HomeMy WebLinkAbout25A - AGMT - EMPLOYEE INSURANCE RENEWALSREQUEST FOR
COUNCIL ACTION
CITY COUNCIL MEETING DATE:
SEPTEMBER 15, 2015
TITLE:
EMPLOYEE GROUP INSURANCE
RENEWALS (STRATEGIC PLAN NO. 7,6)
l °
CITY MANAGER
RECOMMENDED ACTION
CLERK OF COUNCIL USE ONLY:
APPROVED
❑ As Recommended
❑
As Amended
❑
Ordinance on 1" Reading
❑
Ordinance on 2nd Reading
❑
Implementing Resolution
❑
Set Public Hearing For
CONTINUED TO
FILE NUMBER
1. Authorize the City Manager and Clerk of the Council to execute agreements for the renewal of
long term disability, dental, vision, employee assistance, employee group life and accidental death
and dismemberment insurance from January 1, 2016 to expire on December 31, 2016, subject to
non - substantive changes approved by the City Manager and City Attorney.
2. Authorize the City Manager to approve the rates as offered by CalPERS for 2016 Health
Premiums for medical insurance.
3. Authorize the City Manager and Clerk of the Council to recognize the ongoing agreement with
REACH Employee Assistance, Inc. executed in January 1, 2015 expiring on December 31, 2017,
subject to non - substantive changes approved by the City Manager and City Attorney.
DISCUSSION
The City utilizes the services of two insurance brokers Mercer and Cook Insurance Service.
Mercer is the broker of record on the life and accidental death & dismemberment (AD &D)
coverage, long -term disability (LTD) insurance through the carrier Aetna and EAP Program
through REACH for all employees. Cook Insurance Service is the broker of record for dental
coverage through the carriers Delta and MetLife. These coverages are sent out to bid by the
brokers on a regular basis, usually in the summer of each year. Rates are finalized and issued in
time for open enrollment in September of each year. The new rates are effective annually on
January 1. We are currently in the second year of a two -year rate guarantee for Life, AD &D and
LTD rates through December 31, 2016. The City is currently in the second year of a two -year
contract with Delta and MetLife for dental coverage. Delta rates will increase by 6.6 %. However,
MetLife has agreed there will be no rate increase.
The Employee Assistance Program assists employees and their eligible dependents in handling
problems that may be interfering with their performance on the job. Consultation for problems
such as alcohol and drug abuse, legal, marital and family problems are available. REACH
currently provides services under this program. Full time and part time employees are eligible to
25A -1
Employee Group Insurance Renewals
September 15, 2015
Page 2
participate in the Employee Assistance Program. We are currently in the second year of a three -
year rate guarantee through December 31, 2017.
The City purchases its vision insurance through EyeMed. The City does not contribute to the cost
of this coverage. Employees are responsible for the full cost of this coverage. We are currently in
the second year of a four -year rate guarantee through December 31, 2018.
The City purchases its medical insurance through CalPERS. The CaIPERS health benefit
program was established in 1962 under the Public Employees Medical and Hospital care Act
( PEMHCA). In 1967 the program was expanded to allow all public agencies access to the
program. The City through a resolution amended its' contract with CalPERS to allow it to
participate in PEMCHA in 1996.
CaIPERS is the second largest public purchaser of insurance in the nation behind the Federal
government and currently provides insurance for all State employees, public colleges and
universities and to more than 1,000 school districts and local governments. To address the issue
of rising health care costs, market stability, access and choice for contracting agencies, CalPERS
utilizes a regional price approach grouping similar located agencies into regions. This approach
and other polices are credited with holding down health care premiums, negotiating lower prices
from hospitals and negotiating savings on prescription drugs.
The change in CalPERS basic HMO health plan rates range from a decrease of 14.35% for
Anthem HMO Traditional to an increase of 18.76% for Blue Shield NetValue HMO. The average
increase for all HMO health plans will be 4.5% and the average increase for all basic PPO health
plans will be 11.34 %. The City will incur a 9.33% increase in costs for employees enrolled in the
CalPERS medical plans. The City contribution for SEIU and POA are still being negotiated. The
employees will be responsible for any increase in cost above the City contribution.
Retirees are not included in the annual cost estimates. The Police Officers Association maintains
its own insurance programs for medical, dental, vision and LTD coverage. The specific rates are
listed below:
AETNA Life Insurance
Insurance Coverage
Current Insurance
Rate
Insurance
Renewal Rate 2016
Percent Change
Life Insurance
$0.102 per $1000
$0.102 per $1000
0.0%
Accidental Death &
Dismemberment
$0.020 per $1000
$0.020 per $1000
0.0%
25A -2
Employee Group Insurance Renewals
September 15, 2015
Page 3
AETNA Long -Term Disability
Group Coverage
Current Insurance
Insurance
Percent Change
Employee
Rate
Renewal Rate 2016
6.6%
Management
$0.352 per $100
$0.352 per $100
0.0%
Employees
130 day wait
$8.78
$8.78
0.0%
Employees
60 day wait
$15.93
$15.93
0.0%
Dental Plans
Type of Coverage
Delta
Current Rate
Delta Renewal
Rate 2016
Percent Change
Employee
$48.39
$51.58
6.6%
Employee Plus Family
$119.17
$127.04
6.6%
Type of Coverage
MetLife Dental
Current Rate
MetLife Dental
Renewal Rate 2016
Percent Change
Employee
$26.38
$26.38
0.0%
Employee Plus Family
$45.09
$45.09
0.0%
EyeMed Vision Plan
Type of Coverage
Current Insurance
Insurance Renewal
Percent Change
Rate
Rate 2016
Employee
$7.75
$7.75
0.0%
Employee & one
$14.71
$14.71
0.0%
Dependent
Employee & two or
$21.63
$21.63
0.0%
more Dependents
25A -3
Employee Group Insurance Renewals
September 15, 2015
Page 4
CaIPERS Health Program
Plan
Employee
Only
Employee &
one Dependent
Employee & two
De mores
Percent
Change
Anthem HMO Select
$634.75
$1269.50
$1650.50
-2.94%
Anthem HMO Traditional
$710.79
$1412.56
$1848.05
-4.35%
Blue Shield Access+ HMO
$654.87
$1309.74
$1702.66
9.39%
Blue Shield NetValue HMO
$666.35
$1332.70
$1732.51
18.76%
Health Net Salud y Mas
HMO
$535.98
$1071.96
$1393.55
2.96%
Health Net SmartCare HMO
$596.98
$1193.96
$1552.15
2.95%
Kaiser HMO
$605.05
$1210.10
$1573.13
4.35%
Sharp HMO
$561.34
$1122.68
$1459.48
- 0.57%
United Healthcare HMO .
