08-19-2014 City Council Special Meeting Packet
City of Grand Island
Tuesday, August 19, 2014
Special Meeting - Updated Packet
City Council:
Linna Dee Donaldson
John Gericke
Peg Gilbert
Chuck Haase
Julie Hehnke
Kent Mann
Vaughn Minton
Mitchell Nickerson
Mike Paulick
Mark Stelk
Mayor:
Jay Vavricek
City Administrator:
Mary Lou Brown
City Clerk:
RaNae Edwards
7:00 PM
Council Chamber - City Hall
100 East 1st Street
Grand Island Special Meeting - Updated - 8/19/2014 Page 1 / 84
City of Grand Island Tuesday, August 19, 2014
Call to Order
This is an open meeting of the Grand Island City Council. The City of Grand Island abides by the Open
Meetings Act in conducting business. A copy of the Open Meetings Act is displayed in the back of this room
as required by state law.
The City Council may vote to go into Closed Session on any agenda item as allowed by state law.
Invocation
Pledge of Allegiance
Roll Call
A - SUBMITTAL OF REQUESTS FOR FUTURE ITEMS
Individuals who have appropriate items for City Council consideration should complete the Request for
Future Agenda Items form located at the Information Booth. If the issue can be handled administratively
without Council action, notification will be provided. If the item is scheduled for a meeting or study
session, notification of the date will be given.
B - RESERVE TIME TO SPEAK ON AGENDA ITEMS
This is an opportunity for individuals wishing to provide input on any of tonight's agenda items to reserve
time to speak. Please come forward, state your name and address, and the Agenda topic on which you will
be speaking.
Grand Island Special Meeting - Updated - 8/19/2014 Page 2 / 84
City of Grand Island
Tuesday, August 19, 2014
Special Meeting - Updated
Item -1
CRA 2014-2015 Proposed Annual Budget
Staff Contact: Jaye Monter, Finance Director
Grand Island Special Meeting - Updated - 8/19/2014 Page 3 / 84
Council Agenda Memo
From:Chad Nabity, AICP, Director
Meeting:August 19, 2014
Subject:Community Redevelopment Authority 2014-2015
Annual Budget
Item #’s:S-1
Presenter(s):Chad Nabity
It is my privilege to present to you the budget for the Community Redevelopment
Authority (CRA) for 2014-2015. This plan and budget continues the high-quality services
that have enabled the CRA to partner with the City of Grand Island, private developers
and businesses and with property owners in the blighted and substandard areas to make
Grand Island vibrant, clean, safe and attractive.
The CRA budget for 2014-2015 is offered to you with a review of the responsibilities of
the CRA. Those responsibilities and abilities are outlined in State Statutes and are
summarized, in part, as follows:
The creation of a Redevelopment Authority was authorized by the Nebraska Legislature
in order to provide communities with the ability to address certain areas of a city in need
of improvement and development. Powers granted to CRAs are outlined in Chapter l8 of
the Statutes and include the ability to expend funds to acquire substandard or blighted
areas, make public improvements, and assist with development and redevelopment
projects in specified areas. The Authority has virtually the same powers as any political
subdivision, including borrowing money, issuing bonds, undertaking surveys and
appraisals and asking for a levy of taxes.
A five-member board, appointed by the Mayor with the approval of the City Council,
governs the CRA. The CRA is administered by a Director and devotes the overwhelming
share of its resources to highly visible and effective programs. The CRA funds its
programs primarily through assessments on taxable properties within the Grand Island
city limits.
BLIGHTED AND SUBSTANDARD AREAS
There are fifteen designated Blighted and Substandard Areas within the Grand Island
City Limits (see attached map). The City of Grand Island has the authority to designate
Grand Island Special Meeting - Updated - 8/19/2014 Page 4 / 84
up to 35% of the community a blighted and substandard. At present 18.58% of the City
has been designated blighted and substandard. Council has approved three blight studies
during the last year, two along Webb Road and one at Lincoln and Phoenix streets. The
CRA has contracted with a consultant to review the possibility of declaring the Grand
Island Veteran’s Home property and some of the surrounding area as blighted and
substandard.
CRA MISSION
The CRA’s mission is to reduce, slow or eliminate blighting influences on property in
those areas that have been designated as blighted and substandard by the Grand
Island City Council. They do this by encouraging new investment and improved
infrastructure in older areas of the community through the use of tax increment financing.
They also take an active role in purchasing and demolishing properties that need to be
cleared. This property is then made available for redevelopment.
FISCAL RESOURCES
General Revenues for 2014-2015
The CRA is requesting property tax revenues of $686,119 including $198,050 for Lincoln
Pool Construction and Bonds and $488,069 for all other CRA programs. The program
dollars are slightly more than the amount requested for the 2008 to 2014 budgets and
down from $500,000 in 2007-2008. The CRA is requesting the same levy that was
approved last year. This will allow the CRA to meet obligations, continue with their
other successful programs and even expand the programs with the Life Safety and
Infrastructure grants for Downtown. Historically, the levies and tax asking have been:
2013-
2014
2012-
2013
2011-
2012
2010-
2011
2009-
2010
2008-
2009
2007-2008
0.026 0.026 0.026 0.017742 $0.018076 $0.020790 $0.0225655
$669,384 $654,437 $639,405 $425,000 $425,000 $475,000 $500,000
Program Funding
The CRA has the ability to assist private developers and governmental entities with the
commercial, residential or mixed-use redevelopment projects throughout the City.
Specific detail on projects is as follows:
Purchase of Dilapidated Properties/Infrastructure. The 2014-2015 budget includes
$200,000 for the acquisition of substandard properties in the blighted and
substandard areas and for the provision of infrastructure. The Authority will
consider any property within the designated areas.
Grand Island Special Meeting - Updated - 8/19/2014 Page 5 / 84
Facade Development. For the façade development program $200,000 has been
budgeted, including grants and interest buy down; these projects are unidentified at
this time. This program has been used extensively in the Downtown part of
Redevelopment Area #1 but has also been used in Areas #2 and #6. It is only
available in those areas that have a generalized redevelopment plan including
commercial façade development. The CRA approved façade projects that used the
full allocation of façade dollars for the 2013-14 fiscal year.
Life Safety and Infrastructure Grants. This is a proposed program to encourage
upper story residential development in Downtown Grand Island. The CRA has
budgeted $200,000 in this line item but is also showing revenue of $100,000 from
the City of Grand Island General Fund. It is anticipated that this program would be
a multi-year program to encourage the development of 50 additional residential
units over the course of a 5 year period. The Downtown Business Improvement
District has submitted a letter of support for this program. The CRA would not
begin making grants through this program until after the Grand Island City Council
has approved a redevelopment plan amendment defining the parameters of the
program. It is anticipated that the redevelopment plan can be presented for approval
prior to the end of the 2014 calendar year.
Other Projects. In the blighted and substandard areas $175,000 has been reserved
for other projects. In the 2013-14 fiscal year this funding was used:
o to provide matching funds for a housing study for the City of Grand
Island.
o to provide funding for the installation of improvements in Downtown
Grand Island, including rehabilitation of Kaufmann Plaza and installation
of the Historic Downtown lighting.
This funding can be assigned to specific projects including but not limited to
infrastructure improvements in the blighted and substandard areas that would
support larger redevelopment plans. The CRA has used this funding item in the
past to fund additional façade improvement projects and to make grants to fund
specific projects for: the Business Improvement Districts, the Grand Island Parks
Department, Fonner Park, The Central Nebraska Humane Society, St. Stephens,
Habitat for Humanity and other community groups for specific projects that meet
the mission of the CRA.
CONCLUSION
This budget provides for measured funding of redevelopment efforts during the 2014-
2015 fiscal year. The investments this community has made in housing, redevelopment
efforts, infrastructure and economic development bode well for the future of the
community.
The CRA will also continue to examine the community to identify areas that might
benefit from a Blighted and Substandard declaration and to review and recommend
approval of redevelopment plan amendments for tax increment financing projects on both
Grand Island Special Meeting - Updated - 8/19/2014 Page 6 / 84
large and small scale developments. All of the tools used by the CRA are necessary for
them to accomplish their mission: to reduce, slow or eliminate blighting influences on
property in those areas that have been designated as blighted and substandard by
the Grand Island City Council.
Grand Island Special Meeting - Updated - 8/19/2014 Page 7 / 84
Grand Island Special Meeting - Updated - 8/19/2014 Page 8 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
8-19-14
2014-2015
Community Redevelopment Authority
(CRA) Budget
Grand Island Special Meeting - Updated - 8/19/2014 Page 9 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
CRA Budget
2014
Budget
2014
Forecasted
2015 Budget
Revenue 1,426,508 1,131,952 2,236,221
Expenses
Operating 93,550 64,400 88,550
Program 726,000 281,000 1,002,000
TIF/Bond
Payments
629,124
429,976
1,321,092
Lincoln Pool 195,000 195,000 198,050
Total Expense 1,643,674 970,376 2,609,692
Property Tax Asking of $686,119 proposed Levy $0.026
Grand Island Special Meeting - Updated - 8/19/2014 Page 10 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
CRA Budget Highlights
Operating Expenses
$88,550 budgeted down from $93,500
Façade Improvement
$200,000 Same as last year
Property Purchase
$200,000 up from $100,000
Lincoln Pool
Bond Payment Principal and Interest of $198,050
Other Projects
$175,000 down $25,000 from last year
Fire, Life Safety and Infrastructure Grants
$200,000 New Program
Grand Island Special Meeting - Updated - 8/19/2014 Page 11 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
CRA Budget Highlights
Carry Over Projects:
Kaufman Park Project
Life Safety Grant for Tower 217
J Elizabeth Façade Grant
Ryan Waind Chiropractic Office
Grand Island Special Meeting - Updated - 8/19/2014 Page 12 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
Proposed Fire, Life Safety and Infrastructure
Grant Program
Goal
Area of Eligibility
Eligible Activities
Funding
Program Review
Next Steps for Program Creation
Grand Island Special Meeting - Updated - 8/19/2014 Page 13 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
Goal
To add 50 additional upper story residential units in
Downtown Grand Island within the next 5 years.
Over 180,000 square feet of existing upper story space is available
and underutilized in Downtown Grand Island
There are currently about 90 Downtown Apartments
Anecdotal evidence shows that rents for these unique spaces are
beginning to increase
Proposed Fire, Life Safety and Infrastructure
Grant Program
Grand Island Special Meeting - Updated - 8/19/2014 Page 14 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
Grand Island Special Meeting - Updated - 8/19/2014 Page 15 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
Proposed Fire, Life Safety and Infrastructure
Grant Program
Will require installation of Life Safety Equipment or
modification of the building for Life Safety and
Building Code requirements as determined by the
adopted Fire or Building Code:
Improvements include but are not limited to:
Fire Sprinklers
Additional Exits
Monitoring Equipment
Fire Separation Walls
Elevators
Grand Island Special Meeting - Updated - 8/19/2014 Page 16 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
Proposed Fire, Life Safety and Infrastructure
Grant Program
Proposed to be funded as a 5 year program beginning
with the 2015 fiscal year.
Funding Levels
$100,000 from City of Grand Island General Fund
$100,000 from Grand Island CRA
Will require a match of private funds from the
Developer
Funds will not be paid until Occupancy Certificates
are obtained for new Residential Units
Grand Island Special Meeting - Updated - 8/19/2014 Page 17 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
Proposed Fire, Life Safety and Infrastructure
Grant Program Program Review
The CRA would review the program annually beginning
with the 2017 Fiscal Year Budget to determine:
If the CRA has received grant requests
The number of Units created and the grant funding for each Unit
The general rent level and vacancy rate of the new units
The increase in property valuation of buildings involved in the
program
Review will be presented to Council with CRA budget
The program could be cancelled or suspended based on the
results of the review
Grand Island Special Meeting - Updated - 8/19/2014 Page 18 / 84
COMMUNITY
REDEVELOPMENT
AUTHORITY
Proposed Fire, Life Safety and Infrastructure
Grant Program
Next Steps for Program Creation:
Would require an amendment to the Generalized
Redevelopment Plan for the CRA Area #1.
CRA would forward the amendment to the Planning
Commission for a recommendation and to Council for
approval prior to making any grants available.
Amendment could be done and adopted as soon as December
2014.
