Item C30 C.30
Coty f � ,�� ,' BOARD OF COUNTY COMMISSIONERS
�� Mayor David Rice,District 4
The Florida Keys � Mayor Pro Tem Craig Cates,District I
y Michelle Coldiron,District 2
James K.Scholl,District 3
Ij Holly Merrill Raschein,District 5
County Commission Meeting
September 21, 2022
Agenda Item Number: C.30
Agenda Item Summary #11068
BULK ITEM: Yes DEPARTMENT: Employee Services
TIME APPROXIMATE: STAFF CONTACT: Natalie Maddox (305) 292-4450
n/a
AGENDA ITEM WORDING: Approval of a resolution to disburse funds returned to Monroe
County by Delta Dental, the County's dental plan provider, due to underutilization of dental benefits
during the Covid-19 pandemic in 2020 and 2021. Establishment of a 'premium holiday' for current
dental plan participants as method of distribution, and allocation of the remainder of funds for dental
specific wellness items, education, and/or screenings. A premium holiday will consist of a three pay
period suspension of dental premium payroll deductions from employees and a one month
suspension of dental premium collections from retirees.
ITEM BACKGROUND: Delta Dental, Monroe County's dental plan provider, has returned a total
of$ 160,116.75 to the County due to underutilization of dental benefits during the Covid-19
pandemic in 2020 and 2021. Insurance carriers, such as Delta Dental, are regulated such that
premiums collected may not exceed claims incurred by a specified ratio or margin. Due to
underutilization of dental services during the Covid-19 pandemic in 2020 and 2021, Delta Dental
exceeded the allowable margin and thus determined that the County was due this refund.
This resolution provides that employee participants in the County's dental plan shall not have
premiums withheld via payroll deduction for three consecutive payrolls and that retiree participants
in the County's dental plan shall not owe dental premiums for one month. This suspension of
premium collection is known in the industry as a"premium holiday." This premium holiday offsets
approximately $ 133,079.72 of the $160,116.75 rebate the County received. The remaining $
27,037.03 will be used for Dental related wellness items, education, and/or health screenings
available to dental plan participants.
The County's Plan Administrators along with Gallagher Benefits Consultants Legal Compliance
Team and the Monroe County Attorney's office have validated the compliance of this method. This
method avoids administrative costs associated with other methods and returns the greatest value to
plan participants. The Plan Administrators have reviewed this plan with all organizations with
employees and retirees on the County's Health Plans, including the Dental Plan: BOCC, Property
Appraiser, Tax Collector, Supervisor of Elections, Sheriff s Office, Clerk of the Court and
Comptroller, Land Authority, and Court Administration; consensus exists. It must be noted that all
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C.30
active plan participants had continuous dental coverage in force at all times throughout the
pandemic; there was no lapse in coverage associated with this rebate.