$493.99
$987.98
$1284.37
10.00%
PERSCare PPO
$761.50
$1523.00
$1979.90
15.85%
PERSChoice PPO
$683.71
$1367.42
$1777.65
15.03%
PERSSelect PPO
$625.20
$1250.40
$1625.52
6.77%
PORAC(safety members)
$675.00
$1292.00
$1642.00
7.70%
Employee Assistance Program - REACH Employee /Associate Assistance
25A -4
Current Rate based on
Insurance Renewal
Type of Coverage
1460 employees
Rate 2016 based on
Percent Change
1460 employees
Full Time Employee
$1.85 /employee
$1.85 /employee
0.0%
(970 full time)
(970 full time)
Part Time Employee
$1.25 /employee
$1.25 /employee
0.0%
(490 part time)
(490 part time)
25A -4
Employee Group Insurance Renewals
September 15, 2015
Page 5
STRATEGIC PLAN ALIGNMENT
Approval of this item supports the City's efforts to meet Goal #7 Team Santa Ana, Objective #6,
(Provide a positive workplace environment that supports the health of its employees and
celebrates its successes).
FISCAL IMPACT
The annual cost of each plan may vary depending on changes in the number of employees
enrolled during the year. The projected annual costs are calculated using current enrollment as of
July 2015 for City provided insurance and 522 budgeted positions for POA insurance coverage.
Coverage for POA (Sworn and Non - Sworn)
REACH (EAP Provider)* $ 17,784
Total Annual Cost $ 6,513,624
*City administered insurance
25A -5
$ 17,784 $ 0
$ 7,584,277 $1,070,653
CY 2015
CY 2016
Difference
Aetna Life*
$
14,640
$ 14,962
$ 322
POA LTD Insurance
$
396,000
$ 404,712
$ 8,712
POA Dental
$
540,000
$ 551,880
$ 11,880
POA Medical
$
7,074,000
$ 7,495,848
$ 421,848
REACH (EAP Provider)*
$
11,100
$ 11,100
$ 0
Total Annual Cost
$
8,035,740
$ 8,478,502
$ 442,762
Coverage for SEIU,
CASA, SAMA, EM, PMA & PTCS (City Administers)
CY 2015
CY 2016
Difference
Aetna Life /LTD Insurance*
$
115,788
$ 126,250
$ 10,462
Dental Carriers*
$
350,904
$ 404,677
$ 53,773
CalPERS Medical*
$
6,029,148
$ 7,035,566
$1,006,418
REACH (EAP Provider)* $ 17,784
Total Annual Cost $ 6,513,624
*City administered insurance
25A -5
$ 17,784 $ 0
$ 7,584,277 $1,070,653
Employee Group Insurance Renewals
September 15, 2015
Page 6
Funds in the amount of $7,075,012 are budgeted and available in the Personnel Services
Employee Benefits account (account no. 08109053- 64010) to pay for City administered insurance
coverage *. Funds in the amount of $8,452,440 are budgeted and available in the Employee
Benefits account (account no. 08109053- 64010) to pay for the insurance coverage administered
by the POA. The total budgeted amount of $15,527,452 is available in Fiscal Year 2015 -2016.
The balance will be budgeted in Fiscal Year 2016 -2017.
k �� 0-,NL-
Edward aya
Executive Director
Personnel Services
APPROVED AS TO FUNDS AND ACCOUNTS:
Francisco Gutierrez
Executive Director
Finance & Management Services Agency;;.,,-
Exhibits: A- Delta Dental Agreement
B- MetLife Agreement
C- CalPERS 2016 Premiums
D- REACH Employee Assistance Agreement
25A -6
Exhibit "A"
25A -7
AMENDMENT NO. 10 TO AGREEMENT
RENEWAL
GROUP #00599
REVISED
AGREEMENT dated January 1, 2005, as amended, between CITY OF SANTA ANA and DELTA
DENTAL OF CALIFORNIA "Delta Dental," is hereby further amended, effective January 1, 2016, as
follows:
Paragraph 1.4 is amended to read:
1.4 "Contract Term" means the period beginning on January 1, 2016, and ending on December 31,
2016 and each subsequent yearly period during which this Contract remains in effect.
Paragraph 3.1 is amended to read:
3A Within ten days after receipt of Delta Dental's invoice, Contractholder agrees to pay the
following monthly, billed Premiums to Delta Dental, at the address shown on the first page of
this Contract, for all of Contractholder's Primary Enrollees and their Dependents who are
"Enrollees" as set forth in Article2 of this Contract:
$51.58 for each Primary Enrollee without enrolled Dependents; and
$127.04 for each Primary Enrollee with one or more enrolled Dependents.
Delta Dental shall use the plus stabilization existing as of December 31, 2015 to subsidize the
total monthly Premium in the following amounts:
$3.91 for each Primary Enrollee without enrolled Dependents; and
$9.62 for each Primary Enrollee with one or more enrolled Dependents.
