Resolution No. 10097RESOLUTION NO. 10,097
A RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF VERNON APPROVING THE RENEWAL OF HEALTH CARE
BENEFITS FOR RETIRED EMPLOYEES FOR THE
CALENDAR YEAR 2010 WITH AETNA HEALTH INC. AND
AETNA LIFE INSURANCE COMPANY INC.
WHEREAS, on November 3, 2008, the City Council of the
City of Vernon adopted Resolution No. 9756 approving the renewal
of health care benefits with Aetna Life Insurance Company for
Medicare Private fee -for -service (PFFS) Plan Group and HMO Group
with Aetna Health Inc. (collectively, "Aetna") for the period of
January 1, 2008 through December 31., 2008 and a subsequent term
thereafter from January 1, 2009 to December 31, 2009; and
WHEREAS, Aetna has advised the City of an increase of
9.2% for medical benefits for the Health Maintenance Organization
plan (HMO) (an additional $1,817.00 per year) and an increase of
17.1% for medical benefits for Open Access Managed Choice POS
(PPO) (an additional $3,032.00 per year) for retired employees
under 65 years old, for an approximate total annual premium of
$21,529.00 for HMO and $20,760.00 for PPO; and
WHEREAS, Aetna has advised the City of an increase of
1.6% for medical benefits for the HMO (an additional $491.00 per
year) and an increase of 16.4% for medical benefits for the PPO
(an additional $29,104.00 per year) for retired employees over 65
years old, for an approximate total annual premium of $30,511.00
for HMO and $206,836.00 for PPO; and
WHEREAS, Aetna has offered the City an HMO and PPO plan
for the period of January 1, 2010 through December 31, 2010, for a
one (1) year term; and
WHEREAS, the City Council intends to renew the health
benefit plans for 2010 based upon the recommendations of the Risk
Manager.
NOW, THEREFORE, BE IT RESOLVED BY THE.CITY COUNCIL OF
THE CITY OF VERNON AS FOLLOWS:
SECTION 1: The City Council of the City of Vernon
hereby finds and determines that the recitals contained
hereinabove are true and correct.
SECTION 2: The City Council of the City of Vernon
hereby approves the renewal for medical benefits with Aetna Health
Inc. and Aetna Life Insurance Company Inc. for retired employees
that are summarized in the Plan Design & Benefits provided by
Aetna, a copy of which is attached hereto as Exhibit A and
incorporated by reference.
SECTION 3: The City Council of the City of Vernon
hereby authorizes the City Administrator, or his designee, to take
whatever action is deemed necessary or desirable for the purpose
of implementing and carrying out the purpose of this Resolution
and the transactions herein approved or authorized.
2
SECTION 4: The City Clerk of the City of Vernon shall
certify to the passage, approval and adoption of this resolution,
and the City Clerk of the City of Vernon shall cause this
resolution and the City Clerk's certification to be entered in the
File of Resolutions of the Council of this City.
APPROVED AND ADOPTED this 9th day of November, 2009.
ATTE
MAMELA GIRON, City'Clerk
Name: Hilaric Gonzales
Title: Mayor
_3_
STATE OF CALIFORNIA )
) ss
COUNTY OF LOS ANGELES )
I, MANUELA GIRON, City Clerk of the City of Vernon, do
hereby certify that the foregoing Resolution, being Resolution No.
10,097, was duly passed, approved and adopted by the City Council
of the City of Vernon at a regular meeting of the City Council
duly held on Monday, November 9, 2009, and thereafter was duly
signed by the Mayor or or Pro-Tem of the City of Vernon.
Executed this �67�day of November, 2009, at Vernon,
California.
(SEAL)
1 �
MANUELA GIRON City Clerk
- 4 -
EXHIBIT a
)(Aetna Medicare
City of Vernon - HMO MAPD Group Plan
Aetna Medicare sM Plan (HMO)
Medicare 5 Special Plan
Rx Group 012
Arizona, California, Connecticut, Colorado, Delaware, District of Columbia, Florida, Georgia, Illinois, Maryland,
Maine, New Jersey, Nevada, New York, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia
PLAN DESIGN AND BENEFITS
Lifetime Maximum Unlimited
Primary Care Physician Selection
Required
Referral Requirements
Required for all non -emergency, non -urgent and non -
Primary Care physicians services, except direct access
services.
