HomeMy WebLinkAboutDocumentation_Regular_Tab 12F_4/10/1997 •
RESOLUTION NO. 13 - 96/97
A RESOLUTION OF THE VILLAGE COUNCIL OF THE
VILLAGE OF TEQUESTA, PALM BEACH COUNTY,
FLORIDA, APPROVING THE FLORIDA MUNICIPAL
HEALTH TRUST AS THE DENTAL INSURANCE SERVICE
. UNDERWRITER FOR TEQUESTA EMPLOYEES DENTAL
INSURANCE PROGRAM AND AUTHORIZING THE
VILLAGE MANAGER TO DO ALL THINGS NECESSARY
TO EFFECTUATE THIS APPROVAL.
NOW, THEREFORE, BE IT RESOLVED BY THE VILLAGE COUNCIL OF THE
VILLAGE OF TEQUESTA, PALM BEACH COUNTY, FLORIDA, AS FOLLOWS:
Section 1 . The Florida Municipal Health Trust Fund is
hereby approved as the Tequesta employees dental insurance
benefit underwriter effective May 1, 1997 .
Section 2 . The Village Manager is authorized to do all
.things necessary to effectuate the terms of this approval,
including, but not limited to, the execution of an
applicable service agreement.
THE FOREGOING RESOLUTION WAS OFFERED by Councilmember
, who moved its adoption. The motion was
seconded by Councilmember , and upon being
put to a vote, the vote was as follows:
FOR ADOPTION AGAINST ADOPTION
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The Mayor thereupon declared the Resolution duly passed and
L. adopted this 10th day of April, A.D. , 1997 .
MAYOR OF TEQUESTA
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Elizabeth A. Schauer
ATTEST: •
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is Joann Manganiello
is Village Clerk
i, wp60\res\13-97
201 West Park Avenue Public Risk Services
Poet Office Box 1757 13,5 East Colonial Drive
Tallahassee, FL 32302-1757 Post Office Box 530065
Telephone (904) 222-9S84 Orlando, FL, 32R43-0065
Suncom 278-5131 � �IlJ4CAlE � Telephone (407)425-9142
FAX (904) 221-3806 Suncom 344-6767
0 Reply to •
= == - Reply to
•
March 20, 1997
•
Mr. Bill Kascavelis
village of Tequesta
357 Tequesta Drive
Tequesta, FL. 33469-0273
Re: RFP- Group Health Insurance
Dear Mr. Kascavelis:
•
We appreciate the opportunity to provide you with this proposal of insurance for employee benefits. Coverage
Mae been proposed through the Florida Municipal Insurance Trust, a non-profit, non-accessible, group pooled
program.
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The Trust provides medical, dental and short term disability benefi�,and a prescription drug card plan. Other
traditional insured coverages include life insurance through Maccabees Life Insurance Company and vision care
through Vision Service Plan.
Effective October 1, 1995,the Trust has contracted with Sun Health Plans of Florida and Dimension Health Inc.
to provide a statewide managed care network for its participants. This comprehensive network of doctors and
hospitals is available.in most regions.
All rates quoted are guaranteed for sixty (60) days from the date of the proposal. The rates include costs of
• administration.reinsurance and estimated claims costs. Monthly,quarterly and annual loss reports are provided
at no additional charge.
We welcome the opportunity to further discuss our proposal and should you have any questions,please contact
me at 1-800.445-6248.
Si rely,
pa)
Vim'
Sandy Osbo
Health Operations Manager •
SO/jr.
Enclosure
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Florida Municipal Self ` Florida Municipal Health Florida Municipal Pension Florida Municipal Insurance
Insurers Fund(Workers' Trust Fund Trust Fund Trust(Liability and
Compensation) I Property)
•
•
zUl west ran Avenue ruviic n a.Der-vices
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Pit Office Box 1757 • 135 East Colonial Drive
Tallahassee, FL 32302 1757 — Post Office Box 530065
Telephone (904) 222-9684 Orlando, FL 32853-0065
5yncom 278-5331 Telephone (407) 425 9142
FAX (904) 222-3806 ft FLQRIDA �Ct17PS Suncom 344-6767
=ate s=_
Reply to -- _ — --= 0 Reply to
PROPOSAL OF INSURANCE •
FOR
VILLAGE OF TEOUESTA
Effective Date' 05/01/97
Provided by
Florida Municipal Insurance Trust
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Administered by: •
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The Florida League of Cities,Inc.
PUBLIC RISK SERVICES
• P.O Box 530065
Orlando, FL 328534065.
• • 407-425-9142 or Toll Free 1-800-445-6248
March 20, 1997
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•
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Florida Municipal Self Florida Muncpal Health Florida Munudpal Pension f Florida Municipal liuurance
insurers Fund (Workers' Trust Fund Trust Fund Trust(Liability and
Cozrtpensation) Property)
STATEMENT OF OBJECTIVES
Florida Municipal Insurance Trust
The Florida League of Cities, In response to the interest expressed among its' members, has proposed a
program of self-insurance for employee health and accident coverage.
The concept of pooled self-insurance was endorsed by the League Board of Directors primarily because of the
increased control this program provides to local governments over their employee benefits plans. Our
experience with self-insurance pools for workers'compensation and general liability/auto liability has shown that
this method of providing coverage is less expensive and more effective than the traditional forms of risk
management.
The advantages of this type of program are that the employer can control costs through closer management
of losses. The advantages of pooling over Individually self-insuring relate to the problems of proper claims han-
dling, lack of funds to cover the catastrophic or shock losses either through retention or reinsurance, and the
• concentration of risk in a small geographic area.
