Bradenton City Council Meeting, July 22, 2026 — Transcript

everyone and welcome to the Bradenon City Council meeting, Wednesday, July 22nd, 2026 at 8:30 a.m. in City Hall Council Chambers in the beautiful great city of Bradenton, Florida. So at this time we'll ask our pastor to come forward and lead us in the invocation and then we'll do the pledge and we'll start a great meeting. Thank you. >> Good morning. >> Morning. >> Let's pray together to the almighty creator of heaven and earth. To the one and only true God who is the creator and sustainer of all things. to the God who has revealed himself through the person of Jesus Christ who willingly laid down his life for the sins of the world. To you we humbly come today. We acknowledge that according to your word, you have established all those in positions of authority. Further, we recognize that you have established earthly governments for the good of the people. Today we come before you asking for your guidance and your wisdom for those here, for these men and women who sit in positions of authority that you would give them wisdom, that you would give them understanding, Lord, that you would allow them to make decisions and policies that are for the good of all people, that would also bring glory and honor to your name. Lord, we recognize that all good things come from you and that your word says that that you establish and you you provide for both the wicked and the righteous as your rain falls to water the earth for the needs that we have, Lord, that you reign on the good and the bad because you love your creation and desire for us to know you. And so, Lord, I pray that today in this place you would be acknowledged. Lord, I pray for your hand of protection on these men and women here. Lord, that you would guide them. Lord, that you would uphold them and that you would help them to make decisions that are in line with your righteousness and for the good of all people. And Lord, we give you the glory and the honor for the sustaining power that you provide for us each and every day. And it's in the mighty name of Jesus that we pray. Amen. >> Amen. >> Thank you. We join all veterans in the audience in the pledge. [clears throat] I aliance to the flag of the United States of America and to the republic for which it stands. One nation under God, indivisible, with liberty and justice for all. >> Thank you, Dr. Lemons of the Calvary Baptist Church for doing coming this morning. And and as we've said at this council, we will always say a prayer and the pledge before we start every meeting. It's so important as we see what uh we had during break as a July 4th celebration of 250 years of this great country and it was just an honor to uh to still be doing what we're doing and appreciate that Dr. Lemons. Thank you. >> This time I'll call the meeting to order. Madame clerk, >> the first item on the agenda this morning is a proclamation for Judge Gilbert Smith Day, July 31st, 2026. Whereas, Judge Gilbert Smith is a lifelong public servant with his involvement in leadership, integrity, and commitment to all citizens of our community. His service has shaped both its legal community and its broader civic landscape for decades. And whereas throughout his distinguished judicial career, Judge Smith has earned a steadfast reput reputation for fairness, wisdom, and unwavering dedication to justice. His work on the bench reflects not only a deep understanding of the law, but also a genuine respect for the people and community. And whereas his leadership spans numerous civic and nonprofit organizations, including his role as president of the Bradenon Kuanas Club and the Manatee Manatee Chamber of Commerce's legislative affairs chairmanship. He has led with humility, collaboration, and responsibility. And whereas Judge Smith is a dedicated mentor investing his time in guiding young professionals, supporting aspiring attorneys, and mentoring youth during their formative years. And whereas he is a recent recipient of the prestigious Kent C. Schultz Award by the Leadership Manity Alumni Association. And whereas Judge Smith is a respected historian and author, he has made an enduring contribution to preserving the region's story. Work includes Lawyers and Legends of Manatee County, second edition. And in celebration of Bradenton Kuanas' 100th year, he wrote Champions of Children, volumes 1 and two. [clears throat] Now therefore, be it resolved that I, Gene Brown, as mayor of the city of Bradenton, Florida, do hereby proclaim July 31st, 2026, as Judge Gilbert Smith Day, and urge all citizens to honor and thank him for his years of lifelong commitment to all residents. Sign Gan Brown, Mayor. >> Thank you. Judge Smith, you got some words you want to say? >> Well, um, I'm not going to say many words, but as I look out among family, um friends, and colleagues. I um just, um want to thank everyone for being here. Um I'm so honored, uh by this um somewhat speechless, uh to u have this proclamation made. Um I love uh the city of Bradon and I love Manty County. Uh that's what um inspires me to write about this community uh and write about the people here. So, you know, um we've always had um really strong leaders here. In fact, they're so strong and so unique that oftentimes history's made um in this community that otherwise um not anywhere else in the country. So, I want to thank all of you for being here. Um I I really do appreciate you being here. I've enjoyed uh my time serving as a judge. Um it's it's hard. I'm I but I knew that going in. Uh but I really um have enjoyed the time serving uh Many County, the citizens here and the residents of the 12th Judicial Circuit. So, thank you very much. >> All right, before we clap, stay up here. You get to get to the microphone and look at us. Now, [laughter] it it's it's not, as the sheriff would probably say, it's not a roast yet, but but uh it's something that I want to give the council an opportunity. Vice Mayor Coker. >> Oh, thank you. Um Joe Smith, um part of our community strength, I think, is because we have such deep roots and and your family and so many families um have really formed the community like you said. And I think the fact that uh your through your steadfast efforts to put pen to paper, which I don't know how much longer they'll still put pen to paper, but your books um and you documenting um all of the people and events that have that have come before us, and that gives us something to hand down to the next generation so that they can always know where they came from and keep an eye going forward um and not forget about the past. And I thank you for that. and I think the generations to come will too. >> Councilwoman Barnaby. >> Well, Judge, you've had a long distinguished career. But allow me to personally say I think one of the most important things that you did was your family. >> You have a beautiful wife. You have a wonderful family. They've supported you. You've supported them. I mean, Anita has done many things in this community as well. So, I want to salute you for having a wonderful family and I want to thank the family for giving us the gift of his time. >> Thanks. >> Thank you, Councilwoman Coachman. [clears throat] >> You know, I'm not really good at these things. I I don't really like goodbyes or, you know, travel on because I know there's more to come with you. I had the pleasure and the privilege to meet you when I worked with the teen court program and ever since then