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HomeMy WebLinkAboutM-82-0473a D. MARSHALL BARRY. PH.D. 4302 ROSIN LAND TAMPA. FLORIDA 33600 1di31 s7a•2ss2 It( % OMIC CONSULTANTS IN LABOR AND I^NCB !!'' All UNTIMELY CONTRIBUTIONS TO THE TRUST Prudent & Reasonable Timing of Deposits CITY CONTRIBUTIONS ACTUAL TIME OF DEPOSITS TO TRUST LAWRENCE E. JESSUP. JR. 320 N W. 147TH STREET MIAMI, FLORIDA 33163 130SI 681•3454 FY 78/79 Beginning of each month The entire year's contribution was made on 9/17/79 FY 79/80 October 79 11/01/79 November 11/20/79 December 12/27/7 9 January 60 1/21/80 February 2/14/80 March 3/19/80 April 5/07/80 May 6/18/80 June 7/25/80 July 7/25/80 August 9/04/80 September 10/10/80 FY 80/81 October 12/22/80 November 12/22/80 December 12/22/80 January Sl 1/15/81 February 2/25/81 March 4/09/81 April 4/09/81 May 5/06/81 June 6/11/81 July 8/05/81 August 9/22/81 September 9/18/81 FY 81/82 October 1/14/82 November 1/14/82 January 82 1/14/82 February 4/06/82 March 4/06/82 April 4/23/82 82-4'7? - At tat 1V �v 3u 3� LIU bU %Li %D •� A 5 r +! 8 9 to r I i ��SPI�.w� , 4'�' (�� ..,a.- SPi�•Lc_ TR,.aT w li t wgw•L `�+r� Hltll t•yG SC.r.�,� �aa•,La`'.. ,.y vYl.l. r►:. pd F.N1.5.4 5� ..0 _._�(1M'%r 4�, AGdN Cy tNiS v��yira 1�' Se l- apt t.�,►]e '1Iy�Z1L „ .L,t.SA „2'�`t.1'4'l0, S1.L42. `►. 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' 15.1vI;4 , }; �4.9a1S+a. � ,;A.,�, �, J�� ��L.�S:� {,-. _ a_, ._i - �' LL�p7��. . _- .-� --' ! - ,�• I tt•V i►� 1� � , iI � _ ! � i t g...,�,• _ a1aL I�p, S421i: gl�1] i 313'!4 to`I ,1.StrJ.3.S>,. ,.fit►31'1q 31e>rS9 ! i I S.i7 t,3y>�. +.. . I I�LY1►37.Lo, I , 6. 3 t+ L .. 7 H __,..l�._�. 3� -.» ___-�-- - - -,�- - � _—_._._-.�--- --------�-•T-�--.2 i i. S. la • 1 '� 1 i 'L S i ' V I 21 S 3 1 y 3'l ti + 0 0 L 1 ; :' t r - z� �IS'��'.33 y4_ Sol'loyYe _�� c.cY� -g �_f_.i_ � 1.yy_2�---- �--S-9fr�,to _ 3�+r�P l� 3Zyt9 9. �. I ; 1 Tc,iw� Io1,1SoJY9 3,u3t��l. IoY9`Io.L'17, LL41911L9 tO;�JOyIJ 119SZY13. 3,1o�S9Yy L��yYf�; I !. 3t`+79 j• .. ,. , ,, , I I , I f I ;,, � , ' t r it tr' Sti �cREi i PltccR.ua �. . trJ `%. 19 trr. 14 (.3 9t 99 G•11 t t j �; 14� Ya sn 1 ! I 1 I - •• -. " Ir t � i see- V*Q1F 4 (� 9 1 j r � i t L, OMIC CONSULTANTS IN LABOR ANb N NCE D. MARSHALL BARRY, I+H.D. LAWRENCE E. JESSUP. in. 4302 ROGIN LANE 320 N.W. 147TH STREET TAMPA. FLORIDA 33600 MIAM1, FLORIDA 33168 16131 676.2682 13051 681•5454 HISTORICAL ANALYSIS OF RETIREES SUBSIDIZATION SHARE OF RETIREE RETIREE ADMIN. SERVICE DATE CONTRIBUTION CLAIMS CHARGE SUBSIDY 6/78 - 9/78 287.399 350,109 16,530 79,240 FY 78/79 887,293 1,152,542 57,468 322,717 FY 79/80 877,439 1,287,579 689724 478.864 FY 80/81 993,061 1,565,743 88,934 661,616 3,0459192 4,3559973 231,656 1.542,437 NOTE: The loss ratio for all retired employees was as follows: DATE LOSS RATIO 6/78 - 9/78 121.8 78/79 129.9 79/80 146.7 80/81 157.7 82-473 - E�OMIC CONbULtANTli IN LABOR AND %NCE b. MARSHALL bARRY, PH.b. LAWRENCE E. JESSUP, JR. 4302 ROBIN LANE 320 N W. 1497H STREET TAMPA. FLORIDA $3609 MIAM1. FLORIDA 33168 I8131 e7e•2ee: 13051 681.5434 TOTAL ANNUAL CONTRIBUTIONS TO GROUP INSURANCE CURRENT AND PROPOSED ACTIVE CURRENT PROPOSED PERCENT INCREASE Employees under 65 $429.48 $ 697.80 62.5% Dependent under 65 863.28 1236.24 43.5% Employees over 65 240.96 449.04 86.5% Dependent over 65 358.68 437.52 22.0% RETIREES CURRENT PROPOSED PERCENT INCREASE Employees under 65 $504.72 $ 697.80 38.0% Dependent under 65 594.00 1236.24 108.01/0 Employees over 65 287.88 449.04 56.0% Dependent over 65 328.68 437.52 62.0/ 82-4'73- I TOMIC CONSULTANTS IN LABOR AND < NCE D. MARSHALL BARRY. PH.D. LAWRENCE E. JESSUP. JR. 4302 ROSIN LANE 320 N W 147TH STREET TAMPA. FLORIDA 33609 MIAM1. FLORIOA 33166 16131 676.2882 43051 681.5454 DATE 6/78 - 9/78 FY 78/79 FY 79/80 FY 80/81 HISTORICAL ANALYSIS OF ACTIVE EMPLOYEES'LIFE/AD&D PREMIUM 100/ OF PREMIUM PAID BY CITY $ 238,575 6699175 566,777 506,880 $1,981,398 82-4'73 - FORMULA June 178 - Sept. 181 Beginning Fund balance Add: Actual employee and retiree contribution Required City contribution Interest on positive balance end of each month 7,270,777 5,833,084 Less: Expense (claims & administrative cost) 15,293,931 Refund to insurance company 212,691 Fund Balance Add: City overpayment 3,179,603 Adjusted -Fund Balance (1) Life Insurance: Dividend 1,107,898 Retiree contribution 525,512 1,633,410 Cost 2,306,918 673,508) Adjusted Fund Balance (2) Required Reserves 1,235,824 ( 916,518) 2,263,085 1,589,577 82-473- EIT,OMIC CONSULTANTS IN LABOR AND < NCE D. MARSHALL SARRY. PH.D. 4302 ROSIN LANE TAMPA. FLORIDA 33600 16131 876.2062 ANALYSIS OF ADMINISTRATION'S CLAIM OF OVERCONTRIBUTION TO GROUP INSURANCE TRUST Total Amount of alledged City overpayment (6/78-9/81) as per attachment to Item #64 $3,179,603 Total Amount of City payment for active employees life/AD&D Premium (6/78-9/81) $1,981,398 Total Amount of Retiree Subsidy (6/78-9/81) $1,542,437 BALANCE: LAWRENCE E. JESSUP. JR. 320 N.W.147TH STREET MIAM1. FLORIDA 33168 13051 681•3454 $1,198,205 $( 344,232) NOTE: Balance is amount that Active Employees and interest earnings of the Trust Fund have supported retiree claims. 82_473.- I 4 1 18-84 MIAMI CODE buyer, with the exception of the abstract being brought down to date (as set forth in section 18-83 of this article). Buyer may pay cash, cashier's check, or certified check, or a combination thereof. (Ord. No. 9052, § 1, 1-10-80) Sec. 18-85. City attorney responsible for closing of sale. It shall be the responsibility of the city attorney to effect the closing of any city property which is sold under this article. (Ord. No. 9052, § 1, 1-10-80) Sec. 18-86. Disposition of proceeds from sale. All money received from sales under this article shall be turned over to the director of finance in accordance with the city charter. (Ord. No. 9052, § 1, 1-10-80) Secs. 18-87-18-92. Reserved. ARTICLE VI. SELF-INSURANCE AND INSURANCE TRUST FUND Sec. 18-93. Created; sources. There is hereby created a city self-insur- ance and insurance trust fund, the fund to which shall be credited all money deposited in the city treasury by appropriation or from any other source, together with any unexpen- ded balance of any appropriation heretofore made for the expenditure of public funds, for or accruing from: (1) The payment of claims and judgments against the city involving the acts of officers or employees of the city or property belonging to the city. (2) Insuring or providing for the insurance of any real or personal property or operation of the city against risks or hazards. (3) The maintenance of hurricane disaster funds. (4) The recovery of tort claims against other parties. Supp, Na 1 (5) Fines and forfeitures levied against seat- f j ployees as a result of being fo"d responsible for preventable accidents. (6) Amounts received from parties contra& ing with the city for providing insuraoas coverage to protect the parties for a" and all risks involving activities or property associated with the contracts, (7) Income accruing from the investment of the trust funds. { Such funds are to be expended in accord. ance with the provisions and for the purpoaw stated in this article. The fund shall be -( segregated from other funds in the city treasury and shall be administered by the board of trustees appointed for that purpose..; (Code 1967, § 16-47) Sec. 18-94. Appropriation of money. All money accumulated in the fund b hereby appropriated for the purposes for : which designated, to be expended in accord- ance with the provisions and procedures t, established by this article. (Code 1967, ,t 16-48) Sec. 18-95. Board of trustees—Composi tion; discharge of dutiseq ` compensation; powers. The board of trustees for the city self-mi ar l. ance and insurance trust fund, referred to ss "the trustees," shall be composed of the city ; manager as chairman, the director of fumm and the insurance manager. The trustees shall discharge their duties during norms{ duty hours and shall not be entitled to additional compensation by reason of tbdt services as trustees. However, they shall be reimbursed for any expenses incurred. The trustees shall invest all the trust funds to 60 fullest extent consistent with the cash m quirements and investment objectives of the fund. The trustees shall have the power to mab purchases, sales, exchanges, investments and reinvestments for and on behalf of the fund. 1210 82-4'73- 1 11-96 FINANCE it shall be the duty of the trustees to see that the money invested is at all times handled in tiw best interest of the city. (Code 1967, 1M9) Sae. 18.96. Same —Oath of office. Each trustee shall take an oath of office sod make written acknowledgment of his acceptance of the duty, responsibility and authority of a trustee. (Code 1967, § 16-50) Bee. 18.97. Same —Meetings. The board of trustees shall hold regular issetings at least quarterly each year and special meetings at such time as the chair - sun may deem necessary. (Code 1967, § 1"1) See. 16.98. Disbursement of money. The trustees shall disburse money from the fund to the director of finance upon his rquisition and certification that the expendi- ture of the funds to requisitioned is to accomplish the purpose of the self-insurance and insurance program. The receipt for such toads shall constitute a full acquittance to the Uvatees. (Code 1967, § 16-52) S«. 19.99. Sale or exchange of securi- ties and investments. Securities or investments purchased or held tasder the provisions of this article may be NW or exchanged for other securities or iinestments, provided that no sale or ex- c6sage shall be at a price less than the Market price of the securities or investments Is be sold or exchanged. (Code 1967, § 16-53) Sae. 1&100. Investment of funds. TIt funds may be invested without bakation in: 0) Boods, notes or other obligations of the Uaitad States or those guaranteed by the U°i4d States or for which the credit of t6 United States is pledged for the 4► Na 1 1g-102 payment of the principal and interest or dividends thereof. (2) Certificates of deposit of any bank incorporated under the laws of this state or any national bank organized under the laws of the United States to do business and situated in this state, to the extent that such savings accounts are insured with the federal government or any agency thereof, and if the certificates of deposit are secured by the deposit of securities of the United States govern- ment. (Code 1967, § 16-54) Sec. 18-101. Self-insurance and insur- ance committee --Appoint- ment; composition; chair- man. There shall be appointed annually by the city manager a committee to be known as the city self-insurance and insurance committee. The committee shall be composed of three (3) members who shall be selected from among the officers or employees of the city. The city manager shall designate one (1) of the members to act as chairman. The committee shall administer the self-insurance program and maintain appropriate records which shall reflect the status of the program and be in such detail as required to enable the committee to determine appropriate reserves. The committee shall determine and recom- mend to the city commission the amount of reserves to be accumulated and maintained and the amount to be appropriated annually to finance the self-insurance and insurance program. (Code 1967, § 16-55) Sec. 18-102. Same —Responsibilities. The committee shall, as expeditiously as possible, with due regard to the financial security of the city, proceed to establish the means whereby the city shall become self -in- sured in primary insurance coverage while maintaining umbrella coverage to insure against catastrophic losses. The means con- templated include the establishment of finan- 1211 $2- 47'3 I 1 18-102 MIAMI CODE cial reserves and securing adequate qualified personnel, supplies and equipment to perform required services in an economical and efficient manner. The committee is specifical- ly authorized and directed to ascertain that the city's financial interest is fully protected at all times. Any provisions of this article to the contrary notwithstanding, in the event that adequate financial reserves have not been provided or an analysis of the costs involved demonstrates that it is more economical for the city to maintain coverage for certain specific risks through commercial insurance policies, the committee is au- thorized and directed to procure such cover- age. The premiums shall be paid from trust funds unless the city commission shall have directed otherwise and provided funds for that purpose. The committee shall utilize the services of regular city employees to the greatest extent practical, but may procure specialized services on a fee basis from independent contractors when such action is not prohibited by law. Where personal ser- vices for the program rendered by regular city employees require the expenditure of a substantial portion of the employees' working time on a regular or recurring basis the pro rate costs of such time, including all emo- luments, shall be charged as an expense of the program. The commission may provide for the payment of such expenses during the regular budgeting process by providing funds for the payment of such personnel in the appropriate departmental budget with a corresponding reduction in the amount appro- priated directly to the trust fund. In the event that the program shall require personnel services, payment for which shall not have been provided in the budget, the trustees shall provide funds expended or to be expended for such services. (Code 1967. 