The Contractholder is required to pay only the billed, monthly Premiums shown above. The total
monthly Premium, Including billed and subsidized monthly Premiums, Is:
$55.49 for each Primary Enrollee without enrolled Dependents; and
$136.66 for each Primary Enrollee with one or more enrolled Dependents.
Contractholder agrees to pay the Invoiced amount. Eligibility adjustments reported to Delta
Dental after the date the Invoice is prepared will be reflected on the subsequent month's
Invoice. Such adjustments are limited to the three -month period prior to the most current
month for which the Contractholder provides eligibility data.
Contractholder agrees to bear the cost 70% of such Premiums without withholding or otherwise
charging Primary Enrollees for their coverage. Primary Enrollees agree to bear the remaining
30% of the cost of coverage for themselves and the entire cost of coverage for their enrolled
Dependents.
25A -8
Paragraph 9.2 is amended to read:
9.2 If Delta Dental terminates this Contract under paragraph 9.1 (a), all Benefits end and Delta
Dental Is released from all further obligations of this Contract, effective the last day of the
month in which written notice of termination is given. The Contractholder will remain liable to
Delta Dental for the greater of: (1) the unpaid Premiums applicable for the period this
Contract was in effect before termination; or (2) the full amount of all Dentist's statements
paid or otherwise discharged by Delta Dental during the full term of this Contract, plus
15.60% of such amount (to compensate Delta Dental for its administration of the dental
plan), less amounts actually paid by the Contractholder to Delta Dental during the term of
such Contract.
CITY OF SANTA ANA
DELTA DENTAL GROUP #00599
Date Amendment Signed:
Signature
Printed Name
Title
DATE: August 6, 2015
DELTA DENTAL OF CALIFORNIA
Belinda Martinez
Senior Vice President
Sales /Marketing
Kevin Jackson
Group Vice President
Underwriting & Actuarial APPROVED AS TO FORM
� `tc) ,
Laura A. Rossini
Senior Assistant City Attorney
25A -9
25A -10
Exhibit "B"
25A -11
June 1, 2015
Dick Cook
814 Hibiscus Way
Placentia, CA 92870
Re: City of Santa Ana #142337
Renewal – 111116
Dear Dick Cook,
MetLife appreciates the opportunity to be a part of your benefit program. This letter confirms
Your renewal for the 2016 plan year.
In determining the rates for the coming plan year, we have evaluated your plan experience,
taking into account the credibility of the experience and the demographics of your group, Our
objective in the renewal process is to identify rates that will maintain the overall financial stability
of your benefit program.
We have set the following rates for the coming year:
Coverage
Current
Renewal
Change In
Rate/Fee
Rate/Fee
Rate/Fee
DHMO _
Employee o $26.89 $26.89 +0.0%
Employee +Family $45.98 +®Alo
The lratipnt Protection and Affordable Cara Act ( "p»ACA ") includes a health insurance PndsstrJ fe: impoes a-
aU
health insurers, including dental and vision insurers. As with the prior year, this rep in included in the dental
and/or vision rates above.
The rates shown above assume your existing plan design, contribution structure and group
demographics remain the same.
Please do not hesitate to contact me at 949 - 471.2310 if I may answer any questions or assist in
any way.
Once again, thank you for the privilege you have extended to us, You are the reason we are in
business. We look forward to continuing our relationship in the months and years ahead.
Sincerely,
Nick Sala
Account Executive
Request to Notify Alaska Residents of Impending Coverage andlor Premium Changes
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25A -12
Exhibit "C"
25A -13
Page 1 of 1
Ca1PERS 2016 Health Premiums - Regional
Contracting Agencies - PPOs Only
June PHBC Proposed Premiums
25A -14
® 2015 201$ Percent Change
' UC,,t,, 2 -Party Family Single 2 -Party Alame a, Amador, Contra Marin, Napa, Nevada, San Francisco, San Joaquin, an Mateo, Santa Clara, Santa Cruz, Solano,
Sonoma. Sutter, and Yuba
PERS Choice 700.841
1,401.68 1,822.18
798.36
1,596.72
2,075.74
13.91%
PERS Select 690.431
1,380,86 1,795.12
730.07
1,460.14
1,898.18
5.74%
PERSCare 776.081
1,550.16 2,015.211
889.271
1,778.541
2,312.10
14.73%
4 � 1
El Dorado, Placer, Sacramento and Yolo
PIERS Choice
679.26 1,358.521
1,766.081
727.581
1,455.16
1,891.71
7.11%
PERS Select
669.16 1,33$.32
-- 1,739,821
665.351
1,330.701
1,729.91
-0.57%
PERSCare 751.21 1402A21 11953.151 810.401 1,620.801 2107.04 788%
• sm=Efllm' •
* GLos Angeles, San Bernardino, and Ventura
PERS Choice
585.18 1,170.36
1,521.47
598.75
1,197.50
1,556.75
2.32%
PERS Select
576.49 1,152.98
1,498.87
547.55
1,095.10
1,423.63
- 5.02%
PERSCare
647.111 1,29U21
1,682.49
666.91
1,333,821
1,733.97
3.06%
i • q
Fresno, Imperial, inyo, Kern, Kings, Madera, Riverside, Orange, San Diego, San Luis Obispo, Santa Barbara, and Tulare
PIERS Choice 594.40
11188.80 1,545.44 683.71
1,367.42
1,777.65
15.03%
PERS Select 585.58
1,171.16 1,522.51 625.20
1,250.40
1,625.52
6.77 °!°
PERSCaro 657.32
1,314.84 1,709.03 761,501
1,523.00
1,979.90
15.85%