you have inspired me to each day try to make history because you are the type of person that acknowledges what we where we've been where we are and the possibilities of where we're going and I know you are going to do a lot more and just thank you for all you've given to to Manatee County and the city of Bradon and to you and your family. All the best. >> Thank you, Councilwoman Moore. >> Oh, I I this is definitely not goodbye. Um I um I I want to thank you and your family for uh many years of just being an inspiration to not just me, but my family, as you know. Um we've just been honored to observe your dedication to your community and to the preservation of that history. Uh it I personally believe that the preservation of history is so important so that you know where you've been and it can guide your path forward. Um but it's that commitment to community that I think that we you aspire to. So, you've been a fantastic I mean, I can't even there's no words for the uh example that you've set for our legal community and I know that you will continue because I know you can't put it down and I look forward to the next iteration of that preservation of history. >> Councilman Shusler. Yeah, as as uh as someone who's newer to or the newest member of city council, um I wanted to reiterate what we as a body has have already pretty much said, which is uh thank you for your documentation of of the history of this city, for your mentorship, for your leadership, and uh all of your service to Bradenton and the greater Manatee community. >> Thank you. >> Thank you, ma'am. >> Thank you. >> Now, that was great. Everybody, you know, said a lot about their knowledge of you and different things. I'm gonna kind of go back to 10-year-old [clears throat] Jean Brown >> when he was sitting on your dad's lap in that courthouse with something that probably that's why I'm sitting here today because of a situation and a family dynamics and family court. But you just look at the integrity that you've brought to it from what your dad did to what you did the whole time. And now probably the biggest thing that's helped me is reading some of those books and different excerpts that you've done about the city of Bradenton because without history and we've seen a lot over the years and things that are on that if you don't celebrate your history some good some bad we're going to repeat the bad things and we want to definitely try to do good things and some decisions are made whether it's on the bench or whether it's on a dis that don't meet at the moment what people may like But when you look at the future of what it's done for the future, it's something so great. So, I just want to thank you and uh going all the way back. I'm sure your dad treated you the same way to make things better for the children of the world and that's what you've done for those next generations and what's so important to do what we're doing today and what we're going to do for the future and continue writing those because they're such great celebrations of life. but what we learn about our community that we didn't know and the first council members that were here and what Talent Park may have been and the first president of Kowanas that really shaped the city, you know, and what they've done. So, thank you for that. And I know there's always these uh kind of mandates that you retire, but I think you'll be more of a Kanian and Boy Scouts of America and all the things that have been your life. So, thank you for that and we appreciate it. Thank you, Mayor. [applause] >> So, Judge, Judge, you got to come back up. Get your family up with you. And then we're going to ask everybody in the audience to [clears throat] come forward that's here for Judge Smith. And we're going to get a big picture right up here. You got >> We're going to come back here. >> Yeah. You'll stay right in the middle. >> You want your box? >> I'm afraid I >> think it'll be okay. >> Thanks, ma'am. being so tall. [laughter] >> I have a problem. >> Yeah, everybody smile. >> It's your exercise for the day. [laughter] >> You want to share it? [laughter] >> Accurate. I know the safe for the city. Thank you for what you've done for all of us. >> [applause] >> You are so kind. Thank you. >> Your mama raised you. >> That was one thing she offers pretty insistent applaud. >> How are you? >> Good. >> You hold the chair off women. Open the doors. >> Australia. >> It was all all women who chef except for the wonderful to take you all to Australia. [laughter] >> Hi, how are you? >> Good. I'm so glad you came. [laughter] >> He would have said hi to you earlier when he came in. >> Except for that I was late. Yes, that's true. [laughter] Thank you for pointing that out, Chief. >> How are you? Good to see you. Everything good. >> Hey, buddy. That was Wait, that's the wrong picture. >> I had it except for that in Matthew's car. [clears throat] >> I would have had it [cough] in the other car. >> Thank you to everyone for that proclamation. indulgements for Judge Smith. Um, and obviously his family as well as him have played such a pivotal role in our community for helping the youth and children with the teen court and doing all that they do. So, thank you for that, Madame Clerk. >> Next item on the agenda is 4A, fiscal year 2026 through 27, employees and retirees insurance benefits. >> All right. So, we'll ask Danielle to come forward of Brown and Brown and give us a breakdown. Um the reason this got put on the agenda late is the last couple of years obviously everyone knows where we've been with our insurance and how some things had come up and and um through HR they do a great job at at really presenting it but we've started having more meetings because we're trying to get this as as we've talked about making our insurance being self-insured. We saw how we had a catastrophic situation a couple of years ago and we're catching up with that um from the way it happened and went with it. So, we're trying to make this insurance benefits very employeefriendly while making it as businesslike as possible to make it where we can flow through where we can do things and still give even better benefits. Um we've got a a board of 10 right now that we met on Monday. Mr. Perry sits on that but is a non- voting member of it. So um but as far as the overall we spent over two hours or close to two hours on Monday that we can streamline the plan better, make it better for the employees while also working through the monetary parts of things to make it better and then trying to educate. Probably the biggest thing with all of us, me included more than anybody probably, is we're afraid of change. When change can actually save us money at some point, but when and as you get older, that change comes a lot quicker. Your 20s and 30s, you never go to the doctor unless something drastic happens. But now you have to do more things in that. So, um, I appreciate the indulgence of putting it on. I know there's been some information, but Danielle was willing to stay. she [clears throat] lives across the state and give us this presentation today so it gets a little bit more um if you have questions she's a little bit more knowledgeable of the overall part of it so welcome Danielle >> thank you morning mayor vice mayor council nice to see some familiar faces it's been a while since I've been before you but we've done a lot of work with the committee over the years um introduction I am Danielle Bole senior vice