Item C27 C27
BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE Mayor Craig Cates,District 1
The Florida Keys Mayor Pro Tern Holly Merrill Raschein,District 5
Michelle Lincoln,District 2
James K.Scholl,District 3
m' David Rice,District 4
Board of County Commissioners Meeting
October 18, 2023
Agenda Item Number: C27
2023-1292
BULK ITEM: Yes DEPARTMENT: Employee Services
TIME APPROXIMATE: STAFF CONTACT: Natalie Maddox
N/A
AGENDA ITEM WORDING: Approval of a resolution approving and establishing the 2024
Wellness Program and funding levels, which includes health and wellness events (lunch and learns,
health and wellness fairs, exercise and nutrition classes), 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 2024 Wellness Funding. Also provides
for four hours of annual leave to Monroe County BOCC employees and participating Constitutional
Officer(Property Appraiser, Court Administration, Tax Collector, 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. Some Wellness Events may be held online/virtually.
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 of illnesses before major medical treatment is
required. This contributes to a healthier workforce and seeks to reduce long-term medical and
pharmacy claims cost.
As part of the County's agreement renewal with Florida Blue in July 2023, Florida Blue paid the
County a $75,000 wellness contribution upon BOCC approval of the agreement renewal; a $75,000
wellness contribution will be made January 1, 2024, January 1, 2025; January 1, 2026, January 2027,
January 2028. The County has implemented Wellness programs from 2011-2023 using these funds
from Florida Blue to encourage health plan enrollees to participate in wellness programs and
educational opportunities.
The 2024 program includes:
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All wellness program opportunities will be administered either onsite or online.
Recurring Events:
• Community Organized Event Reimbursement up to $100 annually per enrollee for
participation in marathons, walkathons, etc.
• Lunch and Learn Educational Sessions (Topics will address the top 4 risk areas: Diabetes,
BMI,Nutrition, Blood Pressure-Cardiopulmonary Disease)
• Health and Wellness Fairs
• Funding of exercise (Yoga, Zumba, etc.) and nutrition classes (healthy cooking, etc.) held at
Government Centers (Lower, Middle and Upper Keys)
• Wellness Champion Presentations by Staff(Will address the top 4 risk areas: Diabetes, BMI,
Nutrition, Blood Pressure). Staff will research, design, and present worksite wellness education.
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 2025.
Participating employees on the High Deductible Health Plan with Health Savings Account
(HDHP/HSA)will receive $300 deposited into their Health Savings Account in 2025.
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, 2023 — October 31, 2024) 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:
1. Attend the annual Health Fair and participate in biometric, blood pressure, cholesterol, blood
sugar level and body mass index screenings
OR
24. Visit their personal physician and obtain biometric, blood pressure, cholesterol, blood sugar level
and body mass index screenings (on or between the dates of 11/1/23 to 10/31/24) and complete
the on-line personal health assessment by the provided open platform dates.
*Will receive 4 hours of personal time off. *Participating employers.
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ALTERNATE (Online/virtual): Outlined in Section D of Wellness Program Resolution.
Purchases of Goods:
• Gato Building Fitness Center—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 preventive screening participation for 2022 (benefit eligible employees).
2022
2022 TOTAL 2022 Employee 2022
EMPLOYERS Employee
EMPLOYEES Participation
Percentage
MC SHERIFF OFFICE 510 132 26%
COUNTY CLERK 64 25 40%
TAX COLLECTOR 54 28 50%
PROPERTY APPRAISER 30 16 50%
SUPERVISOR OF 10 4 48%
ELECTIONS
COURT 21 6 30%
ADMINISTRATION
LAND AUTHORITY 4 3 99%
BOARD OF COUNTY 541 204 38%
COMMISSIONERS
Total 1234 418 34%
Florida Blue reports that the County has spent approximately $ 4, 197,759.41 in claims on Wellness
screenings over a 8-year period (October 2014— September 2023). For the same period Florida Blue
estimates that the initiatives of the Wellness Program are approaching a savings to the plan of over
almost 16 million dollars (as cost avoidance). Based on this estimate, every $1.00 spent on Wellness
Preventative Screenings saves $6.00 as avoided claims cost. (Attached file: Florida Blue 8-year
wellness claims cost and estimated ROI)
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Florida Blue suggests that the 4 top risk areas for the County are:
• Diabetes
• Obesity/Body Mass Index (BMI)
• Cancer
• Blood Pressure/Cardio-Pulmonary Disease
Budget
The FY2023 program has an ending balance of$ 287,325.24. The program is scheduled to receive
$75,000 from Florida Blue in the first quarter of CY2024,per agreement. Total CY2024 beginning
balance is forecast to be: $ 362,325.24
Summary:
Approximately $720,000.00 is the cumulative revenue of the program since inception, and
approximately $357,674.00 are the cumulative expenses. This derives an approximate $362,325.24
available for CY2024.