CRA would not request funding from the City until after
approval of the amendment and grants have been approved
Finance Department will set this up as separate CRA Division
Grand Island Special Meeting - Updated - 8/19/2014 Page 19 / 84
2012 2013 2013 2013 2014 2014 2015
Actual Budget Forecasted Actuals Budget Forecasted Budget
CONSOLIDATED
Beginning Cash 923,823 298,766 186,509 186,509 377,849 414,486 529,861
REVENUE:
Property Taxes-CRA 464,412 446,578 437,618 476,837 474,384 474,384 488,069
Property Taxes-Lincoln Pool 154,234 207,859 201,787 193,649 195,000 195,000 198,050
Property Taxes-TIF's 404,016 438,016 332,998 384,041 629,124 433,568 1,321,092
Loan Proceeds - - - - - - -
Motor Vehicle Tax 2,658 - - - - - -
Interest Income-CRA 4,667 1,000 2,000 342 1,000 1,000 1,000
Interest Income - TIF's 165 - - 135 - - -
Loan Income (Poplar Street Water Line)- 5,000 1,800 8,154 5,000 6,000 6,000
Land Sales - 100,000 - - 100,000 - 100,000
Bond Proceeds - Lincoln Pool - 1,800,000 1,800,000 1,800,000 - - -
City Share of Life Safety Grant Downtown - - - - - - 100,000
Other Revenue 12,552 22,000 192,658 29,539 22,000 22,000 22,000
Other Revenue - TIF's 10,064 - - 7,707 - - -
TOTAL REVENUE 1,052,768 3,020,453 2,968,861 2,900,404 1,426,508 1,131,952 2,236,211
TOTAL RESOURCES 1,976,591 3,319,219 3,155,371 3,086,913 1,804,357 1,546,438 2,766,072
EXPENSES
Auditing & Accounting 4,025 5,000 4,000 16,075 5,000 5,000 5,000
Legal Services 2,187 3,000 3,000 1,410 3,000 2,000 3,000
Consulting Services - 10,000 5,000 - 10,000 5,000 5,000
Contract Services 44,428 55,000 55,000 50,960 65,000 50,000 65,000
Printing & Binding - 1,000 - - 1,000 - 1,000
Other Professional Services 7,599 5,000 - 7,210 5,000 - 5,000
General Liability Insurance - 250 250 - 250 - 250
Postage 328 200 200 336 200 200 200
Legal Notices 1,979 2,500 1,500 1,693 2,500 2,000 2,500
Licenses & Fees - - - - - - -
Travel & Training 161 1,000 200 - 1,000 - 1,000
Other Expenditures 796 - - - - - -
Office Supplies - 300 300 123 300 100 300
Supplies - 300 - - 300 100 300
Land - 20,000 - - 80,000 - 200,000
Façade Improvement-to be applied for 1,146,639 120,000 117,000 482,361 200,000 130,000 200,000
Lincoln Pool Bond Proceeds pay out 180,658 1,800,000 1,880,062 1,699,883 - - -
Other Projects - 50,000 - - 265,000 100,000 175,000
Property Taxes South Locust Project 11,000 11,000 - 11,000 11,000 11,000
Life Safety Reimbursment Grant - - - - - - 200,000
Outstanding Façade Improvement Grants 318,000 200,000 - 130,000 - 118,000
Other Committed Projects 134,000 152,000 - 40,000 40,000 98,000
Bond Payment /Fees 207,859 - 525
Lincoln Pool Principal Bond Payment - - 170,000 170,000 175,000
Lincoln Pool Interest Bond Payment 15,105 15,105 23,828 23,828 23,050
Other Expenditures-TIF's - 47,373 -
Bond Principal-TIF's 350,317 396,334 291,223 355,016 541,944 397,899 1,236,022
Bond Interest-TIF's 50,965 41,682 41,682 41,730 87,180 32,077 85,070
TOTAL EXPENSES 1,790,082 3,182,425 2,777,522 2,672,427 1,642,501 1,016,577 2,609,692
INCREASE(DECREASE) IN CASH (737,314) (161,972) 191,340 227,977 (215,993) 115,375 (373,481)
ENDING CASH 186,509 136,794 377,849 414,486 161,856 529,861 156,380
- - - - -
AVAILABLE CASH 186,509 136,794 377,849 414,486 161,856 529,861 156,380
CRA CASH 152,203 7,249 249,802 299,440 32,636 452,561 79,080
LINCOLN POOL CASH (26,424) 81,787 80,196 72,058 81,368 73,230 73,230
TIF CASH 60,730 47,758 47,851 42,988 47,852 4,071 4,071
TOTAL CASH 186,509 136,794 377,849 414,486 161,856 529,861 156,380
COMMUNITY REDEVELOPMENT AUTHORITY
FY 2014- 2015 BUDGET
Grand Island Special Meeting - Updated - 8/19/2014 Page 20 / 84
2012 2013 2013 2013 2014 2014 2015
Actual Budget Forecasted Actuals Budget Forecasted Budget
COMMUNITY REDEVELOPMENT AUTHORITY
FY 2014- 2015 BUDGET
CRA
GENERAL OPERATIONS: 01
Property Taxes 464,412 446,578 437,618 476,837 474,384 474,384 488,069
Property Taxes-Lincoln Pool Levy 154,234 207,859 201,787 193,649 195,000 195,000 198,050
Motor Vehicle Tax 2,658 -
Interest Income 4,667 1,000 2,000 342 1,000 1,000 1,000
Loan Income (Poplar Street Water Line)5,000 1,800 8,154 5,000 6,000 6,000
Land Sales 100,000 - 100,000 - 100,000
Bond Proceeds Lincoln Pool 1,800,000 1,800,000 1,800,000
City Share Life Safety Grant Downtown - 100,000
Other Revenue & Motor Vehicle Tax 12,552 22,000 192,658 29,539 22,000 22,000 22,000
TOTAL 638,523 2,582,437 2,635,863 2,508,521 797,384 698,384 915,119
GILI TRUST-07
Property Taxes 32,019 - - - - - -
Interest Income - - - - - - -
Other Revenue 511
TOTAL 32,530 - - - - - -
CHERRY PARK LTD II-08
Property Taxes 64,641 59,180 59,180 62,605 29,588 29,588 -
Interest Income 157 - - 129 - - -
Other Revenue
TOTAL 64,797 59,180 59,180 62,734 29,588 29,588 -
GENTLE DENTAL-09
Property Taxes 4,659 4,202 4,202 4,755 4,202 4,202 -
Interest Income 1 - - 1 - -
Other Revenue -
TOTAL 4,660 4,202 4,202 4,756 4,202 4,202 -
PROCON TIF-10
Property Taxes 27,675 19,162 19,162 9,613 19,162 19,162 19,162
Interest Income 2 - - 2 - - -
Other Revenue 233 271
TOTAL 27,910 19,162 19,162 9,886 19,162 19,162 19,162
WALNUT HOUSING PROJECT-11
Property Taxes 65,147 74,472 74,472 67,032 74,472 74,472 74,472
Interest Income 6 - - 3 -
Other Revenue 9,320 7,436
TOTAL 74,473 74,472 74,472 74,471 74,472 74,472 74,472
BRUNS PET GROOMING-12
Property Taxes 19,667 13,500 12,755 7,360 13,500 13,500 13,500
Interest Income -
TOTAL 19,667 13,500 12,755 7,360 13,500 13,500 13,500
REVENUES
Grand Island Special Meeting - Updated - 8/19/2014 Page 21 / 84
2012 2013 2013 2013 2014 2014 2015
Actual Budget Forecasted Actuals Budget Forecasted Budget
COMMUNITY REDEVELOPMENT AUTHORITY
FY 2014- 2015 BUDGET
GIRAD VET CLINIC-13
Property Taxes 18,736 14,500 14,037 9,883 14,500 14,500 14,500
Interest Income - - - -
TOTAL 18,736 14,500 14,037 9,883 14,500 14,500 14,500
GEDDES ST APTS - PROCON-14
Property Taxes 41,923 30,000 29,099 28,045 30,000 30,000 30,000
Interest Income - - - -
TOTAL 41,923 30,000 29,099 28,045 30,000 30,000 30,000
SOUTHEAST CROSSINGS-15
Property Taxes 12,616 12,000 8,674 13,193 12,000 15,000 15,000
Interest Income - - - -
TOTAL 12,616 12,000 8,674 13,193 12,000 15,000 15,000
POPLAR STREET WATER-16
Property Taxes 2,052 2,500 1,826 7,817 2,500 6,000 6,000
Interest Income - - - -
Other Revenue -
TOTAL 2,052 2,500 1,826 7,817 2,500 6,000 6,000
CASEY'S FIVE POINTS-17
Property Taxes 8,670 10,000 8,670 13,276 10,000 10,000 10,000
Interest Income -
TOTAL CASEY'S FIVE POINTS 8,670 10,000 8,670 13,276 10,000 10,000 10,000
SOUTHPOINTE HOTEL-18
Property Taxes 85,341 90,000 88,000 87,104 90,000 90,000 90,000
Interest Income -
TOTAL SOUTHPOINTE HOTEL 85,341 90,000 88,000 87,104 90,000 90,000 90,000
TODD ENCK-19
Property Taxes 6,059 2,500 3,126 6,169 3,200 6,000 6,000
Interest Income -
TOTAL TC ENCK 6,059 2,500 3,126 6,169 3,200 6,000 6,000
SKAGWAY - 20
Property Taxes - 55,000 - 9,767 55,000 40,000 750,000
Interest Income - -
TOTAL SKAGWAY - 20 - 55,000 - 9,767 55,000 40,000 750,000
JOHN SCHULTE CONSTRUCTION-21
Property Taxes 4,449 6,000 4,448 5,088 6,000 5,900 6,000
Interest Income - -
TOTAL JOHN SCHULTE CONSTRUCTION 4,449 6,000 4,448 5,088 6,000 5,900 6,000
PHARMACY PROPERTIES INC-22
Property Taxes 10,363 11,000 5,347 10,551 11,000 10,700 11,000
Interest Income - -
TOTAL PHARMACY PROPERTIES INC 10,363 11,000 5,347 10,551 11,000 10,700 11,000
KEN-RAY LLC-23
Property Taxes - 34,000 - 38,919 34,000 34,000 34,000
Interest Income - -
TOTAL KEN-RAY LLC - 34,000 - 38,919 34,000 34,000 34,000
COUNTY FUND #8598
Property Taxes - - - 2,864 - 1,458 1,458
Interest Income - -
TOTAL COUNTY FUND #8598 - - - 2,864 - 1,458 1,458
ARNOLD WENN-Duplex 13th & Huston-NEW 2013-2014
Grand Island Special Meeting - Updated - 8/19/2014 Page 22 / 84
2012 2013 2013 2013 2014 2014 2015
Actual Budget Forecasted Actuals Budget Forecasted Budget
COMMUNITY REDEVELOPMENT AUTHORITY
FY 2014- 2015 BUDGET
Property Taxes - - - - 3,000 3000
Interest Income - -
TOTAL ARNOLD WENN - - - - 3,000 - 3,000
TOKEN PROPERTIES LLC -Duplex N Ruby-NEW 2013-2014
Property Taxes - - - 3,000 3,000 3,000
Interest Income - -
TOTAL TOKEN PROPERTIES LLC - - - - 3,000 3,000 3,000
STRATFORD PLAZA-HOWARD JOHNSON-NEW 2013-2014
Property Taxes - - - 15,000 23,086 35,000
Interest Income - -
TOTAL STRATFORD PLAZA - - - - 15,000 23,086 35,000
EIG GRAND ISLAND LLC-STATE STREET-NEW 2013-2014
Property Taxes - - - 40,000 40,000
Interest Income - -
TOTAL EIG GRAND ISLAND LLC - - - - 40,000 - 40,000
BAKER DEVELOPMENT-NEW 2013-2014
Property Taxes - - - 3,000 3,000 3,000
Interest Income - -
TOTAL BAKER DEVELOPMENT - - - - 3,000 3,000 3,000
TOKEN PROPERTIES LLC (CAREY ST) -NEW 2013-2014
Property Taxes - - - 3,000 3,000
Interest Income - -
TOTAL TOKEN PROPERTIES LLC(CAREY ST)- - - - 3,000 - 3,000
GORDMAN GRAND ISLAND LLC-NEW 2013-2014
Property Taxes - - - 40,000 40,000
Interest Income - -
TOTAL GORDMAN GRAND ISLAND LLC - - - - 40,000 - 40,000
TOKEN PROPERTIES LLC (KIMBALL ST)-NEW 2013-2014
Property Taxes - - - 3,000 3,000
Interest Income - -
TOTAL TOKEN PROPERTIES LLC (KIMBALL ST)- - - - 3,000 - 3,000
AUTO GROUP-PINE ST & S LOCUST-NEW 2013-2014
Property Taxes - - - - 10,000 10,000
Interest Income - - -
TOTAL AUTO GROUP - - - - 10,000 - 10,000
HABITAT (ST PAUL RD)-NEW 2013-2014
Property Taxes - - - - 6,000 6,000
Interest Income - - -
TOTAL HABITAT - - - - 6,000 - 6,000
CHIEF FABRICATION(ADAMS ST)-NEW 2013-2014
Property Taxes - - - - 40,000 40,000
Interest Income - - -
TOTAL CHIEF FABRICATION - - - - 40,000 - 40,000
PRIDON LLC-NEW 2013-2014
Property Taxes - - - - -
Interest Income - - -
TOTAL PRIDON LLC - - - - - - -
COPPER CREEK-NEW 2013-2014
Property Taxes - - - - 54,000 54,000
Interest Income - - -
Grand Island Special Meeting - Updated - 8/19/2014 Page 23 / 84
2012 2013 2013 2013 2014 2014 2015
Actual Budget Forecasted Actuals Budget Forecasted Budget
COMMUNITY REDEVELOPMENT AUTHORITY
FY 2014- 2015 BUDGET
TOTAL COPPER CREEK - - - - 54,000 - 54,000
TOTAL REVENUE 1,052,768 3,020,453 2,968,861 2,900,404 1,426,508 1,131,952 2,236,211
Grand Island Special Meeting - Updated - 8/19/2014 Page 24 / 84
2012 2013 2013 2013 2014 2014 2015
Actual Budget Forecasted Actuals Budget Forecasted Budget
COMMUNITY REDEVELOPMENT AUTHORITY
FY 2014- 2015 BUDGET
EXPENSES
CRA
GENERAL OPERATIONS: 01
Auditing & Accounting 4,025 5,000 4,000 16,075 5,000 5,000 5,000
Legal Services 2,187 3,000 3,000 1,410 3,000 2,000 3,000
Consulting Services - 10,000 5,000 - 10,000 5,000 5,000
Contract Services 44,428 55,000 55,000 50,960 65,000 50,000 65,000
Printing & Binding - 1,000 - - 1,000 - 1,000
Other Professional Services 7,599 5,000 - 7,210 5,000 - 5,000
General Liability Insurance - 250 250 - 250 - 250
Postage 328 200 200 336 200 200 200
Legal Notices 1,979 2,500 1,500 1,693 2,500 2,000 2,500
Licenses & Fees - - - -
Travel & Training 161 1,000 200 - 1,000 - 1,000
Other Expenditures 796 - - - -
Office Supplies - 300 300 123 300 100 300
Supplies - 300 - - 300 100 300
Land - 20,000 - - 80,000 - 200,000
- - - -
DEBT - - - -
Bond Payments/Fees 207,859 - 525 207,859
Lincoln Pool Principal Bond Payment - - 170,000 170,000 175,000
Lincoln Pool Interest Bond Payment 15,105 15,105 23,828 23,828 23,050
Payment to City-Lincoln Pool engineering fees - - -
PROJECTS: 05 - -
Façade Improvement 1,146,639 120,000 117,000 482,361 200,000 130,000 200,000
Lincoln Pool Construction From Bond Proceeds 180,658 1,800,000 1,880,062 1,699,883
Life Safety Reimbursment Grant - - - - 200,000
Outstanding Façade Improvement Grants 318,000 200,000 - 118,000
Railroad Horns - - -
Other Committed Projects 134,000 152,000 - 40,000 40,000 98,000
Other Projects 50,000 - 265,000 100,000 175,000
Property Taxes BID Fees 11,000 11,000 - 11,000 11,000 11,000
Property Management - - - - - -
TOTAL CRA OPERATING EXPENSES 1,388,800 2,744,409 2,444,617 2,275,681 1,091,237 539,228 1,288,600
GILI TRUST-07
Bond Principal 33,066 - - - - - -
Bond Interest 1,325 - - - - - -
Other Expenditures -
TOTAL GILI EXPENSES 34,390 - - - - - -
CHERRY PARK LTD II-08
Bond Principal 49,894 53,831 53,831 53,831 28,486 29,496 -
Bond Interest 9,286 5,349 5,349 5,349 1,102 - -
Other Expenditures - - - - - 47,373 -
TOTAL CHERRY PARK EXPENSES 59,180 59,180 59,180 59,180 29,588 76,869 -
GENTLE DENTAL-09
Bond Principal 2,745 2,986 2,986 2,937 3,195 3,195 -
Bond Interest 1,457 1,216 1,216 1,265 1,007 1,007 -
TOTAL GENTLE DENTAL 4,202 4,202 4,202 4,202 4,202 4,202 -
PROCON TIF-10
Bond Principal 11,641 12,467 12,467 12,467 13,355 13,355 13,355
Bond Interest 7,521 6,695 6,695 6,695 5,807 5,807 5,807
TOTAL PROCON TIF 19,162 19,162 19,162 19,162 19,162 19,162 19,162
WALNUT HOUSING PROJECT-11
Bond Principal 43,096 46,051 46,051 46,051 49,209 49,209 49,209
Bond Interest 31,376 28,421 28,421 28,421 25,263 25,263 25,263
TOTAL WALNUT HOUSING PROJECT 74,472 74,472 74,472 74,472 74,472 74,472 74,472
EXPENSES
Grand Island Special Meeting - Updated - 8/19/2014 Page 25 / 84
2012 2013 2013 2013 2014 2014 2015
Actual Budget Forecasted Actuals Budget Forecasted Budget
COMMUNITY REDEVELOPMENT AUTHORITY
FY 2014- 2015 BUDGET
BRUNS PET GROOMING-12
Bond Principal 19,667 13,500 13,170 7,054 13,500 13,500 13,500
Bond Interest -
TOTAL BRUNS PET GROOMING 19,667 13,500 13,170 7,054 13,500 13,500 13,500