PREVIOUS RELEVANT BOCC ACTION:
July 20, 2022—MCBOCC Approved 2 Year Plan Renewal with Delta Dental
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Resolution Delta Dental Covid-19 Fund Disbursement
Disbursement Compliance Gallagher Benefits Consultants and Compliance Team 9 2 22
Delta Dental Notifications of Credits and Refunds 9 2 22
Recap Inbound Funds and Illustration of Recommended Outbound of Funds 9 2 22
FINANCIAL IMPACT:
Effective Date: 09/21/2022
Expiration Date:
Total Dollar Value of Contract: N/A
Total Cost to County: NONE—Fully Insured Benefit
Current Year Portion: N/A
Budgeted: N/A
Source of Funds: Premiums paid by participants
CPI: N/A
Indirect Costs: N/A
Estimated Ongoing Costs Not Included in above dollar amounts: N/A
Revenue Producing: N/A If yes, amount: N/A
Grant: N/A
County Match: N/A
Insurance Required: N/A
Additional Details: N/A
REVIEWED BY:
Natalie Maddox Completed 09/02/2022 2:38 PM
Bryan Cook Completed 09/02/2022 2:40 PM
Cynthia Hall Completed 09/02/2022 3:14 PM
Purchasing Completed 09/02/2022 3:37 PM
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Budget and Finance Completed 09/02/2022 4:01 PM
Brian Bradley Completed 09/02/2022 4:42 PM
Lindsey Ballard Completed 09/06/2022 9:03 AM
Board of County Commissioners Pending 09/21/2022 9:00 AM
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C.30.a
RESOLUTION NO. -2022
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA, APPROVING THE
DISBURSEMENT OF COVID-19 REFUND FROM DELTA DENTAL,
THE COUNTY'S DENTAL PLAN PROVIDER, DUE TO
UNDERUTILIZATION OF DENTAL BENEFITS DURING THE
COVID-19 PANDEMIC BY ESTABLISHING A SHORT SUSPENSION
OF DENTAL INSURANCE PREMIUM COLLECTION FOR
CURRENT PLAN PARTICIPANTS, AND APPROVING THAT THE
REMAINING BALANCE OF THE REFUND BE USED TOWARDS
DENTAL WELLNESS ITEMS,EDUCATION,AND SCREENINGS. U)
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WHEREAS, due to the impact of COVID-19, Delta Dental has returned funds 0
to Monroe County in the form of premium credits for the months of August and September 2020
totaling $ 54,062.56; and in the form of refund check for the month of September 2021 in the
amount of$ 106,054.19; for a grand total of$ 160,116.75; and 0
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WHEREAS, a complaint method to return the Dental refund to plan participants needs to be 0
established; and,
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WHEREAS, Monroe County Delta Dental plan administrators have reviewed various options and
determined the preferred option for returning these funds to participants is to observe a `premium
holiday', which means to suspend collection of dental insurance premiums for three pay periods for
active employees and suspend collection of dental insurance premiums for one month for retirees; E
and that any remaining balance of the rebate will be used for dental wellness and hygiene items,
education, and screenings; and this method returns the greatest value to plan participants with a low
administrative cost; and,
WHEREAS,the described suspension of insurance premium collection for employees and retirees
participants, T-
would return approximately $ 133�079.72 to plan and approximately $ 27037.03 would
be allocated to dental wellness and hygiene items, education, and screenings; and, >
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WHEREAS,this method has been reviewed and approved for compliance by Monroe County
Benefits Consultants and Compliance Team at Gallagher Benefit Services and the Monroe County u
Attorney's office; and,
WHEREAS, Plan Administrators have reviewed this method with all organizations who have
employees and retirees on the County's Health Plans, including the Dental Plan: BOCC, Property 2
Appraiser, Tax Collector, Supervisor of Elections, Sheriff s Office, Clerk of the Court and 0
Comptroller, Land Authority, and Court Administration, and a majority consensus exists.
WHEREAS, it should be noted that all active plan participants had continuous dental coverage in
force at all times throughout the pandemic; there was no lapse in coverage associated with this
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rebate.
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C.30.a
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, THAT:
Employee participants in the County's dental plan shall not have premiums withheld via payroll
deduction for three consecutive payrolls, and retiree participants in the County's dental plan shall not
owe dental premiums for one month.
This suspension of premium collection is known in the health insurance industry as a"premium
holiday." This premium holiday offsets approximately $ 133,079.72 of the $160,116.75 rebate the
County received. This suspension of premium collections (premium holiday)will be observed
when practicable for each payroll department(BOCC, Property Appraiser, Tax Collector, Supervisor
of Elections, Sheriff's Office, Clerk of the Court and Comptroller, Land Authority, and Court U)
Administration), but shall be complete on or before March 31, 2023. 0
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The remaining $ 27,037.03 shall be used for Dental related wellness and hygiene items, education,
and/or health screenings available to dental plan participants.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, U)
at a regular meeting of said Board held on the 21st day of September, 2022.