president with Brown and Brown Insurance and we have had the pleasure of working with the city since about 2023 three. Um over that time we've made some some great uh headway with the committee and today we're going to go through multiple things that were discussed and uh recommended during Monday's meeting. So just in order, we're going to go through the group Medicare plan options that are presented this year and the recommendation group supplemental benefits, which are uh the supplemental coverages that pay the employee directly if they have an accidental injury, a hospitalization, uh one of the big scary critical illnesses like cancer, heart attack, stroke, those types of things. Um stop loss was a very great year for us. this year when I can't say that to many clients, stop-loss market has been on fire. Um, a lot of very high cost claims have been out in the market and uh the city has some great results this year. Pharmacy pharmacy costs continue to be uh one of the hot topics with all of my self-insured clients and I think nationally there's a real focus on finding a better solution, transparency, reducing that cost and taking out a lot of the middlemen and the the ambiguity that's out there with some spread pricing. So, we have a great option here today as well. And then we'll close with the uh 2627 health plan rates and contributions. The group Medicare Advantage plan. So, just to give some context, the city offers Medicare eligible retirees the choice to either remain on the city's active employee health plan with Florida Blue or to choose a group Medicare Advantage plan, which currently is offered through Florida Blue. A group Medicare Advantage plan preserves the city sponsored group health plan experience while using Medicare benefits funding to provide coverage specifically designed for your Medicare eligible retirees. On the group Medicare plan, the co-pays shown that I'll show you in a moment are the amount the retiree pays at the point of service. Whereas on the active plan, a Medicare eligible retiree really doesn't know what they're going to be paying because Medicare by federal law has to pay as primary for retirees and secondary you don't know until Medicare pays first. So that leaves a lot of questions for retirees when they go to use the plan. Um on the Florida Blue Medicare plan renewal that you installed uh two years ago, they released at an 8% increase. However, if the city would have moved to a January renewal date just for that Medicare plan, uh they would have held the rates, the current rates until the end of 2027. And there there was some reason with reinsurance that they cited for that. But a better option was presented through Humanana. Humanana exited the group employer market several years ago and decided to focus primarily on Medicare and they've added quite a bit uh to their programs and services for those Medicare beneficiaries. They came in with a lower cost option, saving the retiree $24 per month, about 5.7%. And then they improved the benefits, things like free hospitalization, inpatient, outpatient, um more competitive co-pay structures for other services that I'll show you. The provider network is also very strong. There's no concern there. And with the Humanana plan, it is a passive PO, which means anywhere that accepts Medicare, the retiree can go and pay the same co-pay. So they don't have to go to a Humanana Medicare in network provider. It's a passive PO structure. The committee did vote to move to Humanana for this renewal and Humanana has uh committed to being present to educate retirees about the the benefits of the plan. I wanted to show you first the plan design and anything that is highlighted in green on the Humanana plan is what we would perceive as a better benefit than what you have today or what the Florida blue renewal was. The Florida blue plan had some mandatory plan design changes which are shaded on the gray column or in the gray in the middle column. So that is the Florida blue plan, but what they proposed for the renewal because for that entire block of business, they made some changes like increasing the annual po annual out-of-pocket maximum for medical from 1,000 to 2,000. Uh they modified the inpatient hospital stay to be $200 per day for 7 days rather than just the five days that they had before. For example, on the Humanana plan, the medical out-of- pocket maximum is $1,500. The co-pays are similar to what you have today. Uh, however, primary care would be $15, specialist 25. Uh, urgent care is aligned with what you pay today, and emergency room is $65. The ones that are shaded in green, you'll see free hospital services for inpatient. Uh, diagnostic procedures at the hospital and freestanding radiology facility for labs and u MRIs, etc. are all free. And I won't read everything to you, but you can see there's a lot of green on the board. And it's also a lowerc cost plan. For for just a moment, I wanted to show you how this plan compares to the two group active plans through Florida Blue that your retirees are enrolled in. The city does offer three plans through Florida Blue. However, one of them is a uh health savings account qualified plan and as a Medicare eligible retiree, they're not eligible for that pre-tax benefit of an HSA. So, I'm showing the two that you have retirees enrolled in. Anything that is shaded in green, of course, is going to be better than what you have with the Florida Blue plans. But, just by way of example, for an inpatient hospital stay on your richest option, it's $250 a day for days one through five. meaning um they are going to be paying a maximum of $1,250 for that hospital stay that would have been free with Humanana and the outpatient experience is similar. So $200 is your richest benefit for that HMO plan on the Florida Blue Active and it would be free on the Humanana plan. I say all of this for the public record and we will say this during open enrollment because I really would like to educate your retirees that this is a great option. I would take this plan tomorrow if I was eligible for it. Um, not only do they know what they will pay at the point of service, it's lower cost and it's lower premium and lower cost at point of service. So, I just wanted to um review that with you. I'll pause for a moment to see if you have any questions on the group Medicare before we move into the supplemental benefits >> questions. All right. >> Okay. Thank you. I I have a quick question here, Mr. >> I did, too. >> Daniel, how many um how many people take advantage of the Medicare? >> You only have 20. >> That's what I thought. I thought it was a small number. >> And generally speaking, I mean, what it's going to do is provide coverage where Medicare doesn't for and more coverage even where it does. >> Yes. >> So those things like part B and C and there's coverage there. So, your Medicare eligible retirees are required to have Medicare Part B. Um, that is something that typically comes out of their retirement, I believe, automatically. This plan replaces that for all intents and purposes. And they just have one card. It'll be a Medicare Advantage card with Humanana. It'll include their hospital, their doctors, their pharmacy, just like you have today with Florida Blue. So, you have one ID card. go and you don't have to worry about showing them your Medicare card. Also, [clears throat] >> Vice Mayor Coker has a question. >> At what age are you I I know 65, but can't you [clears