Item 4EITEM 4E
CITY OF
SOUTHLAK
MEMORANDUM
July 26, 2016
TO: Shana Yelverton, City Manager
FROM: Stacey Black, Director of Human Resources
SUBJECT: Approve a contract renewal with United Healthcare to provide employee
dental benefits for Plan Year October 1, 2016 through September 30,
2017.
Action
Requested: Approve a contract renewal with United Healthcare to provide
employee dental benefits for Plan Year October 1, 2016 to September
30, 2017.
Background
Information: The City's current dental insurance carrier is United Healthcare.
United Healthcare (UHC) has been the City's dental carrier since
October 1, 2010. Employees are offered two plan options: a traditional
Dental PPO (DPPO) plan and a Dental HMO (DHMO) plan. The City
currently pays the entire premium for employee only dental coverage
and the employee pays the entire dependent cost.
The City is currently in the second year of a two year rate guarantee.
As such, there is no rate increase and no plan design changes for Plan
Year October 1, 2016 through September 30, 2016.
Financial
Considerations: The estimated cost of dental insurance premiums is $18,320 per
month, or $219,843 annually (combined City and employee premium
contributions). The City's annual estimated cost is $127,724. There is
no annual estimated increase in the City's portion of dental insurance
premiums for FY 2017.
The proposed dental insurance plan costs will be included in the
proposed budget for Fiscal Year 2017.
Strategic Link: Performance Management and Service Delivery: attract, develop and
retain a skilled workforce.
Citizen Input/
Board Review: N/A
Legal Review: N/A
Shana Yelverton, City Manager ITEM 4E
July 26, 2016
Page 2
Alternatives: Deny the contract renewal with United Healthcare and seek alternative
options.
Supporting
Documents: The following supporting documents are attached:
• United Healthcare Dental Renewal
Staff
Recommendation: Approve a contract renewal with United Healthcare to provide
employee dental benefits for Plan Year October 1, 2016 through
September 30, 2017.
A Renewal for
CITY OF SOUTHLAKE
Issued on: June 5, 2015
() UnitedHealthcarer
Dental Services
Radiographs
Lab and Other Diagnostic Tests
Fluoride Treatment
Sealants
Space Maintainers
Restorations (Amalgams or Composite)'
Emergency Treatment/General Services
Simple Extractions
Periodontics
Endodontics
Inlays/Onlays/Crowns
Dentures and Removable Prosthetics
Fixed Partial Dentures (Bridges)
Orthodontic
Orthodontia
Orthodontia Eligibility
Deductible
Deductible applies to Prev. & Diag.
Annual Max
Lifetime Ortho Max
Waiting Period applies
Out of Network Basis
PPO Network
CMM—Annual Roll -Over
Assumed Enrollment and Rates
Employee
Employee + Spouse
Employee + Child(ren)
Employee + Family
lVIQG1 W A Uair
Renewal Action
Employer Contribution
Participation Requirements
Dependent Children Coverage
Contract Basis
Benefit Period Basis
Exclusions and Limitations
Broker Commissions
Rate Guarantee
CITY OF SOUTHLAKE Dental Renewal
Effective Date: October 1, 2015
Passive PPO
P6821
CS1
In Network Out of Network
100% 100
100% 100%
100% 100%
100%1 00 %
100% 100%
100% 100%
80% 80%
80% 80% +I
80% 80%
0.0%
Contributory
75% of Eligible Employees
To Age 26
Fully Insured
Calendar Year
Standard
Standard Graded
12 Months
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
MMMMM
50%
50%
Adult Child
$50/$150
$50/$150
No
No
$1,500
$1,500
$1,500
$1,500
No
No
UCR 85th
Options PPO 30
Yes
144
Current
Renewal
$39.39
$39.39
22
$78.78
$78.78
46
$87.65
$87.65
44
$133.46
$133.46
256
0.0%
Contributory
75% of Eligible Employees
To Age 26
Fully Insured
Calendar Year
Standard
Standard Graded
12 Months
Dental Services
Radiographs
Lab and Other
Fluoride Treatment
Sealants
Space Maintainers
Tests
Restorations (Amalgams or Composite)'
Emergency Treatment/General Services
Simple Extractions
Oral Surgery (incl. surgical extractions)
Periodontics
Endodontics
Dentures and Removable Prosthetics
Fixed Partial Dentures (Bridges)
Orthodontia Eligibility
Deductible applies to Prev. & Diag
Waiting Period applies
Out of Network Basis
CMM—Annual Rall -Over
Employee
Employee + Spouse
Employee + Child(ren)
Employee + Family
Monthly Premium
Annual Premium
Employer Contribution
Participation Requirements
Dependent Children Coverage
Contract Basis
Exclusions and Limitations
Broker Commissions
Rate Guarantee
DMO
D097N
In Network
Out of Network
CITY OF SOUTHLAKE Dental Renewal
Effective Date: October 1, 2015
See Copay Schedule
See Copay Schedule
See Copay Schedule
See Copay Schedule
No
