a ii =''di`i l L'Z 'fe't°
Go to floridabluecenters.com f
locations or call 1- 877 - 352 -5830
Sources: These guidelines are recommendati
from the organizations listed below and wei
not developed by Florida Blue.
www.ahrq.gov
www.cdc.gov
Ohildhen x e r
;less chef ,
Wellness Exam and Autism /Development Behavioral Assessment Newborn up to age 3: Frequent Wellness Check -ups;
Age 3 -18: Annual Wellness Check-u
Body Mass Index (BMI): Height and Weight Every visit, BMI beginning at age 2
Blood Pressure Annually, beginning at age 3
Hearing /Dental /Vision Screenings Hearing: Newborn then annually beginning atAge 4; Dental: Regularly,
(These services may not be covered bvvour medical benefits plan. Check vour plan documents.) beginning at ace 1; Vision: Annually, becinninc at ace 3
Cholesterol Screening Annually, beginning at age 2
Lead test,TB, Sickle Cell and Blood Sugar As indicated by history and /or symptoms
HIV and other Sexually Transmitted Infections (STIs) Screening and Counseling Discuss with your doctor based on behavioral risks
Skin Cancer Screening Discuss with vour doctor
Injury/Violence Prevention Annually, more often if indicated by your doctor
Diet/Physical Activity/Emotional Well-Being Counseling Every visit
Tobacco/ Alcohol /Substance Abuse /Depression /Pregnancy Screening and Counseling Every visit starting at age 11, earlier if indicated by your doctor
HepatitisA
2 dose series, 12 -23 months
Hepatitis
1st dose
2nddose
3rd dose
vaccinations is always a good idea to prot
your child from illnesses from birth to 18
years of age. Most of these vaccinations
Diphtheria, Tetanus, Pertussis (DTaP)
require additional doses or boosters over
1st dose
2nd dose
3rd dose
'–
4th dose
5th dose
Tetanus, Diphtheria, Pertussis (Tdap)
Tdap Vaccine
Age 11 or 12. Protects against tetanus
(lockjaw), diphtheria and acellular pertus:
Rr
(whooping cough). This is a booster shot of
cn
same vaccine given during early childhooc
lstdose
Meningococcal Vaccine (MCV4)
Two doses beginning at 11 or 12 years, wit
Haemophil us I nfluenzae Type b (Hib)
a booster dose at age 16. Protects against
meningitis, sepsis(a blood infection) and
>
P
lstdose
2nddose
3rd or 4th dose, see footnote **
Human Papillomavirus(HPV)Vaccine
Three doses over six months, beginning at
ages 11 and 12. Protects boys and girls ag
—
Inactivated Poliovirus
wa rts.
1st dose
2nddose
3rd dose
Every year after six months of age.
4th dose
Protects individuals from getting the
influenza virus.
>
Measles, Mumps, Rubella (MMR)
0)
touch with your pediatrician's office or hea
clinic. Be sureto verify your benefitsfor
lstdose
,.
2nd dose
Varicella
1st dose
2nd dose
Pneumococcal PCV13 and PPSV23
lstdose
2nddose
3rd dose
4th dose
Flu (Influenza)
6 monthsthrough 8years 1 or2 doses; 9yearsand older1 doseonly
Rotavlrus
1st dose
2nddose
3rd dose,
see
footnote **
Meningococcal
lstdose
booster
Human Papillomavirus (HPV) 3 dose
series
*These are routine immunizations based upon cdc.gov recommendations. Range of recommended ages for catch -up or certain high -risk groups is at the doctor's discretion based on
the member'sfamily history and personal riskfactors.
** Dosages determined by doctor with the type of brand vaccine used.
Oe
C.8.c
In the ursux t of IheaiI O - i ,..
Are your chfldre ui' t daT
with vaccivations?
Getting the recommended sequence of
vaccinations is always a good idea to prot
your child from illnesses from birth to 18
years of age. Most of these vaccinations
require additional doses or boosters over
time. As children grow up to become
teenagers, they may come in contact with
'–
different diseases. Here are vaccines that
help protect your preteen or teen from th
other illnesses and infections:
Tdap Vaccine
Age 11 or 12. Protects against tetanus
(lockjaw), diphtheria and acellular pertus:
Rr
(whooping cough). This is a booster shot of
cn
same vaccine given during early childhooc
r
Meningococcal Vaccine (MCV4)
Two doses beginning at 11 or 12 years, wit
a booster dose at age 16. Protects against
meningitis, sepsis(a blood infection) and
>
P
other meningococcal diseases. Children wi
higher risk factors may need additional do
Human Papillomavirus(HPV)Vaccine
Three doses over six months, beginning at
ages 11 and 12. Protects boys and girls ag
—
HPV, which can lead to cancers and genital
wa rts.