Routine Physical Exams/Immunizations
Covered 100%
(One annual exam/Pneumonia, Flu, Hepatitis B)
Routine Gynecological Care Exams
Covered 100%
Includes related lab fees for covered females age 18 and older.
Direct Access to participating providers
One routine GYN visit and pap smear every 365 days
Routine Mammograms
Covered 100%
One baseline mammogram for members 35-39; and one annual mammogram for members age 40 and over
Routine Digital Rectal Exams / Prostate Specific Antigen
Covered 100%
Test
For males age 40 and over.
Colorectal Cancer Screening
Covered 100%
For all members 50 and over.
Bone Density Testing
Covered 100%
Routine Eye Exam
Covered 100%
Direct access to participating providers. One annual exam.
Routine Hearing Screening
Covered 100%
One (1) annual exam
Hearing Aid Reimbursement
Discounts where available
Primary Care Physician Visits
(Office hours) $5 copay
(After Office Hours) $10 copay (does not apply to CA)
Specialist Office Visits $15 copay
Podiatry $15 copay
Limited to Medicare covered benefits only
Allergy Testing/Treatment $15 copay
M0001_7A 70650 Pagel
City of Vernon - HMO MAPD Group Plan
)(Aetna: Medicare
Aetna Medicare sM Plan (HMO)
Medicare 5 Special Plan
Rx Group 012
Arizona, California, Connecticut, Colorado, Delaware, District of Columbia, Florida, Georgia, Illinois, Maryland,
Maine, New Jersey, Nevada, New York, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia
PLAN DESIGN AND BENEFITS
PROVIDED BY AETNA HEALTH INC
For initial testing by a specialist; PCP copay for routine injections at PCP office with or without physician encounter
�i:�� /mil .,r-� mf�� y�--,�/y�-� .�yx��-;� -.. � f i --vim vs�, ::��"l �" �ay",��t�• .� r �. � , -: � �,� w � ..
J a %. -i � a�� - 6.; a, ; .lj �� �, � r.. >u; e �s � <- 1n�V s ' x> :�a"✓�,� �,..si !ti�� � / �3e f �� � ¢`�' y ..� i r � � � w .. �� " 's v,�` �� � c� �`� 1'�..vp� , �t1 vE� � •. . � s� �.,/h.
�.i a � f �� „h. � �, ..,.i ?i �. / � .'� r ✓`.i t t� Y Us �� F, Ht - �.,a�:� � izrc RdF zi- ��s s e a,� J�;
,. ,,.���„"�,� 5 ,,;.w.<.d;<:;,.��u�urervo,.,nrJ ,,,.:✓r/1�, :%,_s,,.,,, �. .fit .su �?�,..cnsr<a>o,2.'r.>�;,�sca,,,�,,,,__,�1.,� � �. ,x,.,: <r..,� N'�,sx,.:,xi,. ,a.:_;s✓<.,�o..F� � ..s>i..r �S �� �r �,.,,�/,sr;�i ,.a��,�2i„r�
Diagnostic Laboratory and X-Ray $15 copay
'- ? ram. i�a �- z ii --r :� .� ,�
r:! f t.r�, U� /efj; ii" �,�?N S. l 3 s 5�.,. -3 .� �t -�:F
.k sF%s e i,`:;,'j/ ! r .� P. �;�.ry .:i.f! .;.� a ey�C$ as ?.:s. �d r'C eyi.
.�.%�. e ✓,..,rf �. ,. v...,.,ta ,v. ,.., „ru,� i :.A�.e ax „`. �..,.., �INE` f_.a,/,.; sic..,, n�, �'.,r137a; �+f,,.,,;., Lr.,, ✓.sz.,,,e.x ,o_rv„r-s ,: .,.fti ,a
Urgent Care Provider $35 copay
11 ' 1 Room-, Worldwide (waived if admitted) $50copay
Ambulance Covered 00%i)eril• •
Inpatient Coverage Covered 100%
The member cost sharing applies to covered benefits incurred during a member's inpatient stay.
Outpatient Surgery Covered 100%
The member cost sharing applies to covered benefits incurred during a member's outpatient visit.
Inpatient Mental Illness Covered 100%
The member cost sharing applies to covered benefits incurred during a member's inpatient. stay.