1 16-56) Sec. 18-103. Operation and function of insurance program. It is the intention of the commission of the city that the insurance program shall operate and function in a manner similar to a Supp. No. 1 I 1 IS-ia commercial insurance company. Accordingly, all expenses arising from the opeiration of the program shall be paid from the fund to t6 same extent as similar expenses would be discharged by the payment of premiums to a commercial insurance carrier. (Code 1967, 16-57) Sec. 18-104. Responsibilities of city at. torney. The city attorney shall perform or supervise the performance of all legal services required to accomplish the purposes of the self -incur• ance and insurance program. Legal services shall include, but not be limited to, the defense or prosecution or negotiation of settlement agreements of all claims or euita. the investigation of all claims and settlement of those claims found to be well founded for which the amounts claimed are payable from the trust fund. The city attorney and such of his assistants and claims adjusters as he may designate may compromise, settle and pay all claims which may be discharged by payment of m amount not to exceed four thousand five hundred dollars ($4,500.00) for each individu- al claim. Such settlements or compromisse shall be for all damages claimed for personal injury, property damage, or both. Proposed settlements in excess of four thousand five hundred dollars ($4,500.00) shall be submitted to the city commission for its approval prior to acceptance. Upon approval by the city commission or the city attorney, as specified in the two (2) preceding paragraphs, the city attorney shall authorize the payment of the claim by the finance director and provide such documents as the finance director may require. The city attorney shall render such report or reports for the settlement of claims to the committee and the city commission as they shall require. (Code 1967, § 16-58; Ord. No. 8718, § 1, 10-26.77) 1212 (The next page is 12"l 82-473-- Ch. 518 INVESTMENT OF FIDUCIARY FUNDS F.S.1981 bodies, all banks, bankers, trust companies, savings banks and institutions, building and loan associa. tions, savings and loan associations, investment com- panies, all insurance companies, insurance associa- tions, and other persons carrying on an insurance business, and guardians holding funds received from or currently in receipt of funds from the Veterans Administration to the extent of those funds alone may legally invest any sinking funds, moneys, or oth- er funds belonging to them or within their control in any bonds or other obligations issued by a housing authority pursuant to the Housing Authorities Law of this state (chapter 421), or issued by any public housing authority or agency in the United States, when such bonds or other obligations are secured by a pledge of annual contributions to be paid by the United States Government or any agency thereof, and such bonds and other obligations shall be author- ized security for all public deposits; it being the pur- pose of this section to authorize any person, associa- tions, political subdivisions, bodies, and officers, pub- lic or private, to use any funds owned or controlled by them, including, but not limited to, sinking, insur- ance, investment, retirement, compensation, pension, and trust funds, and funds held on deposit, for the purchase of any bonds or other obligations; provided, however, that nothing contained in this section shall be construed as relieving any person from any duty of exercising reasonable care in selecting securities. History.—%& 1. 2. 3. ch 19512. 1939, CGL 1940 Supp ?10M3•nn). s 4. ch 28154,1953 cf.—s. IS 1 Security to be given. 518.10 Fiduciary defined as used in as. 518.11.518.14.—For the purpose of ss. 518.11-518.14, a "fiduciary" is defined as an executor, administrator, trustee, guardian (except any guard- ian holding funds received from or currently in re- ceipt of funds from the Veterans Administration, to the extent of those funds alone), or other person, whether individual or corporate, who by reason of a written agreement, will, court order, or other instru- ment has the responsibility for the acquisition, in- vestment, reinvestment, exchange, retention, We, or management of money or property of another. History.—s 5. eK 28154. 1951 518.11 Investments by fiduciaries; prudent man rule. —In acquiring, investing, reinvesting, ex- changing, retaining, selling, and managing property for the benefit of another, executors, administrators, trustees, and other fiduciaries shall exercise the judg- ment and care under the circumstances then prevail- ing, which men of prudence, discretion, and intelli- gence exercise in the management of their own af- fairs, not in regard to speculation but in regard to the permanent disposition of their funds, considering the probable income as well as the probable safety of their capital. Within the limitations of the foregoing standard, a fiduciary is authorized to acquire and re- tain every kind of property, real, personal, or mixed, and every kind of investment, specifically including, but not by way of limitation, bonds, debentures and other corporate obligations, and stocks, preferred or common, which men of prudence, discretion, and in- telligence acquire or retain for their own account, and within the limitations of the foregoing standard, a fi- duciary may retain property properly acquired, with- out limitation as to time and without regard to its suitability for original purchase. History.—#. S. ch. 28154. 1953. 618.115 Power of fiduciary or custodian to deposit securities in a central depository,— (1)(a) Notwithstanding any other provision of law, any fiduciary, as defined in 9. 518.10, holding se. curities, as defined in s. 678.102(1), in its fiduciary capacity, and any bank or trust company holding se. curities as a custodian, managing agent, or custodian for a fiduciary, is authorized to deposit or arrange for the deposit of such securities in a clearing corpora. tion, as defined in s. 678.102(3). When such securities are so deposited, certificates representing securities of the same class of the same issuer may be merged and held in bulk in the name of the nominee of such clearing corporation with any other such securities deposited in such clearing corporation by any person, regardless of the ownership of such securities, and certificates of small denomination may be merged into one or more certificates of larger denomination. (b) A bank or a trust company so depositing se. curities with a clearing corporation shall be subject to such rules and regulations with respect to the making and maintenance of such deposit as, in the case of state -chartered institutions, the Department of Banking and Finance and, in the case of national banking associations, the Comptroller of the Curren- cy may from time to time issue. (c) Notwithstanding any other provisions of law, ownership of, and other interests in, the securities credited to such account may be transferred by en- tries on the books of said clearing corporation with- out physical delivery of any securities. The records of such fiduciary and the records of such bank or trust company acting as custodian, managing agent, or cus- todian for a fiduciary shall at all times show the name of the party for whose account the securities are so deposited. A bank or trust company acting as custo- dian for a fiduciary shall, on demand by the fidu- ciary, certify in writing to the fiduciary the securities so deposited by such bank or trust company in such clearing corporation for the account of such fidu- ciary. A fiduciary shall, on demand by any party to a judicial proceeding for the settlement of such fidu- ciary's account or on demand by the attorney for such party, certify in writing to such party the securi- ties deposited by such fiduciary in such clearing cor- poration for its account as such fiduciary. (2) This section shall apply to any fuciary hold- ing securities in its fiduciary capacity, and to any bank or trust company holding securities as a custo- dian, managing agent, or custodian for a fiduciary, acting on June 18,1974, or who thereafter may act re- gardless of the date of the agreement, instrument, or court order by which it is appointed and regardless of whether or not such fiduciary, custodian, managing agent, or custodian for a fiduciary owns capital stock of such clearing corporation. History.--s. 1, ch 74.224. 1466 518.116 Power of certain fiduciaries and 82-4'73-. Ch. 112 PUBLIC OFFICERS AND EMPLOYEES: GENERAL PROVISI.ONS F.S. 1981 on the form prescribed and furnished by the depart- ment. The travel voucher form shall provide for, among other things, the purpose of the official travel and a certification or affirmation, to be signed by the traveler, indicating the truth and correctness of the claim in every material matter, that the travel ex- penses were actually incurred by the traveler as nec- essary in the performance of official duties, that per diem claimed has been appropriately reduced for any meals or lodging included in the convention or con- ference registration fees claimed by the traveler, and that the voucher conforms in every respect with the requirements of this section. The original copy of the executed uniform travel authorization request form shall be attached to the uniform travel voucher on file with the respective agency. (12) ADVANCEMENTS. -Notwithstanding any of the foregoing restrictions and limitations, an agen- cy head may make, or authorize the making of, ad- vances to cover anticipated costs of travel to travel- ers. Such advancements may include the costs of sub- sistence and travel of any person transported in the care or custody of the traveler in the performance of his duties. (13) DIRECT PAYMENT OF EXPENSES BY AGENCY. -Whenever an agency requires an em- ployee to incur either Class A or Class B travel on emergency notice to the employee, such employee may request the agency to pay his expenses for meals and lodging directly to the vendor, and the agency may pay the vendor the actual expenses for his meals and lodging during the travel period, limited to an amount not to exceed that authorized for per diem for such period. The provisions of this subsection shall not be deemed to apply to any legislator or to any employee of either house of the Legislature or of the Joint Legislative Management Committee, History-u 1. 3, ch 22&30, 1945. u. 1. 2. 3, ch 23892. 1947; a 1. 3. ch 25040. 1949. u 1, 3, ch. 26910. 1951. s. 1, ch 28303, 1953; a 1. ch. 29628. 1955. a. 1. ch 57­230; a 1. ch 61.183. a 1, ch. 61.43; a. 1, ch. 63-6. a 1, ch. 63.192; a 1, ch 63-122. s 1, ch. 63.40U, u. 2. 3, ch 67.371; u 1. 2. ch 67.22%, a 1, ch 69 193. s 1, ch W.M. as 12. 23, 31. 35. ch. 69-106. a 65, ch 71.136. t 1, ch 72.213.a 1,ch 72-217,t l.ch 72-324.s 26.ch 72.404;s I.ch 73 169.s L ch 74.15, a I, ch 74.246, a 1, ch 14 365; a I, 2. ch. 75.33, s L ch. 76.166, s 2. ch. 76.2rt& ss 1. 2. ch 76 250, a L ch 77.174; s L ch 77.231; u 1, 2, rh 77.437, a 2, ch. 76 95, s 51, ch 79-190. a L ch 79.205, a L ch 79.303, a I, ch 79•412, ss 1. 2. ch. 61 207. of -s 25019 Expenses for travel on military busmen a 288Oil Department of Commerce, travel and entertainment espenae 112.062 Cabinet members; educational and informational travel expenses. -When he deems it necessary in order to carry out an official function of his office, a member of the Cabinet may incur and be reimbursed for travel expenses pursuant to s. 112.061 for the purpose of educating and informing the public as to his official duties. History".-s. 1, ch 80-212. 112.08 Group insurance for public officers and employees; certain volunteers.