Alpira, Brute. Ci,averas, Colusa. Del Norto, Gienn, blu nboidt, Lake. I_asien, Nlarlr csa. a,Mendoeirto- 4lercad, Modoc. Mono, Monterey °fur ms, San
Benito. Shasta, Sierra, 9isiGyou, Stanistaus. Tahama, Tr?nityj and Tuolumne
Anthem EPO Del Norte
656.08
1,312..16
1,705.81
795.57
1,591.14
2,068.48
21.26%
Anthem EPO Monterey
656.08
1,312.16
1,705,81
795.57
1,591.14
2,068.48
21.26%
PERS Choice
656.08
1,312.16
1,705.81
795.57
1,591.14
2,068.48
21.26%
PERS Select
646.35
1,292.70
100.51
727.47
1,454.94
1,891.42
1255%
PERSCare
725.54
1,451.08
1,886.40
886.15
1,772.30
2,303.99
22.14%
PIERS Choice 653.58
1,307.16 1,699,31
625.31 1,250.621
1,625.81
-433%
PERSCare 1 722.741
1,445.481
1,879.121
696,491 1,392,981
1,810.87
- 3.63%
2015 2016 Percent Change
Single 2 -Party Family Single 2 -Party I Family ( *i>
Medicare Premium Rates - All Regions
PERS Choice 1
339.47
878.94
1,018.41
366.38
732.76
1,099.14
7.93%
PERS Select
339.47
678.94
1,018.41
366.38
732.76
1,499.14
7.93%
PERSCare
368.76
737.52
1,106.28
408,04
816.08
1,224.12
10.65%
25A -14
Page 2 of 3
Ca1PERS 2016 Health Premiums - Regional
Contracting Agencies - HMOs Only
June PHBC Final Proposed Premiums - Alternative 1
a/ New health plan option for 2016
b/ Medicare healthplan is not available for 2016 under the Single Carrier Proposal
25A -15
2015
® " Single I 2 -Party Family
Alameda, Amador, Contra Costa, Marm, Napa, Nevada, San Francisco, San
Sonoma Sutter, and Yuba
2016 1 Percent
I Single I 2 -Party I Family I change( +l -)
Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano,
Anthem HMO Select
$662.41
$1,324.82
$1,722.27
$721.79
$1,44158
$1,876.65
8.96%
Anthem HMO Traditional
827.57
1,655.14
2,151.68
855.42
1,710.84
2,224.09
3.37%
Blue Shield Access+
928.87
1,857.74
2,415.06
1,016.18
2,032.36
2,642.07
9.40%
Blue Shield NetValue
870.60
1,741.20
2,263.56
1,033.86
2,067.72
2,688.04
18.757/6
Health Net SmartCare°i
808.44
11616.88
2,101.94
Kaiser CA
714.45
1,428.90
1,857.57
746.47
1,492.94
1,940.82
4.48%
UnitedHealthcare
850.67
1,701.34
2,211.74
955.44
11910.88
2,484.14
12,32%
El Dorado,
Placer, Sacramento
°
and Yolo
Anthem HMO Select
$811.14
$1,622.28
$2,108.96
$902.07
$1,804.14
$2,345.38
li.m
Anthem HMO Traditional
940.16
1,880.32
2,444.42
1,112.54
2,225.08
2,892.60
18.34%
Blue Shield Access+
809.22
1,618.44
2,103.97
885.33
1,770.66
2,301.86
9.41%
Blue Shield NetValue
758.45
1,516.90
1,971.97
900.73
1,801.46
2,341.90
18.76%
Health Net SmartCare °l
747.55
1,495.10
1,943.63
Kaiser CA
660.96
1,321.92
1,718.50
695.11
1,390.22
1,807.29
6.17%
UnitedHealthcare 623.45 1,246.90 1,620.97 68636 1,372.72 1,784.54 10.09%
o OFAMENNINNEEM
. Los Angeles, San Bernardino, and Ventura
Anthem HMO Select
$493.40
$986.80
$1,282.84
$543.47
$1,086.94
$1,413.02
10.15%
Anthem HMO Traditional
631.62
1,263.24
1,642.21
610.64
1,221.28
1,587.66
- 3.32%
Blue Shield Access+
517.87
1,035.74
1,346.46
566.53
1,133.06
1,472.98
9.40%
Blue Shield NetValue
485.41
970.82
1,262.07
576.46
1,152.92
1,498.80
18.76%
Health Net Salud y Mas
430,71
861.42
1,119.85
466.11
932.22
1,211.89
8.22%
Health Net SmartCare
568.47
1,136.94
1,478.02
585.39
1,170.78
1,522.01
2.98%
Kaiser CA
52118
1,042.36
1,355.07
543.83
1,087.66
1,41196
4.35%
United Healthcare 458.74 917.48 1,192.72 492.24 984,481 1,279.82 7.30%
e a
Fresno, Imperial, Inyo, Kern, Kings, Madera, Riverside, Orange. San Diego, San Luis Obispo, Santa Barbara, and Tulare
Anthem HMO Select
$653.97
$1,307.94
$1,700.32
$634.75
$1,269.50
$1,650.35
-2.94%
Anthem HMO Traditional
743.12
1,486.24
1,932.11
710.79
1,421.58
1,848.05
-4.35%
Blue Shield Access+
596.66
1,197.32
1,556.52
654.87
1,309.74
1,702.66
9.39%
Blue Shield NetValue
561.09
1,122.18
1,458.83
666.35
1,332.70
1,732,51
18.76%
Health Net Salud y M6s
520.59
1,041.18
1,353.53
535.98
1,071.96
1,393.55
2.96%
Health Net SmartCare
579.88
1,159.76
1,507.69
596.98
1,193.96
1,552.15
2.95%
Kaiser CA
579.80
1,159.60
1,507.48
605.05
1,210.10
1,573.13
4.35%
Sharp
564.57
1,129.14
1,467,88
561.34
1,122.68
1,459.48
United Healthcare
449.10
896.20
1,167.66
493.99
987.98
1,284.37
10.00%
a/ New health plan option for 2016
b/ Medicare healthplan is not available for 2016 under the Single Carrier Proposal
25A -15
Page 3 of 3
CalPERS 2016 Health Premiums - Regional
Contracting Agencies - HMOs Only
Jura PNBC Final Proposed Premiums - Alternative 1
® 2015 2016 1 Percent
Single 2 -Party Family Single 2 -Party I Family I Change ( +i -)
V,) "o imor'eray Phunas. Sir
Ban ta. Shnsca.o '� Ssi<i /ou dt.nislaus. �,nama.Tri mly -and Tooiumna
Anthem HMO Select
$726.65
$1,457.30
$1,894.49
$839.10
$1,678.20
$2,181.66
15,16%
Anthem HMO Traditional
838.48
1,676.96
2,180,05
964,91
1,929.82
2,508.77
15.08%
Blue Shield Access+
804.34
1,608.68
2,091.28
879.96
1,759.92
2,287.90
9.40%
Blue Shield NetValuo
753.82
1,507.64
1,999.93
895.17
1,790.34
2,327.44
18.75%
Kaiser CA
716.98
1,433.96
1,864.15
756.27
1,510.54
1,963.70
5.34%
UnitedHealthcare
677.35
1,354.70
1,761.11
794.80
1,589.60
2,066.48
17.34%
y
Kaiser /Out of State $922.78 $1,845.56
$2,399.23
$930.29
$1,860.58
$2,418.75
0.81%
2015 2016 Percent
Single 2 -Party Family Single 2 -Party Family Change( +t.)
