Item C09 C.9
� � �, BOARD OF COUNTY COMMISSIONERS
County of Monroe � ��r�i
�r � s�� Mayor Heather Carruthers,District 3
The Florida.Keys � � � ������]�j Mayor Pro Tem Michelle Coldiron,District 2
Craig Cates,District 1
^_,
David Rice,District 4
Sylvia J.Murphy,District 5
County Commission Meeting
July 15, 2020
Agenda Item Number: C.9
Agenda Item Summary #7020
BULK ITEM: Yes DEPARTMENT: Employee Services
TIME APPROXIMATE: STAFF CONTACT: Natalie Maddox (305) 292-4450
N/A
AGENDA ITEM WORDING: Approval of two-year contract renewal with Delta Dental for dental
benefits for eligible County employees, retirees, and dependents; and approval for the Employee
Services Director to sign all necessary documents. This agreement maintains the County's existing
Dental plan and includes no changes in cost or coverage; approval for Employee Services Director to
sign all necessary documents.
ITEM BACKGROUND:
Approval of two-year contract renewal with Delta Dental for dental benefits for eligible County
employees, retirees, and dependents. This agreement maintains the County's existing Dental plan
and includes no changes in cost or coverage. The new term will run from 1/1/2021 — 12/31/2022.
The County currently offers two dental plans, a Silver and Gold coverage option in the Delta Dental
Premier Network. Both Gold and Silver Plans offer preventive care coverage (cleaning and x-ray) at
100%. By offering two options, the employee can select the coverage that best meets the needs of
the employee and any applicable dependents.
Enrollment in both the Gold and Silver Plan remained steady and almost equally divided during the
open enrollment for calendar-year 2020 benefit coverages. Because of the successful 2019 plan
design changes, premiums being generated have created stability for both plan options, prompting
Delta Dental to offer a two-year renewal with no change in cost to employees.
The County's benefits consultant, Gallagher Benefit Services, Inc, supports this renewal based on
dental networks available in Monroe County, and plan design trends in the broader dental insurance
market.
PREVIOUS RELEVANT BOCC ACTION:
2011 Dental RFP resulted in two-year agreement with United Concordia
2013 Renewed United Concordia
2014 Issued RFP
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C.9
2015 Delta Dental selected, and 2-year contract negotiated. 9/1/15-12/31/17
2018- Delta Dental 1-year renewal
CONTRACT/AGREEMENT CHANGES:
Approval of Two Year Renewal with Delta Dental with No changes in Cost or Coverage
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Renewal Offer 01 01 2021
Financial Comparison & Enrollment 2019 2020
Delta Dental Plan Summary
FINANCIAL IMPACT:
Effective Date: 1/1/2021
Expiration Date: 12/31/2022
Total Dollar Value of Contract:
Total Cost to County: None
Current Year Portion:
Budgeted:
Source of Funds: 100% of cost funded by plan participant premiums
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: N/A If yes, amount:
Grant: N/A
County Match: N/A
Insurance Required: Yes
Additional Details:
REVIEWED BY:
Natalie Maddox Completed 06/11/2020 3:22 PM
Bryan Cook Completed 06/11/2020 4:09 PM
Assistant County Administrator Christine Hurley Completed
06/16/2020 9:54 AM
Cynthia Hall Completed 06/16/2020 1:52 PM
Purchasing Completed 06/18/2020 10:43 AM
Budget and Finance Completed 06/22/2020 4:43 PM
Maria Slavik Completed 06/23/2020 2:30 PM
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C.9
Kathy Peters Completed 06/24/2020 10:01 AM
Board of County Commissioners Pending 07/15/2020 9:00 AM
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C.9.a
IZ=
May 18, 2020
Monroe County Board of County Commissioners
1100 Simonton Street D
Key West, FL 33040
D
RE: Contract Renewal for Monroe County Board of County Commissioners
Delta Dental PPOSM Group# 17858 N
We appreciate your business and thank you for choosing Delta Dental Insurance Company. Your
employees are among the millions nationwide who trust their smiles to Delta Dental.
We are pleased to present you with your dental plan contract renewal information. We are committed
to providing you with quality plan designs combined with excellent customer service.
When reviewing your dental plan,we considered cost factors related to your group's dental service
utilization and claims experience. We have made every attempt to provide the most competitive
renewal possible.
We have calculated your rates based on the employer/employee contribution levels in your contract
remaining the same. If the contribution levels and/or enrollment guidelines have changed or will
change, please notify us immediately, as such a change may affect your renewal rate.
The following is the renewal information for your Delta Dental PPOSM dental plan:
E ective Date January 01, 2021 _ _
Contract Term January 01, 2021 -December 31, 2022
Dtvrsion #1 p001,100�2, 19001 �, Curri�nt fRglts � �` ''R�neul;l�a�es� �.
021 ,X2/31%20 '2
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change 0.00% N
Enrollee Only $55.50 $55.50 T'
Enrollee+Spouse $105.03 $105.03
Enrollee+1 Child $113.37 $113.37 03
Enrollee+Children $16419 $16419 —
Family $164.19 $164.19 Q
Delta Dental Insurance Company Delta Dental of Califomia Delta Dental Mid-Atlantic Region
D
Telephone: 800-521-2651 Telephone: 888-335-8227 Delta Denial of Delaware,Inc.