- (1) Every local governmental unit is authorized to provide and pay out of its available funds for all or part of the premium for life, health, accident, hospi- talization, or annuity insurance, or all or any kinds of such insurance, for the officers and employees of the unit and for health, accident, and hospitalization in- surance for their dependents upon a group insurance plan and, to that end, to enter into contracts with in- surance companies or professional administrators to provide such insurance. Before entering any contract for insurance, the governmental unit shall advertise for competitive bids, and such contract shall be let upon the basis of such bids. However, the govern- mental unit may undertake simultaneous negotia- tions with those companies which have submitted reasonable and timely bids and which are found by the governmental unit to be fully qualified and capa- ble of meeting all servicing requirements. Each coun- ty, municipality, school board, local governmental unit, and special taxing district of the state may self -insure any plan for health, accident, and hoapi- talization coverage, subject to approval based on ac- tuarial soundness by the Department of Insurance. Each shall contract with an insurance company or professional administrator qualified and approved by the Department of Insurance to administer such a plan. (2) Each county, municipality, school board, local governmental unit, and special taxing district is au- thorized to commingle in a common fund, plan, or program all payments for life, health, accident, hospi- talization, or annuity insurance or all or any kinds of such insurance whether paid by the governmental unit, officer or employee, or otherwise. The govern- mental unit may determine the portion of the cost, if any, of such fund, plan, or program to be paid by offi• cers or employees of the governmental unit and fix the amounts to be paid by each such officer or em- ployee as will best serve the public interest. (3) A local governmental unit may, at its discre- tion, provide group insurance consistent with the provisions of this section for volunteer or auxiliary firefighters, volunteer or auxiliary law enforcement agents, or volunteer or auxiliary ambulance or emer- gency service personnel within its jurisdiction. No in- surance provided to volunteer personnel shall be used in the computation of workers' compensation benefits or in the determination of employee status for the purposes of collective bargaining. (4) Benefits provided under group insurance poli- cies pursuant to subsection (3) shall not exceed bene- fits provided to employees under subsection (1) and es. 112.19 and 112.191. (5) The Department of Administration shall ini- tiate and supervise a group insurance program pro- viding death and disability benefits for active mem- bers of the Florida Highway Patrol Auxiliary, with coverage beginning July 1, 1978, and purchased from state funds appropriated for that purpose. The De- partment of Administration, in cooperation with the Department of Insurance and the Division of Pur- chasing of the Department of General Services, shall prepare specifications necessary to implement the program, and the Department of Administration shall receive bids and award the contract in accord- ance with general law. History. -a. 1. ch. 20952. 1941; a 1, ch. 69.300. a 1. ch. 72.336; a 1. ch 76.208, a. t, ch. 77.89, s. 50, ch 79.40; a. 1, ch. 79.337; a. 67, ch. 79.400 112.0801 Group insurance; participation by retired employees. -Any county, municipality, community college, or district school board which provides for its officers and employees and their de- 494 82-=473 - + CiTy OF MIAMI. FLORIDA 64 INT^R-OFFICE MEMORANDUM �(d(Z1 I TO Howard V. Gary ATE April 14, 1982 F'L` City Manager NJF._r Contributions to the Group Benefit Self -Insurance Fund for both Active and Retired Employees of the City of Miami Carlos E. Garcia Director of Finance E N;LOSU Ft=S "It is recommended that the attached resolution authorizing an increase in the rates utilized to determine contributions to Self -Insurance Fund for group health benefits be adopted." The City of Miami has self -funded its group health care benefit plans since June of 1978. The rates utilized in determing contribution levels to that plan were established under the previously fully insured plan, and last revised in February of 1976. Between 1976 and present, medical care costs have risen sharply due to inflation. The contribution levels established in 1976 are not sufficient to maintain a self-sustaining and acturarily-sound insurance fund. The rate levels have been deficient for some time, however, contributions by the City to the program in excess of those required by the rate structure have allowed the program to maintain a capability to pay all claims. .1 The current rate structure establishes different rates for active and retired employees. These different rates appear not*to be justified by the experience of the respective groups. The retired employee group, in effect, is being subsidized by the active employees of the City, and the City itself. The Trustees of the Self -Insurance and Insurance Trust Fund recognized this problem, and secured the services of a qualified firm to promulgate adequate group health care benefit rates, and review the utilization of group benefits by retirees in comparison to premiums paid by that portion of the group. The consultants' report and recommendations (attached) were reviewed by the Self -Insurance and Insurance Committee at their meeting of October 21, 1981 (minutes attached). The Committee unanimously agreed to recommend to the Commission that the rate increases recommended by the consultant be adopted. The Committee also agreed to recommend the rates for active and retired members of the group be equalized. 8z-473; - EHC EDWIN H. COLE C.L.U. AND ASSOCIATES, INC. Life, Health, -Group and Retirement Planning b 1� 9 co W Mr. Donald. Dunlap Director, Risk Management P. O. Box 330708 Dinner Key City Hall Miami, FL 33133 Dear Don:' 6701 SUNSET DRIVE MIAMI, FLORIDA 33143 (305) 666.6249 February 23, 1982 Enclosed is the February issue of.Equitable's Group Operations Commentary. Of particular interest is the 31% increase in premiums coupled with a 13% decrease in benefits for the, Federal Employees Health Benefit Plan covering about 9.2 million employees. This is the nation's largest health insurance group and is viewed as a barometer of benefit costs. EHC/fam 4ncerely, L / , Edwin H. 67�)CC. .U. un Edwin H. Cole, Chartered Life Underwriter r.•u 82-4'73 - ME 7/4f;L 3a AM Released by the Marketing Division of the Group Marketing Department 82-4737 0 GRUUP OPERATIONS COMMENTARY SUMMARIES PART I: BUSINESS DEVELOPMENTS NATIONAL ADVISORY GROUP URGES VOLUNTARY LOCAL COALITIONS FOR HEALTH CARE COST CONTAINMENT - Six major national organizations joined in an effort to encourage the development of voluntary local coalitions, and to promote and assist the efforts of voluntary coalitions which have already been established in locations throughout the country. SHARP INCREASE IN FEHBA PREMIUMS COUPLED WITH CUT IN BENEFITS - s of January , participants in the Federal Employees Health Benefit (FEHB) program are faced with average premium increases of 31% while benefits and coverage are cut an average of 13%. MICHIGAN - ASO BILL ENACTED INTO LAW - Michigan H.B. 4802, granting insurance companies authority to enter into ASO arrangements, has been enacted. The law expands the permissible activities in which life companies may engage and specifically permits life companies to offer ASO to groups of 500 or more employees and members. A tax, albeit modest, will be imposed on this ASO business. PAGE P� 3 NEWPORT NEWS RULING REVERSED BY U.S. COURT OF APPEALS - The U.S. 3 Court of Appeals for the Fourth Circuit has reversed the District Court's decision on a spouse's pregnancy related disability benefit. FEDERAL & STATE LAWMAKERS SEEK REGULATORY POWER OVER SELF -FUNDED 4 M - Mounting concern over self -funded multiple employer trusts TEIT become insolvent prompts federal and state lawmakers and regulators to seek regulatory powers over the METs. CHANGES IN MEDICAL CARE COST LEVELS BASED ON THE CONSUMER PRICE 4 Published by the Marketing Division No. 82-2 of the Group Marketing Department February 9, 1982 82-4 PART I: BUSINESS DEVELOPMENTS NATIONAL ADVISORY GROUP URGES VOLUNTARY LOCAL COALITIONS FOR HEALTH CARE COST CONTAINMENT For about six months, representatives of six major national organiza- tions have been meeting to discuss health care cost containment issues. The participants were the Business Roundtable, AFL-CIO, American Hospital Association, American Medical Association, Blue Cross and Blue Shield Associations and Health Insurance Association of America. On January 14, this national group announced it would join in efforts to encourage voluntary employer coalitions on a local, state or regional basis. There are about 70 voluntary local coalitions throughout the country today. Continued development of coalitions seems likely as existing ones make progress in efforts to address local costs of delivery of medical care and the numerous factors which locally influence such costs. A statement released by the national group advises local coalitions to analyze (1) the level of health care costs in the area, (2) the rate of increase in particular costs and the reasons for the increase; (3j utilization and how it compares with other areas; (4) existing health care facilities and services, with an assessment of the availability of needed services, health benefit packages and operations. Coalitions should then decide on priority projects to exert influence on the health care delivery system. This could take the form of either (1) a limited demonstration to ain experience, establish relationships and test policies, or (2� a community -wide action. The following projects have a demonstrated potential for improving the cost and quality of health care delivery: o Use of alternative forms of care, such as ambulatory and home care, by redesigning insurance benefits. o Increase access to care through health care for the unemployed to care; this includes efforts budget changes. efforts to finance and provide and others who do not have access to mitigate the impact of federal o Increase opportunities to discuss and develop the most cost effective and equitable forms of provider payment. o Develop more effective programs of health promotion and discuss prevention in the work place. 82-4'73 PART II; LEGISLATIVE DEVELOPMENT" SUMMARIES PAGE BILLS AFFECTING BENEFITS AND RIGHTS UNDER GROUP LIFE AND HEALTH N URANCE POLICIES - 1. Continuance and/or Conversion 5 2. Mental Illness 5 3. Limited Practitioner_ 5 4. Outpatient Benefits 6 5. Third Party Prescription Drug Program 6 PART I: BUSINESS DEVELOPMENTS NATIONAL ADVISORY GROUP URGES VOLUNTARY LOCAL COALITIONS FOR HEALTH CARE COST C N INM N For about six months, representatives of six major national organiza- tions have been meeting to discuss health care cost containment issues. The participants were the Business Roundtable, AFL-CIO, American Hospital Association, American Medical Association, Blue Cross and Blue Shield Associations and Health Insurance Association of America. On January 14, this national group announced it would join in efforts to encourage voluntary employer coalitions on a local, state or regional basis. There are about 70 voluntary local coalitions throughout the country today. Continued development of coalitions seems likely as existing ones make progress in efforts to address local costs of delivery of medical care and the numerous factors which locally influence such costs. A statement released by the national group advises local coalitions to analyze (1) the level of health care costs in the area, (2) the rate of increase in particular costs and the reasons for the increase; (3l utilization and how it compares with other areas; (4) existing hea th care facilities and services, with an assessment of the availability of needed services, health benefit packages and operations. Coalitions should then decide on priority projects to exert influence on the health care delivery system. This could take the form of either (1) a limited demonstration to ain experience, establish relationships and test policies, or (23 a community -wide action. The following projects have a demonstrated potential for improving the cost and quality of health care delivery: o Use of alternative forms of care, such as ambulatory and home care, by redesigning insurance benefits. o Increase access to care through efforts to finance and provide health care for the unemployed and others who do not have access to care; this includes efforts to mitigate the impact of federal budget changes. o Increase opportunities to discuss and develop the most cost effective and equitable forms of provider payment. o Develop more effective programs of health promotion and discuss prevention in the work place. 