Agenda 09/08/2015 Item #16E 39/8/2015 16.E.3.
'EXECUTIVE SUMMARY
Recommendation to approve the purchase of Group Life insurance, Accidental Death insurance,
Long Term Disability insurance and Short Term Disability Claims Administration Services from
Aetna in the estimated annual amount of $403,271, a savings of $194,567.
OBJECTIVE: To provide a competitive, best value Group Life and Disability insurance program as part
of the County's comprehensive group insurance package.
CONSIDERATIONS: The Board of Commissioners through the Risk Management Division administers a
Group Insurance Program for its eligible employees and participating constitutional officer employees. As
part of this program, the County provides two times salary life and accidental death insurance and a 40%
short and long term disability benefit. Employees can purchase additional short and long term disability
coverage up to a maximum benefit of 66 2/3% of salary (a 26 2/3% buy -up benefit). The short term
disability benefit is self funded. All other benefits are fully insured. Employees may also purchase
additional voluntary life and accidental death coverage on themselves and their dependents.
The current program is underwritten by Reliance Standard Life and expires on December 31, 2016. Willis,
Inc., the County's benefits brokerage and actuarial firm, marketed the program in anticipation of this
expiration. Willis received proposals from eight carriers including the incumbent, Reliance Standard Life.
After reviewing the terms and pricing of each proposal, the list was narrowed to three carriers for further
review. The carriers are Standard Life, Aetna and Reliance Standard Life. The price quotes are as follows:
Carrier
Total Annual
Price
Price Difference from
Lowest Proposal
Price Difference from the
Expiring Program
Standard
$384,529
NA
$213,309
Aetna
$403,271
$18,742
$194,567
Reliance Standard
(Incumbent)
$446,321
$61,792
$151,517
All three carriers offered price quotes that will save the Board substantial program dollars while matching
or exceeding existing benefit terms. However, to thoroughly assess claims capabilities, staff also
interviewed each of the firms. Although the Aetna proposal is $18,742 higher than the Standard proposal,
Willis and the Risk Management staff recommends Aetna due to the ability to procure value added services
not offered by Standard, but currently utilized under the expiring program. Staff believes these value added
services justify the recommendation. Aetna's value added services are as follows:
1) An electronic vs. paper claim notification process for Disability and Life claims which enhances
both efficiency and accuracy. Once the claim is received, electronic notifications are forwarded to
Risk and Human Resources staff to assure that financial and compliance requirements under the
FMLA (Family Medical Leave Act) are managed appropriately. Standard does not offer an
equivalent system, which will result in an erosion of service to the claimant and the employer.
2) A direct deposit feature which is important for persons on disability. This eliminates the need for
the claimant to make manual deposits at their bank. The other firms did not offer this feature.
3) A dedicated Short and Long Term claims examiner to address claims matters efficiently. The other
carriers offer a bank of examiners which is inherently inefficient and results in a reduction of
customer service for both the claimant and the employer.
Packet Page -1741-
9/8/2015 16.E.3.
Finally, Aetna will transition those currently on disability to their program without interruption.
An agreement for Short Term Disability claims administration has been reviewed by the County Attorney
and is attached for approval.
The program will commence effective January 1, 2016.
FISCAL IMPACT: The total estimated annual cost of the Group Life and Disability insurance program is
$403,271 based upon current reportable payroll. The estimated annual savings to the Board is $194,567 per
year or $583,701 over the three year rate guarantee period. There are sufficient funds available in Fund
517, Group Health and Life, for this purchase.
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this
item.
LEGAL CONSIDERATIONS: This item has been approved as to form and legality and requires majority
vote for approval. - CMG
RECOMMENDATION: It is recommended that the Board approves the purchase of Group Life
insurance, Long Term Disability insurance, Short Term Disability Administration Services, and Accidental
Death Insurance from Aetna as outlined in the executive summary and authorizes the Chairman to execute
the attached agreement.
