HomeMy WebLinkAboutR-83-0610J-83-615
RESOLUTION NO. 83-6101
A RESOLUTION AUTHORIZING THE CITY MANAGER
TO ENTER INTO A PROFESSIONAL SERVICES
AGREEMENT WITH THE FIRM OF JOHNSON AND HIGGINS
OF FLORIDA, INC. FOR THE PERFORMANCE OF A -
BENEFITS CLAIM AUDIT FOR THE GROUP HEALTH
BENEFITS PORTIO14 OF THE SELF-INSURANCE PROGRAM;
ALLOCATING A SUM NOT TO EXCEED $12,000.00
FROM THE 1983 SELF-INSURANCE BUDGET TO COVER
THE COST OF SAID AUDIT.
WHEREAS, the Cit�,'s Self -Insurance and Insurance Committee
recommends that the City Manager be authorized to enter into a
professional services agreement with the firm of Johnson and
Higgins of Florida, Inc.; and
WHEREAS, sound and reasonable management practice for the
operation of a self -insured benefit plan requires the City to
conduct a benefits claim audit for its self -insured health
benefits program; and
WHEREAS, the firm of Johnson and Higgins of Florida, Inc.
is experienced in conducting such audits and is familiar with
the City's group health benefits plan;
NOW, THEREFORE, BE IT RESOLVED BY THE COMMISSION OF THE
CITY OF MIAMI, FLORIDA:
Section 1. The City Manager is authorized to execute a
professional services agreement with Johnson and Higgins of
Florida, Inc. for the conduct of a benefit claims audit for the
group benefits portion of the Self -Insurance Fund.
Section 2. An amount not to exceed $12,000.00 is hereby
allocated from the 1983 Self -Insurance Fund budget to cover the
cost of said audit.
CITY COMMISSION
MEETIIlG OF
JUL 18 1983
RCSOLUIi0(v 14J.-610
REMARKS
PASSED AND ADOPTED THIS Uth_ _DAY OF Jul.y _____, 1983.
Maurice A. Ferre
M A Y 0 R
A T T E S T:
Ci y Clerk
PREPARED AND APPROVED BY:
Assistant City Attorney
APPROVED AS TO FORM AND CORRECTNESS:
City Attorney
83-610t
e t
CITY OF-MMOL FLORIDA
122 1,`", . ER-OFFICE�M,"ORANDUM
To. Howard V. Gary
City Manager
FROM Carlos E. Garcia
Director of. Fina
DATE: June 30, 1983 RILE:
SUBJECT Agenda Item for Approval
REFERENCES:
ENCLOSURES:
L
B11) r P
The City Self -Insurance and Insurance `
Committee recommends that the City Manager
be authorized to enter into a Professional
Services Agreement with the firm of Johnson
and Higgins of Florida, Inc. for the performance
of a benefits claim audit for the Group Health
Benefits portion of the City's Self -Insurance
and Insurance Program, and allocating a sum
not to exceed $12,000.00 from the 1983 Self -
Insurance Fund budget to cover the cost of
said audit.
The City's Self -Insurance and Insurance Fund now expends in
excess of $7,500,000 annually in providing health care benefits
for both active and retired City employees.
Since the inception of the health care portion of the Self -
Insurance and Insurance Fund in 1978, claims for the program have
been administered by The Equitable Life Assurance Society of the
United States.
As Administrators, The Equitable is responsible for the timely
processing of claims, the determination of eligibility of claims,
the enforcement of plan provisions, the review and enforcement of
reasonable charge guidelines, and the active pursuit of coordination
of benefits provisions.
Sound and reasonable management practices require that the performance
of any Claims Administrator for such a program be periodically audited.
Johnson and Higgins of Florida, Inc. is experienced in benefits con-
sulting and has performed as a benefit consultant to the City on
several occasions. The firm is familiar with the City's group
benefits plan.
The consultant will be expected to perform the audit in two parts.
The first part will consist of reviewing with the City plan require-
ments and establishing audit criteria. The second part will consist
of reviewing the actual claim files with the Administrator, and
comparing the performance of the Administrator with the previously
83-61G
Page Two Howard V. Gary June 30, 1983
established audit criteria.
A written analysis of the audit findings will be provided to the
City at conclusion of the audit.
CEG/DCD/ci
83--810,