Delta Dental of the District of Columbia
Delta Dental of New York,Inc.
Delta Dental of Pennsylvania(Maryland)
Delta Dental of West Virginia
Telephone. 8M932-0783
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C.9.a
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� Ctlrret Rees ,renewal Rates
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% change
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Enrollee Only $42.04 $42 04
Enrollee+Spouse $81.38 $81.38
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Enrollee+I Child $87.17 $87.17
Enrollee+Children $130.50 $130.50
Family $130.SO $130.SO '�,
As part of our continued commitment to you and your dental program, Delta Dental maintains a high
level of service. Delta Dental continues to assure you of our dedication through ongoing review of our
performance standards. Please refer to the attached guarantee exhibit for further details.
To renew your dental plan contract, please follow these steps:
1) Review this letter for changes to your dental plan for January 01, 2021 a
2) Begin paying the rates outlined in this letter with your new contract term.
If you have any questions about your renewal,your Account Manager will be happy to help. We
appreciate your continued confidence in Delta Dental. We are proud of our association with you and _
look forward to a long and mutually successful relationship.
Sincerely,
Delta Dental Insurance Company
MohammadReza Navid
Group Vice President, Sales& Marketing
N
N
The American Dental Association (ADA)annually updates its standard dental procedure coding
system,which is a component of its Code on Dental Procedures and Nomenclature (CDT Code)
reference manual. When the ADA changes the codes, carriers must adopt the changes. We process
claims according to the current CDT reference manual. Changes made to comply with the CDT Code
do not constitute a material change to your dental plan design.
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C.9.a
Summary of Contract Amendments to
Monroe County Board of County Commissioners
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Delta Dental PPOsM
OTHER INFORMATION
Delta Dental's retro-termination policy for enrollees. As a reminder, Delta Dental's policy is that
enrollment may be adjusted retroactively to the immediately preceding three months plus the current
month billed if no claims have been processed after the requested termination date for the enrollee.
Provider reimbursement. As a reminder, Delta Dental's policy is to reimburse contracted dentists
based on the network payment provisions for the geographic area in which the services are provided.
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C.9.a
OHCA Notification
Please be informed that consistent with the group application and group contract terms, Delta Dental
considers its relationship with fully insured group health plans as subject to HIPAA's "Organized c
Health Care Arrangement" (OHCA)privacy rules as defined in 45 Code of Federal Regulations
(C.F.R.) §164.501. Functionally, the exchange of enrollment information between Delta Dental and
your group remains the same.
While a Business Associate Agreement is not required between Delta Dental and your fully insured °3
group health plan within an OHCA, any Protected Health Information (PHI) exchanged or shared
between the entities remains subject to HIPAA's minimum necessary rule and other privacy rules in
addition to any applicable state laws and regulations governing the disclosure of individually
identifiable health information.
Additionally, confidentiality requirements remain applicable to the exchange of information within an
OHCA.
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C9.c
efit Highlights for: Monroe County Board of County Commissioners
Group No: 17858
momPrimary enrollee, spouse (includes domestic partner) and eligible
dependent children to the end of the month dependent turns age 26
les $50 per person/$150 per family each calendar year o
les waived for Diagnostic
tive(D & P)and Yes
Itics?
Is Silver Plan: $3,000 per person each calendar year
Gold Plan: $5,000 per person each calendar year
runts toward maximum Yes o
'eriod(s) Basic Benefits Major Benefits Prosthodontics Orthodontics
None None None None
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ben €Dents i
s�DY� ��Il�r@I11�e e�r z�i
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{�eni1S1 � 1IIiYc, `ti `jtYs +Js,hif� # zAdP... Es� Cl
is& Preventive _
(D & P) 100 % 100 % 100 % 100 % 100 % 100 %
,leanings and x-rays_
vices I
3ostedor composites, 90 % 80 % 80 % 90 % 90% 90 % I
ay/only recementation,
,e air/relines and sealants
tICS (root canals) 90 % 80 % 80 % 90 % 90 % 90% I o
Under Basic Services
tics (gum treatment) o
90 % 80% 80 % 90 % 90% 90%
Under Basic Services
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IerY 90 % 80% 80 % 90 % 90 % 90 % 0.
Under Basic Services 0.
,,vices
nlays,onlays and cast 60 % 50 % 50 % 60 % 60% 60 %
nS -- - -- - - - - -
OntICS 60 % 50 % 50 % 60 % 60 % 60%
ind dentures
itic Benefits
50% 50 % 50 % 50 % 50 % 50 % ZL
nt children
itic Maximums $3,000 $3,000 $3,000 $3,000 $3,000 $3,000
Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime
ons or waiting periods may apply for some benefits; some services may be excluded from your plan. ,
irsement is based on Delta Dental contract allowances and not necessarily each dentist's actual fees.
rsement is based on PPO contracted fees for PPO dentists, Premier contracted fees for Premier
and the program allowance for non-Delta Dental dentists.
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�Itats>`Ihsurance Company Cusmer Service Glai!mstAddressl �, , i, f
tCfary�Par�ray i Suite 600 ,8®0-521 2651 , E P Q Box�18U9�1 � , \ t J11�{l�{t� �s
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