The Fund is required to secure the services of a professional administrator which supplies the expertise
necessary to handle claims, reserves, and excess insurance. Their fee is part of the total operating costs or
overhead of the Fund. The Administrator and Trustees have carefully selected the service company end excess
insurance provider to significantly lower total administrative costs to the employer and employees. Any premium
surplus that is generated can be used to offset costs,of eddrtional benefits,or reduce costs of the existing plan.
The exact combination of these alternatives is determined by the Board of Trustees.
The minimum operating costs, the expertise of the Admirstrator and claims service company combined with
the flexibility and responsiveness of the program results in low cost effective health benefit coverages for
employees.
WHY FMIT?
WHY FLORIDA MUNICIPAL INSURANCE TRUST'?
The Florida Municipal Insurance Trust helps put you in control of your health program. Members of the Fund
are currently enjoying benefits seldom provided by other health Insurance carriers
• Monthly, quarterly and annual loss reports provide a management tool to evaluate
your claims experience.
• Participants nominate the Board of Trustees controlling the program.
• The Trust provides specific reinsurance for large losses.
• A program may be designed specifically for your needs.
• Florida League of Cities State League Representatives are assigned geographic
territories throughout the state and are available for representation and general
service Information.
• Administered by-ttie Florida League of Cities,Tallahassee/Oriando
• The Trust works along with PPO's to provide services on a discounted basis.
GROUP DENTAL
SCHEDULEOF BENEFITS
FLORIDA MUNICIPAL INSURANCE TRUST
GENERAL DENTAL CARE BENEFIT ORTHODONTIC CARE BENEFIT
Lifetime Maximum Benefit - Unlimited Lifetime Maximum Benefit - $1,000 per,
Individual.
Calendar Year Maximum Benefit-
$1,000 per individual
SUMMARY OF GENERAL CARE SERVICES SUMMARY OF ORTHODONTIC CARE
1. Examinations end recall services, check-ups and 1. Diagnostic procedures
cleaning of teeth 2.Appliances for tooth guidance and control of
2. Palliative treatment harmful habits
3. Endodontic treatment 3. Retention appliances
4. Space maintainer 4. Comprehensive treatment with fixed and
5. X-rays removable appliances for correction of
6. Oral surgery malocclusion in permanent, primary and
7. Periodontal treatment mixed dentition
8. Normal extraction of teeth 5. Orthodontic treatment must be completed
9. Silver and synthetic permanent fillings, crowns prior to attainment of age 19.
and jackets.
10. Fixed bridges consisting of crowns or jackets
11. Dentures and removable bridges
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DEDUCTIBLE LIFETIME DEDUCTIBLE
$50 per individual per calendar year. $50 per individual.
Maximum $100 per family.
COINSURANCE COINSURANCE
Plan pays 80% of first$1,250 of eligible Plan pays 50%of first $2.000 of eligible
expenses per calendar year. expenses per Individual In their lifetime.
DENTAL RATES(PER MONTH) STANDALONE- (Without Health) •
Employee Dental $17.00 Employee Dental $19.00
Dependent Dental $25.00 Dependent Dental $28.00
FamilyDental $42.00 Family Dental $47.00
Dental coverage written in the Florida Municipal Insurance Trust is subject to a 25% participation of those
employees quoted.
"' Thk summary was designed only to give you a brief description of benefits provided and does
not Include all of the provisions, limitations or exclusions In the policies. In an actual claim
situation,the policy provisions,limitations,exclusions will apply. If this outline disagrees with
the Plan Document In any way,the Plan Document will govern.
DENTAL BENEFIT PLAN SUMMARY
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Reasonable and customary limits will apply to all covered eligible expenses.
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GENERAL DENTAL CARE
Calendar Year Makmum $1,000
Deductible $50 calendar year ($100 family)
After the deductible has been met, unless otherwise stated, the following coinsurance will apply:
This plan will pay 100% preventative services, not subject to the calendar year deductible, as follows:
1- Oral examinations
3. Dental X-rays
3. Fluoride application (for dependents under age 15)
4. Prophylaxis •
This plan will pay 80% for basic dental services as follows:
1. Emergency treatment for pain
3. Space maintainers
3. Biopsies of oral tissue
4. Pulp vitality tests
6 Fillings
�. Extractions
7- Oral Surgery
1• Endodontics
11. Periodontics
This plan will pay 60% for dental restorations and specialty services as follows:
1. kdays,onlays •
I. Crowns
;. Bridges, dentures
•CHEDULEOF ORTHODONTIC BENEFIT(applies only to eligible dependents under age 19).
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gifetlme maximum (per person) $1,000
Lifetime deductible $50 per person
Covered eligible expenses are payable after the deductible at 50%. .
1. Diagnostic procedures.
_. App9ances for tooth guidance and control of harmful habits.
S. Retention Appliances.
4. Comprehensive treatment with fixed and removable appliances for correction of
malocclusion in permanent, primary and mixed dentition.
These summaries are designed only to give you a brief description of the benefits provided and does not Include all
Of the provisions,limitations or exclusions in the policies. In an actual claim situation.the policy provisions,limitations,
jxcluslons will apply. If this outline disagrees with the Plan Document In any way, the Plan Document will govern.
fWM ADMINISTRATOR:
•
Florida League of Cities,Inc.Claims Center (407) 245-0725 •
p.O. Box 025457 (800) 758-3042
Orlando, FL 32853-8135