Medicare Premium Rues - All Re ions
Anthem Blue Cross°!
$445.38
$890.76
$1,336.14
Blue Shieldb'
352.63
705.26
1,057.89
Health Netbl
276.85
553.70
830.55
Kaiser CA
.295.51
591.02
686.53
297.23
594.46
891.69
0.58%
Kaiser Out of State
390.47
780.94
1,171..41
297.23
594.46
891.69
- 23.88%
Sharp b/
327.66
655.32
982.98
UnitedHealthcare
267.41
...534.62
802.23
320.98
641.96
962.94
a/ New health plan option For 2016
b/ Medicare healthplan is not available for 2016 under the Single Carrier Proposal
25A -16
Exhibit "D"
25A -17
A -2014- 176 -01
REACH EMPLOYEE ASSISTANCE PROGRAM SERVICES AGREEMENT
This Employee Assistance Program Services Agreement is made and entered into as of January
1, 2015, between REACH Employee Assistance, Inc, (hereinafter referred to as "REACH "), a
L' California corporation, and the City of Santa Ana, a charter city and Municipal Corporation
9 organized and existing under the Constitution and laws of the State of California (hereafter
r
referred to as "City ".)
Whereas REACH is engaged in the Employee Assistance Program Services business and desires
to service City; and
vWhereas City desires to obtain the Employee Assistance Program Services of REACH,
It is therefore agreed as follows: This is a contract for service outlining the duties and
responsibilities of REACH Employee Assistance, Inc,, to the City of Santa Ana.
I. Below are listed the Scope of Services provided by the REACH:
1.
Assessment/Connseliin eferral for Employeos and Dependents
t
A total assessment will be administered for a well - rounded analysis of the client's problem.
Employees and immediate family members are entitled to up to three (3) sessions per
6Ar
incident every six (6) months. REACH provides professional assessment/counseling to the
tAJ;jp
�R1 1St ; !n
`
point of referring the client to an outside counseling professional or agency. In addition,
as r 3
Li f-
REACH provides follow -up consultation. The nuunber of sessions offered, within this limit,
will be at the sole discretion of the REACH counseling staff.
MN
The City will be assigned a REACH liaison person. REACH provides quality, experienced
counselors knowledgeable in assessment skills to provide personal counseling to employees
and immediate family members. REACH also provides qualified and experienced staff to
assist management on all aspects of Employee Assistance Program. Dr Marcus Dayhoff is
administratively, operationally and clinically responsible for REACH.
A. Confidentiality and Release of Information
As a general rule REACH shall not disclose to the City the identity of City employees or
immediate family members of City employees who elect to participate in the REACH
Program offered under this Agreement.
U, xceptions -
Notwithstanding the above, REACH shall release to the City in writing the following
information on employees who have been referred into the REACH Program as a condition
of employment with the City:
A) Whether employee has agreed to participate in the Assistance Program.
25A -18
B) List of all appointments of employee kept and missed, together with reason, if any, for
missing the appointment.
C) Submission of the employee's anticipated treatment plan as a participant in the Program.
This plan shall consist of the following:
1) The anticipated number of visits, appointments, or sessions requested of the
employee,
2) The type of therapeutic procedures in general terns that the employee is to
receive during the employee's participation with the REACH Program or the
treatment provider(s),
3) Description of the treatment service provider the employee is referred to by
REACH.
4) Any other information not contained in the employee's treatment service provider
medical record deemed appropriate by the City to evaluate the erployees participation
in the Assistance. Program.
D) Any conclusion or opinion of REACH or employee's treatment service provider that the
employee is limited or restricted in his/her ability to perform the employee's job duties, such
limitation may be, but not necessary, limited to physical, psychological, or medical reasons.
E) Any conclusion or opinion of REACH or employee's treatment service provider Chat
employee's participation may necessitate employee's absence from the City.
F) That employee has failed, refused, or othet-wise has discontinued to proceed with the
REACH Program or any treatment service provider.
G) Report consisting of the following:
1) Diagnosis
2) Sunmary of treatment or therapeutic procedures
3) Disabilities, limitations, or restrictions of employee
4) Recommendation on further treatment.