GIRARD VET CLINIC-13
Bond Principal 18,736 14,500 14,037 9,883 14,500 11,000 14,500
Bond Interest -
TOTAL GIRARD VET CLINIC 18,736 14,500 14,037 9,883 14,500 11,000 14,500
GEDDES ST APTS - PROCON-14
Bond Principal 41,923 30,000 28,591 28,045 30,000 30,000 30,000
Bond Interest -
TOTAL GEDDES ST APTS - PROCON 41,923 30,000 28,591 28,045 30,000 30,000 30,000
SOUTHEAST CROSSINGS-15
Bond Principal 12,616 12,000 8,674 12,856 12,000 15,000 15,000
Bond Interest -
TOTAL SOUTHEAST CROSSINGS 12,616 12,000 8,674 12,856 12,000 15,000 15,000
POPLAR STREET WATER-16
Auditing & Accounting - -
Contract Services -
Bond Principal 2,052 2,500 1,826 8,154 2,500 6,000 6,000
Bond Interest -
TOTAL POPLAR STREET WATER 2,052 2,500 1,826 8,154 2,500 6,000 6,000
CASEY'S FIVE POINTS-17
Bond Principal 8,670 10,000 8,670 13,276 10,000 10,000 10,000
Bond Interest -
TOTAL CASEY'S FIVE POINTS 8,670 10,000 8,670 13,276 10,000 10,000 10,000
SOUTHPOINTE HOTEL-18
Bond Principal 85,341 90,000 88,000 87,104 90,000 90,000 90,000
Bond Interest -
TOTAL SOUTHPOINTE HOTEL 85,341 90,000 88,000 87,104 90,000 90,000 90,000
TODD ENCK PROJECT - 19
Bond Principal 6,059 2,500 3,126 6,169 3,200 6,000 6,000
Bond Interest -
TOTAL TODD ENCK PROJECT 6,059 2,500 3,126 6,169 3,200 6,000 6,000
SKAGWAY - 20
Auditing & Accounting -
Bond Principal - 55,000 9,767 55,000 40,000 750,000
Bond Interest -
TOTAL SKAGWAY - 55,000 - 9,767 55,000 40,000 750,000
JOHN SCHULTE CONSTRUCTION-21
Bond Principal 4,449 6,000 4,448 5,088 6,000 5,900 6,000
Bond Interest -
TOTAL JOHN SCHULTE CONSTRUCTION 4,449 6,000 4,448 5,088 6,000 5,900 6,000
PHARMACY PROPERTIES INC-22
Bond Principal 10,363 11,000 5,347 10,551 11,000 10,700 11,000
Bond Interest -
TOTAL PHARMACY PROPERTIES INC 10,363 11,000 5,347 10,551 11,000 10,700 11,000
KEN-RAY LLC-23
Bond Principal - 34,000 - 38,919 34,000 34,000 34,000
Bond Interest -
TOTAL KEN-RAY LLC - 34,000 - 38,919 34,000 34,000 34,000
COUNTY FUND #8598
Bond Principal - - 2,864 - 1,458 1,458
Bond Interest -
TOTAL COUNTY FUND #8598 - - - 2,864 - 1,458 1,458
Grand Island Special Meeting - Updated - 8/19/2014 Page 26 / 84
2012 2013 2013 2013 2014 2014 2015
Actual Budget Forecasted Actuals Budget Forecasted Budget
COMMUNITY REDEVELOPMENT AUTHORITY
FY 2014- 2015 BUDGET
ARNOLD WENN-Duplex 13th & Huston-NEW 2013-2014
Bond Principal - - 3,000 0 3,000
Bond Interest -
TOTAL ARNOLD WENN - - - 3,000 - 3,000
TOKEN PROPERTIES LLC-Duplex N Ruby-NEW 2013-2014
Bond Principal - - 3,000 3,000 3,000
Bond Interest -
TOTAL TOKEN PROPERTIES LLC - - - 3,000 3,000 3,000
STRATFORD PLAZA LLC (HOWARD JOHNSONS)- New 2013-2014
Bond Principal - - 15,000 23,086 35,000
Bond Interest -
TOTAL STRATFORD PLAZA - - - 15,000 23,086 35,000
EIG GRAND ISLAND LLC-STATE ST - New 2013-2014
Bond Principal - - 40,000 40,000
Bond Interest -
TOTAL EIG GRAND ISLAND LLC - - - 40,000 - 40,000
BAKER DEVELOPMENT - New 2013-2014
Bond Principal - - 3,000 3,000 3,000
Bond Interest -
TOTAL BAKER DEVELOPMENT - - - 3,000 3,000 3,000
TOKEN PROPERTIES LLC (CAREY ST) - New 2013-2014
Bond Principal - - 3,000 - 3,000
Bond Interest -
TOTAL TOKEN PROPERTIES LLC - - - 3,000 - 3,000
GORDMAN GRAND ISLAND - New 2013-2014
Bond Principal - - 40,000 40,000
Bond Interest -
TOTAL GORDMAN GRAND ISLAND - - - 40,000 - 40,000
TOKEN PROPERTIES LLC(KIMBALL ST) - New 2013-2014
Bond Principal - - 3,000 - 3,000
Bond Interest -
TOTAL TOKEN PROPERTIES LLC - - - 3,000 - 3,000
AUTO GROUP-PINE ST & LOCUST - New 2013-2014
Bond Principal - - 10,000 - 10,000
Bond Interest -
TOTAL AUTO GROUP - - - 10,000 - 10,000
HABITAT (ST PAUL RD) - New 2013-2014
Bond Principal - - 6,000 - 6,000
Bond Interest -
TOTAL HABITAT - - - 6,000 - 6,000
CHIEF FABRICATION-ADAMS ST - New 2013-2014
Bond Principal - - 40,000 - 40,000
Bond Interest -
TOTAL CHIEF FABRICATION - - - 40,000 - 40,000
PRIDON LLC - New 2013-2014
Bond Principal - - -
Bond Interest -
TOTAL PRIDON LLC - - - - - -
COPPER CREEK - New 2013-2014
Bond Principal - - -
Bond Interest - 54,000 54,000
TOTAL COPPER CREEK - - - 54,000 - 54,000
Habitat (8th and Superior)
Bond Principal - - -
Bond Interest -
Grand Island Special Meeting - Updated - 8/19/2014 Page 27 / 84
2012 2013 2013 2013 2014 2014 2015
Actual Budget Forecasted Actuals Budget Forecasted Budget
COMMUNITY REDEVELOPMENT AUTHORITY
FY 2014- 2015 BUDGET
TOTAL BLANK TIF - - - - - -
Mainstay Suites - New 2013-2014
Bond Principal - - -
Bond Interest -
TOTAL BLANK TIF - - - - - -
Tower 217 - New 2013-2014
Bond Principal - -
Bond Interest -
TOTAL BLANK TIF - - - - - -
Blank TIFF - New 2013-2014
Bond Principal - - -
Bond Interest -
TOTAL BLANK TIF - - - - - -
TOTAL EXPENSES 1,790,082 3,182,425 2,777,522 2,672,427 1,720,360 1,016,577 2,609,692
Grand Island Special Meeting - Updated - 8/19/2014 Page 28 / 84
City of Grand Island
Tuesday, August 19, 2014
Special Meeting - Updated
Item -2
Insurance Reserve Fund
Staff Contact: Jaye Monter, Finance Director
Grand Island Special Meeting - Updated - 8/19/2014 Page 29 / 84
8-19-14
2014-2015
Insurance Reserve Fund
Budget Summary III page 163
Grand Island Special Meeting - Updated - 8/19/2014 Page 30 / 84
Insurance Reserve Fund Cash Balance History
INSURANCE
RESERVE FUND
Worker's General Health
Compensation Insurance Insurance Total
2003 775,768 1,611,089 2,205,974 4,592,831
2004 457,017 1,154,362 2,114,029 3,725,408
2005 303,789 868,178 1,937,635 3,109,602
2006 298,980 835,780 2,035,400 3,170,160
2007 446,768 974,238 2,182,393 3,603,399
2008 152,804 1,155,950 3,325,548 4,634,302
2009 643,051 1,064,170 4,458,069 6,165,290
2010 641,851 1,054,640 3,709,934 5,406,425
2011 640,166 994,731 3,471,262 5,106,159
2012 546,282 931,889 2,653,830 4,132,001
2013 246,225 904,035 2,699,415 3,849,675
Forecast 2014 547,225 832,435 3,186,165 4,565,825
Budget 2015 879,347 713,835 4,009,165 5,602,347
Grand Island Special Meeting - Updated - 8/19/2014 Page 31 / 84
Insurance Reserve Fund Claims/Fees History
INSURANCE
RESERVE FUND
Worker's General Health
Compensation Insurance Insurance Total
2003 805,300 498,120 4,013,770 5,317,190
2004 866,608 487,151 4,563,349 5,917,108
2005 788,088 844,431 5,128,730 6,761,249
2006 932,689 747,770 5,293,054 6,973,513
2007 830,862 720,426 5,253,165 6,804,453
2008 1,288,451 639,343 4,971,926 6,899,720
2009 706,971 537,705 4,936,346 6,181,022
2010 808,667 428,948 5,725,043 6,962,658
2011 801,442 475,717 5,685,588 6,962,747
2012 904,654 486,638 6,222,776 7,614,068
2013 1,145,866 455,511 6,102,955 7,704,332
Forecast 2014 1,000,000 533,000 6,877,250 8,410,250
Budget 2015 1,000,000 580,000 6,829,000 8,409,000
Grand Island Special Meeting - Updated - 8/19/2014 Page 32 / 84
General Property Insurance Cash Reserve
INSURANCE
RESERVE FUND
Forecast
Proposed
Budget
9/30/2014 9/30/2015
Beginning Cash 904,035 832,435
Internal premiums collected
dept budgets 461,400 461,400
Claims & Fees (533,000) (580,000)
Ending Cash Balance 832,435 713,835
Grand Island Special Meeting - Updated - 8/19/2014 Page 33 / 84
Work Comp Insurance Cash Reserve
INSURANCE
RESERVE FUND
Forecast
Proposed
Budget
9/30/2014 9/30/2015
Beginning Cash 246,225 547,225
Premiums collected 1,301,000 1,332,122
(From Payroll Budget)
Claims & Fees (1,000,000) (1,000,000)
Ending Cash Balance 547,225 879,347
Grand Island Special Meeting - Updated - 8/19/2014 Page 34 / 84
Health Insurance Cash Reserve
INSURANCE
RESERVE FUND
Forecast
Proposed
Budget
*Based on 30% plan participation 9/30/2014 9/30/2015
Beginning Cash 2,699,415 3,186,165
Premiums Collected 7,364,000 7,652,000
2015 Payroll Budget
Claims & Fees (6,711,250 ) (6,509,000)
HSA Seed* (166,000) (320,000)
3,186,165 4,009,165
Adjustment for Final Budget (900,000 )
Ending Cash Balance 3,186,165 3,109,165
Grand Island Special Meeting - Updated - 8/19/2014 Page 35 / 84
City of Grand Island
Tuesday, August 19, 2014
Special Meeting - Updated
Item I-1
#2014-231 - Consideration of Approving Health Insurance
Renewal with Blue Cross Blue Shield
Staff Contact: Brenda Sutherland
Grand Island Special Meeting - Updated - 8/19/2014 Page 36 / 84
Council Agenda Memo
From:Brenda Sutherland, Human Resources Director
Meeting:August 19, 2014
Subject:Approval of Health and Dental Benefits
Item #’s:I-1
Presenter(s):Brenda Sutherland, Human Resources Director
Background
The City of Grand Island provides health and dental benefits to its employees. The City
has a partially self-funded plan, meaning that claims are actually paid for by the premium
dollars generated through the plan to a specified limit. The City has paid a third party, in
this case Blue Cross Blue Shield of Nebraska, to administer and pay claims and provide
stop loss coverage.
The City’s current “specific deductible” or stop loss is $150,000 per participant. This
means that the first $150,000 of claims for a plan participant is paid for by the premium
dollars generated and then the reinsurance carrier picks up the claims that go over that
amount. The City’s dental plan is self-funded and the principle is the same as for health
insurance in that the premiums generated pay the claims incurred.
Last year the City Council approved the addition of a Qualified High Deductible Plan and
approved a contribution into a HSA in the amount of $1,000 for single coverage and
$2,000 for family coverage.
Discussion
As the new fiscal and plan years are set to begin on October 1, it is customary to bring the
health insurance renewal forward as well as funding requirements. The City budgeted
$7.2 million in fiscal year 2013/2014 for health and dental insurance expenses. Our
current trend appears to be less than the budgeted amount. The budgeted amount covers
things such as payment of claims, administrative fees, and HSA contributions. I am
pleased to bring this year’s renewal forward with no request for increased funding over
the current year’s funding level.
The addition of the Qualified High Deductible Plan last year has proven to be a good
decision and has had a favorable impact on claims. Around 20% of eligible employees
Grand Island Special Meeting - Updated - 8/19/2014 Page 37 / 84
signed up for the QHDHP last year. Although we have experienced a small number of
very large claims, overall the rest of our claims experience was positive.
The proposed Qualified High Deductible Plan has a $3,000/$5,500 in network deductible.
The traditional plan has a $500/$1,000 in-network deductible. Participants who go out of
network will experience deductibles that are twice the in network amount. That has been
part of the City’s plan design for many years. City employees pay 16% of the premium.
As the initial experience with the high deductible plan has been so positive, I am
proposing the HSA contribution be increased to $1,250 for single coverage and $2,500
for family coverage to be paid to plan participant’s Health Savings Account (HSA). This
contribution will take place in January 2015. The intention is to further incentivize
employees to move to the high deductible plan and continue to control rising costs with
increased consumerism.
I am also proposing that we adjust the contribution for new employees based on their
starting date. The contribution adjustment would be calculated quarterly. As an
example, an employee who becomes eligible for single coverage in April would receive a
contribution for three quarters of the remaining year. After the start of each quarter of the
calendar year, the amount would be reduced by 25%.
Dental insurance was separated from the health plan last year and is a voluntary benefit.
Employees can determine whether or not they want to elect this benefit and at what level.
The employee pays 30% of the premium for the dental benefit. This is comparable in the
market for dental to be a separate benefit.
Delta Dental is the provider of the dental insurance. The service to our plan participants
has been excellent. The administrative fees for dental services are $3.85 per employee per
month to be paid by the City. The City entered into a three year contract with Delta
Dental of Nebraska last year.
The contract with Blue Cross and Blue Shield of Nebraska (BCBSNE) specifies
administrative fees of $29.50 per employee per month. Stop loss coverage will cost
$130.36 per employee per month and the aggregate stop loss coverage will cost $5.48 per
employee per month. The contract with Strong Financial will cost $1,654 per month.
COBRA administration will be handled by Discovery Benefits, Inc. (DBI) The cost for
COBRA administration will be $0.70 per employee per month for the term of the
contract. The fees associated with the wellness physicals will be $65 per participant for
the duration of the contract.
The cost of stop loss coverage increased substantially this year as our reinsurance
provider has paid claims in excess of $1 million dollars for the last two years on our
behalf. Even with the increased cost of reinsurance and the additional HSA
contributions, I am still recommending the City remain at the same $7.2 million funding
level for budget purposes as it did for fiscal year 2013/2014. By incentivizing the move
to the high deductible plan we hope to minimize the medical inflation rate that we have
experienced in years past with our traditional health plan.
