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HomeMy WebLinkAboutBPW-09-18-13 PaperlessBoard of Public Works and Safety Meeting AGENDA Wednesday, September 18, 2013 – 10:00 a.m. Council Chambers City Hall One Civic Square MEETING CALLED TO ORDER 1. MINUTES a. Minutes from the September 4, 2013 Regular Meeting 2. BID OPENINGS AND AWARDS a. Bid Opening for the Keystone Parkway Concrete Bridge Maintenance; Dave Huffman, Street Commissioner 3. PERFORMANCE RELEASES a. Resolution BPW09-18-13-02; Westmont Section 1; Interior Walks; Kenneth Windler, Ryland Homes 4. CONTRACTS a. Request for Purchase of Goods and Services; Blair Clark & Company; ($250.00); Hubbard and Cravens Patio Entertainment; Nancy Heck, Director of Community Relations b. Request for Purchase of Goods and Services; Monroe, LLC; ($63,880.00); Illinois Street Tree Clearing; Mike McBride, City Engineer c. Request for Purchase of Goods and Services; Gordon Flesch Company; Additional Service #1; ($15,241.00); Copier; Chief Matt Hoffman, Carmel Fire Department 5. CITY FACILITIES/STREETS/USE a. Request to Use City Streets; Sport Event; Saturday, September 28, 2013; 10:30 a.m. to 5:30 p.m.; NA Publishing – Village of West Clay b. Request to Amend; Lakewood Gardens Neighborhood Cook-out; From Saturday September 7 to Saturday, September 14, Mr. Glen, Lakewood Gardens c. Request to Use City Streets; Oktoberfest 2013; Friday, October 4, 2013; Noon to Midnight; Victory Sun, on behalf of Pedcor and City of Carmel d. Request to Use Gazebo and Common Area; Event; Wednesday, September 18 and 25, 2013; 6:00 p.m. to 9:00 p.m.; Carmel Young Life e. Request to Use Gazebo and Common Area; Fall Revival; October 18 & 19, 2013; 300 p.m. to 11:00 p.m.; Turning Point Ministries f. Request to Use Center Green; Farmers Market; 2014 schedule; Ron Carter g. Request to Use Gazebo and Common Area; Movie Show; Saturday, October 12, 2013; 6:00 p.m. to 11:00 p.m.; Art with a Heart 6. OTHER a. TABLED 2/6/11; Request for Dedication of Streets; Traditions on the Monon; Robert Potokar, HOA Traditions on the Monon b. TABLED 8/7/13; Request for Replat of Lots 280 & 281; Woodland Springs; Troy Terew, True North Surveying c. Resolution BPW-09-18-13-03; A Resolution Setting 2014 City and Participant Contribution Rates for the City of Carmel Employees; Barb Lamb, Director of Human Resources d. Request for Thirteenth Amendment to the City of Carmel Employee Health Benefit Plan; Barb Lamb, Director of Human Resources e. Request for Water Line Easement; West 96th Street Real Estate, LLC; John Duffy, Director of the Department of Utilities f. Request for Final Plat Approval; HighPointe on Meridian; Colin Patterson, Weihe Engineers g. Request for Dedication of Public Right of Way; Penn Circle; Gary Duncan, Assistant City Engineer h. Request for Drainage Easement; Penn Circle (1); Gary Duncan, Assistant City Engineer i. Request for Drainage Easement; Penn Circle (2); Gary Duncan, Assistant City Engineer j. Request for Perpetual Storm Water Quality Management Easement; Penn Circle, LLC; Gary Duncan, Assistant City Engineer k. Request for Multi-Use Path and Recreational Trail Easement; Penn Circle; Gary Duncan, Assistant City Engineer l. Resolution BPW-09-18-13-01; A Resolution of the Board of Public Works and Safety of the City of Carmel, Indiana Regarding the Release of an Easement; Penn Circle, LLC; Gary Duncan, Assistant City Engineer m. Request for Release of Easement; Penn Circle, LLC; Joyce/Gregory/Travis, Spannan; Gary Duncan, Assistant City Engineer n. Request for Stormwater Technical Standards Waiver; The Meadows at Legacy Section 2; Brett Huff, Stoeppelwerth & Associates o. Request for Stormwater Technical Standards Waiver; HighPointe on Meridian; Colin Patterson, Weihe Engineers p. Request for Lane Restriction; 116th and Pennsylvania; Kevin Maxwell, CSU q. Request for Curb Cut; Harvest Bible Chapel; River Road; Gregory Ilko; CrossRoad Engineers r. Request for Lane Restrictions/Open Pavement Cut; US 31 Reconstruction; Brian Harger, Vectren Energy s. Request for Lane Restrictions/Open Pavement Cut; 5-Locations; 96th Street & Westfield Blvd; Clay Township Regional Waste District; Craig Closser, Culy Contracting t. Request for Lane Restriction; 1020 West 116th; Steven Krebs, AT&T u. Request for Curb Cut and Driveway Variance; Westmont Subdivision, Section One; Anthony Matthews, M&C Concrete v. Request for Parking Spot/Sidewalk Closure; 89 1st Avenue S.W.; Basil Pappas, Pappas Building & Design w. Request for Lane Closure/Open Pavement Cut; Pennsylvania Street and 103rd Street; Leroy Boling, HTI Horizontal Boring x. Hearing on Order