The above information shall be considered confidential information not subject to disclosure by
REACH unless the City employee has on file with REACH and any treatment service provider in the
REACH Program an irrevocable authorization(s), RELEASE OF INFORMATION to the City.
On receipt of the City's request for the above information, REACH shall notify in writing, the City
employee of the City's request.
N'OT& The City agrees that in cases where an employee agrees to be referred by management to
REACH, the Supervisor will seek written permission from the employee to inform REACH of the
circumstances leading up to the referral,
The City agrees to in no way insist or demand confidential information from the REACH program on
specific individuals who do not want their information released to the City.
25A -19
5edvice Providers: Exceptions will also be made in cases when the employee and /or immediate family
members sign a written release authorizing the release of information by REACH to one or more
agreed upon service providers.
2. Munitions
a, "Client" shall mean an employee or his /her immediate family member participating in
the REACH EAP program.
b. "Treatment Service Providers" or "Service Providers" shall mean an outside counseling
professional or agency, referred by REACH, whose services will be paid by the client.
3. Con so ' Hours
REACH provides counseling hours from 8:00 a.m. to 8:00 p.m. Monday through Thursday,
Friday 8:00 to 5 :00 p,m. and will respond appropriately and effectively to employee needs.
Every attempt will be made to see management referrals and employees in crisis as early as
possible to the time of calland no later than 24 hours (during business hours) of the call being
made. All other clients will be seen within 48 hours of the call being made.
The City agrees to provide REACH with names and telephone numbers of liaison individual(s)
Lit the City who can be contacted hi cases of emergencies and keep REACH appraised of
changes in contacts and telephone numbers.
4, 2.1 -Hour Availability. 7 days a week
REACH provides confidential intake and psycho - social assessment and counseling to the point
of referral to employees and their immediate family members with a 24 hour telephone service.
REACH assures that no calls go unanswered and that all crisis callers receive courteous and
prompt service, During non - business hours, all calls answered by the REACH answering
service will be connected to the on -call counselor. The REACHline number is 1 -800- 273 -5273.
5. Location
Employees and firmly members will have a choice of counseling either at one of our several
conveniently located offices or at one of our service provider's office.
6. Referral Network
When necessary, REACH will refer employees and dependents to appropriate, cost effective,
geographically convenient and high quality services provided by individuals and agencies
which have been screened by our staff.
Mlonitoring/Follow -un
REACH will monitor and follow -tip as long as appropriate all people referred by the REACH
program to outside individuals and community resources to assure the problem is resolved and
25A -20
that the person is satisfied with the quality of referrals. In cases of management referrals,
REACH will also follow -up regularly with the City on status ofjob performance.
g. Service Utilization Reports
REACH will provide quarterly confidential reports on service utilization, aggregate client
profiles, assessed problems and outcome at ease closure. Customer satisfaction reports will be
available upon request by the City.
9. Benefits
The City agrees to provide REACH with copies of all the City employee benefit plans and
appraise REACH of all changes as they occur.
10. Ayolding Conflict of Interest
REACH agrees to avoid conflict of interest by providing up to three (3) referrals to clients
based on competency, geography and the most cost effective modality to deal with the client's
problem(s). No referrals will be made to the private practices of REACH counseling staff
members or to any private practitioner and /or agency with whom a REACH counselor has an
economic relationship. Only the City can make exceptions to this rule.
11. Alcoholism and Chemical Denendennev Intervention Services
REACH provides job related alcoholism and chemical dependency intervention services as
required.
1.2. Poliev and Procedure
The City agrees to consider implementing a policy and procedure statement on employee
assistance when appropriate. REACH will provide technical assistance to the City staff in
writing a policy and procedure statement on employee assistance.
1.3. Training
REACH will provide Management and Supervisory training sessions annually, It is
recommended that no more than 25 managers /supervisors attend each session. The purpose of
these training sessions is to make managers and supervisors aware of City employee assistance
program policy and procedures, of how to identify poor job performance as it relates to
personal problems and to familiarize them with the processes of referrals and follow -up. The
effectiveness of each training session will be evaluated.
14. Management Guidelines
REACH supplies on request Management and Supervisor Employee Assistance Program
guidelines for inclusion in City personnel management gtudelines.
25A -21
13. Manag_er /Supervisor Consultation and Assistance
REACH will assist managers and supervisors eailhlg REACHIine for consultation on how to
deal with specific employee incidents or problems, which may require EAP intervention. The
City agrees to encourage managers and supervisors to talce advantage of this consultation
service.
16. krograrn Promotion
The City agrees to support REACH in developing a yearly EAP program promotion plan.
a. EAP orientation classes for employees in groups of up to 50 will be available to the
City as a means of introducing City EAP policy and procedures and utilization of REACH
services.
b. "Munch & Learn" presentations will be conducted periodically upon request by the
City, at City locations to maximize utilization of REACH services.
C. REACII brochure & REACIItine cards will be supplied to the City for distribution
to all employees.
d. REACH Frontline will be electronically supplied to the City quarterly for distribution
to all supervisors.
e. REACI3line.com will be available for ontine use to all employees and family
members. Employees will be supplied a password as mentioned on REAC14 employee
brochure for online secure area access.
E REACHIIne Posters will be supplied from time to time to the City for posting on
official staff bulletin boards.
g. Originals of promotional materials for inclusion as short articles in internal staff'
newsletter or as check stutf'ers will be supplied upon request by the City.
h. REACH staff will participate at the City's employee benefit fair upon request.
i. REACH will assist with drafting of any EAP related materials to announce REACH
services to employees.
17, Ouali
REACH conducts on -going quality assurance audits on all aspects of the program from
inception to end of the contract year. REACH will supply die City with quarterly reports.