throat] ahead of that? >> No. At for Social Security, you can, but for Medicare, it's 65. >> Okay. >> Um, and we do have some retirees that I think have stayed on the group plan for two reasons. One, it's different, right? There it's you're moving to a Medicare plan. And there might be some questions on is that really as good as and 100% it's better. Um the other reason is that many have families. So maybe a spouse is not yet age 65. And we really need retirees to understand that the city's plan as a self-insured plan allows the spouse and dependent to stay on the active plan until the spouse reaches 65 if that retiree would like to go on the Medicare plan. >> So it can it's a win-win. Correct. where they don't have to stay all or nothing. They they're 65, they go on it, but their spouse is still covered, which will still save the plan money overall. >> Yes. >> And that's that's why we thought this was important to to bring it in this way. And there'll be some other discussion about it was not on today's agenda, but we're going to bring up more about our 65 employee 65 year old employees that are have retired. >> Yes. >> But that'll be for a later day. >> Mr. Mayor, I Yes, sir. Um, if I may, I just wanted to kind of highlight Danielle, am I correct in that when you look at some of the smaller ticket items, uh, $25 versus 15, but mainly with the Humanana and the Medicare, what really wanted to highlight is the hospital stays and some of the bigger ticket items. That's really where people aren't prepared and it's it's that's where people get in trouble and it's just a big big s >> and basically those the savings per month >> you're probably not going to change by by the from 20 to 25 $5. You're probably not going five times in the month which would take up that 24 plus savings. >> But if you have to go in the hospital it's $200 a day that you're not paying now, right? So those things when you offset the little bit, you know, you'd like it 85 90%. You can't kill it for that small percentage. >> Yeah. I mean the the the hospital stays the the major labs um those get quite expensive and and there's big big savings with the human plan. >> Yes. And as part of the open enrollment um process, we will of course be educating the retirees of this option, but there's even additional features. There's dental, there's vision, there's a very broad schedule of benefits which was included as an attachment in your agenda packet >> that'll actually improve the plan even more. >> Correct. >> And then we did last year, we gave the current retirees the opportunity to have a once back >> where if they went to something >> and they didn't like it, they could come back on our plan, which most plans don't do that. And that option will still be there if for some reason they get on it. and and uh something happens and they don't like it, but I think they're they really look at it, they're going to think it's such a better plan. >> Just just one other point sitting on the insurance committee and dealing with this for the last couple three years at least. >> Um I I think there's been a general um interest in trying to have retirees transfer off our health care system onto Medicare. One of the reasons is is that you paid for Medicare coverage your whole life and it's a government provided, you know, insurance program, whereas our program is self-insured. And so if we have I forget what the number of retirees on our plan is, Doug and I and a lot of other people have talked about this over the years both on the committee and otherwise, but um if we could get those folks that are are a little bit um more senior that typically have higher health care costs because of that to get transfer off, then our claims experience would be probably less ultimately from our self-insured entity. And again that the individuals have already paid for the Medicare coverage. But the argument is twofold. I think one is it's scary because you're making a a displacement a change. Um and then secondly, you do pay for Medicare in certain cases. Um I got my estimate and it was pretty high. I didn't >> but when you turn my age you start to realize these things that you thought were just free, you know, and and so you do pay for it. and one. But um our program also provides for um the the what do we call it, mayor? Um the payment that you get from from the city. >> Oh, yeah. There's a >> stipen stipen, right? >> Based on your years of service, >> years of service. >> And some people get like $400 a month in a stipen. And then if you also have FRS employment, FRS gives you a stipen. I think their cap went up to 160 a month. But the reality is is that you could actually make money um by taking the stipen using the Medicare coverage, buying the supplemental policy to get better coverage. And so there are scenarios that are like that. But the complexity of our health care system does provide a great deal of um uh misunderstanding, ambiguity, and other things for people to understand it. and and we're dealing with that phenomena. I think we deal with it from the HR benefits perspective when we do our open enrollment and try to educate employees and Danielle's folks help us with that and when we do it on the insurance committee. >> Well, it's going to come, Mr. Perry, and as we talked, it's going to come down to the education that >> we understand it 100%. We've got a great board now with our new fire representative. Um, Steve Rristler is actually in the insurance world. Obviously, we've got some others that are around that understand it and the 10 committee members from each department, you know, [clears throat] have have really seen over the last several years how this can make it better. And if you are that retiree and you get some older retirees get not very much because of the way the plans were. But if if you can go from paying even an HMO $831 a month to $400 a month, I don't see how you don't do it, >> you know. And that's but again, we have to get them to realize, we have to get us to realize of what that is. And if you've been through anything lately, especially when you're older, you've been through things, you realize it can add up. >> All right. So, I think this one's pretty good. Do you have anything else before we want to make a motion for this? >> I think that many times be when you see something that is half the price and better benefit, what's the catch is the first thing that would come to somebody's mind, right? Medicare is the largest purchaser of health care in the United States. They are able to get drug prices for much lower than what we are able to get drug prices. They are able to get hospital services for a fair, reasonable price. So, it's not that it's not as good. They're just they have more clout. They're able to get the fair, transparent pricing that is really I would love for all of us to be able to get. Um, but yes, it's not too good to be true. It's not like what's the catch? It's just it's better buying power and that's it. >> All right. So, any other questions? Well, there's a a preferred motion. So, um Anything else on that one, Daniel? So, we would go through be motion number one. >> Um, chair would entertain a motion. >> Mr. Mayor. >> Yes, sir. Mr. Schlerler, >> I'd like to motion to change from the Florida Blue Group Medicare Advantage plan over to the Humanana Group Medicare Plan for a 5.7% savings with a deadline for employees and retirees to switch carriers on October 1st by October 1st, 