to Vacate; 231 126th Street, Carmel, Indiana; Ashley Ulbricht, Assistant City Attorney 7. ADJOURNMENT BOARD OF PUBLIC WORKS & SAFETY MEETING MINUTES WEDNESDAY, SEPTEMBER 4, 2013 –10:00 A.M. COUNCIL CHAMBERS / CITY HALL / ONE CIVIC SQUARE MEETING CALLED TO ORDER Mayor Brainard called the meeting to order at 10:08 a.m. MEMBERS PRESENT Mayor James Brainard, Board Member; Mary Ann Burke and Lori Watson, Deputy Clerk; Sandy Johnson MINUTES Minutes for the August 21, 2013 Regular Meeting were approved 3-0. PERFORMANCE RELEASES Resolution BPW 09-04-13-01; Stafford Place; Section2; Street and Monuments & Markers; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Resolution BPW 09-04-13-02; One One Six at College Apartments; Erosion Control; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Resolution BPW 09-04-13-03; Hazel Dell Christian Church; Erosion Control and Water Quality; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Resolution BPW 09-04-13-05; Heather Knoll; Sections 1 & 2; Builder Sidewalks; Sidewalks by Builders; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Resolution BPW 09-04-13-06; Legacy Residential 1, Meadows at Legacy 1, Overlook at Legacy 1, Legacy Master Infrastructure 2; Builder Sidewalks, Storm Sewers, Streets, Construction/BMP’s, Common area sidewalk, Asphalt Path; Monument & Markers; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. CONTRACTS Request for Purchase of Goods and Services; Mutual Aid Box Alarm System; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Resolution No. BPW-09-04-13-04; Acknowledging Receipt of Contract with Booth Tarkington Civic Theatre; ($200,000.00); Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Purchase of Goods and Services; Hamilton County Solid Waste Board; ($37,352.00); Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Purchase of Goods and Services; C.E. Solutions; (($5,900.00); Structural Investigation; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Purchase of Goods and Services; TelVue Corporation; ($1,447.50); One Year Maintenance; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Purchase of Goods and Services; Additional Services #1; Wilkinson Brothers; ($13,225.00); Maintenance of Art and Design District Website; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. CITY FACILITIES/STREETS/USE Request to Use City Streets; Neighborhood Gathering; Sunday, September 29, 2013; Noon to 9:00 p.m.; Village of West Clay; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request to Use Caucus Room; Meeting; Thursday, October 24, 2013; 5:30 p.m. to 7:00 p.m.; Creekside Homeowners Association; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request to Use Council Chambers; Meeting; October 1, 2013; 5:30 p.m. to 8:00 p.m.; Carmel Station Homeowners Association; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. OTHER REMAINS TABLED: Request for Dedication of Streets; Traditions on the Monon TABLED; Request for Replat of Lots 280 & 281; Woodland Springs; Troy Terew, True North Surveying; Petitioner request to table. TABLED: Request for Variance Approval; Butler Hyundai; 96th and Randall Bypass; Board Member Burke moved to. Board Member Watson seconded. There was brief discussion. Mayor Brainard moved to table. Board Member Burke seconded. Request tabled 3-0. Board Member Burke moved to remove from table. Board Member Watson seconded. Item removed from table. There was brief discussion. Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Hearing on Property Maintenance Violation; 231 126th Street, Carmel, Indiana; Ashley Ulbricht, Assistant City Attorney presented information on the property with testimony from Janelle Fairman, Core Planning Strategies and Brent Liggett, Code Enforcement/Building Inspection City of Carmel; requested Board to uphold the Order to Vacate Property. There was extensive discussion and evidence presented. Board Member Burke moved to approve the order to vacate. Board Member Watson seconded. Request approved 3-0. Request for Street Dedication; 96th Street; Tom Wood Subaru; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Final Plat Approval; Village of West Clay Section 10010-D; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Open Pavement Cut/Lane Closure/Sidewalk Closure; 625 Carmel Drive; Popeye’s Chicken; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Temporary Construction Entrance; Tottenham Road; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Lane Restrictions; 365/367 W. 116th Street; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Temporary Construction Entrances; River Road; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Two