Item C08 C.8
Coty f � ,�� ,' BOARD OF COUNTY COMMISSIONERS
�� Mayor David Rice,District 4
The Florida Keys � Mayor Pro Tem Craig Cates,District 1
y Michelle Coldiron,District 2
James K.Scholl,District 3
Ij Holly Merrill Raschein,District 5
County Commission Meeting
July 20, 2022
Agenda Item Number: C.8
Agenda Item Summary #10751
BULK ITEM: Yes DEPARTMENT: Employee Services
TIME APPROXIMATE: STAFF CONTACT: Natalie Maddox (305) 292-4450
N/A
AGENDA ITEM WORDING: Approval of a 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 will maintain the
County's existing Dental plan with no changes in costs or coverage through 12/31/2024.
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
with no changes in cost or coverage. The new term will run from 1/1/2023 — 12/31/2024.
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, employees and retirees can select the coverage that best meets their
needs.
Enrollment in both the Gold and Silver Plan remained steady and almost equally divided during the
open enrollment for calendar-year 2022 coverage. Because of the successful of plan design changes
the County made at the last contract renewal, premiums continue to create stability for both plan
options. This has resulted in Delta Dental offering the County an additional 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
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C.8
2014 Issued RFP
2015 Delta Dental selected, and 2-year contract negotiated. 9/1/15-12/31/17
2018- Delta Dental lyear renewal
2019-Delta Dental 2 year renewal
2021-Delta Dental 2 year renewal (expires 12/31/22)
CONTRACT/AGREEMENT CHANGES:
Approval of Two Year Renewal with Delta Dental with No changes in Cost or Coverage
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Renewal Offer 1 12023
Summary Monthly Rates Enrollment
Delta Dental Plan Financial Summary
Delta Dental Highlights 6 2122
FINANCIAL IMPACT:
Effective Date: 1/1/2023
Expiration Date: 12/31/2024
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 06/22/2022 7:13 PM
Bryan Cook Completed 07/05/2022 12:02 PM
Cynthia Hall Completed 07/05/2022 12:37 PM
Purchasing Completed 07/05/2022 12:41 PM
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C.8
Budget and Finance Completed 07/05/2022 4:44 PM
Brian Bradley Completed 07/05/2022 5:14 PM
Lindsey Ballard Completed 07/05/2022 5:26 PM
Board of County Commissioners Pending 07/20/2022 9:00 AM
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June 7, 2022
Monroe County Board of County Commissioners
1100 Simonton Street >
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RE: Contract Renewal for Monroe County Board of County Commissioners 0
Delta Dental PPOsm Group# 17858 U
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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.
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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:
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Effective Date January 01, 2023 4-
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Contract Term January 01, 2023-December 31, 2024
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Current Rates Renewal Rates
Division #10001, 10002, 19001
11112023-1213112024
% change 0.00%
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Enrollee Only $55.50 $55.50 N
Enrollee+Spouse $105.03 $105.03
Enrollee+I Child $113.37 $113.37
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Enrollee+Children $164.19 $164.19 76
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Family $164.19 $164.19 0
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Delta Dental Insurance Company Delta Dental of California Delta Dental Mid-Atlantic Region
Telephone! 800-521-2651 Telephone: 888-335-8227 Delta Dental 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 800-932-0783
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C.8.a
Division #00001, 00002,09001 Current Rates Renewal Rates
11112023-1213112024
% change 0.00%
Enrollee Only $42.04 $42.04
Enrollee+Spouse $81.38 $81.38 U
Enrollee+I Child $87.17 $8717 0
Enrollee+Children $130.50 $130.50 0
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Family $130.50 $130.50 E=
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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. 0
Please keep this renewal letter with your contract documents. It serves as an amendment to your Delta
Dental Contracts for the rates and contract term.