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Mayor David Rice 0
Mayor Pro Tem Craig Cates
Commissioner Michelle Coldiron -�
Commissioner James K. Scholl
Commissioner Holly Merrill Raschein
(SEAL) A
ATTEST: KEVIN MADOK, Clerk BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA U-
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By: By:
As Deputy Clerk Mayor u
Approved as to form and legal sufficiency
Monroe County Attorney's Office: 0
9-2-2022
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C.30.b
Disbursement Compliance: Gallagher Benefits Consultants &Compliance Team
Begin forwarded message:
From: GBS Compliance Help Des -SER<g I
Date: February 4, 2022 at 4:14:58 PM EST A
To:Jeff Reagan <J.eff........[:�ea.ga.!"Cij. ..P. .....L!2.!�.> o
Cc:Janis Goode <
. .. .!......... u.qq.. .. ... .. ..V.g..:..�.q..i;rn>, Kevin Mathis <lkevi..l"!.........!�.at:.:�.!.... .. ..V.g..:.�q..i;rn>, Doug Lemmerman
< u Lr rrnrrnr rrnir"� .c;e�rrn>, Susan Kleiman <. �u sir IICIr irrnir a� Danielle Chanat
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g.............................................................................................................u..g............................... ................................................................i.............................�............➢.g...............................
Ua.ni.�"..11�.........�.-.�:�.a !.�.�:..��..�..u..g.:.ce�i,rn>, Sheila Craft<SI�re%.l.a......_�.ir..f�...�°��.�.u..g..:.�::q..!:�p:> 6
............. ...................
Subject: Monroe County BOCC Issue- [ ref:_OOD80LIGG._5003b1ej5BP:ref]
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RE: Case Number 00580619 >
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Hello Jeff, CN
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There are some best practice insights that we can provide for the client when it comes to a non-ERISA 0)
plan's use of premium refunds.The client should first review the language in the formal plan document
to determine whether it describes how the plan sponsor may use these funds. Additionally, non-federal
governmental plans, like the client's plan, are subject to state (and local) laws.The client will want to
review those laws to ensure that they do not limit or dictate how they can use the refund.
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In addition, non-ERISA employers can use the medical loss ratio (MLR) rebate rules as a guide. Under o
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HHS's MLR regulations, a group health policyholder(employer) must use the portion of a distribution
that can be credited to the amount of premium paid by participants. For example, if an insurer pays a
cash rebate of$20,000 to the policyholder, and participants of the group health plan paid 40%of the
total premium,then the employer must use 40%of the MLR rebate, or$8,000,for the benefit of the
participants. Using the MLR rules as a guide,the client may want to use the portion of the insurer's U)
premium credit or refund that is attributable to participant contributions in one of three ways: t0
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1. Reduce required contributions
2. Give participants a premium holiday
3. Pay a cash rebate to participants
Using the general approach for MLR rebates, an employer may want to provide a contribution holiday, a
reduction in required contributions or a cash rebate to either: (1) participants enrolled in the plan when
the distribution is received (e.g., those currently on the plan), or(2) participants enrolled in the plan
during the period when the surplus was created (e.g., those on the plan during the 2020/21 plan year).
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Another option for non-ERISA employers is their proposed plan, a benefit enhancement.This may 0
include adding a benefit or service equal to the value of the participant's amount owed at no additional
cost to the participants.The most common example of a benefit enhancement is waiving member
copays for some period.The amount due back to participants is technically returned to them via a short- 0
term reduction in a copayment.
The GBS resource Permitted Uses of Insurer Premium Reductions, Premium Holidays, and Rebates for
non-ERISA Plans
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Disbursement Compliance: Gallagher Benefits Consultants 8'Compliance Team
may also be helpful for the client.