82-4'73 MI- -2- SHARP INCREASE IN FEHBA PREMIUMS COUPLED WITH CUT IN BENEFITS The Federal Employees Health Benefit (FEHB) program with an enrollment of about 9.2 million - the nations largest health insurance group - is watched as a bellwether of health insurance coverage. A 31% increase in premiums is coupled with a 13% decrease in benefits and coverage as of January 1, 1982. Most of the cuts involve cost -sharing by the enrollee. Deductible amounts are increased, coinsurance rates modified and copayment features are introduced. Changes in the service benefits plans of Blue Cross and Blue Shield include: - Inpatient copayment $20 (high option) and $30 (low option) for the first 10 days. - Home Health Care after hospitalization under high option only. - A catastrophic protection benefit of $1,000 per contract per calendar year is added under the high option for basic other hospital outpatient benefits and basic surgical -medical benefits which have 20100 coinsurance. - The supplemental per person deductible is increased to $200 (nigh option) and $250 (low option). Changes in the indemnity benefits plan administered by Aetna Life & Casualty include: - The high option deductible is increased to $200 from $75 and the family deductible maximum is increased to $600 from $225. - The hi option catastrophic stop loss is increased to $2,500 from $1,000 per individual and to $5,000 from $2,000 per family. - The high option coinsurance is reduced to 75% from 80%. a -3- r MICHIGAN - ASO GILL ENACTED INTO LAW Recently enacted legislation (Michigan H.B. 4802) substantially broadens life insurance company powers to include administration of ASO contracts. The law, however, is not a model of legislative clarity and contains some provisions which are of concern. o The definition of "non-insured benefit plan", although intended only to apply to ASO-type contracts, is overly broad and can be construed to apply to other such plans, including perhaps certain services performed in connection with pension and profit sharing arrangements. Clarification of this concern is being sought from the Commissioner. o A stringent 500 minimum life requirement for ASO-type agreements was imposed, similar to that imposed on the Blues when specific legislative authority to write ASO was conferred on them, at the insistence of the Michigan Senate's Democratic leadership. In addition, because of Michigan's pressing fiscal concerns, the single business tax will be imposed on ASO contracts written. This tax is quite modest relative to the premium tax. The bill was signed into law in early January, and is effective immediately. NEWPORT NEWS RULING ON EEOC REVERSED BY U.S. COURT OF APPEALS The U.S. Court of Appeals for the Fourth Circuit has overturned the District Court ruling which held that the Pregnancy Discrimination Act (PL 95-555) does not apply to an employee's spouse. The Court of Appeals ruling is the first appellate endorsement of the published EEOC guidelines which interpret the Pregnancy Discrimination Act as applying to wives of workers as well as to female employees. At this time, we have no indication as to whether the employer (Newport News Shipbuilding) intends to appeal this decision. 82-4'73 -a - FEDERAL & STATE LAWMAKERS SEEK REGULATORY POWER OVER SELF-FUNUED METS According to a recent discussion in Business Insurance, U.S. Rep. John Erlenborn is seeking a congressional investigation into the legal problems that self -funded METs pose for state regulators. He will ask Rep. Philip Burton, Chairman of the House Management Relations subcommittee to hold hearings soon on the regulatory void in which the self -funded METs operate. The California Department of Insurance is seeking a sponsor for a bill that would empower the Department to audit the financial records of California's 75 self -funded METs, close down unauthorized METs and freeze the assets of a MET that looks insolvent. The California Insurance Department is now investigating four self -funded METs that appear to be close to insolvency. A half -dozen or more self -funded METs are being investigated by the Illinois Department of insurance. The METs avoid compliance with state insurance codes by claiming that they qualify as benefit plans under ERISA (ERISA pre-empts state reyulation of benefit plans). To qualify under ERISA, the METs go into business and then must prove to the Department of Labor that they are controlled by participating employers - a test which few of the self -funded METs are ultimately able to pass. A spokesman for DUL has pledged that the Department will move faster on requests from states to determine if a MET qualifies under ERISA and will attempt to have state insurance departments serve as its investigating arm. CHANGES IN MEDICAL CARE COST LEVELS BASED ON THE CONSUMER PRICE INDEX FOR DECEMBER, 1981 Based on the Consumer Price Index for December, 1981, recent trends in the annualized inflation rates for medical care are summarized below: HOSPITAL PHYSICIAN DENTIST PRESCRIPTION Latest Month (December) 3.8% 7.4% 10.2% 11.2% Latest 3 months 17.3% 9.9% 5.9% 9.1% Latest 6 months 17.5% 9.0% 6.4% 10.0% Latest 9 months 13.3% 9.0% 6.5% 12.3% Latest 12 months 14.0% 10.6% 8.4%- 12.6% The Hospital and Physician rates dropped substantially from the November rates, while the Dentist and Prescription rates increased substantially. While the overall rise in consumer prices for 1981 was only 8.9%, the lowest annual increase since 1971, the medical care component jumped to 12.5%, the largest increase since the Federal government began reporting on medical care costs in 1935. -5- PART II: LEGISLATIVE DEVELOPMENTS 1. Continuance and/or Conversion: These bills generally mandate continuance of group health insurance coverage for three, six, or twelve months when an insured leaves the group. Some mandate conversion rights on expiration of the period of continuance. Some require only conversion rights as indicated. New bills and activity on previously reported bills: Indiana H1135 - Conversion for dependents Kentucky S38 -Insurer must give written notice to continue after termination Maryland H403 - Continue 1 year 2. Mental Illness: These bills generally mandate specified minimum benefits for mental illness, usually less than benefits for other conditions. New bills and activity on previously reported bills: Maryland S97 - Mandated Coverage extended to halfway houses - extraterriorial. Enacted Massachusetts H3228 - Amends present law, which requires benefits not less than sixty days per calendar year in a mental hospital under the direction and supervision of the department of mental health or in a private mental hospital licensed by that department, to provide during such time usual and customary benefits based upon confinement as an inpatient in a licensed or accredited general hospital and prohibits a lifetime maximum monetary limit for inpatient care in such mental hospital less than any lifetime maximum monetary limit for the treatment of conditions that are not mental or nervous disorders. Effective March 21, 1982. 3. Limited Practitioners: These bills would require payment for the services lawfully performed by a limited practitioner, if those services would have been covered when performed by a doctor of medicine. New bills and activity on previously reported bills: Wisconsin A898/S632 - Chiropractors Wisconsin A940 - Optometrists SZ -4'74 !N -6- 4. Outpatient benefits: these bills may mandate, or a;ana3r.e an offer ot, benefits for A bulatory Care, Home Health Care, Hosoir.A Care or emergency treatment in a doctor's office. New bills and activity on previously reported bills: Maryland S191 - Hospice - mandated offer 5. Third Party Prescription Drug Program: These bills generally provide That', if a third party drug program is installed in any part of the state, all pharmacies in the state must be given advance writter, notice and participants in the progra+n may not be chargeu less for prescriptions than the general public is cnarged. New dills and activity on previousiy reported bills: Missouri H1028 REFUND FROM INSURANCE COMPANY (Reserves returned) June 1978 Total return $1,663,991 Life insurance portion $ 428,187 Health insurance portion 1,235,804 Payment to Insurance Company for "old claims" (Feb. 79) 212,691 8201.—�47c. - 4S BACKGROUND s 1. Fund (self-insurance) created by Ordinance 2. Self-insurance includes: a. Employee health • b. Workers compensation C. Liability - all types d. Employees life insurance 3. Possible revenues to the fund a. Employee contributions as required by union contract b. City contributions for: (1) Employee health (2) Workers compensation (3) Liability (.4) L , f & -cwt C. Interest on fund balance d. Recoveries from others 4. Possible expenditures a. Payments for medical service b. Payments for liability claim C. Payments for workers compensation d. Direct and indirect administrative - expenses 'Eto". Trtil�i� EMPLOYEE HEALTH BENEFIT FUND Two Issues: 1. Fund Balance a. Initial refund from insurance company b. Crediting of interest on fund balance C. Overpayment by City d. Amount of reserves e. Life insurance cost and dividend 2. Rates a. Amount of increase b. Allocation between age groups C. Effective date FORMULA June '78 - Sept. '81 Beginning Fund balance 1,235,824 -� Add: Actual employee and retiree contribution 7,270,777 Required City contribution 5,833,084 Interest on positive balance end of each month 250,419 Less: Expense (claims & administrative cost) 15,293,931 V'Befu-rrd to insurance company 212,691 Fund Balance ( 916,51B) Add: City overpayment 3,179,603 Adjusted Fund Balance (1) ',263,0:;5 Life Insurance: Dividend 1,107,898 Retiree contribution 525,512 1,633,410 Cost 2,306,918 ( 673, 508) Adjusted Fund Balance (2) 1,589,577 Required Reserves 0 1' 1 � B� 82-4'73 46 10 (,'ROUP HEALTH BENEFITS EXPERIENCE 1981-82 Employee Retiree City Claims Over/ Contribution Contribution Obligation Expense Under Oct. 130,036 81,898 137,749 423,541 ( 73,858) Nov. 85,976 82,848 125,660 438,856 (144,372) Dec. 87,601 82,864 127,709 381,381 ( 83,207) Jan. 74,654 82,940 136,843 449,500 (155,063) Feb. 64,730 84,892 136,470 548,768 (262,676) Mar. 72,574 83,043 140,053 378,582 ( 82,912) April 80,700 84,135 142,746 502,718 (195,10-7) 596,271 582,620 947,230 3,123,346 (997,195) WITH CITY OVERPAYMENT City Over -Payment Over/Under ' Oct. 134,986 61,128 Nov. 147,075 2►703 Dec. 144,966 61,759 Jan. 135,892 ( 19,171) Feb. 136,470 (126,206) Mar. 132,682 49,770 April 129,989 ( 65,118) 962,060 ( 35,135) 82-4'73- ' V INDI CisTO:.S 1:'c0-81 Avg. Mo.^.thly Ciai.-ms Cost 1981-32 Avg. Monthly Claims Cost (5 I•Ionths) Avg. Monthly revenue (Mated) Avg. Monthly Pevenue With Overpayment 5,14-3,707 . 11- - 420,059 2, 242,04G 'i 5 = •148,409 ..•ter" 1,522,870 5 = 304,574 2,222,259 - 5 - 444,451 ,s=*" --madam 1"XPECTED :;-)del Group: 4200 Employee Units ) 2400 Dependent Units ) ) 500 Employee &ledicare ) 200 Dependent Medicare ) 6:onthly Revenue 517,000 0 C 14 CITY OF MIAMI, FLORIDA Notes to Financial Statements The City maintains reserves of fund balance as follows: Amount included in Reserved Fund Balance Hurricane loss - established by ordinance. $ 500,000 Workers Compensation - 10% of annual operating budget for this coverage. 343,717 Group accident and health - 252 of the annual operating costs for this coverage, exclusive of life, accidental death and disability for which the City has outside coverage. 1,525,000 General liability - 102 of the number of incidents reported during the year at actual average claim cost. 339,486 $ 2,708,203 (8) Se,ments of Enterprise Activities Key financial data for the various activities of the City's Enterprise Funds for the year ended September 30, 1981 is as follows: Convention Center Stadiums Marinas Auditoriums Golf Others Total Operating revenues $ - 1,601,984 1,041,054 429,706 615,765 36,350 3,924,859 Operating expenses 320,929 2,332,962 1,182,697 909,750 768,910 - 5,515,247 Operating income (loss) $ (320,928) (730,978) (141t643) (480,044) 46,855 36,350 (1,590,388) Net income (loss) 95,237 (295,282) (78,870) (179,191) 89,048 35,326 (333,732) Working cape 1,320,9213 (� 1,092,747) 270 509 (542 221 246,358 61.051 263,878 Assets 93,691,621 15,096,294 4,158,344 5,511,657 1,853,796 525,445 120,837,157 Bonds payable 60,)00,000 - - - - 185,000 60,185,000 Fund equity 27,1932198 14,643,482 4,086,891 5,455,645 1,820,548 320,445 53,520,209 Contributions and equity transfers 9,548,454 1,841,505 - - - - 11,389,959 Property plant and equipment acquisitions $ 26,787,741 367,676 188,126 2,889 54,326 - 27,401,358 51 (Continued). 82-47%'.YW - 0 E 13 CITY OF MIAMI, FLORIDA Notes to Financial Statements The City's pension plans have not adopted the provisions of Statement of Financial Accounting Standards (F No. 35, Accounting and Reporting by Defined Benefit Pension Plans. Therefore, certain other disclor required by SFAS No. 36, Disclosure of Pension information, are not available. (7) Self Insurance The City maintains a Self Insurance Fund to provide insurance for certain property and liability risks, I accident and health, and workers' compensation. The City has continued to purchase outside coverage for Lain exposures where the premium is small in relation to the coverage provided. The charges made by the Insurance Fund are not determined on an actuarial basis and are based on a cash basis estimate of self it ante pay outs. The City believes the amounts charged in the accompanying financial statements would not d: materially from actuarially determined amounts. The City's accounting policy and amount of unpaid claie September 30, 1981, for the various coverages, is explained below; Amount incl, in Claims Pa - (a) General Coverage Departments of the City are assessed a charge for each risk based upon the number of automobiles, square footage of space utilized, etc. As claims are reported, claims personnel investigate each claim and estimate a liability on a case -by -case basis. No provision is made for claims incurred but not reported (IBNR). The amount of the IBNR liability is not determinable at this time. $ 2,155,44E (b) Group Accident and Health Employees participating in the City's group coverage contribute through payroll deductions and departments of the City fund the remaining cost based upon their respective number of participating employees. Retired employees also participate and contribute to the plan. All claims paid are expensed as paid. The amount of claims at September 30, 1981 represents certain September claims paid by the City in October. 