Outpatient Mental Illness $15 copay
The member cost sharing applies to covered benefits incurred during a member's outpatient visit.
Inpatient Substance Abuse (Detox and Rehab) Covered 100%
The member cost sharing applies to all covered benefits incurred during a member's inpatient stay.
Outpatient Substance Abuse (Detox and Rehab) $15 copay
The member cost sharing applies to covered benefits incurred during a member's outpatient visit.
Skilled -Nursing Facility Covered 100% o
(100 days per Medicare benefit period; prior authorization from HMO required)
The member cost sharing applies to covered benefits incurred during a member's inpatient stay.
Home Health Care Covered 100%
Hospice Care Covered by Medicare at Medicare certified Hospice
Outpatient Short -Term Therapy (speech, physical, cardiac $15 copay
and occupational
Chiropractic Care $15 copay
For manual manipulation of the spine to the extent covered by Medicare
Durable Medical Equipment/Prosthetic Devices Covered 100%
Diabetic Supplies No copay for strips, lancets and glucometer
M0001_7A 70650 Page 2
XAetTla Medicare
City of Vernon - HMO MAPD Group Plan
Aetna Medicare SM Plan (HMO)
Medicare 5 Special Plan
Rx Group 012
Arizona, California, Connecticut, Colorado, Delaware, District of Columbia, Florida, Georgia, Illinois_, Maryland,
Maine, New Jersey, Nevada, New York, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia
PLAN DESIGN AND BENEFITS
PROVIDED BY AETNA HEALTH INC
Outpatient Complex Radiology $15 copay
Outpatient Dialysis $15 copay
Dental * Discounts where available
Vision Eyewear Allowance $70 reimbursement every 24 months
Coaching Included
One phone call per week
Prescription drug calendar year deductible
None
Prescription drug calendar year deductible must be satisfied before any Medicare Prescription Drug benefits are paid.
Covered Medicare Prescription Drug expenses will accumulate toward the pharmacy deductible.
Retail - Cost -Sharing $10 Copay for Generic
$20 Copay for Preferred Brand
$35 Copay Non -Preferred Brand
Up to one month (31 day) supply at indicated copay or coinsurance
(Three month (90 day) supply available at retail. Dollar copayments or applicable coinsurance will apply for each
month supply.)
Mail Order through Aetna Rx Home Delivery - Cost- $20 Copay for Generic
Sharing
$40 Copay for Preferred Brand
$70 Copay for Non -Preferred Brand
Up to a three month (90 day) supply available via our preferred vendor, Aetna Rx Home Delivery.
M00012A 70650 Page 3
)(Aetna: Medicare
City of Vernon - HMO MAPD Group Plan
Aetna Medicare SM Plan (HMO)
Medicare 5 Special Plan
Rx Group 012
Arizona, California, Connecticut, Colorado, Delaware, District of Columbia, Florida, Georgia, Illinois, Maryland,
Maine, New Jersey, Nevada, New York, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia
Catastrophic Coverage
PLAN DESIGN AND BENEFITS
PROVIDED BY AETNA HEALTH INC
Greater of $2.50 or 5% for covered generic (including
brand drugs treated as generic) drugs. Greater of
$6.30 or 5% for all other covered drugs.
Catastrophic Coverage benefits start once $4,550 in true out-of-pocket costs is incurred.