Total expenses for the 2024 program are currently planned at approximately$44,000.00.
PREVIOUS RELEVANT BOCC ACTION:
Resolution 256-2022—2023 Wellness Program and Funding
Resolution 256-2022 - 2023 Wellness Program and Funding
Resolution 200-2021 —2022 Wellness Program and Funding
Resolution 242-2020—2021 Wellness Program and Funding
Resolution 267-2019—2020 Wellness Program and Funding
Resolution 262-2018 —2019 Wellness Program and Funding
Resolution 027-2018 —2018 Wellness Program and Funding
Resolution 049-2017—2017 Wellness Program and Funding
Resolution 173-2017—2017 Wellness Program Funding
CONTRACT/AGREEMENT CHANGES:
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
2024—Wellness—Resolution_.pdf
2024-WELLNESS-PHYSICIAN FORM.pdf
2023 General Wellness Guidelines -Bnglish.pdf
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Wellness Funding Chart 09 18 2023.pdf
Preventive Screening & ROI 9 20 23.pdf
Resolution 256-2022.Approval of 2023 Wellness Program and Funding.pdf
FINANCIAL IMPACT:
Total cost to County: $44,000 per plan year(estimated) CC_08005 - Wellness Program
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RESOLUTION NO. -2023
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA APPROVING AND
ESTABLISHING THE CALENDAR YEAR 2024 WELLNESS
PROGRAM; REPEALING PRIOR RESOLUTION NO. 256-2022 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 for plan participants, consisting of $100,000 at execution of the agreement, $75,000
January 2016—2018; upon execution of a renewal contract between Blue Cross Shield of Florida
dated September 19, 2018, a contribution of $ 50,000 was made toward the County's wellness-
related initiatives and activities for plan participants, and $50,000 was contributed January 2019
through January 2023; upon renewal of contract execution in July 2023 Blue Cross Blue Shield
contributed$75,000.00 with an additional $75,000.00 each year beginning January 2024 and each
year through contract period of 2028, per agreement.
WHEREAS, currently, the balance of funds contributed by Florida Blue toward wellness
programs shall stand at approximately $ 362,325.24 ("Wellness Fund") for 2023; and
WHEREAS, the County has received the results from the personal health assessments
completed by the fall 2015, 2016, 2018, and 2019 health fair participants (2017 Health Fair was
canceled due to Hurricane Irma), 2020, 2021 and 2022 Virtual Events due to COVID-19), and
the results indicate that the top four at-risk areas for participants are diabetes, hypertension/
cardio-pulmonary disease, cancer, and obesity; 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
WHEREAS, the County desires to use the Wellness Fund on the activities described
below.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA that:
1. In calendar year 2024,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 2024.
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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 10, 2025.
b. "Lunch and Learn": (Onsite or online) 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. If onsite, 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 twenty dollars ($20.00)per individual per meeting. Planned cumulative
expenditure for all Lunch and Learn events is five thousand dollars ($5,000.00),
and will be less if virtual.
c. Wellness and Exercise Classes: (Onsite or Online) 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 Wellness and
Exercise Classes during CY 2024 is fifteen thousand dollars ($15,000.00) and will
be less if virtual.
d. Annual Health & Wellness Fair: (Onsite or Online) 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.
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Health Fair and Health Assessment Participation
Year Health Fair Participants Online Health Assessment
2017 Hurricane Irma- canceled Hurricane Irma- canceled
2018 326 17
2019 340 9
2020 133-Virtual/Online 0
2021 170-Virtual/Online 0
2022 402 Virtual/Online 0
Hurricane Ian
2023 344 (In-Person) 10 (Est)
2024 will feature an in person Health & Wellness Fair in August 2024 with health
and hygiene safety precautions. Health& Wellness Fairs will feature presentations
by Monroe County Employee Benefits, Florida Blue, Capital Rx, Delta Dental,
VSP, Quantum (EAP), and Minnesota Life. Wellness Funds will be used to
purchase prizes that promote healthy living(i.e.,bicycles,fitness trackers,smoothie
makers) for participants who attend or participate virtually in annual Health &
Wellness Fairs and complete their Passport to Wellness/virtual minimal
requirements. For possible in-person events, 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),but will be less if held
virtually.
e. Staff will develop and deliver onsite or virtual Wellness Champion topics to plan
participants. Topics will address top risk factors among participants as identified
by Florida Blue.