To renew your dental plan contract, please follow these steps:
1) Review this letter for changes to your dental plan for January 01, 2023
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, 0
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Delta Dental Insurance Company 0
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MohammadReza Navid cN
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Group Vice President, Sales& Marketing T-
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.8.a
Summary of Contract Amendments to
Monroe County Board of County Commissioners
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Delta Dental PPOsM U
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OTHER INFORMATION 0
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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. o
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.8.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
Health Care Arrangement" (OHCA)privacy rules as defined in 45 Code of Federal Regulations U
(C.F.R.) §164.501. Functionally,the exchange of enrollment information between Delta Dental and o
your group remains the same. t0
While a Business Associate Agreement is not required between Delta Dental and your fully insured
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 o
identifiable health information.
Additionally,confidentiality requirements remain applicable to the exchange of information within an
OHCA.
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Monroe County Board of County Commissioners
GROUP NUMBER: 17858
DELTA DENTAL INSURANCE COMPANY
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January 1,2023 Renewal
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Group Name: Monroe County Board of County Commissioners
Group Number: 17858
Address: 1100 Simonton Street
Key West, FL 33040 0
Original Effective Date: September 01,2015
Current Contract Effective Date: January 01, 2021
Renewal Date: January 01, 2023
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Current Enrollment: 1,382 primary enrollees(Mar-2022)
Prior Enrollment: 1,386 primary enrollees(Mar-2021)
Dual Choice?: No
Contract Type: Risk-Non-Retention 0
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Current Commission: 0.00%
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Account Manager: Oralie Rodriguez
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Monroe County Board of County Commissioners
GROUP NUMBER: 17868
DELTA DENTAL INSURANCE COMPANY
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Rate History Report
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Tier Proposed Rate Chance Enrollment % Enrolled
Enrollee Only $55.50 538 59.9%
Enrollee+Spouse $105.03 150 16.7%
Enrollee+ 1 Child $113.37 0.00% 63 7.0%
Enrollee+Children $164.19 58 6.5%
Family $164.19 89 9.9%
Total 898 100.0%
DecemberJanuary 1, 2020 -
Tier Rates Rate Change Enrollment %Enrolled
Enrollee Only $55.50 497 57.7%
Enrollee+Spouse $105.03 158 18.3%
Enrollee+1 Child $113.37 - 67 7.8%
Enrollee+Children $164.19 53 6.1%
Family $164.19 86 10.0%
Total 861 100.0%
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January 1, 2019- December 31, 2019
Tier Rates Rate Change Enrollment %Enrolled
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Enrollee Only $48.60 456 58.4% CL
Enrollee+Spouse $91.97 15 00% 147 18.8%
Enrollee+Children $99.27 94 12.1%
Family $143.77 83 10.7%
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Total 780 100.0%
Tier Rates Rate Change Enrollment % Enrolled
Enrollee Only $42.26 461 58.2%
Enrollee+Spouse $79.97 - 157 19.8% o
Enrollee+Children $86.32 102 12.9%
Family $125.02 73 9.2%
Total 792 100.0% E
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Monroe County Board of County Commissioners
GROUP NUMBER: 17858
DELTA DENTAL INSURANCE COMPANY
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Rate History Report
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Tier Proposed Rate Chance Enrollment % Enrolled
Enrollee Only $42.04 322 66.5%
Enrollee+Spouse $81.38 81 16.7%
Enrollee+ 1 Child $87.17 0.00% 26 5.4%
Enrollee+Children $130.50 19 3.9%
Family $130.50 36 7.4%
Total 484 100.0%
January 1, 2020 - December
Tier Rates Rate Chance Enrollment %Enrolled
Enrollee Only $42.04 354 66.1%
Enrollee+Spouse $81.38 88 16.4%
Enrollee+ 1 Child $87.17 - 36 6.7%
Enrollee+Children $130.50 21 4.0%
Family $130.50 37 6.8%
Total 636 100.0%
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DecemberJanuary 1, 2018-
Tier Rates Rate Chance Enrollment %Enrolled
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Enrollee Only $25.86 406 66.0% CL
Enrollee+Spouse $48.94 103 16.7%
Enrollee+Children $52.81 62 10.0%
Family $76.51 45 7.3°%
Total 615 100.0%
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DELTA DENTAL INSURANCE COMPANY
SUMMARY OF KEY STATISTICS 0
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
Group Number: 17858
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• For incurred period ended May 31, 2022, the group had an average exposure of 1,383 primary enrollees. Thi 0
year decrease of 1.5%from the previous period's average exposure of 1,403 primary enrollees.