401,22� (c) Workers Compensation All workers' compensation costs are included in the Self Insurance Fund, with all departments of the City being assessed a charge for this coverage. At September 30, 1981, there is no claim liability for workers compensation recorded. Although significant, the amount of this liability is not determinable at this time, but would be payable over several years. - Total claims payable $ 2,556,67 (Cont 82-47C _ .. 50 April 8, 1982 Don Teems, President I.A.F.F., Local 587 2980 N.W. South River Drive Miami, Florida 33125 RE: Health Insurance Dear Mr. 7,,!ems : In res,_)1ut4.on of the differences of opinion with regard to the Group aa)th Insurance coverage currently provided to eligible empi-oy -2s, bo_h•present and retired, the following concepts are agreed co: A) The proposed insurance rates (see attached) will be effec- tive to all employees currently electing to be included in the City's Group Health Insurance program. B) Said rates will be implemented effective retroactively to March 7, 1982. C) Fund balance for the group health portion of the Self - Insurance Trust Fund only will be accepted by all parties to be 1.6 million dollars effective March 7, 1982. D) Local 587 will secure acceptance of this understanding from the Fraternal Order of Police Lodge No. 20, the Sanitation Employees Association, and the American Federation of State, County, and Municipal Employees Local 1907, as soon as pos- sible, but no later than April 30, 1982. E) Prior to September 30, 1982, Local 587 speaking in behalf of all locals certified to represent City employees may present to the City Manager a proposal to assume complete operation of the group health insurance for all bargaining unit em- ployees both present and retired. Such proposal shall address issues in three general areas: financial administration, general administration and claims administration. 82-•4 i i In recognition of the fact the insurance proposal is yet to be prepared by a coalition of all the City Union representatives, nothing herein shall require the City to accept the proposal to take over the Group Health Insurance by the Unions. Likewise, should the City propose a Health Insurance transfer plan to the Unions, no obligation would extend to the Unions to accept the City's proposal. This understanding represents a good faith attempt by the City and the City's Union coalition to negotiate said transfer of the Group Health Insurance Program to the Union coalition if possible and economically feasible. No increase cost shall occur to the City should said transfer occur other than that which is agreed to in the current City La- bor Agreements. Sincerely, 46 an R. '-tielke Labor Relations Officer DRM/pl Enclosure cc: Howard V. Gary, City Manager Randolph Rosencrantz, Assistant City Manager .- w DON TEEMS, President 4140 S.W. 65th AVE. DAVIE, FLORIDA 33314 April 13, 1982 0 0 MIAMI ASSOCIATION of FIRE FIGHTERS MIAMI, FLORIDA ORGANIZED OCTOBER, 1938 LOCAL NO.587 TELEPHONE: 635.1767 AFFILIATED WITH AMERICAN FEDERATION OF LABOR CONGRESS OF INDUSTRIAL ORGANIZATIONS FLORIDA AFL-CIO PROFESSIONAL FIRE FIGHTERS OF FLORIDA DADE COUNTY COUNCIL OF FIRE FIGHTERS INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS WASHINGTON. O.C. WILLIS ALLEN, JR. Secretary -Treasurer 20025 N.E. 14th CT. MIAMI, FLORIDA 33179 Mr. Dean Mielke Labor Relations Officer City of Miami Re: Health Insurance Dear Mr. Mielke: In response to your April 8, 1982 letter for resolution of the differ- ences of opinion with regard to the Group Health Insurance: A. The proposed insurance premium increases will be effective to all employees currently electing to be included in the City's Group Health Insurance program. B. Said premium increases will be implemented effective the first full pay period after ratification of this agreement. C. Fund balance for the Group Health portion of the self-insurance trust fund only will be accepted by all parties to be 2.4 million dollars effective upon ratification of this agreement. D. Local 587 will attempt to secure acceptance of this understanding from the Fraternal Order of Police Lodge #20, the Sanitation Employees Association, and the American Federation of State, County, and Municipal Employees Local #1907, as soon as possible. E. Within six months of ratification of this agreement, each employee representative may elect to set up their own self-insurance trust fund. In the event any of the employee groups elect to exercise their option to set up their own self-insurance trust fund, that group's proportionate share of a minimum of the 2.4 million dollars shall be turned over to that group's new self-insurance trust. F. In the event any of the employee groups elect to stay in the City of Miami Self -Insurance Program, that group or groups will receive a monthly review of the trust transactions. G. In the event any of the employee groups elect to exercise their option to set up their own self-insurance trust fund, the City's bi-weekly contribution shall be as provided by that groups contract. IINITFn IN rHF_ PRATFnTIr11k ^ - n A09rnf0-A nr I IFE, NnMF_ . IAint ic'rnv i MIAMI ASSOCIATION of FIRE Fla �TERS MIAMI, FLORIDA ORGANIZED OCTOBER, 1938 LOCAL NO.587 TELEPHONE, 635-1767 DON TEEMS, President 4140 S.W. 65th AVE. DAVIE, FLORIDA 33314 Mr. Dean Mielke Page two April 13, 1982 Since ly, Don Teems President I.A.F.F. Local 587 AFFILIATED WITH AMERICAN FEDERATION OF LABOR CONGRESS OF INDUSTRIAL ORGANIZATIONS FLORIDA AFL-CIO PROFESSIONAL FIRE FIGHTERS OF FLORIDA DADE COUNTY COUNCIL OF FIRE FIGHTERS cc. Howard V. Gary, City Manager Randolph Rosencrantz, Asst. City Manager INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS WASHINGTON, Q.C. WILLIS ALLEN, JR. Secretary -Treasurer 20025 N.E.14th CT. MIAMI, FLORIDA 33179 82-474 UNITED IN THE PROTECTION OF AMERICAN LIFE, HOME, INDUSTRY 11 �EDWIN H. COLE C.L.U. A�J ASSOCIATES, INC. ` Life, Health, Group and Retirement Planning 4,1 Mr. Donald Dunlap ;, iyyJ - •�� 11 Director, Risk Management*,iy P. O. Box 330708 1? Dinner Key City Hall Miami, FL 33133 Dear Don: 6701 SUNSET DRIVE MIAMI, FLORIDA 33143 (305) 666-6249 February 11, 1982 This will confirm the information given to you by Joyce Seibert on February 11, 1982, regarding the dividend resulting from the change to ACS on June 1, 1978. Of the total dividend for the "policy year" October 1, 1977 to June 1, 1978 of $1,663,991, the Health reserve portion was $1,235,804. You also requested the amount of drafts applied to the Unified Claims provision of the ACS agreement. Our files indicate that the amount of claim drafts clearing Equitable's bank account after June 1, 1978 which were incurred prior to that date were $212,691.15. Under the Unified Claims provision we were to be refunded that amount by the City. Should=you have any questions concerning this ratter, please do not hesitate to call. Sincerely, 6�'91 /y . ��� Edwin H. Cole C.L. . EHC/fam cc: J. Seibert Edwin H. Cole, Chartered Life Underwriter IOVNO T�t *EDWIN H. COLE C.L.U. At ASSOCIATES INC. Life, Health, Group and Retirement Planning 6701 SUNSET DRIVE MIAMI, FLORIDA 33143 (305)666-6249 March 9, 1982 Mr. Donald Dunlap Director, Risk management P. O. Box 330708 Dinner Key City Hall Miami, FL 33133 Dear Don: Although we have not yet received a response from Don Teems on the specific claim problems he expressed in his letter of January 18, 1982, 1 had Equitable per- form a random audit of your claims since June, 1981. Ed Caldwell's people selected five (5) claims at large for each month, and five (5) claims which reflected in- curral dates of early 1981 and 1980. A copy of the specifics is attached but a summary follows: - Thirty-five claim files were reviewed - The average claim payment time was ten (10) workdays - On the claims where charges were incurred several months before the claim was paid, the claim was not submitted promptly - Them are several examples of delays when the Benefits Office had to write to the doctor for more information We still are very interested in reviewing any additional files which are brought to your attention. Don, to keep you appraised of the claim payment turn- around time, I have asked Equitable to report their production results to us weekly, and I will forward this on to you. Enclosed is a chart which reflects the weekly production since July, 1981. tas ....�' Edwin H. Cole, Chartered Life Underwriter ;o`�; 82-4'73-. ;' Douro T�Yt� Mr. Donald Dunlap_ Page Two ;larch 9, 1982 You will see the balloon in the backlog during December and January, which we have discussed and which now is rectified. I will continue to monitor the claim service closely and will keep you advised. Please contact me if you have any questions on this material. Since ely, . 61-64( E n H. Cole C.L.U.0 EHC/fam Enclosure cc: Ed Caldwell, Divisional Benefits :tanager, Equitable Life Assurance Society of the U.S. Maurice Ferre, Mayor City of Miami Joe Carollo, Commissioner City of Miami J.L. Plur:uner, Commissioner City of *Mani Puller Dawkins, Commissioner City of Miami Demetrio Perez, Commissioner City of ;Miami Howard V. Cary, City Manager Miami Dean Mielke, Labor Relations Officer Don Teems, viiami Assoc. of Fire Fighters 82-4'731 CITY OF MIAMI -- JUNE 1981 Claim Form Claim Name of Insured Date of Charges Signed Received Claim Paid Remarks William Eley 08/31/80 06/20/81 03/05/81 04/20/81 Req. itemized bill 03/12; recd 03/23 William Miller 04/29/81 03/10/81 06/01/81 06/15/81 James Avery 05/20-21/81 05/20/81 06/01/81 06/11/81 Dale Rich 05/18/81 05/18/81 05/20/81 06/01/81 Wi am Suter 04/16/81 None 05/21/81 06/01/81 Richard Baker 10/13/80 Req. form 05/18/81 Amt of ck - $37.55 05/01/81; recd 05/14 Donald Reid 01/04/81 04/24/81 05/11/81 05/21/81 Amt of ck - $165.00 Kim Rabson 12/29/80 None 06/01/81 06/12/81 Amt of ck - $59.60 (James) Claude Smith 11/26/80 03/05/81 04/30/81 05/08/81 Amt of ck - $30.00 Thomas Adkins 06/29/77 Form sent 06/12/81 Amt of ck - $200.00 05/12/78; never recd. Submitted again 05/21/81 I�III I I � CITY OF MIAMI -- JULY 1981 Name of Insured Date of Charges Claim Form Signed Claim Received Claim Paid Remarks Philip Lupo 04/21/81 None 07/07/81 07/13/81 David Murphy 06/08/81 06/08/81 06/10/81 06/23/81 Thomas Dougherty 05/04/81 05/12/81 06/16/81 06/29/81 Thomas Bickett 03/22/81 04/10/81 06/05/81 06/19/81 Antonio Murguia 04/28/81 None 06/12/81 06/17/81 •m .0, .9/81 01/14/31 06/22/81 07/06/81 Amt of ck - $176.75 07/09/81 07/21/81 Amt of ck - $120.00 06/26/81 07/02/81 Amt of ck - $10.00 1 06/19/81 07/02/81 Amt of ck - $91.00 06/16/81 06/29/81 1 Amt of ck - $131.00 CITY OF MIAMI -- AUGUST 1981 Claim Form Claim ; Name of Insured Date of Charges Signed Received Claim Paid Remarks Robert Fink 06/08/81 None 07/02/81 07/29/81 Kenneth Wilson 03/28/81 07/19/81 07/24/81 07/31/81 Gerald Camp 06/81 06/23/81 07/30/81 08/05/81 J Dukes 06, 07/81 06/30/81 08/04/81 08/11/81 R Baker 05/12/81 05/15/81 05/17/81 07/23/81 DCI sent 6/4 DCI reed 7/7 Patrick R. Roach 12/25/80 None 07/09/81 06/04/81 Req form 6/17 07/15/81 07/24/81 Amt of ck - $39.20 Herman Brice 12/01/80 None 07/20/81 08/03/81 Amt of ck - $31.70 Nelson George 11/05/80 02/09/81 02/11/81 02/20/81 Amt of ck - $7.00 Harold Hardaman 01-08/81 08/11/81 08/17/81 08/21/81 Amt of ck - $90.00 David Murphy 08/05-11/25/80 07/28/81 08/05/81 Amt of ck - $285.61 CITY OF MIAMI -- OCTOBER 1981 Name of Insured Date of Charges Claim Form Signed Claim Received Claim Paid Remarks Carrie Nesbitt 08/81 None 10/01/81 10/12/81 Wayne Hinnant 09/08/81 09/08/81 09/28/81 10/09/81 Carl Johnson 08/13/81 08/20/81 08/28/81 09/08/81 Thomas Calloway 09/15/81 09/22/81 09/30/81 10/09/81 Edward Bratz 08/07/81 08/28/81 09/02/81 09/11/81 09/07/81 Req. diag- nosis 09/10 Recd 09/12 10/02/81 Amt of ck - $16.00 08/31/81 09/02/81 Amt of ck - $40.00 09/11/81 09/24/81 Amt of ck - $214.00 10/01/81 10/14/81 Amt of ck - $142.34 09/30/81 10/09/81 Amt of ck - $567.85 CITY OF MIAMI -- NOVEMBER 1981 Claim Form Claim p Name of Insured Date of Charges Signed Received Claim Paid Remarks k Terry Gonzalez 09/17/81 09/30/81 10/19/81 10/27/81 Salvador Landa 09/20/81 None 10/21/81 10/30/81 Thomas G. Lee 09/16/81 09/16/81 09/21/81 Req addl info 9/30; recd 10/15 10/26/81 Charles Allison 07/29/81 10/07/81 10/23/81 11/05/81 D Milley 10/26/81 None 11/02/81 11/11/81 Charles Allison 11/03/80 12/01/80 10/15/81 10/27/81 Amt of ck - $96.00 Mary Halloran 01/18-11/12/80 None 08/24/81 08/26/81 Amt of ck - $35.00 Larry L. Broodway 02/81, 09/81 10/10/81 11/06/81 11/16/81 Amt of ck - $48.00 Frank Rallason 02-03/81 None 09/30/81 10/23/81 Amt of ck - $11.42 Ray J. Hamlin 02-08/81 08/19/81 09/28/81 10/08/81 Amt of ck - $430.44 L-1 CITY OF MIAMI -- DECEMBER 1981 Claim Form Claim ' Name of Insured Date of Charges Signed Received Claim Paid Remarks Gregory Lowe 09/03/81 11/02/81 11/06/81 11/16/81 Jose Arias 07/25/81 None 08/21/81 V Req. form 90 08/25 & 10/20 Recd 11/23 12/15/81 Wilmer Parks 06-10/81 10/20/81 10/26/81 11/11/81 Ja* Byrd 06/81 10/14/81 11/12/81 11/23/81 Richard Hickox 01-10/81 