Grand Island Special Meeting - Updated - 8/19/2014 Page 38 / 84
Alternatives
It appears that the Council has the following alternatives concerning the issue at hand.
The Council may:
1.Move to approve
2.Refer the issue to a Committee
3.Postpone the issue to future date
4.Take no action on the issue
Recommendation
City Administration recommends that the Council approve health plan renewal and the
recommended contributions to the employee’s HSA.
Sample Motion
Move to approve the health plan renewal and the recommended contribution levels to the
employee’s HSA.
Grand Island Special Meeting - Updated - 8/19/2014 Page 39 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 1 -
ADMINISTRATIVE SERVICES AGREEMENT
Plan Sponsor: City of Grand Island (“THE GROUP”)
Effective date: October 1, 2014
Group No.1: 305208
This is an Administrative Services Agreement between City of Grand Island ("THE GROUP" or
"THE PLAN") and Blue Cross and Blue Shield of Nebraska (BCBSNE).
RECITALS
A.BCBSNE is a mutual insurance company, licensed to sell insurance in the State of Nebraska. BCBSNE
is also engaged in the business of providing administrative services to entities which have self-insured,
or partially self-insured, health benefit plans for eligible employees.
B.The Benefit Plan Document includes this document and Attachments, the Master Group Contract and
Endorsements, Group Application and Addenda, all of which are incorporated herein by this reference.
THE GROUP is funded by either Plan Assets or General Assets for THE GROUP's Covered Persons.2
All coverage and benefit determinations are controlled by the Plan Document as defined in this Recital.
The language of this Administrative Services Agreement shall supersede and take precedence over the
language of the Master Group Contract. The Master Group Contract number and Plan or General
Assets funding are indicated on Attachment 1.
C.BCBSNE is able and willing to provide claims administrative services for THE GROUP's health benefit
plan, herein called the "Plan," for Covered Persons and THE GROUP desires to employ BCBSNE to
provide such administrative services.
NOW, THEREFORE, IN CONSIDERATION OF THE ABOVE, IT IS AGREED AS FOLLOWS:
DEFINITIONS
Defined terms are capitalized throughout this Agreement. In addition to the definitions stated in the
Master Group Contract, the following definitions are used in this Agreement:
Subscriber: All enrolled employees, COBRA qualified beneficiaries, retirees (if applicable), or other non-
dependent persons.
Covered Person(s): All enrolled members (Subscribers and their enrolled dependent spouses or children).
I.
APPOINTMENT
BCBSNE is hereby retained and appointed to provide administrative services as herein described for
THE GROUP's benefit plan for Covered Persons under BCBSNE's regular claim payment procedures and
methods; provided, however, that BCBSNE shall not be, nor be considered as, the "Plan Administrator," but
1 Group Numbers are subject to change during the term of this Agreement and shall have no effect on the responsibilities of the parties
hereto.
2 Plan Assets are amounts a participant pays to or has withheld by an employer for contribution to a Plan. Such assets become Plan
Assets as of the earliest date they can reasonably be segregated from the employer's general assets, but in no event later than
90 days from receipt by the employer. Plan Assets are subject to ERISA requirements.
Grand Island Special Meeting - Updated - 8/19/2014 Page 40 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 2 -
shall be considered a "named fiduciary" with respect to claims administration only, within the meaning of any
applicable federal laws and regulations pertaining to employee benefit plans.
The Plan Sponsor shall remain solely responsible for establishing and maintaining the Plan. These
responsibilities include ensuring that the Plan Document and Summary Plan Description are prepared and
distributed to Participants of the Plan; preparing and filing necessary reports required under ERISA (The
Employee Retirement Income Security Act of 1974), and any other requirements set forth in ERISA.
Self-funded political subdivisions are subject to Neb. Rev. Stat.13:1601 et seq., governing provisions of
the Public Health Service Act, and as otherwise determined by the governmental group. Such plans are not
subject to Title 1 of ERISA.
II.
BCBSNE'S SERVICES
In carrying out the terms of this Agreement, BCBSNE agrees to:
A.Prepare the Benefit Plan Document for its approval by THE GROUP.
B.Prepare enrollment forms, Identification Cards and Schedules of Benefits for distribution to Subscribers
who are enrolled in this Plan.
C.Prepare the Summary of Benefit Coverage (SBC) documents once annually for those benefits BCBSNE
administers. BCBSNE will prepare any applicable notice of modifications of the SBC which results from
legal or regulatory changes or benefit changes initiated by BCBSNE. BCBSNE will not provide
translation services for any Summary of Benefit Coverage documents. Distribution of the SBC
documents to THE GROUP’s employees or dependents shall remain the responsibility of THE GROUP.
D.Make payments on behalf of THE GROUP for Covered Services provided to Covered Persons pursuant
to the Benefit Plan Document.
E.Follow BCBSNE's regular claim processing procedures, including the determining of appropriate benefit
amounts, with respect to the processing of claims pursuant to the Benefit Plan Document. With the full
cooperation of THE GROUP, BCBSNE will make reasonable efforts under the circumstances,
considering the chances of successful recovery and the costs thereof to recover payment made in
excess of the amount provided for a Benefit under the Benefit Plan Documents (“Overpayments”). THE
GROUP assigns to BCBSNE the authority to pursue recovery of Overpayments and BCBSNE will
pursue reasonable means of recovery of Overpayments under the circumstances but will not be
obligated to commence litigation, unless otherwise specifically agreed to by the parties. BCBSNE will
only pursue Overpayments for a period of twelve (12) months from the date of the event that
necessitates the overpayment is identified. BCBSNE will not pursue overpayments beyond this twelve
(12) month period for any events that resulted solely from the actions or direction of THE GROUP.
BCBSNE may, at its sole option, choose not to pursue deminimus Overpayment amounts.
F.Provide facilities, personnel, procedures, forms and instructions for the administration of claims under
the Benefit Plan Document.
G.Accept full and exclusive discretion to determine for all parties all matters of fact or interpretation relating to
any claim under the Benefit Plan Document, including questions of eligibility and interpretation of plan
provisions to the extent that BCBSNE is a fiduciary for claims processing purposes. The decisions of
BCBSNE regarding such claims shall be final and binding subject to appeal to BCBSNE under its review
process. Benefits will be paid or denied consistent with the Benefit Plan Document based upon BCBSNE's
determination. NO CLAIM EXCEPTIONS TO THE GROUP MASTER CONTRACT AND ENDORSEMENTS
WILL BE MADE.
Grand Island Special Meeting - Updated - 8/19/2014 Page 41 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 3 -
H.Report to THE GROUP matters of general interest with respect to the Benefit Plan Document, including,
but not limited to, problems of a recurring nature and suspected misuse of benefits.
I.Submit to THE GROUP, with each monthly billing, a monthly Claims Analysis Report which sets forth
the applicable identification number, patient's name, relationship to Subscriber, age, admission or
performance date, discharge date, dollar charge, type of coverage, any refunds or other adjustments,
and Net Paid Claims. (See Net Paid Claims in Part VI., A.)
* BCBSNE will not seek refunds from providers that relate to a retroactive termination of memberships
of Covered Persons and/or their dependents for claims paid more than 60 days prior to the date on
which BCBSNE is made aware of the termination.
J.Maintain membership and claims records for a period of eight years. THE GROUP shall have access to
such records during normal business hours for the purpose of determining compliance with this
Agreement. Any audit initiated pursuant to this Part and authorized by THE GROUP shall be undertaken
at THE GROUP's expense. THE GROUP specifically agrees to reimburse BCBSNE for any reasonable
expense incurred by BCBSNE in accordance with such audit, including but not limited to reimbursement
for BCBSNE personnel providing support to such audit in excess of a total of ten hours and any copying
expenses.
THE GROUP also specifically agrees that BCBSNE has the authority to disapprove of the vendor
providing such audit, which authority shall not be unreasonably exercised, and to refuse access to
membership and claims records by such vendor. THE GROUP, recognizing that patient specific
information is confidential, agrees that it will take reasonable steps to restrict access to this information
to those persons who need to know this information for determining compliance with this Agreement
and for performing any necessary audit.
K.Provide the following services in the development and design of any amendment, revision or
modification of the Plan: Underwriting and actuarial advice, cost estimates and projections, and
proposed language changes, subject to Part III., D.
L.Use its discretion to seek recovery based on subrogation or other theories, from third parties (or their
carriers) who have caused Injury or Illness to a Covered Person or damages to the Plan. BCBSNE may
engage a contractor to perform specialized services for recovery of funds or discovery of overpayment
or fraud. Such contractors may be reimbursed based on a percent of recovery or other reasonable
basis, with the net amount to be returned to THE GROUP. BCBSNE may settle or release claim to
such recoveries and use its discretion to determine amounts recovered, on behalf of THE GROUP.
This includes participation in consolidated or class action lawsuits alleging such injuries. Any recovery
from consolidated or class action suits will be apportioned among all insured and self-insured plans or
pools. The proration may be based on number of covered persons, number of injured persons, claims
volume, or any other basis determined by BCBSNE.
Recoveries made in any plan year will be applied first to the appropriate Stop Loss Amount and,
subsequently, to THE GROUP's claim liability. THE GROUP agrees to cooperate with all such recovery
efforts.
M.Provide its standard Utilization Management Program for Covered Services provided to Covered
Persons and to perform Utilization Review in accordance with the Plan.
N.Furnish THE GROUP copies of available records of BCBSNE which may be required to satisfy the
requirements of ERISA.
O.Indemnify THE GROUP and hold it harmless against any and all loss, damage, and expense with
respect to the administration of the Plan resulting from, or arising out of, any act or omission which
constitutes bad faith, fraudulent or criminal acts of employees of BCBSNE acting alone or in collusion
with others.
Grand Island Special Meeting - Updated - 8/19/2014 Page 42 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 4 -
P.BCBSNE does not underwrite or insure the liability of THE GROUP under this Agreement, except as
specifically provided in any Stop Loss Provision incorporated herein. BCBSNE provides administrative
claims payment services only and does not assume any financial risk or obligation with respect to
claims except as set forth in this Agreement.
Q.Upon mutual agreement of BCBSNE and THE GROUP and/or Plan Sponsor, assist THE GROUP
and/or Plan Sponsor with certain administrative tasks related to compliance obligations of THE GROUP
and/or Plan Sponsor.
R.If applicable, provide administration for the following state assessment mandates by agreeing to:
1.Comply with New York State Health Care Reform Act, if applicable. If THE GROUP elects,
BCBSNE shall make a filing with the New York State Department of Health ("DOH") on behalf
of THE GROUP to elect for the Plan to make direct payments to the DOH of the Plan's
obligations under sections 2807-j and 2807-s of the New York Public Health Law. For each
month in which the Plan's direct payment election is in effect with the DOH, BCBSNE shall
notify THE GROUP of the amount of the required surcharge and covered lives assessment for
such month and shall file appropriate reports with the DOH and make the required payments
to the DOH in accordance with the procedure under this Agreement. For purposes of this
Agreement, such surcharges and covered lives assessments shall be considered authorized
expenses of the Plan and shall be billed to THE GROUP. BCBSNE shall not be liable for any
surcharge or covered lives assessment payable by the Plan under section 2807-j or 2807-s of
the New York Public Health Law and shall not be liable for any interest or penalties assessed
against the Plan or THE GROUP as a result of late or insufficient payment of such surcharges
and assessments, unless the interest or penalty is a result of BCBSNE’S negligence or
mistake. THE GROUP must notify BCBSNE in advance if they choose to pay the surcharge
itself.
2.Comply with Maine Dirigo Health Act, if applicable. BCBSNE, on behalf of THE GROUP, shall
make a filing with the Treasurer of the State of Maine under the Dirigo Health Savings Offset
Payment to be in compliance with the Maine Dirigo Health Act. BCBSNE shall not be liable for
any savings offset payment due under the Maine Dirigo Health Act. Such payments shall be
considered authorized expenses under the Plan and shall be billed to THE GROUP. BCBSNE
shall not be liable for any interest charge for failing to make a savings offset payment in a
timely manner, unless the interest payment is a result of BCBSNE's negligence or mistake.
3.Submit payment to the Maine Vaccine Board in accordance with 22 MRSA Sec. 1066. The
assessment rate has been determined to be $6.98 for each Covered Life Month. Payment is
required by all insurers, which included third-party administrators. A Covered Life Month is any
month in which health benefits are provided to a child under age 19 who resides in the State of
Maine. Such payments shall be considered authorized expenses under the Plan and shall be
billed to THE GROUP. BCBSNE shall not be liable for any interest charge for failing to make a
savings offset payment in a timely manner, unless the interest payment is a result of
BCBSNE's negligence or mistake.
4.Submit payment to the State of Maine for the Maine Guaranteed Access Reinsurance
Association (MGARA) program. Payment is required by all health insurers, which includes
third-party administrators and pharmacy benefit managers who provide administrative services
only. The fee is equal to $4.00 per member who resides in the state of Maine per month. An
additional assessment by MGARA may be assessed of up to $2 per member residing in Maine
per month should MGARA find it necessary to cover any net loss in the operation of this
program. The payment of such fee shall be considered authorized expenses under the Plan
and shall be billed to THE GROUP. BCBSNE shall not be liable for failure to pay the fee,
unless the failure to make payment is a result of BCBSNE’s negligence or mistake.
Grand Island Special Meeting - Updated - 8/19/2014 Page 43 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 5 -
5.Submit payment to the Vermont Health Care Information Technology Fund in accordance with
Sec. 7.005 8 V.S.A. § 4089k. Payment is required by all health insurers, which includes third-
party administrators and pharmacy benefit managers who provide administrative services only.
The fee is equal to 0.199 percent of all health care claims paid by the health insurer for
Vermont members. The payment of such fee shall be considered authorized expenses under
the Plan and shall be billed to THE GROUP. BCBSNE shall not be liable for failure to pay the
fee, unless the failure to make payment is a result of BCBSNE’s negligence or mistake.
6.Submit payment to the Vermont State Health Care Resources Fund in accordance with 8
V.S.A. §4089l. Payment is required by all health insurers, which includes third-party
administrators and pharmacy benefit managers who provide administrative services only. The
fee is equal to the amount of 0.80 of one percent of all health insurance claims paid by the
health insurer for its Vermont members in the previous fiscal year. The payment of such fee
shall be considered authorized expenses under the Plan and shall be billed to THE GROUP.
BCBSNE shall not be liable for failure to pay the fee, unless the failure to make payment is a
result of BCBSNE’s negligence or mistake.
7.Submit the required assessment to the Idaho Immunization Board in compliance with Idaho
Code § 41-6005, if applicable. An assessment is required to be paid by all carriers for any
child under the age of 19 residing in the State of Idaho. The payment of the assessment shall
be considered authorized expenses under the Plan and shall be billed to THE GROUP.
BCBSNE shall not be liable for failure to pay the fee, unless the failure to make payment is a
result of BCBSNE’s negligence or mistake.
8.Submit payment to the Michigan State Department of Treasury in accordance with Act No. 142
of Public Act of 2011. Payment is required by all insurers and third party administrators paying
health claims on residents of Michigan who received services at providers located in Michigan.