• For the current period, incurred claims amounted to$829,963, or 71.1%of premium, compared to$818,981,
premium, during the previous period.
• During the current period, 38.4%of primary enrollees had enrolled dependents vs. 39.2%of primary enrollee
period.
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Premium $1,239,955 100.0% $1,167,530
Incurred Claims* $818,981 66.0% $829,963
Exposure'`' 16,841 16,592
Avg. Exposure 1,403 1,383 c
Avg. Member Count 2,279 2,237
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Includes estimate for incurred but unreported(IBUR). 0
Exposure= Total primary enrollee months during the period.
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Pirlimary Enrollee Distribution CL
May 2021 vs„ May 2022 <
1000 330
900 833 E
800 E
700
600
500
400
3(7(7 252 227 �
2(7(7 104 85 72 79 121 126
IFnrollllee Onlly IFnrollllee Spouse IFnrollllee 1 ChUd IFnrollllee ChHdren IFarnully
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C.8.d
Plan Benefit Highlights for: Monroe County Board of County Commissioners
Group No: 17858
!, Primary enrollee, spouse(includes domestic partner) and eligible
dependent children to the end of the month dependent turns age 26
Deductibles $50 per person/$150 per family each calendar year • 0
Deductibles waived for Diagnostic
&Preventive (D& P) and Yes o
Orthodontics? U)
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Maximums f Silver Plan: $3,000 per person each calendar year U
Gold Plan: $5,000 per person each calendar year °U)
D&P counts toward maximum Yes -
Waiting Period(s) Basic Services Major Services Prosthodontics Orthodontics
None None None TNone
y Delta Delta Delta � Delta
Non-Delta Non-Delta N
Dental Dental Dental Dental
PPO Premier Dental PPO Premier Dental Z
dentistst dentistst dentistst dentistst dentistst dentistst
Diagnostic & Preventive _
Services (D & P) 100% 100% 100% 100% 100% 100%
Exams, cleanings and x-rays 2
Basic ServicesLL
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Fillings, posterior composites, 90% 80% 80% 90% 90 % 90% W
crown/inlay/only recementation, Z
denture re air/relines and sealants W
Endodontics (root canals) 90% 80% $0 % 90% 90% 90% m
Covered Under Basic Services
Periodontics (gum treatment) 90% 80% 80 % 90% 90 % 90
Covered Under Basic Services
Oral Surgery 90% 80% 80% 90 % 1 90 % 90%
Major Services
Under Basic Services,Cover �
Crowns, inlays,onlays and cast 60% 50
-___ % 50% 60 % 60 % 60% L
restorations �
Prosthodontics � 60% 50% 50 % 60% r 60% 60% cN
Bs and dentures w __... .............
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Orthodontic Benefits 50 % 50% 50% 50 % 50% 50
Dependent children j U)
Orthodontic Maximums $3,000 $3,000 $3,000 $3,000 $3,000 $3,000
Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime
Limitations or waiting periods may apply for some benefits„ some services maybe excluded from your plan.
Reimbursement is based on Delta Dental contract allowances and not necessarily each dentist's actual fees.
t Reimbursement is based on PPO contracted fees for PPO dentists„ Premier contracted fees for Premier
dentists and the program allowance for non-Delta Dental dentists.
Delta Dental Insurance Company Customer Service Claims Address
1130 Sanctuary Parkway, Suite 600 800-521-2651 P.O. Box 1809
Alpharetta, GA 30009 Alpharetta, GA 30023-1809
deltadentalins.com
This benefit information is not intended or designed to replace or serve as the plan"s Evidence of Coverage or Summary Plan
Description, If you have specific questions regarding the benefits, limitations or exclusions for your plan, please consult your
company's benefits representative. HST PPo_3H1Lo_ooc(Rev.07r24n020)
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