PREPARED BY: Jeffrey A. Walker, CPCU, ARM, Division Director, Risk Management
Attachments:
Bid Tabulation
Short Term Disability Claims Administration Agreement
Packet Page -1742-
9/8/2015 16.E.3.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.E.16.E.3.
Item Summary: Recommendation to approve the purchase of Group Life insurance,
Accidental Death insurance, Long Term Disability insurance and Short Term Disability Claims
Administration Services from Aetna in the estimated annual amount of $403,271, a savings of
$194,567.
Meeting Date: 9/8/2015
Prepared By
Name: WalkerJeff
Title: Division Director - Risk Management, Administrative Services Department
7/28/2015 8:23:45 AM
Submitted by
Title: Division Director - Risk Management, Administrative Services Department
Name: WalkerJeff
7/28/2015 8:23:46 AM
Approved By
Name: GreeneColleen
Title: Assistant County Attorney, CAO General Services
Date: 8/13/2015 11:58:34 AM
Name: PriceLen
Title: Department Head - Administrative Svc, Administrative Services Department
Date: 8/24/2015 12:41:41 PM
Name: GreeneColleen
Title: Assistant County Attorney, CAO General Services
Date: 8/24/2015 1:38:23 PM
Name: IsacksonMark
Title: Division Director - Corp Fin & Mgmt Svc, Office of Management & Budget
Date: 8/24/2015 3:35:00 PM
Packet Page -1743-
Name: KlatzkowJeff
Title: County Attorney,
Date: 8/24/2015 4:23:52 PM
9/8/2015 16.E.3.
Name: CasalanguidaNick
Title: Deputy County Manager, County Managers Office
Date: 8/25/2015 4:08:21 PM
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0
9/8/2015 16.E.3.
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Page -1745-
0
Co
Collier County Government
9/8/2015
Disability Rate Summary
Proposed Disability Rates
Administrative Service Contract
Per Employee
Coverage Lives Per Month
Monthly Fees
Short Term Disability
ASC 2,011 $2.547
$5,121
We have assumed an annual incidence rate of 3.71 %.
Monthly Fees
$5,121
Annual Fees
$61,453
The above fees are subject to verification of lives as appropriate, if the actual amounts differ
by more than 10% from our assumed amounts then we reserve the right to reevaluate the
fees.
March 2015 amArm Page 1
Packet Page -1746-
16.E.3.
Collier County Government
Fully Insured Long Term Disability
9/8/2015 16.E.3.
Disability Rate Summary
Long Term Disability
Rate Per $100
Monthly of Monthly
Lives Covered Payroll Covered Payroll
Monthly
Premium
Core Only
953 4,147,062 $0.124
$5,138
Buy -Up
1,062 4,703,669 $0.396
$18,650
Monthly Total
2,015 8,850,731
$23,788
Annual Premium
$285,457
The above fees are subject to verification of lives as appropriate. if the actual amounts differ
by more than 10% from our assumed amounts then we reserve the right to reevaluate the
fees.
March 2015
Page 2
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9/8/2015 16.E.3.
Collier County Government Short Term Disability Administrative Services Plan
Administrative Services Contract
Short Term Disability Schedule of Benefits
Effective Date 01/01/2016
Contract Period 36 months
ASC Short Term Disability
Number of Eligible Employees
2,011
Eligibility
Class 1: All Active FT excluding those defined in Class 2
Class 2: County Attorney and Board Aide
Class 3: County Mgr
Eligibility Waiting Period
First of the month following Date of Hire
Minimum Hours Per Week
30 hours
Employee Contribution
100% for Buy -up
Employer FICA Match
Not included
Participation Requirement
None
March 2015
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Page 3
v
9/8/2015 16.E.3.
Collier County Government Short Term Disability Administrative Services Plan
ASC Short Term Disability Schedule
We will administer this plan in accordance with current plan specifications.