The fee is effective January 1, 2012, and is equal to 1% of Michigan paid health claims,
medical services, case management, disease management, utilization review and general
administrative expenses. The payment of such fee shall be considered authorized expenses
under the Plan and shall be billed to THE GROUP. BCBSNE shall not be liable for failure to
pay the fee, unless the failure to make payment is a result of BCBSNE’s negligence or
mistake.
9.Submit payment to the Massachusetts Health Safety Net Office in accordance with the
Massachusetts Act Providing Access to Affordable Quality and Accountable Health Care
Chapter 58 of the Acts of 2006. Payment is required by all purchasers of healthcare services
who make payments to acute hospitals and to ambulatory surgical centers. The surcharge
amount equals the product of the payments subjected to the surcharge and the surcharge
percentage which is 2.00 percent. The payment of such fee shall be considered authorized
expenses under the Plan and shall be billed to THE GROUP. BCBSNE shall not be liable for
failure to pay the fee, unless the failure to make payment is a result of BCBSNE’s negligence
or mistake.
10.Submit payment to the Massachusetts General Fund for the Pediatric Immunization
Assessment in accordance with Massachusetts General Law Section 38 of Chapter 118G.
Payment is required by all health care insurers that conduct business in Massachusetts to
cover the costs of purchasing and distributing childhood vaccines. The surcharge amount
equals 1.90 percent of payments made to acute hospitals and ambulatory surgical centers.
The payment of such fee shall be considered authorized expenses under the Plan and shall be
billed to THE GROUP. BCBSNE shall not be liable for failure to pay the fee, unless the failure
to make payment is a result of BCBSNE’s negligence or mistake.
THE GROUP is responsible for any state assessment on GROUP claims regardless of whether the
state assessment is included in this Section.
Grand Island Special Meeting - Updated - 8/19/2014 Page 44 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 6 -
III.
THE GROUP's SERVICES
In carrying out the terms of this Agreement, THE GROUP agrees to:
A.Provide BCBSNE with the following:
1.Completed enrollment forms for each new Subscriber or online enrollment information, as
applicable.
2.Completed enrollment forms or online notification for each Subscriber changing status of
membership.
3.Completed timely notice of termination of eligibility for membership.
4.A monthly submission of a computerized listing or other mutually acceptable media showing all
active eligible employees. (Also see Part II., I*.)
B.Cooperate with BCBSNE in an audit of Covered Persons, upon request, but not more frequently than
annually. The cost of such audit shall be borne by BCBSNE and shall include, but not be limited to,
reimbursing THE GROUP's personnel providing support to such audit in excess of ten hours and copying
expenses.
C.Notify BCBSNE immediately of any work-related accident suffered by a Covered Person for which
recovery may be available under any Workers' Compensation Law or similar law. THE GROUP agrees
to forward a copy of the First Injury Report to BCBSNE as soon as possible. Work-related injuries or
illnesses are not Covered Services, therefore provider discounts which are available to THE GROUP
under the health coverage, are not available for these services. THE GROUP also agrees to advise
BCBSNE of any potential subrogation rights or other contractual rights of recovery known to THE
GROUP.
D.Review the Benefit Plan Document and any changes or modifications thereto, and notify BCBSNE of
any necessary changes. Such notification must be made within 30 days of receipt of the Benefit Plan
Document. Any changes or modifications to the Benefit Plan Document which are made by THE
GROUP after 90 days of the effective date, will be subject to an increased charge and any additional
administrative expense involved in its implementation. This charge will be determined by BCBSNE.
Benefits cannot be decreased retroactively at any time. Any change to the Benefit Plan Document must
be approved by BCBSNE before it is effective. Such approval will not be unreasonably withheld.
E.Grant to BCBSNE discretionary authority to determine for all parties, all matters of fact or interpretation
relating to any claim under the Benefit Plan, including questions of eligibility and interpretation of Plan
provisions, to the extent that BCBSNE is a fiduciary for claims processing purposes. These decisions
will be final and binding subject to appeal to BCBSNE under its review process.
F.Indemnify BCBSNE and hold it harmless against any and all claim loss, damage, and expense with
respect to the administration of the Plan, except that resulting from, or arising out of, any act or
omission which constitutes bad faith, negligence, fraudulent or criminal acts of employees of BCBSNE,
acting alone or in collusion with others, or expenses incurred by BCBSNE in the regular administration
of the Plan.
THE GROUP agrees that should it fail to make payment due to insolvency or for any other reason, the
provider shall have authority to collect directly for Covered Services from its Covered Persons.
G.Indemnify BCBSNE and hold it harmless, as set forth herein, for any claim, loss, damage and expense
arising from the release of claims specific information to THE GROUP, as required by Part II., I. and
Part II., J., or otherwise required by THE GROUP.
Grand Island Special Meeting - Updated - 8/19/2014 Page 45 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 7 -
H.THE GROUP on behalf of itself and its participants, hereby expressly acknowledges its understanding
that this Agreement constitutes a contract solely between THE GROUP and BCBSNE, that BCBSNE is
an independent corporation operating under a license with the Blue Cross and Blue Shield Association,
an association of independent Blue Cross and Blue Shield Plans, (the "Association") permitting
BCBSNE to use the BCBS Service Marks in Nebraska, and that BCBSNE is not contracting as the
agent of the Association. THE GROUP further acknowledges and agrees that it has not entered into
this Agreement based upon representations by any person other than BCBSNE, and that no person,
entity or organization other than BCBSNE shall be held accountable or liable to THE GROUP for any of
BCBSNE's obligations to THE GROUP created under this Agreement. This paragraph shall not create
any additional obligations whatsoever on the part of BCBSNE other than those obligations created
under other provisions of this Agreement.
I.Execute and be responsible for all HIPAA related compliance, including but not limited to executing any
necessary agreements or notifications.
J.Keep all information received from BCBSNE confidential. THE GROUP will not use or disclose such
information except as necessary for administration of claims pursuant to the Benefit Plan Document. In
the event THE GROUP discloses any such information to a contractor assisting in the administration of
the Benefit Plan Document, it shall first obtain written agreement from the contractor restricting further
disclosure or use for any purpose other than providing such assistance.
IV.
CONTINUATION OF COVERAGE
The applicable Continuation of Coverage provisions are in Part III of the Master Group Contract.
The amount of recommended monthly charges to be collected and retained by THE GROUP shall not
be less than the amounts indicated on Attachment 4.
V.
FINANCING ARRANGEMENTS
The financing arrangements applicable under this Agreement are those set forth on
Attachment 2.
VI.
COMPENSATION
A.Commencing with the effective date of this Agreement, and in consideration of the services
and obligations herein required of BCBSNE, THE GROUP shall pay BCBSNE, monthly, the following
amounts. If the number of Covered Persons increases or decreases by 10% or more, or the terms
of this Agreement are changed by THE GROUP during the Term, BCBSNE reserves the right to revise
the rates contained in this Section or applicable Attachment.
1.Administrative Service Fee: The fee for BCBSNE's services as stated in this Agreement which
includes fees for all persons who have elected to continue membership in THE GROUP pursuant
to COBRA continuation coverage.
The Administrative Service Fee is indicated on Attachment 1, Section A.
Grand Island Special Meeting - Updated - 8/19/2014 Page 46 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 8 -
2.Reimbursement for the total "Net Paid Claims" for the preceding month, unless reimbursement is
otherwise provided in Part V., above. Claims data which is, for any reason, omitted from a
particular month's billing, shall be added to the billing for a subsequent month, and the
Administrative Service Fee for the subsequent month shall reflect any appropriate adjustment.
Net Paid Claims: This is the amount determined after subtraction of any discount and other
adjustments made to the Allowable Charge for Covered Services, pursuant to the contractual
provisions between BCBSNE and the Contracting Providers, or in accordance with other Contract
provisions. These payments are made by BCBSNE or a Blue Cross and/or a Blue Shield plan in
another state, referred to as a “Host Blue.” THE GROUP's payment is made on a Net Paid Claims
basis.
Payment for Covered Services by a Contracting facility inside BCBSNE’s service area is based on
the Contracted Amount less the Covered Person's Deductible, Coinsurance and Copayment.
Payment for Covered Services received from a Contracting facility outside of BCBSNE’s service
area is based on the lesser of the Contracted Amount or the billed charge less the Covered
Person's Deductible, Coinsurance and Copayment. Payment for Covered Services received from
a Contracting professional or noninstitutional provider is based on the lesser of the Contracted
Amount or the billed charge less the Covered Person's Deductible, Coinsurance and Copayment,
regardless of location. The Coinsurance is based on the lesser of the Allowable Charge or the
billed charge for Covered Services.
3.The following fees are related to the BlueCard Program. Additional information about the
BlueCard Program is found in Paragraph B of this Part.
a.Access Fee: If Contracted Provider savings are available from a Host Blue, BCBSNE may be
charged a fee for Covered Persons to access the Host Blue's Contracting Provider network.
This Access Fee for services incurred by a Covered Person will be passed along to THE
GROUP as a claims expense under Net Paid Claims, unless otherwise indicated in
Attachment 1. The Access Fee is a percentage of the discount the Host Blue has made
available to BCBSNE, but not to exceed $2,000 for any claim. If an Access Fee credit is
received, this amount will be credited to THE GROUP. The provider has agreed not to bill
Covered Persons for amounts in excess of the Contracted Amount, but may bill them for
Deductibles, Coinsurance and amounts for Noncovered Services.
The amount of this fee or any credits will be used in the computation of "Net Paid Claims"
charged to THE GROUP. Instances may occur when none of a claim or only a small amount
of the claim is paid due to the application of the Covered Person's Deductible, Coinsurance or
Copayment. If the Host Blue's arrangement with the provider allows the Contracted Amount
to apply when the amount is fully or mostly a Covered Person's obligation, the Access Fee
will be paid and passed to THE GROUP as a claims expense under Net Paid Claims even
though THE GROUP paid little or none of the claim. This process allows the benefit of the
discounted amount to be passed through to the Covered Person.
The Access Fee is indicated on Attachment 1, Section B. 1. a.
Grand Island Special Meeting - Updated - 8/19/2014 Page 47 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 9 -
b.Administrative Expense Allowance (AEA): An Administrative Expense Allowance (AEA) for
each original claim processed through the BlueCard Program by the Host Blue, will be
charged back to THE GROUP as an administrative expense, unless otherwise indicated in
Attachment 1 Section B.
An AEA Fee Report will be provided monthly with the Claims Analysis Report.
The AEA Fees are indicated on Attachment 1, Section B. 1.b.
4.Non-Contracted Providers
For both physician/professional and institutional claims incurred in other plan service areas with
non-contracted providers, no Access Fee applies. The AEA fee for non-contracted provider claims
will be $3.00 per claim.
5.Premium for an Individual Stop Loss.
Premium for an Aggregate Stop Loss.
The Stop Loss premium, however stated, includes fees for all persons who have elected to
continue memberships in THE GROUP pursuant to COBRA.
If applicable, the Stop Loss premiums are indicated on Attachment 3
6.Commissions: If a commission to an agent of record specified by THE GROUP is payable by
BCBSNE, the actual amount paid will be charged to THE GROUP each month during the Term of
this Agreement.
The monthly commission is indicated on Attachment 1, Section C.
B.The following language is mandated by the Blue Cross and Blue Shield Association in order to
explain the methods that are used to calculate claim liability in the various independent Blue
Cross and Blue Shield Plans. The Out-of-Area Services fees and compensation costs are
outlined on Attachment 1, Section B.
Out-of-Area Services: BCBSNE has a variety of relationships with other Blue Cross and/or Blue Shield
Licensees, Referred to generally as “Inter-Plan Programs.” Whenever a Covered Person accesses
services outside the geographic area BCBSNE serves, the claim for those services may be processed
through one of the Inter-Plan Programs and presented to BCBSNE for payment in accordance with the
rules of the Inter-Plan Programs policies then in effect. The Inter-Plan-Programs policies available to
Covered Persons under this Agreement are described generally below. Typically, the Covered Person,
when accessing care outside the geographic area BCBSNE serves, obtains care from healthcare
providers that have a contractual agreement (i.e. are “participating providers”) with the local Blue Cross
and/or Blue Shield Licensee in that other geographic area (Host Blue” or “On-site Plan”). In some
instances, the Covered Person may obtain care from non-participating healthcare providers. BCBSNE
payment practices in both instances are described below.
1.BlueCard Program
Under the BlueCard Program, when a Covered Person accesses Covered Services within
the geographic area served by a Host Blue, BCBSNE will remain responsible to THE
GROUP for fulfilling BCBSNE’s contractual obligations. However, in accordance with
applicable Inter-Plan Programs policies then in effect, the Host Blue will be responsible for
providing such services as contracting and handling substantially all interactions with its
Grand Island Special Meeting - Updated - 8/19/2014 Page 48 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 10 -
participating healthcare providers. The financial terms of the BlueCard Program are
described generally below. Individual circumstances may arise that are not directly
covered by this description; however, in those instances, BCBSNE’s action will be
consistent with the spirit of this description.
a.Liability Calculation Method Per Claim: The calculation of the Covered Person’s
liability on claims for Covered Services processed through BlueCard Program will be
based on the lower of the participating healthcare provider's billed covered charges
or the Contracted Amount made available to BCBSNE by the Host Blue.
The calculation of THE GROUP's liability on claims for Covered Services processed
through the BlueCard Program will be based on the Contracted Amount made
available to BCBSNE by the Host Blue. Sometimes, the Contracted Amount may
be greater than billed charges if the Host Blue has negotiated with its participating
healthcare provider(s) an inclusive allowance (e.g., a Diagnosis Related Group (DRG)
(per case) or a Per Diem (per day) amount) for specific healthcare services. In the
instance of a member’s loss of eligibility occurring during treatment for an inclusive
allowance claim, either due to Plan Termination or the member’s own loss of
eligibility, BCBSNE may administer the inclusive allowance if applied by the Host
Blue, even if the allowance covers services incurred by the member after the loss of
the member’s eligibility.
Host Blues may use various methods to determine the Contracted Amount,
depending on the terms of each Host Blue's healthcare provider contracts. The
Contracted Amount made available to BCBSNE by the Host Blue may represent
payment negotiated by a Host Blue with a healthcare provider that is one of the
following:
i.An actual price negotiated payment without any other increases or
decreases; or
ii.An estimated price negotiated payment reduced or increased by a
percentage to take into account certain payments negotiated with
the provider and other claim and non-claim-related transactions.
Such transactions may include, but are not limited to, anti-fraud and
abuse recoveries, provider refunds not applied on a claim-specific
basis, retrospective settlements, and performance-related bonuses
or incentives; or
iii.An average price as a percentage of billed covered charges
representing the aggregate payments negotiated by the Host Blue
with all of its healthcare providers or a similar classification of its
providers and other claim- and non-claim-related transactions. Such
transactions may include the same ones as noted above for an
estimated price.
Host Blues using either the estimated price or an average price may, in accordance
with Inter-Plan Programs policies, prospectively increase or reduce such prices to
correct for over- or underestimation of past prices (i.e., prospective adjustment
may mean that a current price reflects additional amounts or credits for claims
already paid to providers or anticipated to be paid to or received from providers).
However, the amount paid by the Covered Person and THE GROUP is a final price;
no future price adjustment will result in increases or decreases to the pricing of
past claims. The BlueCard Program requires that the price submitted by a Host Blue
to BCBSNE is a final price irrespective of any future adjustments based on the use
of estimated or average pricing. Regardless of the billed charge amount, BCBSNE is
obligated to pay the providers contracted rate.