Requirements:
Precertification Yes
Step -Therapy Yes
Formulary Standard
* Dental Riders are not available in the following service areas : DE01, ME01, NY03, VA01, and TX05
Please refer to the plan documents (Evidence of Coverage) for a complete
listing of benefits, exclusions and limitations. The following is a partial listing
of exclusions and limitations under the Aetna Medicare sM Plan (HMO):
• All applicable services not referred by your network primary care doctor, except
for services received as a result of an emergency or urgent situation;
• Services that are not medically necessary or covered under the Original Medicare Program
• Plastic or cosmetic surgery unless medically necessary
• Custodial care
• Experimental procedures or treatments beyond Original Medicare limits
• Routine foot care that is not medically necessary
• Drugs used for weight loss, weight gain or anorexia
• Drugs used for cosmetic purposes or to promote hair growth
• Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations
• Barbiturates
• Outpatient drugs that the manufacturer seeks to require that associated tests or monitoring services
be purchased exclusively from the manufacturer as a condition of sale
• Drugs used to promote fertility
• Drugs used for symptomatic relief of cough and colds
• Non-prescription drugs (OTC)
• Benzodiazepines
• Drugs when used for the treatment of sexual or erectile dysfunction
M0001_7A_70650 Page 4
)(Ae1rla Medicare
City of Vernon - HMO MAPD Group Plan
Aetna Medicare sM Plan (HMO)
Medicare 5 Special Plan
Rx Group 012
Arizona, California, Connecticut, Colorado, Delaware, District of Columbia, Florida, Georgia, Illinois, Maryland,
Maine, New Jersey, Nevada, New York, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia
PLAN DESIGN AND BENEFITS
PROVIDED BY AETNA HEALTH INC
This material is for informational purposes only. See plan documents for a complete description of benefits,
exclusions, limitations and conditions of coverage. Aetna does not provide care or guarantee access to health
services. Providers are independent contractors and are not agents of Aetna. Provider participation may change
without notice. Health information programs provide general health information and are not a substitute for
diagnosis 'or treatment by a physician or other health care professional. Discount Programs provide access to
discounted prices and are not insured benefits. While this material is believed to. be accurate as of the print date, it is
subject to change.
Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna's Preferred
Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions.
Members must use network pharmacies to receive plan benefits except in limited, non -routine circumstances when a
network pharmacy is not available, including illness while traveling within the United States but outside of the plan's
service area where there is no network pharmacy. An additional cost may be incurred for drugs received at an out -of -
network pharmacy.
If an individual qualifies for extra help with the Medicare prescription drug plan, premium and costs at the pharmacy
may be lower. Upon enrollment in the Aetna Medicare plan, Medicare will tell us how much extra help an individual
is getting. An individual can obtain information on whether they qualify by calling 1-800-Medicare (1-800-633-
4227). TTY/TDD users should call 1-877-486-2048.
Benefits coverage is provided by Aetna Health Inc., Aetna Health of California Inc. and/or Aetna Health of Illinois
Inc., which are Medicare Advantage organizations with a Medicare contract and benefits, limitations, service areas
and premiums subject to change on January 1 of each year
You must be entitled to Medicare Part A and continue to pay your Part B premium and Part A, if applicable.
You must use network providers except for emergent care or out -of -area urgent care/renal dialysis. If your
primary physician is part of an integrated delivery system or physician group, your primary care physician
will generally refer you to specialists and hospitals that are affiliated with the delivery system or physician
group.
***This is the end of this plan benefit summary***
M0001_7A 70650 Page 5
City of Vernon - 2010 PFFS Group Plan
X1 Aetna Medicare
Aetna Medicare Open sM Plans
Medicare 90 Open Plan
Rx Group 012
National Service Area including Puerto Rico
PLAN DESIGN AND BENEFITS
PROVIDED BY AETNA LIFE INSURANCE COMPANY INC
Deductible (per calendar year)
$0 Deductible
Unless otherwise indicated, the Deductible must be met prior to benefits being payable.
Member Coinsurance 10%
Applies to all expenses unless otherwise stated.
Payment Limit (per calendar year) $2,000
Includes deductible. Certain other member cost sharing elements may not apply towards the Payment Limit.
Lifetime Maximum Unlimited except for where otherwise indicated
Primary Care Physician Selection Not Applicable
Referral Requirements None
One baseline mammogram for members 35-39; and'one annual mammogram for members age 40 and over
Routine Digital Rectal Exams / Prostate Specific Antigen Covered100%
Test
For males age 40 and over.
Colo-re-ctal Cancer Screening
Covered 100%
For all members 50 and over.
Bone Density Testing
Covered 100%
Routine Eye Exam
Covered 100%
One annual exam.
Routine Hearing Screening
Covered 100%
One (1) annual exam
Hearing Aid Reimbursement
Discounts where available
Primary Care Physician Visits
(Office hours) 10%
(After Office Hours) 10%
Specialist Office Visits 10%
H5736_7F_70614 Prepared: 10/16/200911:49 AM Pagel
M
XAetna Medicare
City of Vernon - 2010 PFFS Group Plan
Aetna Medicare Open SM Plans
Medicare 90 Open Plan
Rx Group 012
National Service Area including Puerto Rico
PLAN DESIGN AND BENEFITS
PROVIDED BY AETNA LIFE INSURANCE COMPANY INC
Allergy Testing/Treatment 10%
For initial testing by a specialist; with or without physician encounter
Laboratory and
10%
The member cost sharing applies to covered benefits incurred during a member's outpatient visit.