10/20/81 10/26/81 11/18/81 Richard Hickox 03/07,12/31/80 1.0/20/81 10/26/81 11/18/81 Amt of ck - $10.00 Luis Diaz 01/28/81 None 11/11/81 11/20/81 Amt of ck - $127.00 Kenneth McCullough 01-11/81 11/19/81 11/25/81 12/02/81 Amt of ck - $90.00 R L Hardegree 10/29/80 09/23/81 09/29/81 10/09/81 Amt of ck - $32.00 Ray Verner 01/08,03/05/81 09/16/81 , 11/16/81 11/24/81 Amt of ck - $22.00 0 CITY OF MIAMI -- JANUARY 1982 Name of Insured Date of Charges Claim Form Signed Claim Received Claim Paid r Remarks 01- Julio Mestas 08/20/81 10/15/81 12/04/81 01/04/82 John Montgomery 07,08,09/81 12/01/81 12/04/81 01/05/82 Charles Manetta 10/29/81 12/08/81 12/14/81 01/08/82 Andrew Sears 11/03/81 01/06/82 01/11/82 01/18/82 Gladys Fernandez 12/10/81 None 12/21/81 01/14/82 den Wilot liam Carter 12/12/80- None 09/29/81 10/09/81 Amt of ck - $20.00 08/26/81 Paul Oboz 02/07-12/11/81 12/14/81 12/16/81 01/18/82 Amt of ck - $39.00 Charles Dathard 12/29/80- None 12/07/81 01/19/82 Amt of ck - $16.00 12/03/81 i Gurrell Atchison 01/09-12/17/81 None 08/21/81 Rea addl info 8/26; recd 12/21 01/15/82 Amt of ck - $18.00 James Rehm 09/17/80- None 11/16/81 04/13/81 Req addl info 12/7/81; recd 01/11/82 01/21/32 Amt of ck - $155.00 0 LE CITY OF MIAMI GROUP BENEFIT PLAN Number and Age of Claims in Casselberry Benefits Office 1 I�dla4(-- 2 3 4 5 6 7 8 9 10 11 12 13 OLDER -- '-13r32 811 9 '-2039 89 3 '-27 98 64 23 6 121 1-O3 107 1 87 82 70 29 -10 48 38 79 19 1.26 10 -17 42 106 i 1 -24 127 23 -31 70 146 33 I1 -07 67 79 24 -14 95 14 28 57 0 1 -21 54 77 50 41 103 27 -281 36 40 36 17 95 66 I -051 31 48 40 150 1 -13i 20 75 49 56 44 92 47 19 25 17 12 -1 j��-__--Q_ 0 5 21 1 541 42 2 82-473; CITY OF MIAMI GROUP BENEFIT PLAN ;dumber and Aye of Claims in Casselberry Benefits Office 3 4 5 6 7 8 9 10 11 12 13 OLDER Days Days )-26 0 0 0 0 100 51 1 47 1 1 1 6 �--02 0 5 30 28 101 45 61 33 9 34 -09 0 49 15 12 62 13 16 16 15 25 3 13 --16 0 0 24 4 47 27 4 1 -23 0 27 13 63 115 17 15 1 1 -30 0 I 0 40 105 41 29 23 16 84 12 14 J i 0 I 95 59 4_ 64 59 50 29 80 33 16 14 2 96 i -141 0 57 52 11 103 47 51 741 G 36 53 35 15 115 -21 0 41 51 3 69 50 55 52 6 103 57 73 68 200 __28 0 0 11 43 23 41 1 51. 3 69 50 65 62 6 366 - 05 0 18 18 1-3 65 45 26 15 78 22 43 54 2 705 --11 0� -- 0 0 0 30 14 6 10 25 8 131 4 361 499 -18 T 16 12 8 ( 31 19 4 11 01 38 13 6 7 286 ') -_.5++ 0 38 35 27 49 10 4 1 0 3 2 0 0 9 82-473 0 9.. CITY OF MIAMI GROUP BENEFIT PLAN 6E Nu;iibr-, - and Age of Claims in Cassolberry B3--nefit,i office �__—_ _ _—l�.c� ?-01 41 2 i �c 50 I 3 12 b • r r 115 5 6 7 I b r 9 - f 10 Days 11 C 12 DaVs 13FOLDER pavc -08 46 39 17 .102. 48 '-16 15 52 47 24 106 69 '-2 0 26 16 96 35 36 23 3-01 1. 56 41 11 113 43 61 i I j I i i i I I I 8z~4'73 LAW f3rfICES KAPLAN, SICKING, HESSEN, SUGARMAN, ROSENTHAL & DE CASTRO 1951 NORTHWEST 17th AVFNUF MIAMI, FLORIDA MAILING ADORFSS PO DRAWER 520117 MIAMI, FLORIDA 11152 ABRAHAM BASSIF General Prartire STEVEN BLOOM Iahor Law ALFREDO F. DE CASTRO (,Pneral Practice PAMELA FLFISCHMANN General Prar fire PAT RICK O. HEIM General Practice ARNOLD D. HESSEN Personal Inµ(ry and Wrongful Death Famih Law )OSEPH H. KAPLAN Labor Law HENRY S. PRETTYMAN Criminal law GERALD A. ROSENTHAL Workers Compensation RICHARD A. SICKING Workers Compensation Adminrstratwe and Governmental law ROBERT A. SUGARMAN I ahm I aw HOWARD S SUSSKIND I abor I aw TELEPHONES: (305) 12511,61 FROM RROAARD DIAL 02t141159 FROM PRIM BI ACH DIAL 654-2262 WEST PALM BEACH OFFICE SUIT( 9(17 • FORUM III 16hS PALM RF A(H 1 AK E S LIOUI E VARD WEST PRIM BEACH, II ORIDA 34401 TPI No (30S)683-4400 PROFESSIONAL ASSOCIATION May 11, 1982 Mr. Don Teems, President Miami I.A.F.F. Local 587 4140 S. W. 65th Avenue Davie, Florida 33314 Dear Don: As I understand the question you posed to us for a legal opinion, during recent contract negotiations with the City of Miami, neither the City nor the Union raised the question of an increase in employee contributions to the group health insurance program; and subsequent to those negotiations the City proposed an increase in employee con- tributions which was disputed by your Union. Moreover, as I understand it, both the City and the Union had been nego- tiating changes in several issues relating to the group health insurance program when the City unilaterally placed the matter of increasing the employees' contributions on the agenda of today's City Commission meeting, Your query whether. the City's conduct, if they in fact increased the employees' contributions, would violate either your collec- tive bargaining agreement or the Public Employee Relaticns Act, or both. Your collective bargaining agreement is clearly vio- lated by the City's unilaterally increasing the employees' contributions to the group health insurance program. Article V of your contract provides that any proposed changes in rights and benefits not specifically covered by the agreement will be negotiated by the City and the Union. In Article XVII of your agreement, the amount of premium to be increased and paid by the employee is not "specifically covered by the agreement" and thus the City has a duty under Article V to negotiate any proposed increase in the employees' share of that premium. Moreover, there is little lateral action in this matter (1) (a) (c) F.S. (1979) . In the question that the City's uni- would violate Section 447.501 most recent case involving 82-473 Mr. Don Teems May 11, 1982 Page -2- a matter almost identical to the facts you present, the City of Dunedin case appearing 8 FPER T13102, PERC speci- fically found that under facts quite like the facts in your case, the City of Dunedin could not unilaterally increase the cost of health insurance paid by the employees without prior notice to and negotiating with the employees' bargaining agent. I suggest that you call these matters to the atten- tion of the City Commission and encourage them not to vio- late either the collective bargaining agreement or State law by the actions which appear to be proposed by the Administration. JHK/rla 82-473 - Cite at: 8 FPEA 1113102 Certification— un►on's Ofeclalmer Of /nftlresf-- Retrocetfon-- 32.98 Union's certification as representative of unit of county's emergency medical service workers revoked where union filed disclaimer of interest in representation of unit employees. Douglas R. Draxler, Ft. Walton Reach, representative fc{r petitioner. Robert Norton, Con it Gables, attorney for respondent. ORDER DISMISSING PETITION AND REVOKING CERTIFICATION On April 14, 1981, following a secret ballot election. Commission certified the Okaloom island Fire Figh, Association, Local 2617, as the exclusive bargaining represents, for empinvees of Oksloosa County in the following unit emergency medical service workers: INCLUDED: Drivers and Emergency Medic& Technicians. EXCLUDED: Director. Assistant Director. dispateheri and clerical employees and all other County employees.' On January 13, 1982. Douglas Draxler, President of Local 2617. filed a petition to Revoke Certification, seeking the decertification of Local 2617 as the exclusive bargaining representative of the above -cited unit. Pursuant to Section 447.308(I), Florida Statutes (1981) and Florida Administrative Code Rule 3813-17.15, the petition is DISMISSED as untimely because it was filed within twelve months of the representation election in this bargaining unit. Furst M. Coltman v. /BEW. Local 2358, 6 FPER 4111163 (1980).t On January 19, 1982, in accordance with Florida Administrative Code Rule 3813-17.13, Mr. Draxler, on behalf of Local 2617. filed a disclaimer of interest in representing the previously defined unit of emergency medical servioe workers. It appears, upon review of the statements made in the disclaimer, that Local 2617 has satisfied the requirements of Rule 38D-17.13(1). Therefore, Certification No. 533 is REVOKED with prejudice. Local 2617 shall not be permitted to file, or intervene in, a petition to represent the same employees in the bargaining unit for a one- year period following the dale of this order. Fla. Admin. Code Rule 38 D-17.13(2) It is so ordered. i Okalnnsa Wand Fire Fighters Assorlation, !oral 2617, /AFFv. Okaloosa County. Case No. RC-80-041(Certifiation No. 533). t The petition also is defective because it is not supported by a 30 percent showing of interest as required by ()447.308t 1) Florida Statutes and Florida Administrative Code Rule 38D-17,14(4). % CITY OF DUNEDIN Decision of PERC Pinellas County Police 9ertevolenl Association, Inc., Charging Party, v. City of Dunedin, Respondent. Case No. CA-81-087, 821J-048 February 9, 1982 Before Powers, Chairman; Brook%, Commissioner Unllahlal Changiv - fnereasad Health /nauranee MY Dadoothme— Wafwr-- 09. 042,43.78,43. ?#, 72.651, 72.6" Neither broadly -worded zipper clause nor management, rightai clause, which did not specifically reserve to city tight to .alter insurance program. constituted clear and unmistakable waiver by police union of its right to bargain concerning city's unilateral implementation of increased health insurance payroll deductions. Although, in order to maintain health benefits at current level, city was required by insurance carrier to increase premiums, city was notified by, carrier several months in advance of impending increase. Thus, city had adequate time to commence negotiations with union regarding change. Accordingly, city's unilateral action was unlawful. Gene "Hal" Johnson, Tallahassee, attorney for charging party. Jolffl G. Hubbard. FRA7.FR ik HURRARD, Dunedin, and Harrison C. Thompson, Jr., SHACkLEFORD, FARRIOR, S7ALLiNGS dt EVANS, Tampa, attorneys for respondent. ORDER On October 7, 1981, the Pinellas County Police Benevolent Association (Union) filed an unfair labor practice charge alleging that the City of Dunedin (City) violated Section 447.501( 1)(a) and (c), Florida Statutes (1981). by unilaterally increasing the health insurance premium paid by bargaining unit members On October 9. 1981, the Commission determined the charge to he sufficient and ordered that an evidentiary hearing be held. On November 24, 1991. a hearing was conducted before a Commission appointed Hearing Officer, at which time both parties were given the opportunity to present testimony and evidence and to cross-examine witnesses. Both parties filed briefs to the Hearing Officer. The Hearing Officer's Recommended Order issued on December 23. 1981, a copy of which is attached and incorporated herein.' The Hearing Officer concluded that the City violated Section "730l(1)(a) and (c), Florida Statutes ( 1981). The Commission has reviewed the Hearing Officer's Recommended Order and has determined that the findings of fact therein are supported by competent substantial evidence. Accordingly, the Commission adopts the Hearing Officer's findings of fact as its own findings of fact. Having examined the (fearing Officer's dt%cu%mon of the issues and conclusion% of law, the Commission finds itself in agreement with the Hearing Officer. Accordingly, the Commission adopts the Heannp Officer's conclusions of law. The Commtssion has reviewed the remedy recommended by the )fearing Officer and is in substantial agreement with it. However, the Commission disagrees with that portion of the recommendation which provide% that, "if nn agreement can he 82-4'73 - .102 Public Employee Reporter (Florlds Edltlon) reached within twenty days after the PBA's request for negotiations, the City shall reimburse any qualified employee for the loss of pay caused by the increased premium from August 7, 1981. until the date that agreement on the insurance premium was reached as a result of negotiations for a successor contract." The appropriate remedy in unilateral change casts isa return to the .status quo ants until agreement is reached. See. e.g., Hernando CTA v. Hernando County School Board, 3 FPER 246 (1977). We find no reason to require reimbursement only if agreement is not reached within twenty days of the request for negotiations. The City should be required to "make whole" all bargaining unit employees by reimbursing them for the amount of the increase already deducted from their paychecks and to assume full payment of the increased cost of the premium until agreement is reached on the method of payment.' Pursuant to Section 447.501(6xa). Florida Statutes (1981), the Public Employees Relations Commission orders the City of Dunedin to: I. Cease and desist from: a. Changing the costs paid by employees with dependents for the health insurance program, without prior notice to, and negotiations with, the PRA. h. In any like or related manner, interfering with the exercise of employee rights guaranteed by Chapter 447, Part 11, Florida Statutes (1981). 