Injury - Day Benefits begin
8th day
Illness - Day Benefits begin
8th day
Maximum Benefit Period
26 weeks
Base rate of earnings exclusive of commissions, bonuses,
Definition of Covered Earnings
overtime or extra compensation.
Class 1: Core: 40% of earnings, Buy -up: 66 2/3% of earnings;
Benefit Percentage
Class 2: 50% of earnings
Class 3: 66 2/3% of earnings
Percentage Cap
N/A
Class 1: $2,000
Maximum Weekly Benefit
Class 2 & 3: $2,250
Minimum Benefit
None
Coverage Type
Non - Occupational
Inability to perform own occupation and have a 20% earnings
Definition of Disability
loss.
Partial Disability Benefit
included
First Day Hospitalization
Not Included
Integration Method
Not Applicable - LTD will still be affected by Offsets
Rehabilitation Provision
Voluntary
Separate Periods of Disability
Less than 15 consecutive days
Pre - existing Condition Exclusion
Not Included
Does not cover any disability that:
• Occupational disabilities
• Self- inflicted injuries
• Committing or attempting to commit a criminal act
Exclusions
• Act of war, driving while intoxicated
• Insurrection
• Rebellion
• Taking art in a riot or civil commotion
March 2015
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Page 4
D
9/8/2015 16. E.3.
Collier County Government Administrative Services
Administrative Services Contract
Basic Services
Self- Funded (ASC) Short Term
Core Services and Programs included in Administrative Fees
Eligibility Verification
Included
Clinical Model: Physician Review, Senior Nurse
Review, Behavioral Health Unit, Case Management
Included
Intake (3 point contact)
Included
Claim Determination
Included
Contract Issuance
Included
W2s (included if Aetna pays benefit)
included
Standard Reporting
Included
Standard Portal
included
Standard Correspondence
included
Independent Medical Examination
Included
Vocational Rehabilitation (fee for external services)
Included
Social Security Assistance (fee for external services
per event)
included
Physician Peer Review
included
Special Investigations Unit (fee for external
services)
Included
Subrogation
Not Included
Appeals
1 Level
Optional Services
Reverse File Feed
$10,000 per file
Eligibility File requiring customization
$150 per hour
Dedicated 800 number
$5,000 per line
Customization of Communication Letters
$150 per hour
Customization of Intake Script
$150 per hour
Customization of Reports
$150 per hour
{Fee Based is direct billed back to the customer at Aetna's cost.
[ *Aetna will not be fiduciary on non -ERISA plans
March 2015
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Page 5
Collier County Government
Long Term Disability Schedule of Benefits
9/8/2015 16.E.3.
Long Term Disability
Effective Date
01/01/2016
Contract Period
36 months
Commission Level
10% Commissions on Buy -up
Long Term Disability
Number of Eligible Employees
2,015
Total Covered Payroll
$8,850,731
Eligibility
Class 1: EEs excluding Exec Mgr to Board, County Mgr & County
Attorney;
Class 2: Exec Mgr to Board & County Attorney;
Class 3: County Mgr.
Eligibility Waiting Period
First of the month following Date of Hire
Minimum Hours Per Week
30 hours
Employee Contribution
100% Post -Tax for Buy -up
Employer FICA Match
included on Employer paid lines
Evidence of insurability
Included for Late Entrants on Buy -up
Participation Requirement
None
March 2015 �1�r
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Page 6
Collier County Government
Long Term Disability Schedule
9/8/2015 16. E.3.
Long Term Disability
For additional details, refer to the LTD Plan Provisions and Glossary sections.
Class 1: Core 40% of earnings; Buy -up 66 2/3% of earnings;
Monthly Benefit Percent
Class 2: 50% of earnings
Class 3: 66 2/3% of earnings
Class 1 & 2:$9,000;
Monthly Maximum Benefit
Class 3: $10,000
Monthly Minimum Benefit
$100
Elimination Period
180 days
Definition of Covered Earnings
Base rate of earnings exclusive of commissions, bonuses,
overtime or extra compensation.