Flu Vaccine
Every year after six months of age.
Protects individuals from getting the
influenza virus.
>
Keep your teens safe from preventable, pa
and life- threatening diseases by staying in
0)
touch with your pediatrician's office or hea
clinic. Be sureto verify your benefitsfor
preventive services.
,.
Sources: These guidelines are recommenda
from the organizations listed below and wei
not developed by Florida Blue.
www.cdc.gov
www.aap.org
Florida Blue is an Independent Licensee of the
Blue Cross and Blue skWA
Packet Pg. 306'
I Description of Expenditure I Expenditures I
Race
Wellness Funds from Florida Blue based on contract
Revenue
Race
Nov 2011 -
$40.000
$40
Race
Reimbursement 2014
June 2015
- $5
$5
Reimbursement 2015
$182.07
Nov 2015 -
$100
$100
$80.00
Feb 2016 -
$75.000
$75
Race
Feb 2017 -
$75
$75
Feb 2018 -
$50
$50
Nov 2018 -
$50 upon contract excecution future
$50
Feb 2019 -
$50 future
$50
Total
$445.000.00
I Description of Expenditure I Expenditures I
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
Race
Reimbursement 2017
$288.00
Race
Reimbursement 2018
$286.63
Sum of Expenses to date $245,125.03
2019 Wellness Program Available Funds $199
2019 Planned Events: Resolution Expenditures
Community Organized Event Reimbursement Walks /Bikes /Swims $2
Lunch and Learn $5
Exercise Classes $20
Annual Health & Wellness Fair $15
WUelln�;5� °Cli'�rr► ion X 28 995�OD
Purchases of Goods:
Sum of Planned Expenses for 2019 $73,995.00
Expected Program Balance for 12/31/19 $125,879.97
County of Monroe
The Florida Keys
4 l
Employee Health Preventive Care - Assessment Acknowledgment Form
Effective January 1, 2019
Services provided between: 11/1/2018 - 10/31/19
Employee Name: Age:
(Please Print)
Male: Female: EMPLOYER:
Physician Name: (Please Print) Completion Date:
(Please Print)
Physician Acknowledgement: My signature below indicates that the following tests, assessments, clinicals indicated, pertain to
the employee identified above, have been measured, if I deemed appropriate . The results of which have been reviewed with the
employee in accordance with established treatment protocols.
Biometrics Information:
Check if
completed
Recommended tests (Not required) if applicable at
Ph sicianIs discretion:
Wellness checkup/ Physical
Comprehensive Metabolic Panel (CPT Codes 80053,
84436, 84479)
The below can be done at the County's annual
health fair or with your personal physician:
Vitamin B
Height/Weight
CBC
Blood Pressure: Systolic/ Diastolic
CMP
Cholesterol : LDL HDL Tri I cerides
TSH
Blood Sugar Level
Bilirubin screenin
Body Mass Index BMI
HBAic 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.
Mammogram: Annually at ages 40+
OR
Not required at this time (age, screening given within past year, etc.)
Pap Test /Pelvic Exam: Women age 21 -65 every 3 years or women age 30 -65 Pap Test /HPV combined every 5 year:
Ages 65+ discuss with doctor
OR
Not required at this time
Screening for Colorectal Cancer: Ages 50 -75 with either a colonoscopy, fecal occult blood test or sigmoidoscopy
OR
Not required at this time
P"
Page 1 of 2 Revised 9/28/2018
Abdominal Aortic Aneurysm Check: One -time men ages 65 -75 who have ever smoked or history of AAA
OR
Not required at this time
Lung Cancer Screening: Ages 55 -80; 30 pack smoker history, current smoker /quit within past 15 years
OR
Not required at this time
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
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
necessary follow up to prevent further health issues:
Physician Signature:
Physician Address:
Physician Phone #:
Date:
Please give patient a copy of this form, completed by physician and mail completed, signed form to:
Monroe County Employee Benefits Office
Gato Building, 2 nd 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,
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
be subject to testing to verify non -use of tobacco products. A refusal to submit to a test is considered "positive" for
tobacco use.