2. Take the following affirmative action: a. Upon a proper request, negotiate with the PBA concerning the rate change of the health insurance program for employees with dependents that became effective August 7, 1991. b. Commencing with the first premium payment due following the issuance of this order. make full payment of the increased portion of the premium for the health insurance program for employees with dependents and continue such payments until the date that agreement on the method of payment of the insurance premium is reached. c. Reimburse any qualified bargaining unit employee for the loss of pay caused by the increased premium from August 7, 1981, until the date that the City commences payment of the increased premium or until the date that agreement on the method of payment of insurance premium is reached, whichever may be sooner. d. Pay reasonable attorney's feet and costs of litigation to the PBA in accordance with the procedures set forth in Florida Administrative Code Rule 3813-14.04. e. Post immediately for sixty days in conspicuous placer where notices are customarily posted, the attached Notice to Employees stating that the City shall tease and desist from the actions set forth in paragraph 1 above. Copies of the Notice shalt be signed by the City's authorired representative prior to posting. The City shall take reasonable steps to ensure that the notices are not altered, defaced, or covered with other material. f. Notify the Public Employees Relations Commission in writing within twenty calendar days from the date of this order of steps that have been taken to comply with this order. It is so ordered. i No exceptions to the Recommended Order were filed by HEARING OFFICER'S RrCOMML`DI U ORI►FR On November 24. 1991, the undersigned hearing ottitcr conducted a public hearing in Dunedin. I lotida, concerning issues raised in the above -styled case. I. PRELIMINARY S1A1FMt-NT On October 7, 1981, the Pinellas County Police Reoevolent Association, Inc. (PBA), filed an unfair labor practice charge in accordance with the procedures required by Section 447 501(I ). Florida Statutes (1979), and Florida Administrative Cede Rule 3813-21.01. The PBA alleged thnt on August 7, 19R1. the City of Dunedin unilaterally increased the health insurance premium paid by bargaining unit employees in violation of Section 447 501(11(a) and (e). The Commission determined the a harge to he sufficient by its order dated October 9, 1991. and schrduled an etidentiary hearing for November 3, 1991. At the rcyucst of the PHA, and without objection by the City, the hearing was rescheduled for November 24. 1981. On October 28. 1981. the city filed a dismissal motion and an answer. The motion to dismiss was denied by the hearing officer in an order issued on November 20, 1991. In its answer the City admitted that it had increased the health insurance premium for dependent coverage of bargaining unit memhcrs un August 7, 198I, without prior negotiations with the PRA However, the City affirmatively defended its action on two grounds first, the City contended that the increase in premium did not constitute a substantive change in working conditions that required bargaining Second, the City claimed that a contractual waiver permitted the unilateral iUrease. Both parties timely filed prehearing and pnsthearing statements and briefs. II. ISSUES 1. Whether the City unilaterally increased the health insurance premium for coverage of dependents of bargaining unit employees in violation of Section 441.501(I Na) and (c), Florida Statutes (1979). 2. Whether the PBA should he awarded reasonable attorney's fees and costs of litigation. Ill. STIPULATED FACTS At hearing the parties agreed to the following I. The PRA is the certified bargaining agent for all full-time permanent patrolmen and sergeants of the City (g) i 2. The City is a public employer within the meaning of Section 447.20)(2), Florida Statutes (1979) (9-9). 3. The PBA and the City are signatories to a collective bargaining agreement (Agreement) which was in effect from October 1, 1990 through September 10, 1991 (9, Exh al at 40) r Relevant clauses of the management rights, maintenance of conditions and duration articles, provide. in pertinent part: Article 4- Alanagrment Rights Section I Except as expressly protidrd for in this Agrremrut. the City retains the sole right. to manage a%onrration% and direct the working force, tntluding the ights to either party. decide the number and location tit statiom, the t We emphasire that the remedy applies only to employees in operating of motortied equipment, the %cope of the unit represented by the PRA. service it) he prrfornied. the method -4 wrvit c and the 82-4'73 - Cite as: 8 FPER 0 113102 rr rr rrr� schedule of work time; to contract and subcontract existing and future work; to determine whether and to what extent the work required in its operations shalt be performed by employees covered by this Agreement; to maintain order and efficiency in its stations and locations; to curtail or discontinue temporarily or permanently, in whole or in part, operations whenever in the opinion of the City good business judgment makes such curtailment or discontinuance advisable; to hire, lay off, assign. transfer, promote and determine the qualifications of employees and to determine the starting and quitting time and the number of hour to be worked and to have complete authority to exercise those rights and powers incidental thereto. including the right to make unilateral changes in the above subject only to such regulations governing the exercise of these rights as are expressly and specifically provided in this Agreement. Section 4 The City and the PRA, for the life of this Agreement, each voluntarily and unqualifiedly waives the right and agrees that the other shall not be obliged to bargain collectively with respect to any subject or matter not specifically referred to or covered in this Agreement, even though such subject or matter may not have been within the knowledge orcontemplation of either or both parties at the time that they negotiated or signed this Agreement. Article 22- Maintenance of Conditions Section i All rights, privileges and working conditions enjoyed by the employees at the present time, which are not included in this Agreement, will be presumed to be reasonable and proper. Article 40• Duration Section The City and the PDA, for the duration of this Agreement each voluntarily and unqualifiedly waives the right and agrees that the other shall not be obligated to bargain collectively with respect to any subject or matter not specifically referred to or covered in this Agreement, even though such subject matter may not have been within the knowledge or contemplation of either or both parties at the time that they negotiated this Agreement. unless otherwise provided for herein. (Exh. N 1 at 4. 22 and 40) 4. On or about August 1. 1991, the City implemented a new dental insurance plan, second surgical opinion program and revised life insurance program applicable only to employees who arc not members of the certified bargaining unit represented by the PDA (nonunion employees). At the same time all employees, both nonunion and union. were notified that the employee dependent health insurance coverage premium would increase $4.52 per biweekly pay period ($117.52 annually) effective August 7, 1981. due to the premium increase instituted by the insurance carrier. The new dental insurance plan, second surgical opinion program and revised life insurance program were implemented for nonunion employees at no cost to the nonunion employees (9.10). 5. The health insurance program for the employees represented by the PDA was entirely unchanged from the health insurance program that was in existence on October I. 1980 (11). 6. The increased employee dependent health insurance coverage premium in the amount of $4.52 per biweekly pay period wilts implemented August 7. 1991 and began to he deducted from the paychecks of all participating nonunion and union employees on that date (11). 7. in light of the fact that its bargaining tinit employees had suffered an increase in premium payment, as had all nonunion employees, but had not received the revised benefits (new dental insurance plan, second surgical opinion program and revised life insurance program) that were received by all nonunion employees. the PDA. on August 17, 1981. requested by letter that the City- (a) implement the new dental health insurance plan, second surgical opinion program and revised life insurance program for its bargaining unit employees; or (h) negotiate the changes in those benefits and premiums. The increase in premium was not related in any manner to the newly implemented dental insurance plan, second surgical opinion program or revised life insurance program. The increase in premium resulted solely and exclusively from the premium increase instituted by the insurance carrier. The City had no control over the premium increase (I 1.12). 8. On August 31, 1981, the City responded to the PBA's August 17. 1981 letter by denying the request to negotiate on the ground that the PDA had waived its right to impact bargaining (13). 9. The PHA sent another letter to the City, dated September 8, 1981. In if,, -the PHA objected to the City's refusal to negotiate on the above -stated insurance coverage and premium (14). 10. At no time prior to or immediately after the implementation of the premium increase did the City negotiate with the PHA the change or its affect or impact on unit employees. Several months prior to the implementation of the premium increase the City and the PDA commenced collective negotiation for a new contract year beginning October 1, 19H 1. As part of those negotiations health insurance programs and other medical programs were negotiated and discussed both prior to and after August 1. 1981. The negotiations for the subsequent contract did not include impact bargaining over the increased premium for dependent coverage (14-I5). 11. A previous collective bargaining agreement between the City and the PDA, effective from October 1, 1974 through September 30, 1973, contained management rights and duration articles similar to the provisions in the 1980-1981 Agreement (16, Exh. # 1 at 4 and 30). 12. Prior to the premium change on August 7. 1981. the City paid all costs for a unit employee's medical insurance coverage and the City paid $24.33 toward the costs of an employee's dependent medical insurance coverage. if the employee elected such coverage. After the premium change on August 7, 1981. the Citycontinued to pay all costs of a unit employee's medical insurance coverage and the City continued to pay S24.33 toward the costs of an employee's dependent medical insurance coverage, if the employeeelected such coverage (17). IV. FINDINGS OF FACT The City's insurance carrier notified the City several months before August 7, 1981 of a premium increase (20). The increase in premium had to be paid by August 7, 1981, in order to maintain the status quo in dependent coverage. On August 1, 1981, the City 82-r4'731 A02 PI4c Employee Reporter (Florida E0on) 0 notified its employees of the $4.52 increase in premium that would be deducted from their biweekly paychecks starting August 7, 1981. Before August 7, 1981, the PRA was not notified that unit employees with dependents would he required to pay an additional amount for health insurance. V. DISCUSSION 1. Unilateral Change The PRA alleges, and the City does not deny, that on August 7. 1981. the City began deducting S4.52 more per biweekly pay period from the paychecks of employees whose insurance coverage included dependents. Several months beforehand, the insurance carrier had notified the City that an increased premium would be necessary to maintain its existing insurance program. After this notification, the City did not promptly inform its employees of the impending increase in the cost of health insurance, or seek to negotiate the matter with the PRA. It eventually notified its employees (on August 1, 1981) that health insurance premiums would increase for those with dependent coverage. There is no record evidence that the Cityever notified the PBA of the impending health insurance premium increase. However, the record supports the reasonable inference that the PBA learned of the increase from its unit members, who were notified of it on August 1, 1981. Andrus v. Florida Department of Labor and En►ployment Security, 379 So.2d 468. 470 (Fla. 4th DCA). Both parties agree that the subject was not included in the negotiations for a subsequent contract, which began several months prior to the City's implementation of the increase. There is no record evidence that the PBA ever communicated to the City either its agreement to the increase or its intent not to negotiate the matter. To the contrary, the PBA, on August 17. 1981. requested negotiations on the premium increase. Substantial evidence, therefore, reveals that the City implemented the premium change without prior notice to. or negotiations with, the PBA. The City's insurance program is provided to all of its employees. Neither the program nor its cost to employees is expressly mentioned in the 1990-1991 Agreement, which expired September 30, 1991. The only reference to extracontractual "rights, privileges, and working conditions" is contained in Article 2Z Maintenance of Conditions. The section provides that such employee benefits "will be presumed to be reasonable and proper." (Exh. 01 at 22). A similar provision appeared in a prior collective bargaining agreement between the parties. No evidence was submitted that would demonstrate that the City ever previously implemented a premium increase without prior notice to, and negotiations with, the PRA. The Commission has held that an employee insurance program Is a term and condition of employment within the meaning of Section 447.309(1). Florida Statutes (1979). United Fieulty of Florida, Local 1880 v. Board ojRegents. 