Own Occupation Period
Class 1: 24 months;
Class 2 & 3: Own Occupation
Work Incentive Benefit
Included, 12 months
Partial Disability Benefit
Proportional Loss Formula (See LTD Plan Provisions)
Integration Method
Direct Employee Only
Zero Day Residual
Included
Maximum Benefit Period
ADEA 1 with SSNRA (See LTD Plan Provisions)
Rehabilitation Program
Mandatory
Rehabilitation Incentive Benefit
Included
Child Care Benefit
Included
Separate Periods of Disability
During the Elimination Period: less than 30 consecutive days.
After the Elimination Period: Less than 6 consecutive months.
Mental /Nervous Limitation
24 months of benefit payments per occurrence
Alcohol /Drug Umitation
24 months of benefit payments per occurrence
Survivor Benefit
3 months of gross benefit payable in a lump sum
Pre - existing Condition Exclusion
3/12
Cost of Living Adjustment
Not Included
Does not cover any disability that result from:
• Self- inflicted injuries
• Committing or attempting to commit a criminal act,
• Act of war,
Exclusions
• Driving while intoxicated
• Insurrection
• Rebellion
• Taking part in a riot or civil commotion
• Pre-existing conditions.
Conversion
Not included
Benefit Escalator
Not Included
Extended Disability Benefit
included
Accidental Personal Loss Indemnity
included
Benefit
March 2015
Packet Page -1752-
Page 7
Collier County Government
Disability Glossary
9/8/2015 16.E.3.
Disability Glossary
Contribution Percentage
The percentage of premium paid by the employee.
The requirement disabled employees must meet to be eligible to
Definition of Disability
receive benefits.
The amount of an employee's earnings used to calculate benefit
Definition of Earnings
payments.
The continuous period of time the employee must be working before
Eligibility Waiting Period
becoming eligible for disability coverage.
Eligible Class
The group(s) of employees who are eligible for coverage.
The period of time the employee must be disabled prior to receiving
Elimination Period
benefits.
Satisfactory evidence of good health that is submitted in certain
Evidence of Insurability
situations. Completion of Aetna's Evidence of Insurability statement is
required.
Exclusions
Those conditions for which benefits are not paid.
Employer FICA match program applies only to taxes paid on the
Employer FICA Match
Employer portion of benefits.
The United States of America, the Commonwealth of Puerto Rico,
Home Area
Guam, and the Virgin islands of the United States.
Maximum Benefit
The maximum disability benefit payable.
The maximum period of time benefits are payable after satisfaction of
Maximum Benefit Period
the elimination period.
Minimum Benefit
The minimum disability Benefit payable.
The minimum number of hours that employees regularly work each
Minimum Hours
week to be eligible for disability coverage.
The method used to offset employment earnings during a period of
Partial Disability Benefit
disability.
Physical, mental or vocational rehabilitation designed to maximize the
Rehabilitation
disabled employee's work capabilities.
Scheduled Benefit
The gross disability benefit payable.
The maximum amount of time a disabled employee can return to work
Separate Periods of
and have it considered the same period of disability. The periods of
Disability
disability must be due to the same or related condition.
The determination of whether disabilities occurring on or off the job
Types of Disabilities
are covered.
March 2015 > W w
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9
9/8/2015 16.E.3.
Collier County Government Long Term Disability Plan Provisions 't-1
LTD Plan Provisions
March 2015'
Packet Page -1754-
Page 9
Any day that an individual is unable to perform the material
duties of his /her own occupation; or while unable to perform the
material duties of his /her own occupation, is performing at least
one of the material duties of any occupation on a part-time or
full -time basis and has lost at least 20% of his /her indexed pre -
Own Occupation Test
disability earnings due to a disabling condition.
Please note: The loss of a professional or occupational license or
certification that is required by your own occupation does not
mean you meet the test of disability. You must meet the plan's
test of disability to be considered disabled.