Note: If the client's name was included in your email, the answer will be stored in Salesforce as one of
the cases for that client. |f you have follow-up questions aboutthisCase, p|easenep|yvviththisemaii T
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Best,
Kevin
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Arthur || h a a8 er ��C o� 4-
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Southeast Region Compliance He|pdesk 76
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Gallagher Benefit Services, Inc. CL
Doug Lemmerman,]D rw
Area Senior Vice President, Compliance Counsel w
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Phone: 919.913.1934 �
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Susan Kleiman,]D
Area Vice President, Compliance Counsel
Phone: Z4U.Z382U7Z =
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Kevin Mathis,JD �
Compliance Consultant
Danie||eChanat' CEBS 0
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Area Vice President, Senior Compliance Consultant
Phone: 704.9712553 w
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Sheila Craft
Compliance Consultant
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Phone: 704.9712562
The intent ofthis analysis is to provide you with general information regarding the status of, and/or CL
potential concerns related to, your current compliance issue. It is not intended to provide, nor should it o
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be construed as, legal advice. Questions regarding specific legal issues should be directed to the client's
general counsel oran attorney who specializes in this practice area.
Confidentiality Notice:This e-mail and any files transmitted with it are intended only for the person or
entity towhich it is addressed and may contain confidential material and/or material protected by law. �T
Any retransmission or use of this information may bea violation ofthat law. If you received this in error, a
please contact the sender and delete this material from any computer.
C.30.b
Disbursement Compliance: Gallagher Benefits Consultants &Compliance Team
From:Jeff Reagan as
Date Received: 2/4/2022
Subject: Monroe County BOCC Issue
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Original email:
The above referenced client has received approximately$160,000 in premium refunds from their dental
carrier, Delta Dental. Delta provided the County with an employee by employee breakdown of these as
premiums over the 2020/21 Plan years so they have an accurate count.The refund was due to potential
loss of services due to COVID although the members had access during this period.
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The issue the County now faces is what and/or how to return these funds to roughly 1,300 employees CL
with a 100 or so no longer employed. Logistically, cutting a refund check is nearly impossible as well as
costly with in their system.The County has asked us for guidance here.The plan that they are 04
considering would be to place those funds into dental wellness initiatives over the coming year. 04
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Initiatives would be in the area of dental health fairs,free oral exams and other dental-related actions. E
As you may know, Monroe County is the Florida Keys and very rural in their ability to deliver healthcare as
services.
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They are not an ERISA group obviously, but would like to know what best practices may apply in this
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area. Please let me know if you need any additional information. E
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Visit Gallagher COVID-19 Resources<htt1 .� ll. ............. . .vir s-c vid-19-1 .. . . > page
.................. ... .. c �. e�.ir. ............................................................................................. ..ir.rrrrj.cz for information to prepare your business and your employees for pandemic outbreaks, including COVID-
19.
Jeff Reagan Area Senior Vice President
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[/Users/tmcnair/Desktop/GaIIagherSig/signature-Gallagher_wTAG_HorizontalSmall.png]
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mobile: 305.304.4780 1 direct: 561.998.6762 as
2255 Glades Road, Suite 240W, Boca Raton, FL 33431
Confidentiality Note:This communication and any attachment to it may contain information that is
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privileged, proprietary, confidential and/or exempt from disclosure under applicable law. It is intended
only for the use of the person(s)to whom it is properly addressed. If you are not the intended recipient,
you are hereby notified that review, retransmission, disclosure, copying(whether electronic or hardcopy
format), distribution or use of the information contained herein (including any reliance thereon) is _
strictly prohibited. If you have received this communication in error, please immediately notify the CL
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sender by return email or by telephone, and delete any copies of the communication and/or its contents
from your files.The recipient should check this communication and any attachments for the presence of
viruses. Neither Arthur J. Gallagher &Co., its subsidiaries, affiliates, or divisions accept any liability for as
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damage caused by any virus transmitted by this communication.Thank you.
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Delta Dental Notifications
Your COVI D--1 9 prernium credit
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As you focus on the weil-being of your employees due to pressures brought on by the COVID-1 9
pandemic, we want you to know that Delta Dental is here to help.