Inpatient Substance Abuse (Detox and Rehab) 10%
The member cost sharing applies to all covered benefits incurred during a member's inpatient stay.
Outpatient Substance Abuse (Detox and Rehab) 10%
The member cost sharing applies to covered benefits incurred during a member's outpatient visit.
Skilled Nursing Facility 0% per day - days 1-20;
10% per day - days 21-100
(100 days per Medicare benefit period)
The member cost sharing applies to covered benefits incurred during a member's inpatient stay.
Home Health Care Covered 100%
Hospice Care Covered by Medicare at a Medicare certified hospice
Outpatient Short -Term Therapy (speech, physical, cardiac 10%
and occupational)
Chiropractic Care 10%
For manual manipulation of the spine to the extent covered by Medicare
Durable Medical Equipment/Prosthetic Devices 10%
H5736_7F_70614 Prepared: 10/16/200911:49 AM Page 2
City of Vernon - 2010 PFFS Group Plan,
XAetm M ed Ica re Aetna Medicare Open sM Plans
Medicare 90 Open Plan
Rx Group 012
National Service Area including Puerto Rico
PLAN DESIGN AND BENEFITS
PROVIDED BY AETNA LIFE INSURANCE COMPANY INC
Podiatry 10%
Limited to Medicare covered benefits only
Diabetic Supplies Covered 100%
Includes test strips, lancets and glucometer
Outpatient Complex Radiology 10%
Outpatient Dialysis 10%
Prescription drug calendar year deductible must be satisfied before any Medicare Prescription Drug benefits are paid.
Covered Medicare Prescription Drug expenses will accumulate toward the pharmacy deductible.
Retail - Cost -Sharing $10 Copay for Generic
$20 Copay for Preferred Brand
$35 Copay Non -Preferred Brand
Up to one month (31 day) supply at indicated copay or coinsurance
(Three month (90 day) supply available at retail. Dollar copayments or applicable coinsurance will apply for each
month supply.)
H5736_7F_70614 Prepared: 10/16/200911:49 AM Page 3
M
XAetna° Medicare
City of Vernon - 2010 PFFS Group Plan
Aetna Medicare Open SM Plans
Medicare 90 Open Plan
Rx Group 012
National Service Area including Puerto Rico
PLAN DESIGN AND BENEFITS
PROVIDED BY AETNA LIFE INSURANCE COMPANY INC
Mail Order through Aetna Rx Home Delivery - Cost- $20 Copay for Generic
Sharing
$40 Copay for Preferred Brand
$70 Copay for Non -Preferred Brand
Up to a three month (90 day) supply available via our preferred vendor, Aetna Rx Home Delivery.
Catastrophic Coverage Greater of $2.50 or 5% for covered generic (including
brand drugs treated as generic) drugs. Greater of
$6.30 or 5% for all other covered drugs.
Catastrophic Coverage benefits start once $4,550 in true out-of-pocket costs is incurred.
Requirements:
Precertification Yes
Step -Therapy Yes
Formulary Standard
Please refer to the plan documents (Evidence of Coverage) for a complete listing of benefits, exclusions and
limitations. The following is a partial listing of exclusions and limitations under the Aetna Medicare Open
Plan:
• "Services that are not medically necessary or covered under the Original Medicare Program unless otherwise noted
• Plastic or cosmetic surgery unless medically necessary
• Custodial care
• Experimental procedures or treatments beyond Original Medicare limits
• Routine foot care that is not medically necessary
• Drugs used for weight loss, weight gain or anorexia
• Drugs used for cosmetic purposes or to promote hair growth
• Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations
• Barbiturates
• Outpatient drugs that the manufacturer seeks to require that associated tests or monitoring
services be purchased exclusively from the manufacturer as a condition of sale
• Drugs used to promote fertility
• Drugs used for symptomatic relief of cough and colds
• Non-prescription drugs (OTC)
H5736_7F_70614 Prepared: 10/16/200911:49 AM Page 4
XiAetna° Medicare
- Benzodiazepines
City of Vernon - 2010 PFFS Group Plan
Aetna Medicare Open sM Plans
Medicare 90 Open Plan
Rx Group 012
National Service Area including Puerto Rico
PLAN DESIGN AND BENEFITS
PROVIDED BY AETNA LIFE INSURANCE COMPANY INC
- Drugs when used for the treatment of sexual or erectile dysfunction
This material is for informational purposes only. See plan documents for a complete description of benefits,
exclusions, limitations and conditions of coverage. Aetna does not provide care or guarantee access to health
services. Providers are independent contractors and are not agents of Aetna. Provider participation may change
without notice. Health information programs provide general health information and are not a substitute for
diagnosis or treatment by a physician or other health care professional. Discount Programs provide access to
discounted prices and are not insured benefits. VAhile this material is believed to be accurate as of the print date, it is
subject to change.