Any day that an individual is unable to perform the material
duties of any occupation for which he /she is or may become
fitted, based on training, education or experience; or while
unable to perform the material duties of any reasonable
Any Occupation Test
occupation, is performing at least one of the material duties of
any occupation on a part-time or full -time basis and has lost at
least 20% of his /her indexed pre - disability earnings due to a
disabling condition.
During the disabled employee's active participation in an Aetna
Approved Rehabilitation Program, Aetna will pay an additional
Rehabilitation Incentive Benefit
10% net monthly benefit, but not more than $500 per month.
This incentive will be paid up to 6 consecutive months for each
period of disability.
An additional monthly benefit paid for child care expenses for a
Child Care Benefit
disabled employee participating in an approved rehabilitation
program of $250 per month per dependent child under age 13
with a maximum of $500 payable up to 24 months.
Benefit Escalator
Not Included
A benefit paid to an eligible survivor if the employee dies while
benefits are payable. The amount of the benefit is equal to the
gross monthly benefit multiplied by the number of months
Survivor Benefit
shown in the Schedule of Benefits. An eligible survivor is defined
as the spouse and /or unmarried dependent children under age
25.
March 2015'
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Collier County Government
9/8/2015 16.E.3.
Long Term Disability Plan Provisions
March 2015
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Page 10
Other income sources which are used to reduce the monthly
benefit. This includes but is not limited to:
• 50% of the Jones Act /Maritime Doctrine.
• Statutory disability, retirement, or unemployment benefits.
• Automobile no- fault; Social Security, Railroad Retirement,
Canada Pension Plan, Quebec Pension Plan.
other Income Benefits
. Other Disability benefits arranged for by the employer.
• Disability Payments resulting from membership in any
association, union, or other organization.
• Retirement and Pension benefits.
• 3rd Party Liability payments.
• Group Mortizage or Group Credit disability benefits.
If while monthly benefits are payable, an individual has
employment income from any occupation which is greater than
20% of indexed pre - disability earnings, the monthly net benefit
will be adjusted as follows:
Work incentive Benefit
During the first 12 months the employee has such employment
income, the monthly benefit will be reduced only to the extent
the amount of that employment income plus the gross monthly
benefit exceeds 100% of indexed pre-disability earnings.
After 12 months, the adjusted benefit will be determined as
Proportional Loss Formula
follows:
(A divided by B) x C where:
A = Indexed pre - disability earnings minus such employment
income.
B = Indexed pre - disability earnings.
C = The monthly net benefit.
This is your predisability earnings plus any increase made on
each January 1, starting on the January 1 following 12 months of
Adjusted Predisabliity Earnings
a period of disability. The increase on each such January 1 will be
(Indexing)
by the percentage increase in the Consumer Price Index, rounded
to the nearest tenth; but not by more than 10%.
March 2015
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Page 10
Collier County Government
9/8/2015 16.E.3.
Long Term Disability Plan Provisions
There is no period of time where you have to be 'totally disabled'
(including during the elimination period).
Residual test of disability: An insured is considered to be disabled
if:
• from the date that the insured becomes disabled until the
end of the own occ period: the insured is unable to perform
Day Residual the material duties of their own occupation solely because
dual Test of Disability) of disease or injury and the insured's work earnings are no
more than 80% of their adjusted predisability earnings.
after the end of the own occ period: the insured is unable to
work at any reasonable occupation (which includes that the
insured's work earnings be no more than 60% of their
adjusted predisability earnings) solely because of disease or
Integration Method
Direct
Social Security Type
The method used to offset other income benefits. Our quote
includes the following:
Under direct integration, offsets are subtracted from the
Scheduled Monthly Benefit
Other income benefit sources include those which are payable to
the employee's spouse, children and dependents.
A period of disability will end after the number of months listed
in the Schedule of Benefits are payable if it is determined that
the disability is primarily caused by:
• a Mental Health or Psychiatric condition, including physical
manifestations of these conditions, but excluding those
conditions with demonstrable, structural brain damage; or
• Alcohol and /or Drug Abuse.
