Resolution 189-2024 I 4Y
l
I
RESOLUTION NO. 189 -2024
A RESOLUTION OF THE MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS REVISING MONROE COUNTY
HEALTH PLAN DESIGN; LOWERING MAXIMUM OUT-OF-
POCKET THRESHOLDS; LOWERING THE COST SHARE
(COINSURANCE) PERCENTAGES; SETTING MAXIMUM
SPECIALIST OFFICE VISIT CO-PAYS FOR PHYSICAL AND
OCCUPATIONAL THERAPY, CHIROPRACTIC THERAPY,
AND OBSTETRIC SERVICES; AND ESTABLISHING AN
EFFECTIVE DATE.
WHEREAS, Monroe County Board of County Commissioners ("BOCC") is the plan
administrator for the health plan providing medical benefits for active and retired employees of
Monroe County, the Monroe County Land Authority, and the constitutional officers; and
WHEREAS, Monroe County desires to make certain changes to its health plan design, in
order to deliver the most cost-effective medical and prescription coverage; and
WHEREAS, the County desires to lower the maximum out-of-pocket thresholds for
the Traditional Plans and High Deductible Health Plans ("HDHP"); and
WHEREAS, the County desires to lower the member cost share (coinsurance) in the
Traditional Plans to match the member share in the HDHPs; and
WHEREAS, the County desires to lower specialist office visit co-pays for physical
and occupational therapy, chiropractic and obstetric services office visits in the Traditional
Plans, creating a specialist office visit carve-out for these three categories; and
WHEREAS, the County wishes for these changes to take effect for the plan year
beginning January 1, 2025.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA,
Section 1. The recitals above are hereby adopted and incorporated in this Resolution.
Section 2. Plans 03559 and 03769 (Traditional Plans)will be amended to lower the maximum
out-of-pocket thresholds for each plan year. from $7,150 per person/$14,300 family aggregate, to
$5,000 single coverage/$10,000 family coverage.
1
Section 3. Plans 05182 and 05183 (High Deductible Plans) will be amended to lower the
maximum out-of:pocket thresholds from $6,650 per person/$13,300 family aggregate, to $4,000
single coverage/ 8,000 family.coverage. •
• Section .4. In:Plans 03559 and 03769 (Traditional Plans : the cost share (coinsurance) will be
amended, to lower the member:responsibility from 25% to 20% for in-network services, and from
0 to o for out-of-network services.
Section 5. • In: Plans 03559 and 03769 (Traditional .Plans), specialist office visit co-pay for
Physical :& Occupational Therapy,.Chiropractic Therapy, and Obstetric:Services will be reduced to
$30.00 per visit. :.
Section 6. The above changes .to,plan design for the Monroe health plan shall take
effect ect on January 1, 2025.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida, at a regular meeting held on the 11I day of July, 2024
• Mayor Holly Merrill Raschein .' Yes.
Mayor Pro Tern James K. Scholl Yes :. •
Commissioner Craig Cates Absent
Commissioner Michelle Lincoln Yes
Commissioner David Rice Yes.
•e✓a t`ti tp.^r� n�i y��. .. .. .. .. .. ..
f°`:,i;,,,,,•,./." , '',-...i..-.--.(§..:E.A7'1,,")) N„,L,•::&"1.,,,,,N .
•
1 ..:•. , i , c,. " ;',.>-..'rBOARD OF COUNTY COMMISSIONERS
;` Attest:fnKEVIN MADOK, CLERK: OF MONROE COUNTY,: FLORIDA
''',..]:-:,„:,,-;:,:c.,,,z,. '',.'..-:::-.,',1,-..,;:::',:',,,'' :
''`H.,-.,,..,_:-:;:,':::,.,.::,,,, ,,,--:-T(-::.',:.-,--'''
BY: ot*10 WVv\OY Y� , • #
A eputy Clerk oily.. rrill Raschein, Mayor.
s. )
',::::"F2 4= .
f!4
r )M'
Approved as to form and legal sufficiency:
Monroe CountyAttorneys Office ,
Date: 7-1-2024� . _.��: -. . ..-�
2