Members must use network pharmacies to receive plan benefits except in limited, non -routine circumstances when a
network pharmacy is not available, including illness while traveling within the United States but outside of the plan's
service area where there is no network pharmacy. An additional cost may be incurred for drugs received at an out -of -
network pharmacy.
If an individual qualifies for extra help with the Medicare prescription drug plan, premium and costs at the pharmacy
may be lower. Upon enrollment in the Aetna Medicare plan, Medicare will tell us how much extra help an individual
is getting. An individual can obtain information on whether they qualify by calling 1-800-Medicare (1-800-633-
4227). TTY/TDD users should call 1-877-486-2048.
Benefits coverage is provided by Aetna Life Insurance Company, a Medicare Advantage organization, with a
Medicare contract and benefits, limitations, service areas and premiums subject to change on January 1 of each year.
You can receive covered services from any licensed doctor or hospital that is eligible to receive payment from
Medicare, agrees to treat you and accepts the Aetna Medicare Open Plan private fee -for -service terms and conditions
of payment. This product does not require a contracted network. You must be entitled to Medicare Part A and
continuetopay your Part B premium and Part A, if applicable.
A Medicare Advantage Private Fee -for -Service plan works differently than a Medicare supplement plan. Your doctor
or hospital must agree to accept the plan's terms and conditions prior to providing healthcare services to you, with
the exception of emergencies. If your doctor or hospital does not agree to accept our payment terms and conditions,
they may not provide healthcare services to you, except in emergencies. Providers can find the plan's terms and
conditions on our website at: www.aetna.com
***This is the end of this plan benefit summary***
H5736_7F_70614 Prepared: 10/16/200911:49 AM Page 5
City of Vernon - 2010 Medicare Advantage Renewal Increase Summary Based on Current Enrollment
PFFS Group Plan
Enrolled
Rate Band MDCR members
Current Rate
Renewal Rate
Rate Inc.
II 1
$234.80
$293.40
25.0%
III 8
$289.80
$342.90
18.3%
VI 31
$383.10
$440.80
15.1 %
VI I 1
$381.70
$534.90
40.1 %
National Avg
16.4%
HMO MAPD Group Plan
Enrolled
State/Serv. Area MDCR members Current Rate
California/ CA02 13 $150.80
Nevada/ NV01 1 $239.68
Renewal Rate Rate Inc.
$151.20 0.3%
$274.62 14.6%
National Avg 1.8%
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I
CITY CLERK'S OFFICE
INTEROFFICE MEMORANDUM
DATE: November 10, 2009
TO: illard Yamaguchi, Chief Deputy City Attorney/Risk Manager
FROM: Nelly Giron, City Clerk
RE: Resolution No. 10,097 A Resolution of the City Council of
the City of Vernon Approving the Renewal of Health Care
Benefits for Retired Employees for the Calendar Year 2010
With Aetna Health Inc. and Aetna Life Insurance Company Inc.
Transmitted herewith is a copy of Resolution No. 10,097 referenced
above, which was approved by City Council on November 9, 2009
Thank you.