2026. >> Second. >> All right. Any other questions or comments? Hearing none, we'll start the vote in ward one. >> Yes. >> Two. >> Yes. >> Three. >> Yes. >> Four. >> Yes. >> And five. >> Yes. >> Carries five to zero. Thank you. Next, Danielle. >> All right. The next item is your group supplemental benefits. Supplemental coverages. Accident, hospital indemnity, and critical illness are available to employees. Um, it's fully paid by the employee. And right now, you have two carriers that are offering those coverages to employees, AFLAC and All State. Payments from those providers if the employee signs up and files a claim, goes directly to the employee to help them pay for household expenses or for the things that your insurance doesn't pay. So, if you have co-pays, deductibles, patient responsibility, it can help with all of those. But really the employee chooses what to do with the money uh for for their best uh of their household. On the group market we see quite a bit of savings whenever there's a competitive process if a legacy plan has been in place for for many years and this year we did see that. Um very happy with the premium savings that we uh were able to achieve here. The committee is recommending Sunlife for these coverages. There's substantial premium savings that I will show you in a moment. But all three plans have no pre-existing condition exclusions, which is an advantage from what you currently have today. So, for example, a um a pregnancy [clears throat] would be excluded. So, somebody wanting to use their plan for a hospital stay under your current plan and they're already pregnant, they would say no. um or even if you have any pre-existing condition, you don't you cannot have a hospital stay covered for that pre-existing condition for 12 months under your current plan. So, these plans do not have that limitation. That's a huge win for somebody that knows they're going to be facing a hospitalization in the coming year. There's no evidence of insurability required ever. So, not this open enrollment and not in subsequent open enrollments. People can just come on the plan, get critical illness, and there's not an evidence of insurability that would be required saying, "Are you um on high blood pressure medicine? We're going to exclude you from critical illness," for example. They are portable, meaning the employee can take them take the plan with them at the same rate if they leave employment, whether that be um retirement or at termination. An update for the committee. This is actually something that could be available for your retirees if you wanted to offer it to them as well. It's fully paid by the person, so you can absolutely can do that. The current hospital indemnity plan has that 12-month pre-existing condition exclusion, and I already said the uh pregnancy. Sunlife also wanted to help the city with a goal that we've had for a couple of years, which is getting the employees an online enrollment platform where they don't have to do as much paper during open enrollment. That doesn't mean that that would be the only option or that we'd throw them out and just say the technology is is all you have. There is support that we wrap around that. Um, but in order to help cover the cost, Sunlife has thrown in a $5,000 implementation fund and a commitment to pay 3% of any premium they receive back to the city or the selected vendor so employees can have that option. Um, with I think in the past three years I've moved three other cities that were still using paper because sometimes um, Ununice Tyler Technologies can be a little difficult to work within that HR portal. Um so this is something that we would be able to look at for 2027. So more to come on that just a quick overview and as in the appendix of this I've included the full schedules of all the benefits because they are very long in the way that the accident plan works. For example, the benefits stack on top of one another, meaning everything that is associated with that accident, whether it's I needed crutches, an ER visit, and follow-up care, or I was in a motorcycle accident and I was hospitalized, ICU, um, intensive care unit per day benefit, uh, stacks all the way on top, and it there's not a cap as far as what would be received associated with that accident. Um, so the premiums here were 8% lower on the low plan. So there's two plans that are offered. 8% lower on the low plan, 13% lower on the high plan versus what you currently have today. Stronger benefits. There is an accidental death benefit that I did want to highlight because I think it's often overlooked. I use this to buy very cheap accidental death coverage for myself and my spouse because if you're killed in a car accident, that's always what you worry about when you have kids at home. um it does pay out 50,000 on the low plan and 75 on the high and there's no evidence of insurability or anything because it's accident can be a lowcost option and then a $50 wellness screening benefit per person. So, I've called out the wellness screening benefits, which are 50 on the accident, 50 on the hospital indemnity, and 100 on the critical illness because when you look at how much the premium is, and then you look at the wellness benefit, you really just need to go get your physical, and the premiums usually pay for themselves, at least for an employee only. Um, the hospital indemnity plan, the premiums were 10 to 75% lower than they are today. 75% lower. So, the older employees right now have an agebanded rate. So if they are in the 50 60 [clears throat] 70 plus range, they're going to be paying quite a bit more currently. And these are just complete composite rates. So your younger employees are paying the same as the older for the hospital indemnity plan. Uh pregnancy covered day one. And then in addition for maternity, newborn benefits pay on top of the mom benefits. And normally I don't see newborn benefits covered on these plans. Uh there is a $50 wellness screening benefit as well. critical illness. We saw premiums in the range of 15 to 60% below current. And a feature that I have not seen, this is newer to the market, is it includes a benefit as a critical illness if a woman cannot get pregnant and needs to have IVF or other treatment for fertility. $15,000 benefit for that. And just from what I've encountered in the market, that's that can be what a round of IVF costs. um that's a good price. It can be more than that. Includes health navigator call lines. So if somebody, let's say, is facing that fertility issue and needs a recommendation to the best-in-class provider or they are facing a a new scary condition like cancer. This is somebody that they can ask questions, uh help with claims, etc. There's a $100 wellness screening benefit here, of course, because you want people to have their screenings to avoid catching something at a later date. [clears throat] Uh there is one thing that came up during the insurance committee meeting that I didn't highlight here and I do want to mention it's important that employees look at their coverages today if they have one of the cancer plans because these plans work differently. like a critical illness here will pay a lump sum when you're diagnosed with something. So diagnosed with stroke, cancer, heart attack. Um there's um many many other things that are listed in your ben or in the uh appendix with the schedule of benefits including Parkinson's, Alzheimer's, childhood conditions, but cancer