4 FPER 44319 (1979) (group insurance program is a proper subject of bargaining if dw employer can lawfully implement the negotiated placer. PbwAn 6owtty PRA v. City of St. Petersburg. 3 FPER 205(1977) (We, and accident insurance programs are proper subjects of bargaining). In the private sector. the cost of health insurance for employees with dependents is a mandatory subject of bargaining. Ord Chemical and Atomle Workers International Union v. NLRA 547 F.2d 375, 382 (D.C. Cir. 1977). It is clear. then. that health insurance programs and related premiums that cover public employees and their dependents are negotiable terms and conditions of employment in Florida. City of Tallahastee v. PERC. C&* 60.334 (M. [let:. 3. 1991) (rehearing pending). bftuse a health insurance program is a mandatory subject of barpining, the City had to notify the PRA of any proposed increase in the programs cost that its employees might have to pay. Updw a j►taper request. the increased cost had to be negotiated with de >ptlA prior to being implemented. See, e.g., St. Peterthrtrf) AtWtotlon of Aw fighters, Local747 v. Ciry of St. Petersburg. S MR +110381. Wed. 389 So.2d 1124 (Fla. 2d DCA 10191; PWowiteh v. Orange County School Board, 3 FPER 280 (101), ahtd. 367 So.2d 730 (Fla. let DCA 1979) (Po/ow•itch case). The only legitimate affirmative defenses that the Citycan raise to a unilateral change charge are a clear and unmistakable contractual waiver. some exigent circumstance requiring immediate action or legislative body action resolving an impasse issue. Martin Count►- Education Assn. Local .ibis v. Afartin Count►- School Board. S FPER 110302 (1979), ajrd, 390 So.2d 830 (Fla. Ist DCA 1980); Florida PBA v. State of Florida, 7 FPER 1(12051 (1980). Thiscase does not involve legislative action after impasse. Hence, only two affirmative defenses are available to that City. The City asserts that it had no choice but to deduct the increased premium from paychecks of employees with dependent coverage. However, it had sufficient time (several months) after initial notification of the rate increase to negotiate the change with the PBA. Such negotiations would have acquainted the PRA with the proposed change and enabled it to consult with its unit members to determine whether they wished to accept it, reject it or propose an alternative. If the parties were unable to reach agreement by the critical date, August 7, 19R1. then the City might have been jUstified in implementing the increased cost to maintain the s►atur quo in substantive insurance coverage for em ployees with dependents. Because no exigent circumstance existed several months before the August 7. 1981 implementation, the City's action cannot be affirmatively defended on this ground. The City next asserts that the PRA, in Article 4, Section 1, Management Rights, waived its right to negotiate the increased cost of the insurance program. In the article the City "retains the sole right" to do such things as "maintain order." "contract and subcontract existingand future work, -and hire employees (Exh. al at 4). The last phrase of the article authorizes the City "to make unilateral changes in the above subject only to such regulations governing the exercise of these rights as are expressly and specifically provided in this Agreement " This sectinn is a generalired management rights provisions which grants the City the authority to unilaterally alter many delineated working conditions. The insurance program, however, is not one of the explicit delineations. Commission precedent states that generalised contractual language, without more, will not be construed as a waiver of the right to bargain over subsequent proposed alternations to existing terms and conditions of employment. See. r R., Palo witrh case. 3 FPER at 280. "A lawful waiver must he based on a clear and unmistakable showing that the labor organiration consciously yielded its nght to negotiate on a specific issue." iRPO, 1ocal621 v. City of Ho/lvwood, 7 FPER 112293 (19R1). Because the management rights provision does not meet the requirement of specificity regarding the insurance program, it does not constitute a valid contractual waiver defense to the City's unilateral change in the program on August 7, 1981. Moreover, Article 4, Sectinn 4, Management Rights, and Article 40. Section 4, Duration, both provide that neither the City nor the PBA is obligated to hargam over "am• subject or matter not 82-473— I* CIls me: 8 FPEA I_........... - ¶13102 specifically referred to or covered in this Agreement, even though such suhject matter may not have been within the knowledge or contemplation of either or both ponies at the tirrle that they netrotiated this Agreement...." These general "ripper clause" provisions do not constitute the unmistakable waiver required by the Palo -itch case, because there is no express delineation waiving the PBA's right to negotiate concerning the proposed change in the insurance plan's rate for employees with dependents. The relevant contractual provisions are not similar to those in which the Commission has found a clear waiver$ to negotiate proposed changes to existing working conditions. See, e.g., IRPO, Local621 v. Ciry of Holl wood. 7 FPER 112293 (1991) (explicit waiver to negotiate changes in shift system). In view of the above discussion. the City's unilateral increase in the cost of its insurance program paid by employees with dependents, violates Section 447,301(IXa) and (c). Florida Statutes+ (1979). The appropriate remedy to a valid unilateral change unfair labor practice charge is usually an order which requires the charged party to return to the bargaining table upon a proper request for negotiations. However, in this case negotiations could be futile because the critical date. August 7. 1981, has passed. Therefore, if negotiations are unsuccessful after a reasonable period of time, the City should be required to reimburse qualified employees for their payment of unlawfully implemented insurance premiums from August 7, 1981 until the date when the parties reach agreement on this subject as a result of negotiations for the successor to the 19M 1991 Agreement. See ,Norion Count)- PBA v, Ciry of Ocala, 3 FPER 110088 (1979). affd, 392 So.2d 26 (Fla. lit DCA 1980). 2.Arrornes-'s Fees and Costs The Commission's standard for awarding attorney's fees and costs pursuant to its authority in Section 447,503(6)(e). Florida Statutes (1979), has been explained most recently in the case of Orlando Professional Fire Figh►ers, local1363v. atvofOrlando, 7 FPER 112386 (1981). One of the circumstances in which fees are awarded is when the violation is blatant because the charged party should have known that its action was violative of the collective bargaining rights of employees protected by Chapter 447. Knowledge of violations can be gained through published Commission decisions. In this case. Florida public sector pr+ecedenl since 19" has made it clear that a unilateral change in working conditions is violative of employees' rights. Set, e.g., Polowitch case. 3 FPER at 280. Consequently, the City should have known that its unilateral increase in insurance costs to employees with dependents would violate Section 447.301(I xa) and (c). Florida Statutes (1979). Therefore. the City should be required to pay the reasonable attorneys fees and costs of the PBA's counsel. VI. CONCLUSIONS OF LAW Based upon the foregoing, 1 recommend that the Commission make the following legal conclusions: I. The City is a public employer within the meaning of Section 447.203(2), Florida Statutes (1979). 2. The PBA is the certified bargaining agents of the City's full-time permanent patrolmen and sergeants, within the meaning of Section 447.203(12), Florida Statutes (1979). 3. bargaining unit members had a reasonable expectation that the cost of their health insurance would not be increased Butting the duration of the 19M1981 Agreement. 4. By its August 7. 1981 unilateral increase in the cost of health insurance paid by employees. with dependents, without prior rltctlee to, and negotiations with, the PBA, the City violated Section 40.501001 and (c). Florida Statutes (1919). VI1. ORDER I recommend that the Commission issue the following order: 1. The City shall cease and desist from: (a) Changing the cost paid by employees with dependents for the health insurance program, without prior notice to, and negotiations with, the PBA. (b) in any like or related manner, interfering with the exercise of employee rights guaranteed by Chapter 447, Part 11, Florida Statutes (1979). 2. The City shall take the following affirmative action: (a) Upon a proper request, negotiate with the PBA concerning the rate change in the health insurance program for employers with dependents that became effective August 7, 1981. If no agreement can be reached within 20daysafter the PBA's request for negotiations, the City shall reimburse any qualified employee for the loss of pay caused by the increased premium from August 7, 1991 until the date that agreement on the insurance premium was reached as a result of negotiations for a successor contract. (b) Pay to the PBA its reasonable costs and attorney's fees for litigating this case. (c) Post immediately for 60 days in conspicuous places where notices are customarily posted, the attached Notice to Employees stating that the City shall cease and desist from the actions set forth in paragraph 1, above. Copies of the notice shall he signed by the City's authorized representative prior to posting. The City shall take reasonable steps to insure that the notices are not altered, defaced or covered with other material. (d) Notify the Public Fmployees Relations Commission in writing within 20 calendar days from the date of this order of steps that have been taken to comply with this order i The transcript of the November 24, 1991 hearing shall he referenced parenthetically by page number. Citations to the record are not necessarily the only support in the record for a particular finding of fact. t The three exhibits shall he referenced parenthetically by exhibit number and relevant article number. ) As noted by the City, the Commission's application of the standard of specificity appears to be less stringent in one case, Hillsborough PBA v. Ciry of Tampa. 6 FPER ¶11033 (1990) (provision allowing alteration of "past practices" is valid waiver of right to home use of unmarked cars). 82-4t73 _. r a RESOLUTION NO. A RESOLUTION AUTHORIZING THE INCREASE AND EQUALIZATION OF CONTRIBUTIONS TO THE GROUP BENEFITS SELF-T:'ISCRANCE FUND FOR BOTH ACTIVE AND RETIRED EMPLOYEES OF THE CITY OF `IAMI IN THE CITY' S HEALTH CARE PLAN. WHEREAS, the contribution levels currently established for the Self -Insured Health Care Plan of the City of Miami are not sufficient to maintain both a self-sustaining and actuarily-sound fund; and WHEREAS, the firm of Johnson & Higgins of Florida, Inc., after a thorough review of the Cit;, Self -Insurance Plan, had recommended that current rates for this portion of the Self - Insurance Fund be increased in order to maintain a self-sustain- ing and actuarily-sound fund; and WHEREAS, it has been determined that a basic inequity exists in the current rate structure between contributions made by active and retired employees; and WHEREAS, the Self -Insurance and Insurance Committee of the City of Miami, at their meeting of October 21, 1981, unani- mously agreed to recommend that the City Commission adopt the rates recommended by Johnson & Higgins of Florida, Inc. which would both equalize the active and retiree contribution levels, and provide for a sound fund; NOW, THEREFORE, BE�IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI, FLORIDA: Section 1. A. Effective March 7, 1982► the following 1/ monthly rates will be used in the City's Health Care Plan for employees for determining both employee and City contributions to the Group Benefit Self -Insurance Fund: ACTIVE Employee under 65 $ 58.15 Dependent under 65 103.02 Employee 65 & over 37.42 Dependent 65 & over 36.46 RETIRED 0 Employee under 65 $ 58.15 Dependent under 65 103.02 Employee 65 & over 37.42 Dependent 65 & over 36.46 ---------------------------------------------------------------- 1/ Increased rates equalized for active and retired employee contributions N 82-4737 0 B. The portion of the cost contributed by both the employee and the City shall be determined in accord- ance with the Collective Bargaining Agreement for each respec tive employee. C. City contributions shall be made from the Self - Insurance Fund. PASSED AND ADOPTED this day of 1982. M A Y O R ATTEST: RALPH G. ONGIE, CITY CLERK PREPARED AND APPROVED BY: 644* t -,7. ROBERT F. CLARK $ APPROVED AS TO FORM AND CORRECTNESS: l - P 1 GEORCyElF. KNOX, JR.- CITY WTTORNEY 82-473