HomeMy WebLinkAboutR-2025-148 Supplemental Medicare Renewal FY 2025-2026; Exceed 50KRESOLUTION NO. 2025-148
A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF DANIA BEACH, FLORIDA, AUTHORIZING THE PROPER CITY OFFICIALS TO EXECUTE AND ACCEPT AN AGREEMENT WITH HUMANA FOR THE CITY’S MEDICARE ADVANTAGE INSURANCE COVERAGE, PROCURED
BY THE GEHRING GROUP AS BROKER OF RECORD, FOR INSURANCE COVERAGE BEGINNING JANUARY 1, 2026 THROUGH DECEMBER 31, 2026 FOR MEDICARE ELIGIBLE RETIRED EMPLOYEES AND THEIR ELIGIBLE DEPENDENTS THAT EXCEEDS AN ANNUAL VENDOR TOTAL AMOUNT OF FIFTY THOUSAND DOLLARS ($50,000.00); PROVIDING
FOR CONFLICTS; FURTHER, PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, the City of Dania Beach obtained the services of the Gehring Group as a
Broker of Record to secure coverage for the City’s Medicare Advantage Insurance plan for
Medicare eligible retired employees and their Medicare eligible dependents for the 2026 plan
year; and
WHEREAS, the Gehring Group secured Medicare Advantage PPO coverage for the City
through Humana for the plan year 2026; and
WHEREAS, the coverage from Humana offers rates for Medicare Advantage Insurance
coverage for all Medicare eligible retirees, regardless of residence, including prescription rates;
and
WHEREAS, based on current Medicare eligible retiree census data, the City’s Medicare
Advantage PPO plan premium cost will be increased by an estimated Two Point Seven (2.7%),
resulting in an estimated Six Thousand Fifty-Five dollar ($6,055.00) increase to the City and an
estimated Three Thousand Twenty-Eight dollar ($3,028.00) increase in total cost to eligible
retirees; and
WHEREAS, the total expenditures for fiscal year 2025-26 will exceed the annual Fifty
Thousand Dollars ($50,000.00) City purchase threshold for a single vendor and, therefore, City
Commission approval is required; and
WHEREAS, the City Administration recommends that the City Commission approve the
Humana Medicare Advantage PPO Medicare Advantage Insurance plan.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE
CITY OF DANIA BEACH, FLORIDA:
Section 1. That the above “Whereas” clauses are ratified and confirmed as being true
and correct, and they are made a part of and incorporated into this Resolution by this reference.
RESOLUTION #2025-148 2
Section 2. That the proper City officials are authorized to execute appropriate
documents to accept the renewal proposal of the Humana Medicare Advantage PPO plan on
behalf of the City of Dania Beach to provide Medicare Advantage Medical and Prescription
Insurance coverage to Medicare eligible retirees at the following not to exceed monthly rates:
2025 Renewal Total Premium 2026 Renewal Total Premium
$317.29 $325.99
2025 Retiree Monthly Premium 2026 Retiree Monthly Premium
$105.76 $108.66
2025 City Monthly Premium 2026 City Monthly Premium
$211.53 $217.33
Section 3. That funding for the cost of the City’s health claims program
administration for Medicare Advantage Insurance coverage is planned and shall be charged to
the City Health Insurance Fund, Professional Services Account, Account No. 001-18-00-519-45-
41.
Section 4. That all resolutions or parts of resolutions in conflict with this Resolution
are repealed to the extent of such conflict.
Section 5. That all resolutions or parts of resolutions in conflict with this Resolution
are repealed to the extent of such conflict.
Section 6. That this Resolution shall be effective immediately after passage.
PASSED AND ADOPTED on September 25, 2025.
Motion by Commissioner Ryan, second by Commissioner Lewellen.
FINAL VOTE ON ADOPTION: Unanimous X
Yes No
Commissioner Lori Lewellen ____ ____
Commissioner Luis Rimoli ____ ____
Commissioner Archibald J. Ryan IV ____ ____
Vice Mayor Marco Salvino ____ ____
Mayor Joyce L. Davis ____ ____
RESOLUTION #2025-148 3
ATTEST:
ELORA RIERA, MMC JOYCE L. DAVIS CITY CLERK MAYOR
APPROVED AS TO FORM AND CORRECTNESS: EVE A. BOUTSIS
CITY ATTORNEY
City of Dania Beach
Medicare Advantage for Retired Employees 65 and Over
Effective Date: January 1, 2026
CURRENT RENEWAL ALTERNATIVE #1 ALTERNATIVE #2
UnitedHealthcare UnitedHealthcare Humana Humana
Calendar Year Deductible In-Network / Out of Network In-Network / Out of Network In-Network / Out of Network In-Network / Out of Network
Single $500 $500 None None
Out of Pocket Maximum
Single $1,000 $1,000 $4,000 $2,500
Coinsurance 0%0%0%0%
Office Visits
Primary Care Visit $20 after CYD $20 after CYD $10 Copayment $5 Copayment
Specialist Visit $40 after CYD $40 after CYD $20 Copayment $15 Copayment
Therapy - PT/ST/OT $40 after CYD $40 after CYD $20 Copayment $15 Copayment
Hospital
Inpatient $0 after CYD $0 after CYD $150 Copayment $175 Copayment
Outpatient $100 after CYD $100 after CYD $50 Copayment $50 Copayment
Emergency Room Visit $0 Copayment $0 Copayment $65 Copayment $65 Copayment
Physician Services in Hospital $0 after CYD $0 after CYD $0 Copayment $0 Copayment
Skilled Nursing Facility $0 after CYD (Days 1-100)$0 after CYD (Days 1-100)$0 (Days 1-20); $75 (Days 21-100)$0 (Days 1-20); $50 (Days 21-100)
Rx Deductible: $500
$2,000 Rx OOP Max
Rx Deductible: $500
$2,100 Rx OOP Max
Rx Deductible: $0
$2,100 Rx OOP Max
Rx Deductible: $0
$2,100 Rx OOP Max
Tier 1: Preferred Generic $5 $5 $5 $5
Tier 2: Preferred Brand $30 $30 $30 $30
Tier 3: Non-Preferred Drug $60 $60 $60 $60
Tier 4: Specialty $60 $60 33%33%
Mail Order (90-Day Supply)$10/$60/$120/$120 $10/$60/$120/$120 $0/$60/$120/33%-30 Day Supply $0/$60/$120/33%-30 Day Supply
Medical and Prescription Rate All Retiree Rates 100% Composite*All Retiree Rates 100% Composite*All Retiree Rates 100% Composite*All Retiree Rates 100% Composite*
Monthly Premium Per Enrollee 87 $317.29 $440.78 $310.93 $325.99
Monthly Premium $27,604 $38,348 $27,051 $28,361
Annual Premium $331,251 $460,174 $324,611 $340,334
$ Increase N/A $128,924 -$6,640 $9,083
% Increase N/A 38.9%-2.0%2.7%
Premium Cost Sharing
Annual City Cost Share - Total $220,834 $306,783 $216,407 $226,889
Annual Retiree Cost Share - Total $110,417 $153,391 $108,204 $113,445
Monthly Retiree Cost Share - Per Retiree $105.76 $146.93 $103.64 $108.66
Prescription Drugs -
Initial Coverage Limit & Coverage Gap
1