2008-022 Medical Insurance Opt-Out PolicyRESOLUTION 2008-22
A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE OF NORTH
PALM BEACH, FLORIDA, ADOPTING A GROUP MEDICAL INSURANCE
"OPT OUT" POLICY TO BE INCORPORATED INTO THE VILLAGE'S
ADMINISTRATIVE POLICES AND PROCEDURES MANUAL; PROVIDING
FOR CONFLICTS AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, Village Administration is recommending the adoption of a formal policy outlining
the circumstances under which full-time Village employees may waive Village group medical
coverage and receive an "opt out" incentive; and
WHEREAS, the Village Council determines that the adoption of this Resolution is in the best
interests ofthe Village, its residents and its employees.
NOW, THEREFORE, BE IT RESOLVED BY THE VILLAGE COUNCIL OF NORTH PALM
BEACH, FLORIDA as follows:
Section 1. The foregoing recitals are hereby ratified and aze incorporated herein.
Section 2. The Village Council hereby adopts the Medical Insurance "Opt Out" Policy
(Policy Number 08-002), a copy of which is attached hereto and incorporated herein by
• reference. This policy shall be incorporated into the Village of North Palm Beach
Administrative Policies and Procedures Manual.
Section 3. All resolutions, parts of resolutions, memoranda or existing policies in conflict
herewith aze hereby repealed to the extent of such conflict.
Section 4. This Resolution shall take effect on April 1, 2008, provided, however, that the
provisions of the Policy adopted by this Resolution shall not apply to employees within
bargaining units until the Village and the union representing the bazgaining unit execute a
Memorandum of Understanding with respect to such Policy or the union waives bargaining and
consents to its implementation.
PASSED AND ADOPTED THIS 27th DAY OF MARCH, 2008.
(Village Seal) //~~~%~~/~~ ~G%%~~~
`/~ MAYOR
ATTEST:
VILLAGE CLERK
Village of North Palm Beach _
ADMINISTRATIVE POLICIES AND PROCEDURES MANUAL
~* Policy Title: MEDICAL INSURANCE Policy Number: 08-003
"OPT-OUT" POLICY
~ Effective Date: ~ Originating Dept.: FI. R.
Revision Date: None Supercedes: All previous memos or
,policies in conflict
I. REFERENCE: Village of North Palm Beach Resolution No. 2ga8-22
II. PURPOSE:
To establish and outline the Village of North Palm Beach's policy for allowing employees to "opt
out" or waive medical insurance as provided under the Village's group plan, the eligibility
requirements for waiving insurance and receiving an "opt out" incentive, and the procedures by
which coverage can be waived or reinstated as applicable.
III. POLICY:
Due to the rising cost of health care and corresponding employer-paid premiums for health
insurance for employees, the Village of North Palm Beach is desirous of allowing employees to
seek alternate insurance, or "opting out" of insurance through the Village's group health
insurance plan. As incentive for employees with alternate coverage to provide evidence of
insurance and waive coverage through the Village's group plan, the Village will ,provide an
incentive payment payable through the normal payroll process as outlined in this policy.
Full-time Village employees shall be eligible to waive medical insurance through the Village's
group health insurance plans by providing adequate proof of insurance through an alternate
insurance policy. Employees eligible to waive the medical insurance coverage through the
Village's group plan will receive compensation as outlined in this policy as a benefit of waiving
the Village's coverage thereby reducing the Village's overall premium costs and is not intended
to encourage employees not to have adequate medical insurance coverage. This "opt out"
incentive is intended to provide employees with adequate alternate coverage with incentive to
waive coverage through the Village and thereby reduce the Village's overall premium casts.
Non-insured employees drive up other casts, i.e. lost time, workers' compensation and liability
claims and premiums, etc.
In order to help ensure the safety and well-being of its employees, the Village will require all full-
time employees to be covered by its group medical plan or to provide proof of alternate
coverage. The "opt out" incentive monies will not be paid to employees unable to show proof of
coverage with another policy andlor policies. At no time will employees be eligible to remain on
the Village's group medical plan and receive "opt out" monies at the same time.
Once waived, insurance coverage on the Village's group medical plan can only be reinstated as
a result of a "qualifying event" {as defined by the Village's medical plan) or during an annual
open enrollment period. Failure on the part of the employee to maintain adequate insurance
andlor to request reinstatement on the Village's group medical insurance plan once alternate
coverage has terminated will be viewed as a violation of this policy.
Employees shall be eligible to waive coverage upon hire, at times of "qualifying event" as
defined by the insurance carriers, andlor during periods of open enrollment for Village group
medical plan. Employees must show proof of alternate insurance annually or they will be
enrolled in the Village's lowest cast plan for employee coverage (only) and not receive further
opt out monies while on the Village's plan. This policy shall only apply to the group medical
insurance policy; employees will not receive any compensation for waiving any other employer-
Employees shall be eligible to waive coverage upon hire, as a result of a "qualifying event" as
defined by the insurance carriers, and/or during periods of open enrollment far Village group
medical plan. Employees must show proof of alternate insurance annually or they will be
enrolled in the Village's lowest cost plan for employee coverage (only) and not receive further
opt out monies while on the Village's plan. This policy shall only apply to the group medical
insurance policy; employees will not receive any compensation for waiving any other employer-
paid insurance benefits.
kV. PROCEDURE:
A. Prior to being eligible to receive "opt out" monies, the employee must provide Human
Resources with proof of alternate insurance coverage. Eligible alternate coverage must
include a minimum of medical, hospitalization, and prescription drug coverage.
B. Employees who have met this requirement will be eligible to receive "opt out" incentive
monies payable through the normal payroll process at a rate of $85 per month (or
$39.23 per biweekly pay cycle}.
C. After reviewing the proof of insurance and confirming with the employee that helshe is
eligible to receive "opt out" monies, the Human Resources Department shall complete a
change form noting the effective date of the termination of employee coverage on the
Village group plan and submit a Personnel Action Form (PAF} to the Finance
Department for applicable payment of "opt out" monies.
D. Once waived, insurance coverage on the Village's group medical plan can only be
reinstated as a result of a "qualifying event" (as defined by the Village's medical plan) or
during the Village's annual open enrollment period. Failure on the part of the employee
to maintain adequate insurance and/or to request reinstatement on the Village's group
medical insurance plan once alternate coverage has terminated will be viewed as a
violation of this policy.
Approved
/~/~~
~ ~
Jimm~fnig~it " ^ate
Village Manager