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Item C06 C6 BOARD OF COUNTY COMMISSIONERS COUNTY of MONROE i Mayor Holly Merrill Raschein,District 5 The Florida Keys Mayor Pro Tern James K.Scholl,District 3 Craig Cates,District 1 Michelle Lincoln,District 2 David Rice,District 4 Board of County Commissioners Meeting October 16, 2024 Agenda Item Number: C6 2023-2873 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 annual 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 annual 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. Any future changes to funding amounts or program design will be accomplished by subsequent resolution. 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 renewal agreement and again on January 1, 2024; for the remainder of the agreement, a $75,000 wellness contribution will be made January 1, 2025; January 1, 2026, January 2027, January 2028. The County has implemented Wellness programs from 2011-2024 using these funds from Florida Blue to encourage health plan enrollees to participate in wellness programs and educational opportunities. 412 The annual program includes: 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 $ 50.00 per month($600 per year)premium discount. Participating employees on the High Deductible Health Plan with Health Savings Account (HDHP/HSA)will receive $600 deposited into their Health Savings Account. 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 (Annually,November 1 —October 31) 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 (annually, on or between the dates of November 1 st of one year and through October 31 st of the following year) and complete the on-line personal health assessment by the provided open platform dates. 413 *Will receive 4 hours of personal time off. *Participating employers. 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. Florida Blue reports that the County has spent approximately $ 5, 197,759.41 in claims on Wellness screenings over a 10-year period(October 2014 September 2024). For the same period Florida Blue estimates that the initiatives of the Wellness Program are approaching a savings to the plan of over almost 17 million dollars (as cost avoidance). Based on this estimate, every $1.00 spent on Wellness Preventative Screenings saves $6.00 as avoided claims cost. 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 FY2024 program has an ending balance of$362,325.24. The program is scheduled to receive $75,000 from Florida Blue in the first quarter of Calendar Year 2025,per agreement. Total Calendar Year 2025 beginning balance is forecast to be: $426,173.72 Summary: Total expenses for the annual program are currently planned at approximately $49,000.00. (excluding reduction in employee premiums). In future years, expenses will be planned to not exceed the $75,000 annual contribution the county receives from Florida Blue for Wellness. PREVIOUS RELEVANT BOCC ACTION: 414 Resolution 294-2023 - 2024 Wellness Program and Funding 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 INSURANCE REQUIRED: No CONTRACT/AGREEMENT CHANGES: STAFF RECOMMENDATION: Approval DOCUMENTATION: Resolution 294-2023.Wellness Program and Funding.pdf 2025-WELLNESS-PHYSICIAN FORN1.pdf Annual—Wellness—Resolution -2024.FINAL.pdf FINANCIAL IMPACT: Total cost to County: $ 240,000 (estimated) CC_08005 - Wellness Program Rewards Reduction in employee contributions from estimated 400 employees at $ 600 annually 415 RESOLUTION NO. 294 -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. Page 1 of 6 416 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. Page 2 of 6 417 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. Page 3 of 6 418 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 Page 4 of 6 419 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: Page 5 of 6 420 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 18th day of October 2023. Mayor, Craig Cates Yes Mayor Pro Tem,Holly Merrill Raschein Yes i,, �''`" Commissioner Michelle Lincoln Yes ' Commissioner James Scholl Yes ' -- �a 3 a Commissioner David Rice Yes A P p 3 BOARD OF CO Y COMMISSIONERS °o 10% ADOK,Clerk OF MONROE NTY,FLO IDA By: iAAn A00n X By: As Deputy Cler k Approved as to form and legal sufficiency: Monroe County Attorney's Office 10-2-2023 ZZ- r- p M 1-3 .11 —a -n c v c r n Page 6 of 6 p cam. 421 County of Monroe 07 FIT The Florida Keys Z 11/p� Employee Health Preventive Care-Assessment Acknowledgment Form Passport to Wellness Year 2025 Services provided between: 11/1/2024 through 10/31/2025 Discount Period: 1/1/2026—12/31/2026 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 2/21/18 422 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 2/21/18 423 RESOLUTION NO. -2024 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA APPROVING AND ESTABLISHING THE ANNUAL WELLNESS PROGRAM; REPEALING PRIOR RESOLUTION NO.294-2023 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 $ 426,173.72 ("Wellness Fund")for 2024; and WHEREAS, the County has received the results from the personal health assessments completed by the fall 2015 through 2023 (including virtual events and excluding events cancelled due to COVID and hurricanes)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 2025,and annually through 2028 for the remainder of the current agreement with Florida Blue,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. Page 1 of 6 424 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, of each year. Virtual events do not qualify (only Monroe County In-Person participation). 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 each calendar year, 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. Page 2 of 6 425 Annually, the event will feature an in-person Health& Wellness Fair in August 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, and other relevant vendors. 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 ($20,000),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 6 426 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 in Year 2 (second calendar year following approval of this resolution), 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 $50.00 per month ($600 per year) premium discount annually in the calendar year following submittal of a completed wellness form (due October 31 of each year). Participating employees on the High Deductible Health Plan with Health Savings Account(HDHP/HSA)will receive $600 deposited into their Health Savings Account in the calendar year following submittal of a completed wellness form (due October 31 of each year). 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. 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 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 Page 4 of 6 427 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 Wellness Funds among categories: 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. Page 5 of 6 428 2. Resolution No.294-2023 is inconsistent with this resolution and is repealed on October 31, 2024. 3. This resolution shall take effect on November 1, 2024, and becomes the annual program for the remainder of the current agreement with Florida Blue through 2028, or as amended by subsequent resolution. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting held on the 1 lth day of September, 2024. Mayor Holly Merrill Raschein Mayor Pro Tem James K.Scholl Commissioner Craig Cates Commissioner Michelle Lincoln Commissioner David Rice (SEAL) BOARD OF COUNTY COMMISSIONERS Attest: 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 Date: Page 6 of 6 429