policies, if an employee buys those at a a younger age, they're locked in at whatever age that was and they have different types of benefits that pay out specifically for chemo or specifically for travel or experimental treatments, etc. So they may want to keep that and they absolutely can. I would encourage anyone that is looking at keeping their accident, hospital indemnity or critical illness to really think about that though because the premium savings is just in every tier. It was premium savings for for a better benefit. Any questions on that? >> A couple quick questions. >> Mr. Daniel, how many people actually take advantage out of all of our employees and employabil employee insurable employee retirees take advantage of a supplemental benefit program? >> I believe you're a couple hundred. >> Okay. And who would be like I know that if I you know I have at open enrollment a decision to make whether I'm going to go with a health savings account, an HSA, an HMO or PO. So, I believe that I'm I've got insurance, but I also understand that there's limits that I got to pay like 4500, no, up to 4,500 for certain things and then other deals. And so, this fills the gap. I look at this as as part of a gap >> sub when it says supplemental, that's what I'm doing. But, I've heard stories, I think even the mayor told me a story, which was pretty good story about someone that uh did have a sizable, not just a stop loss, but other things too that are covered in here. So, I can understand why why somebody would do that. Um, I I I guess my my big thing is that you can have insurance, but you can still get hit with a whole heck of a lot of medical bills, >> right? And that's what this is designed to do, >> okay? >> And uh Mr. prepared too. Not only that, not only for uh health issues, but if just as an as an example, if an employee is out for an extended period of time and his spouse has to take care of them, these are supplemental policies. So, they pay directly to you, not to the provider. So, it really saves you in terms of mortgage payments, car payments, um you know, since they are payable directly to you. So, it's not just in healthcare coverage. Um, and they're they're quite inexpensive. And so for those that are young and bulletproof and feel that they're going to live forever and then they get in a car accident and they're out for an extended period of time, >> this can really cover the family. >> Yeah. For the price of the premium, it was very attractive once I learned more about it. I never looked at it quite that way. And I think I probably shared that sentiment with a lot of other people that go, I got health insurance. I'm covered. But as you said, there's other scenarios [clears throat] beyond just the the cost of the health care that's covered as well. And Danielle pointed out things like accidental death and >> you know, >> well, we've all had friends or in your own family where you've had an accident or something with your child or whether it's in sports or whether it's in all of that. So, you just look at it and you know when you're young and invincible as was said, you don't think about that. But at the cost that it is, it's almost worth doing. It's another insurance, but if you have one, you know, ACL tear in a child, it's helping you offset some of those costs to you. And I've we've all had friends or seen it to ourselves, but um so I think we've got this information. So chair would entertain a motion for >> supplemental insurance. >> Mr. Mayor. >> Yes, sir. Mr. Shler, >> I would motion to replace all state and AFLAC supplemental insurance options with Sunlife supplemental insurance coverage options. >> Second. >> All right. Seconded by Miss Barnaby. Any other discussion? Hearing none, we'll start the vote in W two. >> Yes. >> Three. >> Yes. >> Four. >> Yes. >> Five. >> Yes. >> One. >> Yes. >> Approved. Five to zero. Thank you, Danielle. >> Thank you. I think your employees will appreciate the little money back in their paychecks too from the lower premiums. That's great. >> All right, stop loss. This was u like I said a great result this year. the market generally we are assuming when before we get renewals a 30% increase for our clients when we are using our actuary to project forward what the cost will be and the reason is there's just been many many more 500,000 a million plus claims that are happening uh left and right that used to be very unusual um the city has not had that experience for this year or last year a few years ago there was an anomaly That was quite catastrophic. But where we ended up is, well, just a quick refresher, you are self-insured, but you have stop loss that protects you against catastrophic losses. The individual stop loss that you have today is 275,000, and you pay a premium to HM, which is part of Florida Blue. They have a partnership for that stop-loss coverage. You've been with them for many years. Each year, we do shop the market to find the best deal. And this year the recommendation is to move to Sunlife. Sunlife uh is a great stop-loss partner. Actually, I have more stop-loss business with them than I even do supplemental benefits. And it's because they add additional things um that like they did for you all this year. The premium is coming in 4% lower than what you're paying today, which it's not often that we're seeing a decrease in this market. It's about $42,000 lower in annual cost than what the city's paying today for that protection. Florida Blue did come back and um through negotiations and offer a slightly below current, but it was about 30,000 more than Sunlife. So, was something that's not employee facing is behind the scenes. It's the committee was um it [clears throat] was a no-brainer. I think the included provisions like a 50% rate renewal cap, which may sound crazy. Why would we want to who's ever going to have a 50% renewal? I've had clients with a hundred 100% renewals or they will throw in things like a a laser which is an alternate stop-loss level for one person based on their condition. That can really throw your budget haywire. And so this having that rate cap is important. $2 million aggregate limit. So, one other thing that you pay for, it's a much smaller portion of your stop-loss premium, is what if the whole plan, not just one person's claims are high, but we have a really bad year with a lot of people with $50,000, $100,000 claims, we never really get that stop-loss protection for the one person. Aggregate coverage kicks in and it caps your losses at um 125% of expected. And so, right now, you have a million dollars in coverage. We got them to increase that to two million, which means if you have an awful year and you get to that 125% of what we c thought you would be at or what the underwriters thought you would be at, SunLife would come in and pick up the next $2 million, which means you likely would not exceed that because you have catastrophic loss for one person. So, if you were to have that crazy claimant come in, that's protected, but the whole plan as a whole wouldn't go 2 million over. Experience refund provision. So, your claims have run well the past two years. We've barely had any stop-loss activity this year. You've had no one that has exceeded the stop loss so far through June, uh, with several, we have until October or the end of September for that to materialize, and there's a couple that are close. But really, when that happens, the stop-loss carrier is making all of that money