12
Current Renewal
$13.33
$13.33
6
$24.91
$24.91
8
$22.65
$22.65
16
$32.51
$32.51
42
$1,010.78 $1,010.78
$12,129.36 $12,129.36
0.0%
Contributory
75% of Eligible Employees
To Age 26
Fully Insured
Standard
Standard Graded
12 Months
CITY OF SOUTH LAKElAssumptions
- We reserve the right to change rates and/or plan provisions if the number of lives or volume of insurance
change by more than 10% before, on, or after the effective date listed above or if factors used to generate this
quote such as group demographics or effective date are changed, found to be incomplete or incorrect.
Rates assume no changes in legislation or regulation that affects the benefits payable, eligibility or contract.
Rates assume standard administrative services including Claims & Data processing, Enrollment & Billing,
Customer Service, Case Management, Provider Relations, and Reporting.
Assumed contract situs is Texas.
Employees must be U.S. citizens or residents regularly working and living in the U.S. Coverage for U.S.
citizens working outside of the U.S. must be approved in writing by us. Approval depends on locale and length
of assignment.
Employer's assumed primary business is classified as 9111.
Rates may increase on renewal in accordance with the terms of the policy.
The Dental and/or Vision premium includes expenses related to state & federal taxes, fees, and assessments
It may also include additional new taxes, fees and assessments from the Affordable Care Act.
Rates listed above assume the plan designs quoted. Rates may change, if plan design changes.
Our contract covers only those procedures performed in the United States.
One or more of these plan design offerings include the MaxMultiplier benefit.
Some of the unused portion of your annual maximum may be available in future periods.
Please contact your sales representative for more details on the network quoted in your proposal.
The In- and Out -of -Network Plan Deductibles, Maximums and Lifetime Ortho Maximums are combined.
Participation in qualifying dental and vision plans must be 75 percent or greater of eligible medical employees
for Packaged Savings to be activated.
Please contact your sales representative to confirm specific plan Restorations (Amalgams or Composite)
coverage.
Please note that the summary of benefits in this document provides a brief description of coverage. State
mandates may preclude certain benefit plan design features. This is not a policy, certificate of insurance or
coverage document. For complete details on coverage, exclusions, limitations and the terms under which
coverage may continue, please contact your sales representative.
CITY OF SOUTHLAKE
This proposal is valid for 90 days from the issued date, unless otherwise noted within this document.
Brokers and agents may receive commissions, bonuses and other compensation for selling the products presented in this
proposal. The cost of this compensation may be directly or indirectly reflected in the premium or fees for those products.
Contact your broker and/or agent if you have questions regarding their compensation relating to products in this proposal.
This proposal is subject to negotiation and execution of a written agreement, which will supersede the proposal contents.
This proposal does not constitute an agreement, and is based on assumptions made from the written information in our
possession and provided by you. We retain the right to modify our proposal if the information upon which this proposal is
based is changed or is supplemented.
We consider much of the information contained in the proposal to be proprietary or otherwise confidential, and are
releasing this proposal to you on the understanding that you and your representatives will only use it, and any data included
in the proposal, for the specific purpose of evaluating its content. If this is not consistent with your understanding, please
notify us before reviewing the proposal.
In addition, by accepting and reviewing the contents of this proposal, you and your agents or other designees agree, to the
extent permitted by law, that certain information contained herein, or other information provided to you in connection with
this proposal response or associated request for proposal (RFP), is proprietary and/or confidential to United Healthcare and
its related entities, and may not be copied, used, distributed or disclosed without prior written consent from an authorized
representative of UnitedHealthcare, other than is necessary to evaluate this proposal.