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
(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.
Employee Name Employee Signature Date
Submitted to County on:
Date
Received by Employee Services Employee Name /Signature: Date:
Page 2 of 2 Revised 9/28/2018
PREVENTATIVE SCREENINGS
2016
2017
2016
2016 TOTAL
2016 Employee
Employee
2017 TOTAL
2017 Employee
2017 Employee
EMPLOYERS
EMPLOYEES
Participation
Percentage
EMPLOYEES
Participation
Percentage
Benefit given for participation
$25 /Month - $300 /year savings on health
MC SHERIFF OFFICE
532
17
3%
511
175
34%
linsurance
$25 /Month - $300 /year savings on health
COUNTY CLERK
73
10
14%
76
31
41%
insurance
$25 /Month - $300 /year savings on health
TAX COLLECTOR
52
8
15%
53
36
68%
insurance
$25 /Month - $300 /year savings on health
PROPERTY APPRAISER
38
5
13%
37
21
57%
insurance
$25 /Month - $300 /year savings on health
SUPERVISOR OF ELECTIONS
9
4
44%
9
7
77%
insurance PLUS 8 hours time off
$25 /Month - $300 /year savings on health
COURT ADMINISTRATION
21
3
14%
22
12
55%
insurance
$25 /Month - $300 /year savings on health
LAND AUTHORITY
3
2
67%
3
3
100%
insurance
BOARD OF COUNTY
$25 /Month - $300 /year savings on health
COMMISSIONERS
508
59
12%
524
208
40%
insurance
Total
1z36
sos
9%
$�
�
1G9n '
i
MONROE COUNTY BOCC - B0611
Summary of Wellness /Cancer Preventive Screenings
Incurred: 10/01/2014 - 09/30/2017
Report Date: 01/15/2018
Report contains Eiorida Bice proprietary & confidentiai information
OCT14- SEPT15
ADULT WELLNESS EXAM
460
$75,874.34
BREAST CANCER SCREENING
262
$98,808.22
CERVICAL CANCER SCREENING
62
$3,513.06
COLORECTAL CANCER SCREENING
160
$174,612.79
OCT14- SEPT15 Total
1,468
$352,808.41
7CT15- SEPT16
ADULT WELLNESS EXAM
530
$87,987.02
BREAST CANCER SCREENING
302
$139,858.10
CERVICAL CANCER SCREENING
58
$3,443.90
COLORECTAL CANCER SCREENING
182
$240,353.24
OCT15- SEPT16 Total
1,788
$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 SCREENING
152
$186,311.32
OCT16- SEPT17 Total
1,565
$430,341.72
Grand Total
4,821
$1,254,792.39
Estimated ROI over the 3 year period $7,528,752
#
VA2 ' y 131 '14
In MOT
[V-l)Ji IJJ 1 (03 DVXMI 'tlj
UOUT LINE
1. In calendar year 2018, the Monroe County Wellness Program shall consist of the followin,-q
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 2018.
Recundng Events:
n. 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
Z-113UM,
-F ! q
Employee Participation in Wellness Events:
1,V M. '. I
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
• reduced to $50.00 per month. These discounts are administered •
the employee direct deposit pay statements or pay checks.
ii. High Deductible Health Plan with Health Savings Account (HDHPRA-8�.
Employees on this plan pay zero in premiums, so a monthly discount does
not apply. Instead employees • the HDHP/HSA will receive $300
deposited into their Health Savings Account.
Purchases of Goods:
2. Resolution Nos. 049-2017 and 173-2017 are inconsistent with this resolution and are
hereby repealed.
rx �G
I Q Q%TfUs PIPP, 14b a tif iw r. I a j I lii;44 I I J!xq) ILlyr. 1 14 0 sp I* rm I SlIqUILI)IR90 rumpmo
Mayor David Rice Yes
Mayor Pro Tem Sylvia Murphy Yes
Commissioner Danny Kolhage Yes
Commissioner George Neugent Yes
Commissioner Heather Carruthers Yes
Y®
Deputy Clerk
# # - T - W
13 3
IS.-
0,1=