1I. THE CITY OF SANTA ANA REALIZES AND UNDERSTANDS
25A -22
Top management support and commitment is essential to the success of the REACH Employee
Assistance Program at the City of Santa Ana.
2. REACH is a totally confidential program. The City will only be aware of employees referred
officially by management and information about that employee will not be released without
written consent of the employee.
3. REACH will not, in all cases, be able to resolve the employee's or dependent's problem(s) in
the set number of counseling sessions. In such cases the employee or family member will be
referred to duality, cost effective resources available within the community.
4. Employees and dependents will not be charged for the services provided by REACH. If
referrals are necessary, those referrals may result in additional cost to the City's benefit plan and
may result in added costs to the employee or family member.
5. The REACH program is made available to all full - and part -time employees and their
dependents, The REACH benefit starts on the fast day of employment.
6. It is anticipated that the yearly employee utilization rate will be a minimum of 6 -8 %. The
REACH promotional program will aim at achieving at least this utilization rate.
III. TERMS AND CONDITIONS
The Agreement period will extend from January 1, 2015 to December 31, 2017.
2. The total cost to the City for the services to be provided to the City and its employees by
REACH under this Agreement shall be $1,85 per full time employee/inouth, and $1.25 per
part time employee/month. While the number of persons employed by the City may fluctuate
from time to time during the term of this Agreement, the City agrees the amount of
compensation payable to REACH during the tern of the Agreement shall be based on the
number of persons employed by the City at the beginning of the month invoiced for, The
beginning employee count will be 970 F/T and 490 P/T,
3. The City will be invoiced on the first of each month for that month's installment. Cheeks will
be made payable to RE, ACII Employee Assistance, Inc. and mailed to 650 N. Rose Drive,
4350, Placentia, CA 92870 - Attu.: Accounts Receivable.
4. The City will make payment within 30 days fiom the date of the receipt of the invoice from
REACH Employee Assistance, Inc.
5. The City or REACH has the tight to cancel this contract at any time without cause by giving 60
days written notice to that effect.
6. REACH Employee Assistance, Inc. agrees to indenmify, defand, and hold harmless the City, its
officers, employees, agents and representatives, fiom any and all claims, demands, purported
25A -23
liability, or consequential damages of any kind or nature arising out of or in connection with
REACHs acts or omissions in carrying out the terms of this Agreement or exercising the rights
herein granted; excepting those chums, demands, purported liability, or consequential damages
which arise out of the sole negligence of City.
REACH agrees to maintain, during the course of this Agreement the following insurance
coverage:
a) Comprehensive general liability insurance coverage, including personal injury and
contractual liability coverage, in an amount equal to One Million Dollars
($1,000,000.00) per occurrence, combined single limit;
b) Worker's Compensation insurance as required by State of California statutes;
c) Professional liability insurance with a One Million Dollar ($1,000,000,00) limit, per
occurrence. REACH agrees to keep such policy h1 force and effect for at least five (S)
years from the date of completion of this Agreement.
Also, the City of Santa Ana, its officers, agents and employees will be named as additional
insured on the above referred comprehensive general liability coverage and REACH will
provide an endorsement to that effect. Such insurance shall (a) name the City, its officers,
employees, agents, volunteers and representatives as additional insured(s); (b) be primary
and not contributory with respect to insurance or self - insurance programs maintained by the
City; and (c) contain standard separation of insured's provisions. Such insurance will be
evidenced by certificate and issued by companies licensed to do business in California and
acceptable to the City. Before REACH performs any work, it will furnish certificates of
insurance and endorsements, as required by City, evidencing the aforementioned general
liability, and professional liability insurance coverages on forms acceptable to the City which
shall provide that the insurance in force not be canceled or modified without 30 days prior
written notice to the City.
8. NO ASSIGNMENT. REACH shall not assign or transfer this Agreement or any rights
hercumder without the prior written consent of the City and approval by the City's City Attorney,
which may be withhold in the City's solo discretion. Any unauthorized assigned or transfer shall be
null and void and shall constitute a material breach by REACH of its obligations under this
Agreement. No assignment shall release the original ,parties or otherwise constitute a notation.
9. COMPLIANCE WITH LAWS. REACH shall comply with all Federal, State, County and
City laws, ordinances, rules and regulations, which are, as amended from time to time, incorporated
herein and applicable to the performance hereof.
10. ATTORNEY FEES. If any action at law or in equity is brought to enforce or interpret the
terms of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, costs
and necessary disbursements in addition to the relief to which such party may be entitled.
11. INTERPRETATION.
25A -24
(a) Applicable Law. This Agreement, and the rights and duties of the parties hereunder (both
procedural and substantive), shall be governed by and construed according to the laws of the
State of California, with venue in Orange County.
(b) Entire Agreement. This Agreement, including any exhibits attached hereto, constitutes
the entire agreement and understanding between the parties regarding its subject matter and
supersedes all prior or contemporaneous negotiations, representations, understandings,
correspondence, documentation and agreements (written or oral). To the extent there is any
conflict or inconsistency between the terms and provisions of this Agreement and the
exhibits attached hereto, the terms and provisions of this Agreement shall govern the rights
and obligations the parties hereto.
(c) Written Amendment. This Agreement may only be changed by written amendment
signed by REACH and the City Manager of the City or other authorized representative of
the City, subject to any requisite authorization by the City Council, Any oral representations
or modifications concerning this Agreement shall be of no force or effect.
(d) Severabil�. If any provisions of this Agreement is held by any court of competent
jurisdiction to be invalid, illegal, void, or unenforceable, such portion shall. be deemed
severed from this Agreement, and the remaining provisions shall nevertheless continue in
full force and effect as fully as though such invalid, illegal, or unenforceable portion had
never been part of this Agreement,
(e) Oder of Precedence In case of conflict between the terms of this
Agreement and the terms contained in any document attached as an exhibit or otherwise
incorporated by reference, the terms of this Agreement shall strictly prevail.