in profit. They're not paying anything out in claims. And what some proposed was to share that underwriting profit with you. So if your loss ratio is better than a 70%, they are going to give you 50% of the profit back. So that that's a great feature if you are running well. They also included a cancer expert medical service, which is something that I've been recommending for my clients across the board, but it has a fee. Um but what this provides is one-on-one um second opinion service between the treating provider, so the local physician if somebody is diagnosed with cancer can get a written second opinion from the bestin-class for that type of cancer. Um, the provider community actually likes this because maybe you have a a a cancer that you're not experienced with dealing or maybe you don't have the time or resources to stay up to date with the most cutting edge that a Sloan Ketering doctor may have. Um, it's not required, but employees do have access to that second opinion service and they will work with the local physician team. uh 41% of the written second opinion Sunlife helped the members with led to a change in treatment. Sometimes it changes the diagnosis. We had one employee who was told that they had breast cancer and needed a double mastctomy. This was three years ago and got a second opinion did not have breast cancer. So there this thing things happen. It it can help to have a second set of eyes especially the bestin-class out there. Um, I did provide the detail on the experience refund provision, but I already hit on that. So, any questions I can answer on the stop loss >> questions? >> Yes, Mr. >> What [clears throat] happens to the benefit of the refund? So, it gets returned to the city and then >> it would go into the health insurance fund to be used for claims and other insurance expenses. >> Mr. Perry, >> I was I was kind of scared the situation we were in two years ago. We had probably one of the most catastrophic um exposures that I've ever [clears throat] seen. We had an individual and sad terrible situation with I think it was upwards of $40 million over 40 million. >> Yeah. And so we had stop loss for that basically, but it was a continuing situation and the stop-loss we weren't sure we were going to get anybody to write a stop-loss for the next insurable year because who would take on that kind of exposure and um I think at the end of the day Florida Blue and was the one they did >> one group that came up and they they had a laser I didn't know what that term meant, but it's a carveout. It says we'll provide stop loss, but we're not going to provide stop-loss for that patient >> and that insured. That's a bad situation to be in for self-insured entity because if we had to cover that, we couldn't. I I don't know where $40 million would come from for for for one insurance claim. Um and and and this what's before us is a lot better than what we had both from a fiscal from a coverage and uh for probably a strategic reason as far as liability protections. I'm glad to see that we are basically able to be insurable at reasonable rates in the stop-loss market. And the way they do that, not one I call it excess coverage. That's what lawyers call it. It's insured to a certain expense. You're insured to a certain amount and then the excess is covered. There's usually like seven excess carriers that have tiers of that additional amount. 275,000. That's what the threshold is. Anything over 275 is excess covered >> by by a a syndicate of insurance basically. And that's kind of the way we handle it. Florida Blue and HM picked up the next layer up to $4 million and then the reinsurance had to cover the Delta between four and $40 million. That was a really big hit for the reinsurance for Florida Blue that year. >> In your in your career, have you ever seen a larger one? >> No. >> Neither neither had Florida Blue. >> Yeah. No. And that was something that policies changed, plans changed, and we also, you never individual because we wanted >> them to get the best coverage they could in in their, you know, to help do what they could to with their medical part. But the biggest thing was we saw that that you can stand up to big pharma hospitals and but at what cost? And I like that, you know, the maximum increase can be up to only 50%. >> Where you could come in and we could be >> 5,000% if we would have been on the other situation, you know, and then not been able to pay it. So, um, a lot of discussion on this. The chair will entertain a motion for the stop loss coverage. >> Mr. [clears throat] Mayor. >> Yes, ma'am. Motion to switch from Humanana. What is that? Jim Insurance over to Sunlife Financial [clears throat] Stop Loss Coverage. >> Thank you. Motion. Do I have a second? >> Second. >> All right. By Vice Mayor Coker. Any other discussion? Hearing none, we'll start the vote in W three. >> Yes. >> Four. >> Yes. >> Five. >> Yes. >> One. >> Yes. >> Two. >> Yes. >> Thank you. Approved. Danielle. >> Moving right on. Uh the next topic we are going to address is the pharmacy benefit manager. So just to set the stage, the city is self-insured and uh about three or three years ago we carves out the pharmacy from Florida Blue to get a more competitive offer through RX benefits which is a group purchasing organization. Basically they combine all of their groups together and approach the pharmacy benefit managers to get better pricing. Um they've been a great partner. Uh, I think the service has been has been great, but we've seen the pharmacy claims over the past 18 months are really all that's been driving the cost. Your medical claims haven't really increased even at market level trends, but the pharmacy has. And so, we needed to look at the the full market again. Um, our Brown and Brown has a pharmacy consulting arm and we also have a managed pharmacy alliance which does something like RX benefits does. combines [clears throat] the purchasing power of u all brown and brown clients to go to not only the big three PBMs that RX benefits partners with Express Script, CVS and Optum which are owned by insurance companies but also transparent independent PBMs and uh RX Benefits is also on that panel. We do think they do a great job, but this year the results came back and there was a a better option and I'm really happy that it was Med Impact that was recommended by the committee. They are the largest independent pharmacy benefit manager in the world. And you say what does independent mean? It means they don't they're not owned by an insurance carrier who has other profit motives, right? And so by going in that independent route, we're able to do some more creative solutions like taking advantage of the manufact drug manufacturers coupon assistance programs that are out there for specialty and brand medications to the tune of about $300,000 in savings that the plan would have and members pay 0 to5. It's it's an it's a win-win, but we weren't able to do that with the the major PBMs. Um, there are other services that they provide and the hands-on advocacy that you are used to today with uh RX benefits, but a little bit richer than that. So, the overall savings of 24% uh roughly $615,000 versus the renewal PBM. So, that doesn't mean your costs are going down by $615,000. With pharmacy, it is mitigating what the increase is. Um, but versus your renewal contract terms, the same medications under that plan would have been $615,000 more than they will be with Meta Impact. There's