There are two exceptions which apply if you are confined as an
Mental /Nervous Limitation
inpatient in a hospital or treatment facility for treatment of that
Alcohol /Drug Limitation
condition at the end of such period:
• If the inpatient confinement lasts less than 30 days, the
period of disability will cease when you are no longer
confined.
• if the inpatient confinement lasts 30 days or more, the
period of disability may continue until 90 days after the date
you have not be so continuously confined.
The Separate Periods of Disability section does not apply beyond
such period to periods of disability which are subject to the
above.
March 2015
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Collier County Government
9/8/2015 16.E.3.
Long Term Disability Plan Provisions
March 2015
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Page 12
These employees are not covered since they are not active
Employees on COBRA, lay -off,
employees and they also do not meet the minimum hours
leave of absence or severance
worked requirement.
No benefit is payable for any disability that is caused by or
contributed to by a "pre - existing condition" and starts before the
end of the first 12 months following your effective date of
coverage.
A disease or injury is a pre - existing condition if, during the 3
Pre - Existing Condition Exclusion
months before your effective date coverage:
• it was diagnosed or treated; or
• services were received for the diagnosis or treatment of the
disease or injury; or
• you took drugs or medicines prescribed or recommended by
a physician for that condition.
A reduced disability benefit may be payable for up to 60 months
beyond the maximum duration if disabled employee is confined
or receiving home health care and requires substantial assistance
Extended Disability Benefit
to perform 2 or more ADLs or substantial supervision due to
cognitive impairment. Benefit is reduced to 85% of the monthly
benefit after offsets applied, up to $5000 /month
Subject to the elimination period, a set number of benefit
Accidental Personal Loss
payments will be made if an employee suffers a covered
Indemnity Benefit
accidental personal loss according to the following schedule:
Personal Loss
Benefit Payments
Both hands; Both feet; Entire
sight of both eyes; Hearing in
both ears; Speech; One hand
& one foot; One hand and
46 Months
entire sight in one eye; One
foot and entire sight in one
eye
One arm; One leg
35 Months
One hand; One foot
23 Months
Entire sight in one eye; Entire
15 Months
hearing in one ear
Employees who enroll for any contributory LTD coverage more
Evidence of insurability
than 31 days later than the date they are first eligible must
provide medical evidence of insurability.
Cessation of employment, contract termination, ineligible class,
Termination of Coverage
failure to make contribution.
March 2015
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9/8/2015 16.E.3.
Collier County Government Long Term Disability Plan Provisions
Maximum Benefit Period
Benefits are payable while disabled according to the following schedule or until the 1983 amended
Social Security Normal Retirement Age, if later.
Age when disability occurs
Benefits period
61 or younger
continue to end of month age 65
62
42 months
63
36 months
64
30 months
65
24 months
66
21 months
67
18 months
68
15 months
69+
12 months
The 1983 Normal Retirement Age (NRA) amendment to the Social Security Act results in the
following schedule:
i Ctlf {Jf DOW L11
ivormai Ketirement Age (NKA)
1937 or earlier
65
1938
65 & 2 months
1939
65 & 4 months
1940
65 & 6 months
1941
65 & 8 months
1942
65 & 10 months
1943 -1954
66
1955
66 & 2 months
1956
66 & 4 months
1957
66 & 6 months
1958
66 & 8 months
1959
66 & 10 months
1960 and later
67
March 2015
Packet Page -1758-
Page 13
9/8/2015 16.E.3.
IN WITNESS WHEREOF, authorized representatives of the parties have confirmed the agreement of the
parties to the foregoing terms by affixing their signatures below:
By:
Name:
Title:
Date:
I�7
By:
Name: Eric Bunce
Title: Sales Executive
Date:
Packet Page -1759-
ATTEST
DWIGHT E. BROCK, Clerk
By:
Approved a to foam and kpiity
&16'
AWatant Cm" Attorney
Page 14
G