(f) Choice of Forma. The parties hereby agree that this Agreement is to be executed ill
accordance with the applicable laws of the State of California, is entered into and is to be
performed in the City of Santa. Ana and that all claims or controversies arising out of or
related to performance under this Agreement shall be submitted to and resolved in a forum
within the City of Santa Ana at a place to be determined by the rules of the forum.
12, TIME OF ESSENCE. Time is strictly of the essence of this Agreement and each and every
covenant, term and provision hereof.
13. AUTHORITY OF REAC%I, REACH hereby represents and warrants to the City that
REACH has the right, power, legal capacity and authority to enter into and perform its obligations
under this Agreement, and its execution of this Agreement has been duly authorized.
14. INSURANCE. REACH shall, at its own expense, procure and maintain policies of insurance
of the types turd in the amoruuts set forth in the Agreement to which this Addendum is attached for
the duration of the Agreement, including any extensions hereto. The policies shall state that they
afford primary coverage. Failure to maintain required insurance at all times shall constitute a default:
and material breach. In such event, REACH. shall immediately notify City and cease all
25A -25
performance ruiner this Agreement until further directed by the City. In the absence of satisfactory
insurance coverage, City may, at its option: (a) procure insurance with collection rights for
premiums, attorney's fees and costs against REACH by way of set-off or recoupment from the sums
due REACH, at City's option; (b) immediately terminate this Agreement; or (c) self insure the risk,
with all damages and costs incurred, by judgment, settlement or otherwise, including attorney's fees
and costs, being collectible from REACH, by way of set -off or recoupment from any sums due
REACH.
15, NOTICES. Any notice or demand to be given by one party to the other shall be given in
writing and by personal delivery or prepaid first- class, registered or certified mail, addressed as
follows. Notice simply to the City of Santa Ana or any other City department is not adequate notice.
To City: Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P,O. Box 1988
Santa Ana, CA 92702 -1988
Fax 714- 647 -6956
Copies to: Executive Director of the Personnel Services Agency
City of Santa Ana
20 Civic Center Plaza (M -24)
P.O. Box 1988
Santa Ana, California 92702
Fax 714- 647 -6930
City Attorney
City of Santa Ana
20 Civic Center Plaza (M -29)
P.O. Box 1988
Santa Ana, California 92702
Fax 714- 647 -6515
If to REACH: REACH Employee Assistance, Inc.
101 East Lincoln Avenue, Suite 230
Anaheim, CA 92805
Attn.: Dr. Marcus Dayhoff
Any such notice shall be deemed to have been given upon delivery, if personally delivered, or, if
mailed, upon receipt or upon expiration of three (3) business days from the date of posting,
whichever is earlier. Either party may change the address at which it desires to receive notice upon
giving written notice of such request to the other party.
16. TERMINATION FOR CONVENIENCE (Without Cause). The City or REACH may
terminate this Agreement in whole or in part at any tinge, for any cause or without cause, upon sixty
(60) calendar days' written notice to the other. If the Agreement is thus terminated by the City for
25A -26
reasons other than REACH's ffflu e to perform its obligations, the City shall pay REACH a
prorated amount based on the services satisfactorily completed, and accepted prior to the effective
date of termination, Such payment shall be REACH's exclusive remedy for termination without
cause.
17. DEFAULT, In the event either party materially defaults in its obligations hereunder, the
other party may declare a. default and terminate this Agreement by written notice to the defaulting
party, The notice shall specify the basis for the effective date of termination stated in such notice,
which date shall be no sooner than ten (10) days after the date of the notice.
Termination for cause shall relieve the terminating party of further liability or responsibility under
this Agreement, including the payment of money, except for payment of services satisfactorily and
timely pen- formed prior to the service of the notice of termination, and except for reimbursement of
(1) any payments made by the City for service not subsequently performed in a timely and
satisfactory manner, and (2) costs incurred by the City in obtaining substitute performance.
18. EQUAL EMPLOYMENT OPPORTUNITY. During the performance of this Agreement,
REACH agrees as follows:
a. REACH shall not discriminate against any employee or applicant for employment because
of race, color, religion, sex, national origin or mental or physical disability.
REACH will ensure that applicants are employed and that employees are
treated during employment, without regard to race, color, religion, sex, national
origin or mental or physical disability. Such actions shall include, but not
limited to the following: employment, upgrading, demotion or transfer,
recruitment or recruitment advertising, layoff or termination, rates of pay or
other forms of compensation and selection training, including apprenticeship.
REACH agrees to post in conspicuous places, available to all employees and
applicants for employment, a notice setting forth provisions of this non-
discrimination clause.
b, REACH shall, in all solicitations and advertisements for employees
placed by, or on behalf of REACH, state that all qualified applicants will
receive consideration for employment without regard to race, color, religion,
sex, national origin, or mental or physical disability.
c. REACH shall, cause the foregoing paragraphs (a) and (b) to be inserted in all
subcontracts for any work covered by this Agreement, provided that the
foregoing provisions shall not apply to subcontracts for standard commercial
supplies or raw materials.
10
25A -27
19. CONFLICT, REACH hereby represents, warrants and certifies that no member, officer or
employee of REACH is a director, officer or employee of the City, or a member of any of its
boards, commissions or committees, except to the extent permitted by law.
(Signatures on Following Page)
11
25A -28
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and you first
above written.
ATTEST:
Maria D. S uim /J
Clerk of the Council
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By: c
Lisa S'torck
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
Edward Raya, Exirector
Personnel Services Agency
CITY OF SANTA ANA
Dave Cavazos
City Manager
REACH Employee Assistance, Inc.
fIf
By:�l iz•.�
Marcu. Dayhoff
CEO & Clinical Direct /r
12
25A -29
25A -30