NG : di
c: Resolution Nos. 9756, 9757, 10,097
Agreement No. 09-018
/0� a?;,-
APPROVED NOV0 9 '09 CITY COU CIL
NOV 0 3 2009
v1P r CLcRI \1 °I*f)% 0rflVt Staff Report
Risk Management
DA: November 3, 2009
TO: Honorable Mayor and City Council
FR: Willard G. Yamaguchi, Risk Manager
RE: Aetna Medical Insurance Renewal 2010
Retired Employee Benefits
Agenda Item for November 9, 2009
Our insurance broker for medical benefits, Arthur J. Gallagher, solicited bids from Aetna,
Vernon's current provider, CIGNA, and United Health Care ("UHC") for active employees and
retirees. Upon review of said bids, Risk Management recommends the renewal of the Aetna
medical insurance benefit package for retired employees with no change in benefits at a cost of
$279,636. This represents an increase of $34,444, or 14% over 2009.
Fiscal Impact
The cost for medical, dental and basic life premiums for active employees, council members and
retirees is $5,120,606. $5,500,000 has been budgeted for this expenditure.
Recommendation
Risk Management recommends the renewal of the Aetna medical insurance benefit package for
retired employees with no change in benefits.
cc: Donal O'Callaghan
C F,IVED
NOV 0 3 2009
BY:
e(, 'evd,
Inter Office Memorandum
Risk Management
DA: November 3, 2009
TO: Donal O'Callaghan, City Administrator
FR: Willard G. Yamaguchi, Risk Manager wf�
RECEIVED
NUV 0 3 2009
CITY CLERK'S OFFICE
RE: Aetna Medical Insurance Renewal 2010
Retired Employee Benefits
Agenda Item for November 9, 2009
Our insurance broker for medical benefits, Arthur J. Gallagher, solicited bids from Aetna,
Vernon's current provider, CIGNA, and United Health Care ("UHC") for active employees and
retirees. Upon review of said bids, Risk Management recommends the renewal of the Aetna
medical insurance benefit package for retired employees with no change in benefits at a cost of
$279,636. This represents an increase of $34,444, or 14% over 2009.
Fiscal Impact
The cost for medical, dental and basic life premiums for active employees, council members and
retirees is $5,120,606. $5,500,000 has been budgeted for this expenditure.
Recommendation
Risk Management recommends the renewal of the Aetna medical insurance benefit package for
retired employees with no change in benefits.
RECEIVED
NOV 0 3 2009
Page 1 of 2
Juarez, Debbie
From: Rueda, Karina
Sent: Wednesday, November 18, 2009 3:49 PM
To: Juarez, Debbie
Subject: FW: City of Vernon - 1/1/10 Aetna Medical Renewal Plans
Debbie,
Here is the confirmation for the Aetna medical benefit renewals for both active employees and retirees.
Karina
From: Brenda_Lee@ajg.com [mailto:Brenda_Lee@ajg.com]
Sent: Monday, October 19, 2009 12:11 PM
To: RadiusR@aetna.com
Cc: Allyn_Heck@AJG.com; ivana_wong@ajg.com; Yamaguchi, Willard; Rueda, Karina
Subject: City of Vernon - 1/1/10 Medical Renewal Confirmation
Dear Rob:
On behalf of City of Vernon, this e-mail confirms acceptance of the 1/1/10 Aetna medical renewal, as follows:
ACTIVE EMPLOYEES:
Effective 1/1/10, benefits will remain unchanged. Listed below are the rates for the period 1/1/10 through
12/31/10:
HMO:
Employee: $348.57
EE + 1 Dep: $749.43
EE + Family: $1,028.28
PPO:
Employee: $542.20
EE + 1 Dep: $1,165.71
EE + Family: $1,599.47
PPO CITY COUNCIL:
Employee: $3,922.21
EE + 1 Dep: $8,432.75
Family: $11,570.52
RETIREES:
Effective 1/1/10, benefits will remain unchanged. Attached are the rates for the period 1/1/10 through 12/31/10.
Please confirm WHEN Aetna will be notifying retirees of the 1/1/10 renewal rates.
11/18/2009
Page 2 of 2
Rob, thank you for your assistance through this renewal. Please let us know if you see any discrepancies on the
enclosed. Thank you.
Brenda K Lee
Area Assistant Vice President
Phone: 818.539.1321 1 Mobile: 818.298.5922
Fax: 818.539.1621 1 Main: 818.539.2300 x1321
Gallagher Benefit Services, Inc. I T h i n k i n g A h e a d
505 N. Brand Blvd. 6th Floor I Glendale, CA 91203
Corp. Lic. #OD36879
Brenda_Lee@ajg.com I Learn More About Gallagher Benefit Services
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11/18/2009