a portion of that savings that will have a delay. This plan does still get pharmacy rebates. So, with uh anytime somebody fills a brand or specialty medication, the manufacturer of that medication sends a check to the pharmacy benefit manager. The difference is with Met Impact, that check is sent right to the city without them taking any of it. It's a pass through uh model, but it's also there's a delay. So, they have to wait for those rebates to be received and then they do a reconciliation. And so, it's 150 days after the close of a quarter is when the first MET impact rebate will be received. So, that's where the 18-month lag comes in. But your immediate savings on the better drug cost and the um programs like the manufacturers's assistance happen on day one. And I think that may Oh, I have included that already. The last thing I'll say is the recommendation I think supports that the committee's responsibility which is to ensure that your plan dollars are spent wisely while maintaining access to highquality providers uh prescription benefits for your employees and retirees and that is something that is my sole focus is helping employers get the tools to do that. Uh just quickly, there is going to be all members will be getting new ID cards this year because your Florida Blue card also houses your pharmacy benefit manager information. So all of the people that are on the Florida Blue plan will get a new ID card with the med impact pharmacy information. Uh we will be able to um look for we are going to have files that go over to make the transition easier. So prior authorizations that are already out there will feed over to Med Impact, things like that. So just know that we're working everything behind the scenes. Um there's also no disruption to your pharmacies. So the members can still go to the sameies that they're used to going to. Uh mail order and specialty will just be changing and we'll get some notification out on that. Uh this is just a some of the ways that they save money. They being met impact. So the specialty co-pay and patient assistance programs, they do that for nonsp specialty medications, which is unique in the market. Most of the PBMs out there that will do any of it will only do it for specialty meds, which represent like 15 of your medications and not any of the brands like the Ozmpics that are out there, for example. Don't we want to have a little bit of manufacturers assistance for that? Um, they also do a bioimilar conversion, which means for the very expensive specialty medications that are out there, there are generics, for lack of a better term, but they're called biosimilars that are 20% of the cost. 20% of the cost on something that's 10 to $15,000 a month currently is a huge gamecher for a self-insured plan. So, we will be tracking their performance and I'm happy to report back to you um as requested. Any questions on the pharmacy benefit manager >> question Mrs. Moore and then M coachman did you have okay then Mr. issues left. Okay. >> For that benefit for the [clears throat] um for the bioimilar. >> Yeah. >> Um do they have to choose that? >> So for if they are interchangeable, so there's two types of uh biosimilars. If they are considered interchangeable, meaning the pharmacist could truly just say no, this is the same thing. Yes, it's mandatory. Um so hum is an example of that. Stellar is getting there. um the the price of those medications have been I just [clears throat] excessive and the PE or the manufacturers will do something creative like change the way that you receive the medication by putting it in a pen instead of a needle and that extends the patent for another five years and meanwhile employers are paying 10 15 20 grand per person that's on the medication. So yes it is mandatory for things that are interchangeable. If there are biosimilars that are new to market and they're not considered interchangeable yet then no it is not mandatory but the member will have the guidance on the phone but whenever they are filling that specialty medication to discuss that option. >> Mr. Schustler. >> Yeah. My my question was along the same lines as uh Councilwoman Moors in that if it is bioimilar but your doctor says absolutely not you need to take this medicine and not the bioimilar are there exclusions >> no so here is um I'm glad that you brought that up not only for specialty medications but for brandame medications so many times s or not many times, very little time, but we do see this. Maybe there is something within the uh generic that the member is allergic to a coding on the pill for example, there is a dispenses written policy that will is written into your plan where if the provider says this patient needs this, the member can get that medication. >> That was my question. Okay. >> Yeah. All right. >> Any other questions? Hearing none, the chair will entertain a motion. >> Uh, Mr. Mayor. >> Yes, sir. >> Um, I motion to move uh pharmacy coverage from RX Benefits Optimum RX to MPA Med Impact. >> Second. >> Second by Vice Mayor Coker. Any other questions? Hearing none, we'll start the vote in ward four. >> Yes. >> Five. >> Yes. [clears throat] >> One, >> yes. >> Two, >> yes. Three. >> Yes. >> Carries five to zero. Thank you, >> Danielle. >> All right. The grand finale. We have we have an internal actuary that does your projections for your renewals and that's how the overall premiums are are established. So instead of a fully insured carrier where they say your rate is $500 a month, we actually have an actuary that does this for you. With claims through May, the reforcast of your current year is good. We're not over budget. right at budget. So, uh that's always helpful. And the way that that works is they'll look at a a rolling 24-month claims period and project forward what uh the the cost will be using medical and pharmacy trend uh and other factors. But good news that we're not expected to land over budget. The renewal with the Sunlife stop-loss coming in at a decrease um is now projected at a 5.6% 6% increase to today's funding rates. So that means the city's cost, the employee cost, that alto together is your funding rate. It's fully insured equivalent rate. The insurance committee voted to proportionally split that this year so that employees and retirey premiums will increase by 5.6% and the city will also increase funding by 5.6% approximately 507,000 for the city. The 5.6% 6% increase for your employees is between 51 cents and $25 per month. And I'll show you the details on that in in a moment, but it basically depends on which plan they enroll in and if they cover their dependence where they fall within that 51 cents to $25 per month per paycheck. It's even less than that. >> Excuse me. >> Thank you. [cough and clears throat] Uh this is probably going to be too small for some to see, but I've tried my best to call out the important things. Uh just to talk you through how it's structured. The top row is your HMO plan. The uh middle section is your PO and the bottom section is your high deductible health plan which is paired with a health savings account. What I have put the red square or rectangles around is the percentage that the employee pays of the total premium today and what they would pay at renewal and that will be the same. So for example, somebody that is on your HMO plan that has employee only coverage, they pay 9% of whatever that premium is and the city picks up the other 91%. That goes all the way th