Agenda 12/10/2013 Item #16E 3 12/10/2013 16.E.3.
EXECUTIVE SUMMARY
Recommendation to approve the Collier County Government Employee Benefit Plan
Document, Flexible Benefits Plan Document and Health Reimbursement Arrangement
Document effective January 1, 2014.
OBJECTIVE: To receive approval of the Group Health, Flexible Benefits and Health Reimbursement
Account Plan Documents for the purpose of administering these programs effective January 1, 2014.
CONSIDERATIONS: The Board of Commissioners provides group health insurance, a flexible
reimbursement program and a health reimbursement account program to its employees and
participating agencies through a partially self-insured group benefits program. Federal and state law
requires that the Board adopt Master Plan Documents (the Policy or Plan Documents) to govern
covered benefits and exclusions provided by these Plans. The County's third party claims
administrator, Allegiance, Inc., utilizes the Plan Documents to adjudicate claims. The Plan's
reinsurance carriers use the Plan Documents to determine reinsurance pricing and reimbursement
eligibility. The County's actuarial and benefit consulting firm utilizes the Documents to determine Plan
rates and to comply with Florida Department of Insurance rate filings pursuant to Florida Statutes
Chapter 112.08. Finally, the Risk Management staff utilizes the Plan Documents to administer the
overall program.
The current Plan Documents were approved by the Board effective January 1, 2012. The proposed
Plan Documents will take effect January 1, 2014. The significant changes to the Plan Documents are
as follows:
1. The Group Health Plan Document recognizes Envision, Inc. as the Pharmacy Benefit
Management Company effective January 1, 2014.
2. The Group Health Plan Document incorporates the administrative rule provisions of the Patient
Protection and Affordable Care Act (PPACA) signed into law on March 23, 2010 as well as other
state and federal laws applicable to the Plan.
3. The Group Health Plan Document incorporates a requirement by PPACA that co-payments,
deductibles and other out of pocket expenses, with the exception of pharmacy out of pocket
expenses, be included in the maximum out of pocket limit. Currently, co-payments do not apply
toward the maximum out of pocket limit. Therefore, the maximum out of pocket limit has been
increased accordingly to remain expense neutral to the Plan as recommended by the County's
actuary, Willis, Inc.
4. The Group Health Plan Document reflects Plan wording which meets best practices as
recommended by Allegiance, Inc., the County's third party claims administrator.
5. The Flexible Benefit Plan Document incorporates the provisions of PPACA including the limiting
of account maximums to $2,500.
The Plan Documents were prepared by the staff attorneys at Allegiance, Inc., the county's third party
administrator in conjunction with risk management staff. The Documents have also been reviewed for
legality by the County Attorney's Office.
The Plan Documents are attached as part of the agenda item. Once approved by the Board, each
employee will be provided a copy of both a Summary Plan Description and Plan Documents as
required by PPACA and as recommended by Allegiance, Inc.
Packet Page-1870-
12/10/2013 16.E.3.
FISCAL IMPACT: There is no fiscal impact associated with the approval of the Plan Documents. The
Fund 517, Group Health and Life Insurance budget for FY 14 has been approved by the Board and the
adoption of these Plan Documents does not change the adopted budget.
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with the
approval of these Documents.
LEGAL CONSIDERATIONS: This item is approved as to form and legality, and requires majority vote
for Board approval.—SRT
RECOMMENDATION: It is recommended that the Board approves the Collier County Government
Employee Benefit Plan Document, Flexible Benefits Plan Document and Health Reimbursement
Arrangement Document effective January 1, 2014.
PREPARED BY: Jeff Walker, CPCU, ARM, Director Risk Management
Attachments:
http://www.collierciov.net/ftp/AciendaDecl 013/Risk/PlanDocumentEmploveeBenefitPlanCAOStamped.pdf
http://www.colliergov.net/ftp/AciendaDecl 013/Risk/Plan DocumentFlexibleBenefitsPlanCAOStam ped.pdf
http://www.colliergov.net/ftp/AgendaDec1013/Risk/PlanDocumentHealthReimbursementArrangementCAOStampe
d.pdf
•
Packet Page-1871-
12/10/2013 16.E.3.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.E.16.E.3.
Item Summary: Recommendation to approve the Collier County Government Employee
Benefit Plan Document, Flexible Benefits Plan Document and Health Reimbursement
Arrangement Document effective January 1, 2014.
Meeting Date: 12/10/2013
Prepared By
Name: WalkerJeff
Title: Director-Risk Management,Risk Management
11/7/2013 4:02:17 PM
Submitted by
Title:Director-Risk Management,Risk Management
Name: WalkerJeff
11/7/2013 4:02:18 PM
Approved By
Name: pochopinpat
Title:Administrative Assistant.Facilities Management
Date: 11/14/2013 4:53:46 PM
Name: PriceLen
Title: Administrator, Administrative Services
Date: 11/15/2013 12:51:02 PM
Name: TeachScott
Title:Deputy County Attorney,County Attorney
Date: 11/19/2013 6:42:45 PM
Name: KlatzkowJeff
Title: County Attorney
Date: 11/20/2013 9:26:09 AM
Packet Page -1872-
12/10/2013 16.E.3.
Name: PryorCheryl
Title: Management/Budget Analyst, Senior,Office of Manag
Date: 11/22/2013 10:27:43 AM
Name: OchsLeo
Title: County Manager
Date: 11/25/2013 1:28:04 PM
Agiatok
Packet Page -1873-