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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: (Onsite or Online) Four hours of annual leave to Monroe
County BOCC employees and participating Constitutional Officer (Property
Appraiser, Court Administration, Land Authority, Tax Collector 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. Virtual requirements as noted
in section D. Leave (above) will be deposited the first payday in April, following
the "use-it or lose-if' (forfeiture) date each year. Florida Blue documents
participation and provides confirmation 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.
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 2025. Participating employees on the High Deductible Health
Plan with Health Savings Account(HDHP/HSA) will receive $300 deposited into
their Health Savings Account in 2025. 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 Officers) 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, 2022, 415 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.
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
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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, 2023 — October 31, 2024) 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. Monroe County's prescription plan provider
also supports tobacco cessation and covers tobacco cessation products (patches,
gum, Rx). Employees are not limited in the number of attempts to become tobacco
free during a calendar year. Participation in wellness and cessation programs are
completely voluntary.
Purchases of Goods:
i. Gato Building Fitness Center: Up to $5000.00 annually shall be planned for
equipment maintenance, repair, and replenishment of fitness center supplies.
The Gato Building Fitness Center will be open to health plan participants, covered
spouses, and covered dependents age 18 and over.
The Gato Building Fitness Center 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.
Use of 2024 Wellness Funds among categories:
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j. Employee Services may reassign funds among the wellness program categories,
based on under or over utilization, in order to meet demand and manage the needs
of the specified programs.
2. Resolution No. 256-2022 is inconsistent with this resolution and is repealed on October 31,
2023.
3. This resolution shall take effect on November 1, 2023.
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 2023.
Mayor, Craig Cates
Mayor Pro Tem, Holly Merrill Raschein
Commissioner Michelle Lincoln _
Commissioner James Scholl _
Commissioner David Rice
(SEAL)
ATTEST: BOARD OF COUNTY COMMISSIONERS
KEVIN MADOK, Clerk OF MONROE COUNTY,FLORIDA
By: By:
As Deputy Clerk Mayor
Approved as to form and legal sufficiency:
Monroe County Attorney's Office 10-2-2023
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County of Monroe 07 FIT
The Florida Keys Z 11/p�
Employee Health Preventive Care-Assessment Acknowledgment Form
Passport to Wellness Year 2024
Services provided between: 11/1/2023 through 10/31/2024
Discount Period: 1/1/2024-12/31/2024
Employee Name: Phone No. Age:
(Please Print)
Male: Female: EMPLOYER: (Please Print)
Physician Name: (Please Print) Completion Date:
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 Recommended tests (Not required) if applicable at
completed Physician's discretion:
Wellness checkup/Physical Comprehensive Metabolic Panel (CPT Codes 80053,
84436, 84479)
The below can be done at the County's annual Vitamin B
health fair or with your personal physician:
Height/Weight CBC
Blood Pressure: Systolic/Diastolic CMP
Cholesterol : LDL/HDL/Triglycerides TSH
Blood Sugar Level Bilirubin screening
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: Women every two years between age 40-50. Annually at ages 50+
OR
Not required at this time (age, screening given within past year, etc.) Date lastcompleted:
Pap Test/Pelvic Exam: Women age 21-65 every 3 years or women age 30-65 Pap Test/HPV combined every 5 years;
Ages 65+ discuss with doctor
OR
Not required at this time. Date Last Completed:
Screening for Colorectal Cancer: Ages 45-75 with either a colonoscopy,fecal occult blood test or sigmoidoscopy;
OR
once every 10 years.
Not required at this time Date Last Completed:
Page 1 of 2 Approved BOCC 2/21/18
1188
Abdominal Aortic Aneurysm Check: One-time men ages 65-75 who have ever smoked or history of AAA
OR
Not required at this time. Date lastcompleted:
Lung Cancer Screening: Ages 50-80;20 pack smoker history, current smoker/quit within past 15 years
OR
Not required at this time. Date last completed:
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. Date last completed:
Prostate Cancer Screening: Discuss withdoctor.
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: Date:
Physician Address:
Physician Phone #:
Please give patient a copy of this form for submission to Employee Benefits.
Physicians submitting forms on behalf of employee must also submit proof of age appropriate screenings to:
Monroe County Employee Benefits Department
1100 Simonton Street Suite 2-268 Key West, FL 33040
Email:wellness@monroecounty-fl.gov
Fax: 305-292-4452
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.
