Sec. 116.1406. - Self-Insurance.

Effective January 1 of each year, the City may provide plan benefits through a self-insurance arrangement rather than through a fully insured Group Health Vendor. The following provisions shall apply to such self-insurance: (a) Procurement of a Plan Administrator. A contract with a plan administrator must have been competitively procured in the preceding five years. Before awarding or contracting with the plan administrator, the Employee Services Department shall provide a written advisory report to City Council on the vendor responses to the competitive solicitation. The written advisory report shall be submitted to each Council Member and shall contain a recommendation of the response that best serves the interests of the City. The report shall describe the basis for the recommendation, including a comparison of the responding vendors with respect to the fees to be charged and the provider networks to be offered. The Mayor shall consider the report before awarding the contract to any vendor. (b) Annual Review. By July 1 of each year, Employee Services shall (i) review an actuarial analysis of the cost-benefits of a proposal to self-insure; (ii) review the terms of any plan administrator contract; and (iii) make plan recommendations to the Mayor. (c) Annual Notice to City Council. By August 1 of each year, the City Council shall be advised of any changes in the plan and the actuarial estimated costs of self-insuring the plan (and any proposed changes). (d) Funding Requirement. The funding necessary to cover the City's self-insurance obligations shall be included in the Mayor's proposed annual budget request and shall include the amounts necessary to pay for (i) plan administration services; (ii) stop loss insurance; (iii) estimated expenses and claims of the self-insurance program; (iv) reserves required by the State of Florida; and, (v) any other sums necessary for the operation of the Group Health Plan. Such funding shall be subject to approval by the City Council and, if approved, shall be deposited in the Group Health Fund. (Ord. 2014-546-E, § 1; Ord. 2016-140-E , § 16; Ord. 2021-378-E , § 1)