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HomeMy WebLinkAboutResolution # 3823RESOLUTION NO. 3823 A RESOLUTION APPROVING AN INTERGOVERNMENTAL HEALTH BENEFIT AGREEMENT BETWEEN THE CITY OF CANTON AND THE CANTON PARK DISTRICT IN DIRECTING THE MAYOR AND CITY CLERK TO EXECUTE AND DELIVER SAID AGREEMENT ON BEHALF OF THE CITY OF CANTON, ILLINOIS. WHEREAS, the Legal and Ordinance Committee of the City of Canton has determined that it is necessary and in the best interest to enter into an intergovernmental Health Benefit Agreement with the Canton Park District as set forth in Exhibit A attached hereto and incorporated herein; and WHEREAS, the City Council of the City of Canton has made a similar determination. NOW, THEREFORE, BE IT RESOLVED by the Mayor and the City Council of the City of Canton, Illinois as follows: I. That the Agreement attached hereto and incorporated herein as Exhibit A is hereby approved by the Canton City Council. 2. That the Mayor and City Clerk of the City of Canton, Illinois are hereby authorized and directed to execute said Agreement on behalf of the City of Canton. 3. That this Resolution shall be in full force and effect immediately upon its passage by the City Council of the City of Canton, Illinois and approval by the Mayor thereof. PASSED BY THE CITY COUNCIL OF THE CITY OF CANTON, ILLINOIS AT A REGULAR MEETING THIS 21st DAY OF August , 2007, UPON A ROLL CALL VOTE AS FOLLOWS: AYES: Aldermen Lewis, Strarxlberg, Meade, West, Sarff, Berardi, Schenck. NAYS: None . ABSENT: Alderman Nidiffer , Nancy Whites, ity Clerk ,~ HEALTH BENEFIT AGREEMENT This Health Benefit Agreement, for the participation in the City of Canton's health benefit plan, is entered into as of the day of , 2007, by and among the City of Canton ("City"), an Illinois Municipal corporation, 2 N. Main Street, Canton, Illinois 61520, and the Canton Park District ("Park District"), an Illinois Park District. WITNESSETH: WHEREAS, the Constitution of the State of Illinois, 1970, Article VII, Section 10, authorizes units of local government to enter into intergovernmental arrangements and agreements or to otherwise associate among themselves in any manner not prohibited by law or ordinance; and WHEREAS, the Intergovernmental Cooperation Act (5 ILCS 220/1 et. seq.) provides that any power or powers, privileges or authority exercised or which may be exercised and enjoyed jointly with any other unit of local government pursuant to agreement; and WHEREAS, Section 5 of the Intergovernmental Cooperation Act (5 ILCS 220/5) provides that any one or more public agencies may contract with any one or more other public agencies to perform any governmental services, activity or undertaking which any of the public agencies entering into the agreement is authorized by law to perform, provided that such agreement shall be authorized by the governing body of each party to the agreement; and WHEREAS, the parties to this agreement consist of an Illinois Municipal Corporation operating under the Illinois Municipal Code (65 ILLS 1/1 et. seq.) and an Illinois Park District operating under the Illinois Park District Code (70 ILCS 1205/1 et. seq.); and WHEREAS, the aforesaid City maintains a health benefit plan to provide medical, dental, life insurance and Section 125 ("flex account") benefits for covered plan participants of the City; and WHEREAS, the health benefit plan represents the City's efforts to provide covered plan participants with the best possible health benefits at an affordable cost; and WHEREAS, the parties have determined that it is in their best interests to enter into an agreement whereby the Park District can participate in the City's health benefit Plan for Park District employees and dependents as a "plan participant" at the costs set forth herein. NOW, THEREFORE, in consideration of the preceding recitals of fact for the further considerations hereinafter stated, IT IS AGREED AS FOLLOWS: 1. Coverage: Medical coverage under the City of Canton Health Benefit Plan through Health Alliance is pursuant to the Summary Plan attached hereto and incorporated herein as Addendum A. Dental coverage under the City of Canton Health Benefit Plan is pursuant to the Summary Plan attached hereto and incorporated herein as Addendum B. Coverage is subject to change per action of the City Council or per Health Alliance. 2. FeesBilling: a. Medical: Current fees for Medical Coverage will be billed directly to the Park District from Health Alliance. Fees for medical coverage will be paid directly to Health Alliance from the Park District. The Park District is responsible for any increase in premium. b. Dental: Fees for dental coverage are charged on a pro-rata basis of the total number of Park District Employees versus total number of participants enrolled in the dental plan. Any decrease in fees will be adjusted to the Park District's billing statement or reimbursed, accordingly. If, at the end of the City's fiscal year, the health care fund remains in a deficit, the Park District will reimburse the City cost proportionate to the number of Park District employees and dependents participating in the plan. c. Section 125 Plan: Fees for the Section 125 plan ("Flex Plan") are per the deduction elected by the employee. Administrative costs are set by BPC and will be charged per participating employee. d. Life Insurance: Life insurance costs are those based on actual costs billed by Fort Dearborn Life. 3. Insurance Committee: The City's health benefit plan is directed by an Insurance Committee comprised of nine (9) individuals, who are representative of each department within the City, as well as the Mayor, City Treasurer and two (2) Aldermen. The Park District is entitled to representation by the designee of their choice. The designee may fully participate in all Insurance Committee meetings by attendance and vote. The Insurance Committee is designed to make recommendations to the City Council. Final action on all insurance matters is decided by the City Council of the City of Canton. 