NOTE:*Either original,emailed and faxed assessment form completed by physician must be submitted to Monroe County
with any proofs of age appropriate screenings.
Employee Name Employee Signature Date
Submitted to County on:
Date
Received by Employee Services Employee Name/Signature: Date:
Page 2 of 2 Approved BOCC 2/21/18
1189
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Wellness Funds from Florida Blue Based Per Contract Revenue
Nov 2011 -Feb 2021 $545,000.00
Feb 2022-$50,000 $50,000.00
Feb 2023-$50,000 $50,000.00
July 2023-New Contract Execution Allocation $75,000.00
Feb 2024-Plan Year 2024 Future $75,000.00
Total $720,000.00
Program Year Expenditures
2012-2021 $343,523.00
2022 $3,402.84
2023 As of 9/18/23 $10,748.92
Sum of Expenses to date $357,674.76
2024 Wellness Program Available Funds $362,325.24
2023 & 2024 Budgeted Events Per Resolution Expenditures
Virtually or onsite,depending upon applicable future safety guidelines;events held
virtually will incur less expense.
Communitv Or anized Event Reimbursement Walks/Bikes/Swims $4,000.00
Lunch and Learn $10,000.00
Exercise Classes/Health&Nutrition Classes $30,000.00
Annual Health& Wellness Fair $30,000.00
Wellness Champion Visits by Staff $4,000.00
Purchases of Goods:
Gato Fitness Center-Equipment Maintenance and Supplies $10,000.00
Sum of Planned Expenses for 2023&2024 $88,000.00
Expected Program Balance for 12/31/24 $274,325.24
1194
MONROE COUNTY BOCC-B0611
Summary of Wellness/Cancer Preventive Screenings
Incurred: 10/01/2014-09/30/2022
Report Date: 09/19/2023
Report contahis FoHd'a U ue propHetary& confid'eostW' hiforniadon
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 SCREENIN 160 $174,612.79
OCT14-SEPT15 Total $352,808.41
OCT15-SEPT16 ADULT WELLNESS EXAM 530 $87,987.02
BREAST CANCER SCREENING 302 $139,858.10
CERVICAL CANCER SCREENING 58 $3,443.90
COLORECTAL CANCER SCREENIN 182 $240,353.24
OCT15-SEPT16 Total $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 SCREENIN 152 $186,311.32
OCT16-SEPT17 Total $430,341.72
OCT17-SEPT18 ADULT WELLNESS EXAM 664 $117,101.28
BREAST CANCER SCREENING 305 $116,041.77
CERVICAL CANCER SCREENING 74 $1,975.15
COLORECTAL CANCER SCREENIN 145 $249,016.75
OCT17-SEPT18 Total $484,134.95
OCT18-SEPT19 ADULT WELLNESS EXAM 668 $119,039.32
BREAST CANCER SCREENING 287 $136,410.16
CERVICAL CANCER SCREENING 53 $2,131.33
COLORECTAL CANCER SCREENIN 176 $287,797.47
OCT18-SEPT19 Total $545,378.28
OCT19-SEPT20 ADULT WELLNESS EXAM 593 $111,080.84
BREAST CANCER SCREENING 272 $137,900.28
CERVICAL CANCER SCREENING 44 $1,766.95
COLORECTAL CANCER SCREENIN 117 $210,947.49
OCT19-SEPT20 Total $461,695.56
OCT20-SEPT21 ADULT WELLNESS EXAM 730 $137,831.07
BREAST CANCER SCREENING 319 $172,202.25
CERVICAL CANCER SCREENING 79 $2,110.66
COLORECTAL CANCER SCREENIN 164 $373,880.50
OCT20-SEPT21 Total $686,024.48
OCT21-SEPT22 ADULT WELLNESS EXAM 682 $124,683.34
BREAST CANCER SCREENING 313 $183,929.65
CERVICAL CANCER SCREENING 74 $2,261.90
COLORECTAL CANCER SCREENIN 174 $454,858.86
OCT21-SEPT22 Total $765,733.75
Grand Total $4,197,759.41
1195
RESOLUTION NO. 256-2022
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA APPROVING AND
ESTABLISHING THE CALENDAR YEAR 2023 WELLNESS
PROGRAM; REPEALING PRIOR RESOLUTION NO. 200-2021 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 a renewal contract between Blue Cross Shield of Florida dated September 19, 2018
and the County, a contribution of $ 50,000 was made toward the County's wellness-related
initiatives and activities, and $50,000 was contributed January 2019, January 2020 and January
2021. $50,000 was contributed to the County in 2022, and will be contributed in January 2023,
per agreement.