For our customers andl members in particular, our goal is to provide beneficial and meaningful
financial support, highlighted by the following support for you:
• All fully insured renewals, effective August 2020 through July 2021, will retain current rates
for 12 months,
• In addition, you will receive a 25% premium credit for August and September 2020, which
will be applied to the first month's invoice following your contract anniversary. (Credits for
groups with August, September and October 2020, contract anniversaries will be applied to
the October 2020 invoice.)
From the (beginning of this crisis, our priority has been to support all our stakeholders—clients, 0
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enrollees, dentists, our employees and the communities we serve—by ensuring and expanding
access to dental care.: 4-
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This pandemic, and the health care community's response, continues to evolve. We will closely, >
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monitor emerging information and take additional supportive actions as appropriate. We will be CL
sure to keep your informed about any additional actions we may take.
As always, I am available to answer any questions you may have,. Please don't hesitate to reach CN
out, CN
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Silirceireiv,
Oirafle Rodriguez A,,,�cr,,�f � k9
I orodrjguezQdj.ic..delta.o[g
Delta Dental Insurance , 5 3 2"3
We- keeljp y'oiu,i ,3milinq"" ' www,dlettadentalins.com
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Delta Dental Notifications
IM SwiduwV Pwkwar
Auotara,GA IM
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December 2021
AC OVlD.,-19 refuind for select insured aiccounts
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Dearly two years after COVID-19 first impacted the world, Delta Dental remains committed to ensuring that 2
we don't profit from the effects of the pandemic.As part of our ongoing assessment of COVID-19's impact
on plan utilization,enclosed is a check equal to the September 2021 premium on your insured non-retention
account.
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From,the beginning of the pandemic, Detta Dentars priority has been to support all our stakeholders
clients,members,providers,employees and communities --- by ensuring and expanding access tcodental
care.
CN
Please don't hesitate to reach coot to your Delta Dental Account Manager if you have any questions, �
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Thank you for your continued partnership.
Sincerely,
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DELTA DENTAL
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Recap Inbound Funds and Illustration of Recommended Outbound of Funds
Delta Dental provided a total of$ 160,116.75 in COVID 2020&2021 refunds to MCBOCC
2020:
Delta Dental August 2020-25% Credit $ 27,050.19
Delta Dental September 2020-25% Credit $ 27,012.47 T
Total Credit: $54,062.56 (Exact Match to Delta Dental Documentation) o
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2021:
Delta Dental September 2021 Refund Check: $ 106,054.19 -
Exact Match to Delta Dental Documentation)
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2020: $ 54,062.56
2021: $106,054.19 �
Total: $ 160,116.75 c14
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- Employree'Seirvices/Benefirts IRiecornmendaflon �
Option 3-Combination of premiurrn Iholiday and enhanced benefits 0
1) Premium Holidays for last three payrol[s In 2022 for dentall participants-0.4 2022 �
2) Beinefit enhanceinieintt:s via education,heal'tlh&welllnes,s fairs and derma]equipment
am
Avg.,Cnerntall P,er IPay[All l 9=
Employer 2022 Pay Period uC,llas,ses.,Fklll Grcouosll
3 Payday
B4OCC&CourtAdirnin 2/11,&2,12,5 16,100.09 Halliiiday'+1
Clerk 2' 4&2, 1,'8, 2,331.76
Mdloirru:t,h �
2,331..76 R etioiree ds
Land Authority 2f11,&2,/2,5 96.96 Actrves 1.1.2,041.36
f cso 2f4&2,/1,8 15,558.70 RLVrees 21,038.36 9=
Property A.13praiser 1/28&2,/11 1,167.+338 2
SupervV or of Eleet,ions 2/4&2/1,8, 263,.70 1,33,0,79,.72,
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Tax Collector 2/4&2/1,8, 1,828,.54
Ail Actives gi-weeOy A,v 377,347.12' Approx.
E'n'dancement, U)
Tot,alll 27',037.413
Retirees Mllonthly Avg.
Mgh& Low Options Jan-2.2 Vie.IEFeh-22 21,D38.136
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