Grand Island Special Meeting - Updated - 8/19/2014 Page 49 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 11 -
If a Host Blue uses either an estimated price or an average price on a claim, it
may also hold some portion of the amount that THE GROUP pays in a variance
account, pending settlement with its participating healthcare providers. Because all
amounts paid are final, neither variance account funds held to be paid, nor the funds
expected to be received, are due to or from THE GROUP. Such payable or
receivable would eventually be exhausted by healthcare provider settlements and/or
through prospective adjustment to the Contracted Amounts. Some Host Blues may
retain interest earned, if any, on funds held in variance accounts.
A small number of states require Host Blues either (i) to use a basis for determining
Covered Person liability for Covered Services that does not reflect the entire savings
realized, or expected to be realized, on a particular claim or (ii) to add a surcharge.
Should the state in which healthcare services are accessed mandate liability
calculation methods that differ from the Contracted Amount methodology or require
a surcharge, BCBSNE would then calculate Covered Persons liability and THE
GROUP's liability in accordance with applicable law.
b.Return of Overpayments:
Under the BlueCard Program, recoveries from a Host Blue or its participating
healthcare providers can arise in several ways, including but not limited to, anti-fraud
and abuse recoveries, healthcare provider/hospital audits, credit balance audits,
utilization review refunds, and unsolicited refunds. In some cases, the Host Blue will
engage a third party to assist in identification or collection of recovery amounts.
Recovery amounts determined in these ways will be applied in accordance with
applicable Inter-Plan policies, which generally require correction on a claim-by-claim
or prospective basis.
Unless otherwise agreed to by the Host Blue, BCBSNE may request adjustments from
the Host Blue for full refunds from healthcare providers due to the retroactive
cancellation of membership but only for one year after the date of the Inter-Plan
financial settlement process for the original claim. In some cases, recovery of claim
payments associated with a retroactive cancellation may not be possible if, as an
example, the recovery conflicts with the Host Blue’s state law or healthcare provider
contracts or would jeopardize its relationship with its healthcare providers.
c.BlueCard Program Fees and Compensation:
THE GROUP understands and agrees to reimburse BCBSNE for certain fees and
compensation which BCBSNE is obligated under the BlueCard Program to pay to
the Host Blues, to the Blue Cross and Blue Shield Association (BCBSA), and/or to
the BlueCard Program vendors as described below. Fees and compensation under
the BlueCard Program may be revised in accordance with the Program’s standard
procedures for revising such fees and compensation, which do not provide for prior
approval by any groups. Such revisions typically are made annually as a result of
Program policy changes and/or vendor negotiations. These revisions may occur
at any time during the course of a given calendar year, and they do not necessarily
coincide with THE GROUP’s benefit period under this Agreement.
BCBSNE will charge these fees as follows:
Access Fees
Administrative Expense Allowance (AEA) fees
Some of these fees and compensation are charged each time a claim is processed
through the BlueCard Program and include, but are not limited to, Access Fees and
Grand Island Special Meeting - Updated - 8/19/2014 Page 50 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 12 -
Administrative Expense allowance (AEA) fees. An Access Fee may be passed on
to THE GROUP as an additional claim liability. If one is charged, it will be a
percentage of the discount/differential BCBSNE receives from the Host Blue, based
on the current rate in accordance with the Program’s standard procedures for
establishing the Access Fee rate. The Access Fee will not exceed $2,000 for any
claim. Other Program-related fees that BCBSNE may charge include, but are not
limited to, a toll-free number fee and a fee for providing PPO healthcare provider
directories. (See Attachment 1)
d.BlueCard Program Access Fees
A BlueCard Program Access Fee may be charged only if the Host Blue’s
arrangement with its healthcare provider prohibits billing Covered Persons for
amounts in excess of the Contracted Amount. However, a healthcare provider may
bill for Noncovered Services and for Covered Person cost sharing (for example,
Deductibles, Copayments, and/or Coinsurance) related to a particular claim.
e.How the BlueCard Program Access Fee Affects THE GROUP
When BCBSNE is charged a BlueCard Program Access Fee, BCBSNE may pass
the charge along to THE GROUP as a claim expense or as a separate amount.
The Access Fee will not exceed $2,000 for any claim. If BCBSNE receives an
Access Fee credit, BCBSNE will give THE GROUP a claim expense credit or a
separate credit.
Instances may occur in which the claim payment is zero or BCBSNE pays only a
small amount because the amounts eligible for payment were applied to patient
cost sharing (such as a Deductible or Coinsurance). In these instances, BCBSNE will
pay the Host Blue’s Access Fee and pass it along to THE GROUP as stated above
even though THE GROUP paid little or had no claim liability.
2. Non-Participating Healthcare Providers Outside BCBSNE’s Service Area
a. Covered Person Liability Calculation
i.In General
When Covered Services are provided outside of BCBSNE’s service
area by non-participating healthcare providers, the amount a
Covered Person pays for such services will generally be based on
either the Host Blue’s non-participating healthcare provider local
payment or the pricing arrangements required by applicable state
law. In these situations, the Covered Person may be responsible
for the difference between the amount that the non-participating
healthcare provider bills and the payment BCBSNE will make for
the Covered Services as set forth in this paragraph.
ii.Exceptions
In some exception cases, BCBSNE may pay claims from non-
participating healthcare providers outside of BCBSNE’s service
area based on the provider’s billed charge, such as in situations
where the Covered Person did not have reasonable access to a
participating provider, as determined by BCBSNE in BCBSNE’s
sole and absolute discretion or by applicable state law. In other
exception cases, BCBSNE may pay such claims based on the
Grand Island Special Meeting - Updated - 8/19/2014 Page 51 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 13 -
payment BCBSNE would make if BCBSNE were paying a non-
participating provider inside of BCBSNE’s service area, as
described elsewhere in this Agreement, where the Host Blue’s
corresponding payment would be more than BCBSNE’s in-
service area non-participating provider payment, or in BCBSNE’s
sole and absolute discretion, BCBSNE may negotiate a payment
with such a provider on an exception basis. In any of these
exception situations, the Covered Person may be responsible for
the difference between the amount that the non-participating
healthcare provider bills and the payment BCBSNE will make for
the Covered Services as set forth in this paragraph.
b.Fees and Compensation
THE GROUP understands and agrees to reimburse BCBSNE for certain fees and
compensation which BCBSNE is obligated under applicable Inter-Plan Programs
requirements to pay to the Host Blues, to the BCBSA, and/or to Inter-Plan
Programs vendors. Fees and compensation under applicable Inter-Plan Programs
may be revised in accordance with the specific Program’s standard procedures for
revising such fees and compensation, which do not provide for prior approval by any
groups. Such revisions typically are made annually as a result of Inter-Plan Programs
policy changes and/or vendor negotiations. These revisions may occur at any time
during the course of a given calendar year, and they do not necessarily coincide with
THE GROUP’s benefit period under this Agreement.
In addition, BCBSNE must pay an administrative fee to the Host Blue, and THE GROUP
further agrees to reimburse BCBSNE for any such administrative fee as set forth
below, which may include:
Administrative Expense Allowance (AEA) fees
(See Attachment 1)
C.Rx Nebraska Program Fees: Prime Therapeutics, LLC, (Prime) is the Pharmacy Benefit Manager
which processes pharmacy claims for the Rx Nebraska Program. Any fees Prime charges BCBSNE for
managing the Rx Nebraska Program are included in the Administrative Service Fee. In some cases,
Prime receives manufacturer administrative fees, which are retained by Prime unless otherwise noted in
Attachment 1. One hundred percent (100%) of Rx rebates received from manufacturers of drugs and
supplies are passed through to BCBSNE, unless otherwise agreed by the parties hereto.
D.BCBSNE shall provide THE GROUP with a monthly billing reflecting the amount due BCBSNE from
THE GROUP, less any credits. This billing will be provided on or before the 10th day of the following
month and shall be payable within 15 days of its mailing by BCBSNE.
Interest will be charged for Net Paid Claims, Administrative Service fees, Stop Loss charges and
amounts previously unreimbursed by THE GROUP, which are received more than 15 calendar days
after the date notification is mailed.
Interest will be based on a rate of 12% per annum for the actual number of days which have elapsed
beyond the 15-day grace period. The interest charge will be added to the next subsequent billing for
claims reimbursement and will not be included in the Aggregate Stop Loss Limit. Interest charges will
also be applicable on any past due interest charge.
Grand Island Special Meeting - Updated - 8/19/2014 Page 52 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 14 -
E.In connection with the administration of this Agreement, if at any time BCBSNE shall be or become
subject to the imposition of, or any increase in, a premium tax or other tax whatsoever, the amount of
compensation shall be increased by a like amount. (The present premium taxes on the Stop Loss
premiums are included in the costs shown above, if applicable.) Assessments by a state arising from
the operation of the Plan, including but not limited to a surcharge on claims and/or an assessment on
residents of that state, shall be considered a tax for purpose of this paragraph.
If a change in a law or regulation occurs during the term of this Agreement which results in additional
administrative costs such increases in cost will be communicated to and incurred by THE GROUP.
F.BCBSNE may employ the services of an outside company to seek recovery of credit balances from
providers and facilities. The outside company may: a) retain a percentage of the monies recovered as
compensation for its services. The remaining balance will be refunded to THE GROUP; or b) charge
BCBSNE a fee as compensation for its services. In that instance, the Claims Analysis Report will reflect
the full amount of the recovery as a credit. Any fee associated with the collection of these recoveries
will be reflected as a charge on the summary invoice provided to THE GROUP.
G.This Agreement is effective only as to expenses incurred after the effective date of this Agreement, and
prior to its termination, subject to Part IX.
VII.
LITIGATION
Should suit be filed against BCBSNE or THE GROUP, or both, for damages or equitable relief, arising
out of a determination of benefits, the parties agree to cooperate fully and assist one another in the defense
of such claims. Should BCBSNE be named as defendant in such a suit, BCBSNE and its liability carrier shall
maintain primary control of such litigation, including the selection of counsel; however, notice will be provided
to THE GROUP. Reimbursement will be made to BCBSNE by THE GROUP for the amount of any benefits
determined to be payable pursuant to the Benefit Plan Document, by way of settlement or award pursuant to
judgment, and THE GROUP shall be responsible for the fees of any separate counsel retained to represent
its interests independently. If Plaintiff’s attorney fees or taxable court costs are a part of the settlement or
award, the parties agree they will split such fees and costs evenly.
VIII.
TERM
This Agreement shall be effective for a Contract Term which is indicated on Attachment 1. It may be
extended by written consent of both parties, with such modifications as shall be agreed to by the parties.
This Agreement may be terminated by either party, without cause, but any such termination shall only
be effective commencing with the first day of the month at least 60 days following written notice to the other
party.
This Agreement shall terminate immediately upon written notice by BCBSNE to THE GROUP, should
THE GROUP fail, refuse or neglect to meet any of its financial obligations hereunder.
Grand Island Special Meeting - Updated - 8/19/2014 Page 53 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 15 -
IX.
PROCESSING OF CLAIMS IN THE EVENT OF TERMINATION
In the event of termination of this Agreement, liability for unreported and pending claims as of the date
of termination rests with THE GROUP. The following administrative alternatives are available and the
selected option is indicated in Attachment 1, section D:
A.THE GROUP will arrange with another claims administrator for processing, handling and payment of
such claims as are incurred during the Term of this Agreement, but not submitted for payment until after
the termination date. BCBSNE will have no responsibility for such claims except to notify the Covered
Person/Provider of the termination date. Covered Person/Provider must resubmit the claims to either
the new claims administrator or THE GROUP, as instructed by THE GROUP.
or
B.THE GROUP will arrange with BCBSNE for payment of such claims. Unless the parties agree
otherwise, BCBSNE will continue to process claims for services provided during the Term of this
Agreement for a period of 15 months after termination of this Agreement. The advance deposit will be
returned as set forth on Attachment 2, Section A., 2.
THE GROUP agrees to compensate BCBSNE as provided herein. BCBSNE will send a monthly invoice
reporting the amount of claims reimbursement and Administrative Expense for Net Paid Claims during the
preceding month. The Administrative Expense applicable to the processing of such claims shall be
determined by BCBSNE after notification of termination is received. BCBSNE will have no financial risk or
obligation for claims incurred after the current or prior Terms of the Agreement, i.e., there is no limit to the
extent of THE GROUP's liability under this paragraph B. as benefits paid pursuant to this Part IX. shall not
apply to any Stop Loss Provision (see Attachment 3). BCBSNE may request THE GROUP to provide a
letter of credit guaranteeing payment up to an amount determined by BCBSNE to be the estimated liability
for these payments.
The alternative selected is indicated on Attachment 1, D.
The Reserve for Unreported and Pending Claims at the end of the Term of this Agreement is
indicated on Attachment 5.
X.
DATA
Data contained in membership files submitted to BCBSNE by THE GROUP are the property of THE
GROUP. Once files which are submitted to BCBSNE are entered into BCBSNE proprietary systems, the
data produced, extracted or reported from the BCBSNE systems is the property of BCBSNE (“BCBSNE
Proprietary Data”). Any requests for disclosures to third parties or uses of BCBSNE Proprietary Data by THE
GROUP shall require mutual consent of the parties hereto.
XI.
NONASSIGNMENT
BCBSNE may not assign its rights or obligations under this Agreement without the written consent of
THE GROUP, provided, however, that any reinsurance obtained by BCBSNE shall not constitute an
assignment hereunder.
XII.
Grand Island Special Meeting - Updated - 8/19/2014 Page 54 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 16 -
STOP LOSS PROVISION
If Stop Loss coverage is selected, the applicable Stop Loss contract or provision will be
included as Attachment 3.
XIII.
MODIFICATION
This Agreement contains the entire agreement of the parties. No representations were made or relied
upon by either party other than those that are expressly set forth herein. No change in this Agreement shall
be valid until approved in writing by an officer of each of the parties. Any such change, however, shall be
effective at the time, and with respect to the eligible employees, therein provided.
CITY OF GRAND ISLAND
(PLAN SPONSOR / THE GROUP)
By
Signature
Title
Address
City State Zip Code
Date:
BLUE CROSS AND BLUE SHIELD OF
NEBRASKA (BCBSNE)
By
Signature
Title
Mailing Address:P.O. Box 3248
Omaha, NE 68180-0001
Date:
Grand Island Special Meeting - Updated - 8/19/2014 Page 55 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 17 -
ATTACHMENT 1
ADMINISTRATIVE SERVICES AGREEMENT
SUMMARY
Group: City of Grand Island
Contract Term: October 1, 2014 through September 30, 2015
Group No.: 305208
Master Group Contract Number and revision date: Health: 96-067-S 1/2014
N/A Plan Assets. X General Assets.
A.Administrative Service Fee:
1. N/A% of Net Paid Claims for health coverage.
2. N/A% of Net Paid Claims for dental coverage.
3.$29.50 per enrolled Subscriber under health coverage.
4.$N/A per enrolled Subscriber under dental coverage.
5.$N/A per enrolled Subscriber under health coverage for utilization management.
B.Out-of-Area Service Fees
1.BlueCard Fees:
a.BlueCard Fees are included within the Administrative Service Fee above.
C.Commissions:
1.N/A No commission is payable to an agent of record.
2. X The consulting fee payable to consultant’s agency, Strong Financial Resources, Inc., for 10/1/14
through 9/30/15 is $1,654 each month.
a.X This amount is not included in the Administrative Service Fee in A. above and will be billed
additionally.
b.N/A This amount is included in the Administrative Service Fee in A. above.