2 't 4. Release and Indemnification: The Park District agrees to be solely responsible for its decisions and actions relating to Park District employees and consequent costs regarding benefits and coverage, and agrees to indemnify and hold harmless the City, its Aldermen, departments, officers, agents and employees against any claims arising from such Library decisions and actions by a Park District employee or employee's dependent. 5. Effective Date/Term/Termination: This agreement shall be in effect on the date it is fully executed by the duly authorized officers of each party and will remain in effect until Apri130, 2008. Unless terminated in the manner provided for below, it shall automatically renew for successive one year terms. This agreement shall remain in effect until such time as either party to this agreement requests that the terms of the agreement be reviewed and/or a new agreement is executed, or the parties agree to a termination. 6. Notices: All notices hereunder shall be in writing and shall be served personally, by registered mail or certified mail to the parties at such addresses as designated below: To the City: City of Canton 2 North Main Street Canton, Illinois 61520 Attn: City Treasurer To the Park: Canton Park District. 250 South Avenue D Canton, Illinois 61520 Attn: Insurance Committee 7. General Terms: This agreement shall be binding upon and inure to the benefit of any successor entity which may assume the obligations of any party hereto, provided, however, that this agreement may not be assigned by a party without prior written consent of the parties hereto. This agreement shall be governed by and constructed under the law of the State of Illinois. A declaration of the invalidity of any provision of this agreement shall not render invalid any other provision. If, for any reason, any provision of this agreement is determined by a court of competent jurisdiction to be invalid or unenforceable, that provision shall be deemed severable and this agreement may be enforced with that provision severed or modified by court order. This agreement may be executed in multiple counterparts or duplicate originals, each of which shall constitute and be deemed as one and the same document. In Witness, the parties have executed this Agreement by authorized officials in Canton, Illinois this day of , 2007, pursuant to the authority granted by the respective governing bodies of each party. CANTON PARK DISTRICT By: Title: Attest: By: Title: CITY OF CANTON, an Illinois Municipal Corporation By: Title: Attest: By: Title: 4 ADDENDUM A SUMMARY PLAN DESCRIPTION OF THE CITY OF CANTON DENTAL PLAN Dental Benefits (a) Services Reasonable and Customary Dental Expenses Incurred for: (1) Preventative Dental services (not subject to Deductible) (A) routine oral examinations, up to a maximum of twice per calendar year; (B1 prophylaxis (cleaning, scaling and polishingl, up to a maximum of twice per calendar year; (C) topical fluoride application, limited to persons under age nineteen (191, up to a maximum of twice per calendar year; (D) x-rays-bitewing (as needed), complete mouth x-ray (every thirty-six (36) months; (E) space maintainers, limited to persons under age sixteen (16) and not when part of orthodontic treatment; and IF) emergency treatment for relief of pain. (2) Primary Dental Services (A) amalgam fillings; (B) composites on anterior (front teeth; (C) synthetic porcelain and plastic restorations; (D) extractions-simple and surgical extractions including pre- and post-operative care; 5 (E) endodontics-root canal and pulpal therapy; (F) periodontics-treatment of gums and bones supporting teeth; (G) general anesthesia when administered by a Dentist properly licensed to administer general anesthesia fora covered procedure; (H) sealants for Covered Dependents under age nineteen (19) to caries-free occlusal surfaces of first and second permanent molars (once in five years); (I) repair of dentures and bridgework; and (J) occlusal guards (once per lifetime; (3) Major Dental Services (A) crowns, jackets, labial veneers and cast restorations, including replacements (but only once in five years except for an accidental Injury); (B) inlays and onlays for restorative purposes, including replacements (but only once in five years, except for accidental Injury); (C) Oral Surgery including procedures such as frenectomies, removal of cysts and neoplasms and other surgical procedures not covered under Primary Dental Services and not covered under the medical benefits provisions of the plan; ID) Initial installation of, or addition to, full or partial dentures or fixed bridgework, if such installation or addition is required due to the extraction, on or after the Covered Person's or Dependent's Effective Date, of one or more natural teeth due to Sickness or Injury, and such denture includes the replacement of the extracted tooth and is completed within twelve (12) months after the date of the extraction; 6 (E- Replacement or alteration of full or partial dentures or fixed bridgework, if such charge is due to one of the following events, and