WHEREAS, currently, the balance of funds contributed by Florida Blue toward wellness
programs shall stand at approximately $ 217,477.14 ("Wellness Fund") for 2022; and
WHEREAS, the County has received the results from the personal health assessments
completed by the fall 2015, 2016, 2018, and 2019 health fair participants (2017 Health Fair
canceled due to Hurricane Irma, 2020 and 2021 Virtual Events due to COVID-19), and the results
indicate that the top four at-risk areas for participants are diabetes, hypertension/cardio-pulmonary
disease, cancer, and obesity; 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
WHEREAS, the County desires to use the Wellness Fund on the activities described
below.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA that:
1. In calendar year 2023,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 2023.
Page 1 of 6
1196
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 9, 2023.
b. "Lunch and Learn": (Onsite or online) 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. If onsite, 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 twenty dollars ($20.00)per individual per meeting. Planned cumulative
expenditure for all Lunch and Learn events is five thousand dollars ($5,000.00),
and will be less if virtual.
c. Wellness and Exercise Classes: (Onsite or Online) 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 Wellness and
Exercise Classes during CY 2023 is fifteen thousand dollars ($15,000) and will be
less if virtual.
d. Annual Health & Wellness Fair: (Onsite or Online) 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.
Page 2 of 6
1197
Health Fair and Health Assessment Participation
Year Health Fair Participants Online Health Assessment
2015 335 32
2016 369 29
2017 Hurricane Irma- canceled Hurricane Irma- canceled
2018 326 17
2019 340 9
2020 133-Virtual/Online 0
2021 170-Virtual/Online 0
2022 will feature an in person Health & Wellness Fair in September 2022 with
health and hygiene safety precautions. Health & Wellness Fairs will feature
presentations by Monroe County Employee Benefits, Florida Blue, Capital Rx,
Delta Dental, VSP, Quantum (EAP), and Minnesota Life. Wellness Funds will be
used to purchase prizes that promote healthy living (i.e., bicycles, fitness trackers,
smoothie makers) for participants who attend or participate virtually in annual
Health & Wellness Fairs and complete their Passport to Wellness/virtual minimal
requirements. For possible in-person events, 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),but will be less if held
virtually.
e. Staff will develop and deliver onsite or virtual Wellness Champion topics to plan
participants. Topics will address top risk factors among participants as identified
by Florida Blue.
Page 3 of 6
1198
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: (Onsite or Online) Four hours of annual leave to Monroe
County BOCC employees and participating Constitutional Officer (Property
Appraiser, Court Administration, Land Authority, Tax Collector 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. Virtual requirements as noted
in section D. Leave (above) will be deposited the first payday in April, following
the "use-it or lose-it" (forfeiture) date each year. Florida Blue documents
participation and provides confirmation 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.
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 2024. Participating employees on the High Deductible Health
Plan with Health Savings Account(HDHP/HSA) will receive $300 deposited into
their Health Savings Account in 2024. 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 Officers) 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 31,2021;429 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.
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
Page 4 of 6
1199
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, 2022 — October 31, 2023) 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. Monroe County's prescription plan provider
also supports tobacco cessation and covers tobacco cessation products (patches,
gum, Rx). Employees are not limited in the number of attempts to become tobacco
free during a calendar year. Participation in wellness and cessation programs are
completely voluntary.
Purchases of Goods:
i. Gato Building Fitness Center: Up to $5000.00 annually shall be planned for
equipment maintenance, repair, and replenishment of fitness center supplies.
The Gato Building Fitness Center will be open to health plan participants, covered
spouses, and covered dependents age 18 and over.
The Gato Building Fitness Center 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.
Use of 2023 Wellness Funds among categories:
Page 5 of 6
1200
j. Employee Services may reassign funds among the wellness program categories,
based on under or over utilization, in order to meet demand and manage the needs
of the specified programs.
2. Resolution No.200-2021 is inconsistent with this resolution and is repealed on October 31,
2022.
3. This resolution shall take effect on November 1, 2022.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida, at a regular meeting of said Board held on the 21 st day of September 2022.
Mayor David Rice Yes
Mayor Pro Tem Craig Cates Yes
0 Commissioner Michelle Coldiron Yes
�' .; Commissioner James Scholl Yes
�a 23 Commissioner Holly Merrill Raschein Yes
�pQHro ,.°a BOARD OF COUNTY COMMISSIONERS
ADOK,Clerk OF MONROE COUNTY,FLORIDA
By: By:
As D uty C erk May
-;
Approved as to form and legal sufficiency:
Monroe County Attorney's Office 9-1-2022
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1201