3.N/A The commission payable to the agent of record is N/A % of the total applicable Specific and
Aggregate Stop Loss monthly premiums charged to THE GROUP as indicated in Attachment 3,
Part III. The commission amount is included in the Stop Loss premium and will not be billed
separately to THE GROUP.
Grand Island Special Meeting - Updated - 8/19/2014 Page 56 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 18 -
D.Termination Provisions: In event of termination of this Agreement, the alternative selected by THE
GROUP is:
1. N/A THE GROUP will arrange with another claims administrator for processing, handling and
payment of such claims as are incurred during the Term of this Agreement, but not submitted for
payment until after the termination date.
2.X THE GROUP will arrange with BCBSNE for payment of such claims.
Grand Island Special Meeting - Updated - 8/19/2014 Page 57 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 19 -
ATTACHMENT 2
City of Grand Island
"THE GROUP"
October 1, 2013
Effective Date
SPECIAL FINANCING ARRANGEMENTS
A. N/A No Special Financing Arrangement: There are no special financing arrangements under this
Agreement. BCBSNE shall make payments for claims out of its own funds, subject to reimbursement
from THE GROUP.
1. N/A THE GROUP shall remit to BCBSNE an advance deposit of $ N/A .
2. N/A THE GROUP shall remit to BCBSNE an additional advance deposit of $ N/A . The current
advance deposit held by BCBSNE is $ N/A and the total amount upon receipt of the amount
specified above will be $ N/A .
BCBSNE will credit such advance deposit in the name of THE GROUP. Six months following
termination of this Agreement, BCBSNE shall return 50% of THE GROUP's advance deposit. As
stated at Part IX., BCBSNE will continue to pay claims for a period of 15 months (or a previously
agreed-upon runout period). Within 30 days following this period, BCBSNE shall refund the
balance of the advance deposit less any deficits from previous billings.
3. X BCBSNE has agreed to waive the advance deposit, if daily or weekly wire transfer is made.
B. X Special Financial Arrangements: Pursuant to the following, BCBSNE has agreed to waive the
advance deposit:
1.BCBSNE shall make payments for claims out of its own funds, subject to reimbursement from THE
GROUP. BCBSNE shall (N/A daily,X weekly, etc) notify THE GROUP of the amount of payments
which have been made since the last previous notification. THE GROUP shall reimburse
BCBSNE within 24 hours of each notification, and be responsible for all service charges made for
maintenance and use of any wire transfer arrangement between its bank account and BCBSNE's
account.
At the end of each month, a summary report will be provided to THE GROUP, showing individual
Net Paid Claims, refunds or other adjustments, correction entries, Stop Loss adjustments, the
Administrative Service Fee, AEA Fee, Stop Loss premiums and Total Net Paid Claims. Any
additional amount due will be payable within 15 days of the mailing of the summary invoice by
BCBSNE.
2.BCBSNE employees authorized to notify THE GROUP of the amounts required are:
Dave Sederburg Christy Hinton
Mike Fye
Mark Schadde
Pat Puetz
3.THE GROUP's employees who are authorized to communicate with BCBSNE's authorized
employees are:
Tami Herald
Bonnie Kosmicki
Brenda Sutherland
Upon written request, either party may add or delete names of the employees who are authorized
to communicate with the other party.
Grand Island Special Meeting - Updated - 8/19/2014 Page 58 / 84
96-060 Rev. 4/2012
ATTACHMENT 3
City of Grand Island
"THE GROUP"
October 1, 2014
Effective Date
STOP LOSS PROVISIONS
FOR HEALTH COVERAGE
This Stop Loss Contract (Contract) is offered by Blue Cross and Blue Shield of Nebraska
(BCBSNE), a mutual insurance company, licensed by the State of Nebraska.
Blue Cross and Blue Shield of Nebraska and the Group agree to the terms as described herein
during the Contract Term. This Contract is effective beginning 12:01 a.m. on the effective date
stated in the Administrative Services Agreement, in consideration of the payment of premiums,
charges or as otherwise provided.
Only Blue Cross and Blue Shield of Nebraska can approve a change to this Contract and that
change must be in writing. No agent may change the Contract in any way.
This Contract is made in and governed by the laws of the State of Nebraska. Defined terms are
capitalized in this Contract.
Grand Island Special Meeting - Updated - 8/19/2014 Page 59 / 84
96-060 Rev. 4/2012
TABLE OF CONTENTS
PAGE
PART I.RECITALS ...........................................................................................................22
PART II.STOP LOSS COVERAGE ...................................................................................22
PART III.COMPENSATION................................................................................................24
PART IV.GENERAL PROVISIONS ....................................................................................24
PART V.DEFINITIONS ......................................................................................................26
Grand Island Special Meeting - Updated - 8/19/2014 Page 60 / 84
96-060 Rev. 4/2012 - 22 -
PART I. RECITALS
A. The Group has established and maintains a self-funded employee welfare benefit plan, which
provides, among other things, various benefits to Covered Persons in the Plan.
B. BCBSNE provides certain services to the Plan pursuant to the Administrative Services
Agreement.
C. Claims are administered according to the Preferred Provider Organization Master Group
Contract, Form 96-067-S 1/14, as amended.
D. BCBSNE has agreed to provide Stop Loss coverage to the Group as indicated in Part II. below.
E. The Group and BCBSNE intend this Contract to be between and for the benefit of each other.
PART II. STOP LOSS COVERAGE
(Check the applicable provisions for A. and B.)
A. X Individual Stop Loss: BCBSNE will reimburse the Group for 100% of any excess over the
Individual Stop Loss Amount, if, during the Contract Term, the total amount of eligible Net Paid
Claims for any Covered Person exceeds the Individual Stop Loss Amount of $150,000. This
reimbursement will be made the month after such Individual Stop Loss Amount is exceeded. In
addition, any final adjustment will be included following the end of the Term, subject to the
applicable stop loss reimbursement terms. The Individual Stop Loss Amount is subject to the Total
Benefits maximum as indicated in the Master Group Contract and any attached endorsements.
The Individual Stop Loss does not apply to claims incurred under dental coverage or coverage
secondary or supplemental to Medicare, to expenses incurred for Covered Services over the
Individual’s total benefits payable, or to ineligible claims.
1. Claims eligible for reimbursement under Individual Stop Loss must be incurred on or
after October 1, 2012 and before October 1, 2015. In addition, eligible claims must be
paid on or after October 1, 2014 and before October 1, 2015.
2.Coverages eligible for Individual Stop Loss coverage include:
X Medical claims
X Prescription drug claims
3. The Group has elected an Aggregating Specific Stop Loss deductible. The Aggregating
Specific Stop Loss deductible is $50,000. All eligible claims for Covered Persons
exceeding the Individual Stop Loss Amount will be combined for the purposes of
satisfying the Aggregating Specific Stop Loss deductible. No payment will be made
under Part A until both the Individual Stop Loss and Aggregating Specific Stop Loss
have been met.
B. X Aggregate Stop Loss: BCBSNE will reimburse the Group for 100% of any excess over the
Aggregate Stop Loss Amount, if the total amount of Net Paid Claims exceeds such Aggregate Stop
Loss Amount unless otherwise indicated below. Claims reimbursed in A. above or used to satisfy
an aggregating specific and/or Lasered deductible(s), will be deducted from the Net Paid Claims
when determining this liability. This reimbursement will be subject to the Aggregate Stop Loss
reimbursement terms noted in 5. below. The Aggregate Stop Loss does not apply to claims
incurred under dental or coverage secondary or supplemental to Medicare, or to expenses incurred
for Covered Services over the Covered Person’s total benefits payable.
Grand Island Special Meeting - Updated - 8/19/2014 Page 61 / 84
96-060 Rev. 4/2012 - 23 -
1. Claims eligible for reimbursement under Aggregate Stop Loss must be incurred on or
after October 1, 2012 and before October 1, 2015. In addition, eligible claims must be
paid on or after October 1, 2014 and before October 1, 2015.
2. The Initial Aggregate Composite Factor and the Minimum Aggregate Claim Liability of
the Group shall be based on the factors, at the beginning of the Contract Term, as
follows:
a. Stop Loss corridor:125 %
b. Expected average enrollment during each month
of the Contract Term 457
c. Initial Monthly Aggregate Composite Factor to be used
per employee (to include COBRA subscribers and
retirees) for determination of liability under this
Aggregate Stop Loss:$ 1,240.27
d.Minimum Aggregate Claim Liability during each
month of the Contract Term: (2.b. x 2.c. x 90%)$ 510,123
3. The Minimum Aggregate Stop Loss Amount is the minimum amount of aggregate claim
liability and will never be less than the monthly amount calculated in B.2.d. above.
4. The Final Aggregate Stop Loss Liability of the Group shall be calculated as follows, at
the end of the Contract Term, not to be less than the cumulative Minimum Aggregate
Claim Liability of the Group as set forth in section B.2. above.
a.Cumulative number of enrolled employees (to include
COBRA subscribers and retirees) during each month
of the Contract Term:To be determined
b.Total factor to be used per employee (to include
COBRA subscribers and retirees) for determination
of liability under the Aggregate Stop Loss, as
indicated in 2.c. above:$ 1,240.27
c. Final Aggregate Stop Loss Liability (4.a. x 4.b.):To be determined
5. Aggregate Reimbursement: Aggregate reimbursement by BCBSNE to the Group will
occur at the end of the Contract Term if the Net Paid Claims, less any claims
reimbursement made under the Individual Stop Loss, exceed the Final Aggregate Stop
Loss Amount.
6. After the end of the Contract Term, BCBSNE will provide the Group with a summary
report which includes a comparison between the final Aggregate Stop Loss Amount and
the final Net Paid Claims and Administrative Service Fee, if applicable. Adjustments
made to the Group’s liability pursuant to this Contract, including credits previously
provided using the Initial Stop Loss Amount, will be reported and made at this time.
C. The Group has elected to exclude the following classes or departments from Stop Loss
coverage: N/A .
D. Payments made for disputed claims which are paid at the specific direction of the Group, under
the Administrative Services Agreement, despite BCBSNE’s determination that such payment is
inconsistent with the Plan, are not chargeable payments within the terms of this Contract.
Grand Island Special Meeting - Updated - 8/19/2014 Page 62 / 84
96-060 Rev. 4/2012 - 24 -
PART III. COMPENSATION
A. Individual Stop Loss premium: $130.36 per employee (to include COBRA subscribers and
retirees)/retiree per month
B. Aggregate Stop Loss premium: $5.48 per employee (to include COBRA subscribers and
retirees)/retiree per month
PART IV. GENERAL PROVISIONS
A. CANCELLATION OF CONTRACT: This Contract may be cancelled by either party, without
cause, but any such cancellation shall only be effective commencing with the first day of the month
at least 60 days following written notice to the other party. This Contract shall be cancelled
immediately upon written notice by BCBSNE to the Group, should the Group fail, refuse or neglect
to meet any of its financial obligations hereunder. Termination shall not affect any claim for
Covered Services provided before the effective date of termination.
Cancellation or termination of the Administrative Services Agreement, whether during the Contract
Term or at its conclusion, shall also terminate this Contract. There is no limit to the extent of the
Group’s liability for claims processed by BCBSNE after the date of said termination.
B. CERTAIN DEFENSES: All statements, in the absence of fraud, made by the Group will be deemed
representations and not warranties. Neither the acceptance of premium nor the payment of claims shall
constitute a waiver of available defenses.
C. CONFIDENTIALITY: The Group is responsible for keeping confidential records. These records
are to be kept in a way that will assure the privacy of the Covered Persons’ medical and other
personal information.
The Group agrees that any information that the Group has or reviews will be used only for the
purpose of administering this Contract. In the event that the Group discloses any such information to
a third party assisting in the administration of this Contract, the Group is responsible for obtaining a
written agreement from the third party restricting further disclosure or use for any purpose other than
providing such service.
D. CONFORMITY WITH STATUTES: Any Contract provision which on its effective date, is in
conflict with the law of the federal government or the state of Nebraska is hereby amended to
conform to the minimum requirements of such law.
E. FRAUD OR MISREPRESENTATION: Coverage hereunder may be canceled for fraud or
misrepresentation about a claim or eligibility for this coverage. Written notice will be sent by certified
mail to the Covered Person at his or her last-known address as shown by the membership records
and shall be effective the date notice is mailed.
Additionally, if a misrepresentation is made in connection with enrollment and that fact is discovered
within two years of the enrollment, coverage may be rescinded and the Covered Person would not be
eligible for benefits. The amount of premiums paid for coverage will be reduced by any benefits that
were paid and will be refunded to you. If benefits paid exceed premiums received, BCBSNE may
recover the difference.
F.GRACE PERIOD, CANCELLATION: A 31-day grace period is allowed after the due date for
payment each month. The Contract remains in force if the payment is received during that 31-day
grace period. If payment is not received during the 31-day grace period, the Contract is canceled
as of midnight of the last day for which premiums have been paid. No payment shall be made for
Grand Island Special Meeting - Updated - 8/19/2014 Page 63 / 84
96-060 Rev. 4/2012 - 25 -
Covered Services provided after the effective date of cancellation of this Contract and refunds of
claims paid will be required for the period of time that no premiums were paid to BCBSNE.
G. INDEPENDENT CORPORATION: The Group, on behalf of itself and its participants, hereby
expressly acknowledges its understanding that this Contract constitutes a contract solely between
the Group and BCBSNE, which is an independent corporation operating under a license from the
Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue
Shield Plans, (the "Association") permitting BCBSNE to use the Blue Cross and/or Blue Shield
Service Marks and that BCBSNE is not contracting as the agent of the Association. The Group, on
behalf of itself and its participants, further acknowledges and agrees that it has not entered into this
Contract based upon representations by any person other than BCBSNE and that no person,
entity, or organization other than BCBSNE shall be held accountable or liable to the Group for any
of BCBSNE's obligations created under this Contract. This paragraph shall not create any
additional obligations whatsoever on the part of BCBSNE other than those obligations created
under other provisions of this Contract.
H.LEGAL ACTIONS: Legal action to recover under the Contract cannot be brought for at least 60
days after written proof of loss is given to BCBSNE. Nor can a legal action begin after three years
from the date written proof of loss is required.
I.LIMITATIONS OF DAMAGES: The entire liability of BCBSNE shall not exceed the amount of
benefits provided by this Contract, regardless of the form of the action. In no event shall Blue
Cross and Blue Shield of Nebraska be liable for consequential, incidental, special or indirect
damages regardless of whether it has been advised of the possibility of such damages.
J.MODIFICATIONS: This Contract may be modified:
1. by mutual agreement between the Group and BCBSNE;
2.at renewal at BCBSNE’s discretion; or
3.anytime at BCBSNE’s discretion if the same modification is made for all employer groups with
the same contract form and plan design.
Any modification must be in writing and signed by an officer of Us.
K. NOTICE OF CLAIM: A proof of loss must be filed with BCBSNE within 90 days after the claim
was incurred, or as soon thereafter as reasonably possible. The Group shall submit, on a timely
basis, all proofs, reports or any other supporting documentation requested by BCBSNE.
L. SUBROGATION: The Group agrees to repay BCBSNE for amount recovered through
subrogation or workers’ compensation, even if the recovery is received after the Contract Term.