if such event occurred on or after the Covered Person's or Dependent's Effective Date, and if the replacement or alteration is completed within twelve (12) months after such event: (i) accidental Injury requiring Oral Surgery; (ii) Oral Surgery involving the repositioning of muscle attachments, or the removal of a tumor, cyst, torus or redundant tissue. (F) replacement of a full denture, if required as a result of structural change within the mouth and if made more than five (51 years after installation of the denture, but not within two (2) years after the Covered Person's or Dependent's Effective Ddate; (G) replacement of congenitally missing teeth; and (H) dental implants as reviewed on a case by case basis. (I) full and partial dentures (J) denture adjustments during first six (6) months after obtaining dentures or having them repaired, provided that the services are performed by someone other than the dentist or his associates who provided or repaired the dentures; Replacements of crowns, bridges or dentures are not covered (1) until five (5) years have elapsed since the original acquisition of the crowns, bridges or dentures, or unless additional teeth have been extracted, and 12) unless the original crowns, bridges or dentures could not have been repaired and made serviceable. (bl Limitations (1) Deductible Expenses During each calendar year, except where specifically indicated to the contrary, each Covered Person or Covered Dependent shall be responsible for the first S50 of covered Expenses Incurred ("Deductible Expenses") pursuant to this Dental Benefits 7 Section. This limitation does not apply to Expenses Incurred for Preventative Dental Services as defined herein. If a Covered Person or Covered Dependent incurs Deductible Expenses during the last three (3) months of a calendar year, such expenses shall be considered Deductible Expenses for the next calendar year as well. Notwithstanding any provision in this Section to the contrary, the total number of Deductible Expense limits to be paid by a Covered Person and his Covered Dependents during one calendar year under the provisions of this Section shall not exceed three (3). The Deductible Expenses incurred under this Section of the Plan shall not be applied to satisfy the Deductible Expense requirement under any other Section of the Plan. (2) Shared Expenses Notwithstanding any provision herein to the contrary, during each calendar year, a Covered Person or Covered Dependent shall be responsible for a portion of Reasonable and Customary Expenses Incurred pursuant to this Dental Benefits Section, in excess of the expenses excluded pursuant to Subsection 11- above, determined in accordance with the following schedule: Benefits: Preventative 100% Primary 80%/20% Major 50%/50% 8 (3) Maximum Dental Benefits Notwithstanding any provision herein to the contrary, the maximum benefits available for each Covered Person or Covered Dependent pursuant to this Dental Benefits Section shall not exceed 51,000 per calendar year for all benefits provided for Preventative, Primary, or Major Dental Services. (4) Precertification If a dentist recommends a course of treatment with an estimated cost of more than 5200, the dentist may submit a report describing the planned treatment, including copies of necessary x-rays, photographs and models and an estimate of the total cost of the course of treatment. The Contract Administrator will review the proposed course of treatment and will notify the Covered Person or Covered Dependent and dentist of the benefits available under the Plan. (5) Alternate Benefits If more than one (1) course of treatment is available, benefits will be computed and paid based on the least costly course of treatment. 16) Care By More Than One (11 Dentist If a Covered Person or Covered Dependent switches dentists during a particular course of treatment, benefits will be provided as if the course of treatment had been provided under the original treatment plan. (7) Limitations The following limitations apply to benefits provided pursuant to this Dental Benefits Section, in addition to those limitations specified in the General Limitations Section which are applicable to all benefits provided under the Plan. Pursuant to these additional limitations, no benefits will be provided under this Dental Benefits Section for: (A1 Dental Services not ordered by a Physician or dentist; (B) Dental Services which do not meet the standards set by the American Dental Association; (C) Dental Services incurred due to loss or theft of dentures or bridges; 9 (D) Dental Services obtained from a health department maintained by the Employer, a union, a trustee or a similar type of entity; IE) Dental Services obtained for cosmetic reasons, including altering or extracting and replacing sound teeth to change appearance; (F) The following items: (i) myofunctional therapy; (ii) athletic mouthguards (iii) implants; (iv) oral hygiene, dietary, plaque control and other educational programs; (v) duplicate prosthetic appliances; (vi) porcelain veneered crowns or pontics placed on or in place of a tooth behind the second bicuspid, to the extent the charges would be more than the charges that would have been a Covered Dental Charge for acrylic veneered crowns or onlays; and (vii) gold inlays or onlays; (G) diagnosis and treatment of temporomandibular joint syndrome including intraoral prosthetic devices, or any other procedure to alter vertial dimension. 10 ADDENDUM B SUMMARY PLAN DESCRIPTION OF THE CITY OF CANTON HEALTH BENEFIT PLAN PER HEALTH ALLIANCE 11