Subrogation recoveries, as described in the Administrative Services Agreement, will be applied first
to the appropriate Stop Loss Amount and, subsequently, to the Group’s claim liability.
M. ANNUAL MEETING: When this Contract becomes effective, You become a member of Blue
Cross and Blue Shield of Nebraska, which is to be distinguished from a member of an association
as is referred to in this Contract. You have the right to vote at the Annual Meeting of members
held at the Blue Cross and Blue Shield of Nebraska home office in Omaha. The Meeting is held at
4:00 p.m. on the second Monday of February each year. If You do not attend the meeting, You
may appoint another member as your proxy to vote for You. To have another person vote for You,
You must appoint that person in writing and file that appointment with Us at least five days before
the meeting. If You do not attend the meeting, and do not appoint another person as Your proxy,
the Chairperson of the Board of Directors of Blue Cross and Blue Shield of Nebraska, or in the
absence of the Chairperson, a person the Chairperson appoints, will be Your proxy to vote for You
Grand Island Special Meeting - Updated - 8/19/2014 Page 64 / 84
96-060 Rev. 4/2012 - 26 -
on all matters coming before the meeting. This proxy will be valid as long as this Contract remains
in force, unless You revoke it.
PART V. DEFINITIONS
Administrative Services Agreement: The agreement entered into between the Group and
BCBSNE for administration of the Group’s self-insured, or partially self-insured, health care
programs for eligible employees.
Administrative Service Fee: The fee for BCBSNE’s services as stated in the Administrative
Services Agreement which includes fees for all persons who have elected to continue membership
in the Group pursuant to COBRA continuation coverage.
Contract Term: The time period in which this Contract is in effect as indicated in the
Administrative Services Agreement.
Covered Person: Any person entitled to benefits for Covered Services pursuant to the Master
Group Contract administered by BCBSNE.
Covered Services: Hospital, medical or surgical procedures, treatments, drugs, supplies, or other
health or dental care, including any single service or combination of services, for which benefits are
payable while the Administrative Services Agreement and Master Group Contract are in effect.
Group: The employer or association which establishes and maintains a health care program for its
employees or members.
Incur(red): The date on which Covered Services were provided to a Covered Person pursuant to
the Master Group Contract.
Laser(ed): Providing higher or no limit stop loss coverage for certain individuals in order to
maintain a lower Individual Stop Loss level or premium for the Group. If applicable, the Lasered
individuals are listed in Part II.A. above.
Master Group Contract: The document which describes the benefits payable for Covered
Services to a Covered Person.
Net Paid Claims: The amount determined after subtraction of any discount and other adjustments
made to the allowable charge for Covered Services; pursuant to the contractual provision between
BCBSNE and the contracting providers, or in accordance with other Master Group Contract
provisions.
Plan: A self-funded plan of benefits which a plan sponsor provides for eligible employees and their
dependents.
Total Benefits: The total amounts payable under the Master Group Contract for expenses
incurred for Covered Services provided while the Master Group Contract is in effect.
Grand Island Special Meeting - Updated - 8/19/2014 Page 65 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 27 -
ATTACHMENT 4
City of Grand Island
"THE GROUP"
October 1, 2014
Effective Date
FUNDING RATES
The amount of recommended monthly charges to be collected and retained by THE GROUP shall be
determined by THE GROUP. BCBSNE will not be held liable for insufficient funding on the part of THE
GROUP.
Grand Island Special Meeting - Updated - 8/19/2014 Page 66 / 84
LEG170-14 Rev. 9-01-13 (AF-CITYGI14)- 28 -
ATTACHMENT 5
City of Grand Island
"THE GROUP"
October 1, 2014
Effective Date
RESERVE FOR UNREPORTED AND PENDING CLAIMS
AT THE END OF THE TERM OF THIS AGREEMENT
The current estimate by BCBSNE of the potential liability, excluding Administrative Expense, of THE
GROUP in the event of termination of this Agreement during, or at the end of the Term of this Agreement is:
Health Coverage:$556,147
Grand Island Special Meeting - Updated - 8/19/2014 Page 67 / 84
Approved as to Form ¤ ___________
August 18, 2014 ¤ City Attorney
RESOLUTION 2014-231
WHEREAS, the City subscribes to health and dental insurance for its
employees and other eligible participants, as authorized by the City of Grand Island
Personnel Rules and Regulations and federal regulations; and
WHEREAS, a Health Insurance Committee consisting of union, non-
union, management and non-management employees, along with the Human Resources
Director, the Finance Director, and the Attorney/Purchasing Agent met and reviewed
plan changes; and
WHEREAS, Blue Cross and Blue Shield of Nebraska is the Third Party
Administrator for the City’s health insurance plan; and
WHEREAS, the City’s dental insurance benefit is administered by Delta
Dental of Nebraska for a fee of $3.85 per employee per month and this fee will remain
the same for the duration of the three year contract period; and
WHEREAS, the reinsurance coverage and administration of the health
plan is provided under a contract with Blue Cross and Blue Shield of Nebraska. COBRA
administration is provided by Discovery Benefits, Inc. The broker is Strong Financial
Resources, and the current agreement with Healthways is covered under the Bluepartners
Program agreement and;
WHEREAS, contracts were approved in 2012 for a period of three years
with the aforementioned providers; and
WHEREAS, the City will make a contribution on behalf of the employee
participating in the Qualified High Deductible Health Plan with an added Health Savings
Account (HSA) contribution of $1250 for single coverage and $2500 for family coverage
to be reduced by a quarterly sliding scale for newly hired employees; and
WHEREAS, the contract with Blue Cross and Blue Shield of Nebraska
(BCBSNE) specifies administrative fees of $29.50 per employee per month. Stop loss
coverage will cost $130.36 per employee per month and the aggregate stop loss coverage
will cost $5.48 per employee per month. The contract with Strong Financial will cost
$1,654 per month. COBRA administration will be handled by Discovery Benefits, Inc.
(DBI) The cost for COBRA administration will be $0.70 per employee per month for the
term of the contract. The fees associated with the wellness physicals will be
approximately $65 per participant.
Grand Island Special Meeting - Updated - 8/19/2014 Page 68 / 84
NOW, THEREFORE BE IT RESOLVED BY THE MAYOR AND
COUNCIL OF THE CITY OF GRAND ISLAND, NEBRASKA, that the annual renewal
contracts with Blue Cross and Blue Shield of Nebraska, Delta Dental of Nebraska,
Discovery Benefits, Inc., Strong Financial Resources and Bluepartners Program for the
administration of health insurance, COBRA administration, broker services and wellness
program as set out by the contracts as well as the HSA contributions are hereby approved.
- - -
Adopted by the City Council of the City of Grand Island, Nebraska, August 19, 2014.
______________________________________
Jay Vavricek, Mayor
Attest:
_______________________________________
RaNae Edwards, City Clerk
Grand Island Special Meeting - Updated - 8/19/2014 Page 69 / 84
City of Grand Island
Tuesday, August 19, 2014
Special Meeting - Updated
Item I-2
#2014-232 - Consideration of Approving Voluntary Employee
Vision Plan
Staff Contact: Brenda Sutherland
Grand Island Special Meeting - Updated - 8/19/2014 Page 70 / 84
Council Agenda Memo
From:Brenda Sutherland, Human Resources Director
Meeting:August 19, 2014
Subject:Consideration of Approving Voluntary Employee Vision
Plan
Item #’s:I-2
Presenter(s):Brenda Sutherland, Human Resources Director
Background
The City of Grand Island provides its employees with a comprehensive benefit package.
Employees receive contributions to their retirement plans, health and dental insurance, to
name a few. One benefit that hasn’t been part of the City’s offerings is a vision plan. We
receive many inquiries about the availability of this benefit and it has been a topic visited
by the health insurance committee over the years.
Discussion
This past July, The Human Resources Department advertised a request for proposals
(RFP) for a voluntary vision plan. The City’s health insurance committee assigned a sub-
committee to review the RFPs and bring forward a recommendation for a vendor.
The contract that is being brought forward for Council approval requires no funding on
the part of the City. The cost of the premiums will be the sole responsibility of the
employee who chooses to participate in the program. The plan will run through the City’s
payroll system and Section 125 plan. This will allow the employee to receive the
associated tax advantage.
The sub-committee selected Eye Med as the vendor to provide the voluntary vision plan.
This plan will be offered during the City’s open enrollment period. Eye Med is a national
vendor that has a good local network, which includes some local eye care providers as
well as some of the National Chains. Eye Med has provided a 48 month guarantee on
premiums.
Again, no funding is being requested from the City. The cost of the plan will be assumed
by the employees who choose to participate.
Grand Island Special Meeting - Updated - 8/19/2014 Page 71 / 84
Alternatives
It appears that the Council has the following alternatives concerning the issue at hand.
The Council may:
1.Move to approve
2.Refer the issue to a Committee
3.Postpone the issue to future date
4.Take no action on the issue
Recommendation
City Administration recommends that the Council approve the contract with Eye Med to
provide a voluntary vision plan.
Sample Motion
Move to approve the contract with Eye Med.
Grand Island Special Meeting - Updated - 8/19/2014 Page 72 / 84
Purchasing Division of Legal Department
INTEROFFICE MEMORANDUM
Stacy Nonhof, Purchasing Agent
Working Together for a
Better Tomorrow, Today
REQUEST FOR PROPOSAL
FOR
VOLUNTARY EMPLOYEE VISION PLAN
RFP DUE DATE:July 30, 2014 at 4:00 p.m.
DEPARTMENT:Human Resources
PUBLICATION DATE:July 7, 2014
NO. POTENTIAL BIDDERS:
SUMMARY OF PROPOSALS RECEIVED
Humana Strong Financial Resources, Inc.
Overland Park, KS MetLife, Bloomington, MN
VSP, Rancho Cordova, CA
EyeMed Vision Care, Mason, OH
Superior Vision
Rancho Cordova, CA
cc:Brenda Sutherland, Human Resources Director Tami Herald, HR Risk Mngt/Benefits Coor.
Mary Lou Brown, City Administrator Jaye Monter, Finance Director
Stacy Nonhoff, Purchasing Agent
P1744
Grand Island Special Meeting - Updated - 8/19/2014 Page 73 / 84
Grand Island Special Meeting - Updated - 8/19/2014 Page 74 / 84
Approved as to Form ¤ ___________
August 18, 2014 ¤ City Attorney
RESOLUTION 2014-232
WHEREAS, the City provides several benefits to its employees; and
WHEREAS, a Health Insurance Committee consisting of union, non-
union, management and non-management employees, along with the Human Resources
Director, the Finance Director, and the Attorney/Purchasing Agent participate in
reviewing plan changes as well as selecting vendors to provide related benefits; and
WHEREAS, the Human Resources Department advertised a request for
proposals for a voluntary vision plan; and
WHEREAS, the City’s Health Insurance Committee assigned a sub-
committee to review vendor proposals for a voluntary vision plan; and
WHEREAS, Eye Med was selected as the vendor to provide the voluntary
vision plan benefit; and
WHEREAS, Eye Med has guaranteed the rates on the agreement for a four
year period; and
WHEREAS, no funding will be required by the City and the premiums
will be the sole responsibility of the employees; and
WHEREAS, the City will allow the premiums to run through the Section
125 plan.
NOW, THEREFORE BE IT RESOLVED BY THE MAYOR AND
COUNCIL OF THE CITY OF GRAND ISLAND, NEBRASKA, that the contract with
Eye Med to provide a voluntary vision plan for City employees is hereby approved.
- - -
Adopted by the City Council of the City of Grand Island, Nebraska, August 19, 2014.
_______________________________________
Jay Vavricek, Mayor
Attest:
_______________________________________
RaNae Edwards, City Clerk
Grand Island Special Meeting - Updated - 8/19/2014 Page 75 / 84
City of Grand Island
Tuesday, August 19, 2014
Special Meeting - Updated
Item X-1
Food and Beverage Occupation Tax Ballot Language
Staff Contact:
Grand Island Special Meeting - Updated - 8/19/2014 Page 76 / 84
Council Agenda Memo
From:
Meeting:August 19, 2014
Subject:Food and Beverage Occupation Tax Ballot Language
Item #s:X-1
Presenter(s):
Background
Any ballot measure for voter consideration in the 2014 general election would need to be
submitted to the Hall County Election Office no later than September 2, 2014. A
resolution approved by the City council is required prior to the submittal of a ballot
measure.
Discussion
Some citizens and council members have indicated a desire to explore the renewal of the
food and beverage occupation tax when the current tax expires December 31, 2015 as a
result of Ordinance 9315 approved by council on August 11, 2011.
The ability to raise revenue by levying and collecting an occupation tax is governed by
Nebraska State Statutes 16-205 and 18-1208. Nebraska State Statute 18-1208 became
effective July 19, 2012 and requires any new occupation taxes or rate increases of
existing occupation taxes for cities of the first class to be subject to voter approval.
The City Attorney has opined an election is necessary to continue the occupation tax
given the tax expires and any future food and beverage occupation tax is new and falls
under Nebraska State Statute 18-208.
For discussion purposes, it is assumed the rate would remain at 1.5%, today’s current
rate. The budgeted revenue for the 2015 budget is $1,584,317.
The draft language assumes the revenue would commence January 1, 2016, effectively as
soon as the existing food and beverage occupation tax expires. It is difficult to set the
exact allocation of the consumption tax given the tax dollars collected will
increase/decrease on a year-over-year basis. The following is a potential allocation:
Grand Island Special Meeting - Updated - 8/19/2014 Page 77 / 84
Provide a funding source for the Nebraska State Fair host city expense (2015
budget amount is $425,000).
Remainder of the revenue would be dedicated to the city’s capital improvement
projects.
Draft ballot language is as follows:
Shall the City of Grand Island levy an occupation tax on the consumption of food and
beverages at the rate of 1.5% to benefit the community through the provision of a funding
source for the required funding for the Nebraska State Fair host city expense with the
remainder of the revenue being dedicated to the city’s capital improvement projects? The
tax would become effective January 1, 2016.
Grand Island Special Meeting - Updated - 8/19/2014 Page 78 / 84
Grand Island Special Meeting - Updated - 8/19/2014 Page 79 / 84
Grand Island Special Meeting - Updated - 8/19/2014 Page 80 / 84
Grand Island Special Meeting - Updated - 8/19/2014 Page 81 / 84
Grand Island Special Meeting - Updated - 8/19/2014 Page 82 / 84
Grand Island Special Meeting - Updated - 8/19/2014 Page 83 / 84
City of Grand Island
Tuesday, August 19, 2014
Special Meeting - Updated
Item X-2
Strategy Session with Respect to Labor Negotiations with IBEW -
Utilities
The City Council may hold a closed or Executive Session as permitted by Neb. Rev. Stat. Sec. 84-1410.
Closed sessions may be held for, but shall not be limited to such reasons as:
1. Protection of the public interest.
2. Needless injury to the reputation of an individual.
3. Strategy sessions with respect to
a. collective bargaining,
b. real estate purchases,
c. pending litigation, or
d. imminent or threatened litigation.
4. Discussion regarding deployment of security personnel or devices.
5. For the Community Trust created under Sec. 81-1801.02, discussion regarding the amounts to be
paid to individuals who have suffered from a tragedy of violence or natural disaster.
Staff Contact: Robert J. Sivick, City Attorney
Grand Island Special Meeting - Updated - 8/19/2014 Page 84 / 84