Curb Cuts; St. Mary and St. Mark Coptic Church; Construction Entrance & Multi Use Path Closure; 121st and Shelborne; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Recreational Path Closure; Barrington Assisted Living Project; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Variance; 12902 Tuscany Blvd; Deck in Easement; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Variance; 14344 Saint Clair Lane; Request for Fence within Easement; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Variance; 1312 Hazel Dell Parkway; Landscaping in Right of Way; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Request for Stormwater Technical Standards Waiver; The Congressional; Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. ADD ON Mike McBride, City Engineer request the Board add a Utility Reimbursement Agreement from Clay Regional Waste for the Illinois Street Project; Board Member Burke moved to add item to agenda. Board Member Watson seconded. Item added 3-0. Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. Mike Hollibaugh, Director of the Department of Community Services request the Board add Bid Rejection for the Brookshire Cell Tower Project to the agenda; Board Member Burke moved to add item to agenda. Board Member Watson seconded. Item added 3-0. There was brief discussion. Board Member Burke moved to approve. Board Member Watson seconded. Request approved 3-0. ADJOURNMENT Mayor Brainard adjourned the meeting at 10:45 a.m. _____________________________________ Diana L. Cordray, IAMC Clerk-Treasurer Approved ____________________________________ Mayor James Brainard ATTEST: __________________________________ Diana L. Cordray, IAMC - Clerk-Treasurer NOTICE TO BIDDERS City of Carmel, Indiana Notice is hereby given that the Board of Public Works and Safety for the City of Carmel, Hamilton County, Indiana, will receive sealed bids for the Keystone Bridges Concrete Maintenance Program. Bids will be accepted in the office of the Clerk Treasurer, third floor City Hall during regular business hours, up to, but not later than 10:00 A.M. Local Time, Wednesday, September 18h, 2013. The bids will be opened at the Board of Public Works meeting on the same date at 10:00 a.m. All bids and proposals shall be properly and completely executed on the proposal forms provided with the plans and specifications, and shall include the non-collusion affidavit required by the State of Indiana. The bid envelope must be sealed and have the following words only written in ink on the outside of the envelope: Bid: KEYSTONE BRIDGES CONCRETE MAINTENANCE PROGRAM Project manuals may be obtained from the Carmel Street Department, 3400 W. 131st Street, Carmel, IN 46074. General Form No. 96 must be completed and filed as a part of the bid package. All bids are to be sealed with the word “BID – KEYSTONE BRIDGES CONCRETE MAINTENANCE PROGRAM” on the lower left hand corner of the envelope. Bids will be opened and read aloud at 10:00 a.m. on September 18th, 2013 at the Board of Public Works and Safety meeting on the 2nd floor of Carmel City Hall, One Civic Square, Carmel, IN. All persons interested in bidding shall register a contact name and address with the Street Department to ensure that all changes or questions and answers are available for review by all interested parties. No bidder may withdraw any bid or proposal within a period of thirty (30) days following the date set for receiving bids or proposals. The Carmel Board of Public Works and Safety reserves the right to hold any or all bids and proposals for a period of not more than thirty (30) days, such bids and proposals to remain in full force and effect during said time period. The City of Carmel reserves the right to reject and/or cancel any and all bids, solicitations and/or offers in whole or in part as specified in the solicitation for bids when, in the City's sole discretion, it believes that it is in the best interests of the City to do so, as determined by the purchasing agency in accordance with IC 5-22-18-2. __________________________ Diana L. Cordray Clerk-Treasurer Please publish August 29th, 2013 and September 5th, 2013 RESOLUTION BPW-09-18-13-03 A RESOLUTION SETTING 2014 CITY AND PARTICIPANT CONTRIBUTION RATES FOR THE CITY OF CARMEL EMPLOYEE HEALTH BENEFIT PLAN WHEREAS, the City of Carmel operates the City of Carmel Employee Health Benefit Plan (the “Plan”) to provide medical and dental benefits for its employees and retirees; and WHEREAS, the Board of Public Works and Safety, as Plan Administrator, is responsible for ensuring adequate current and reserve funding for the Plan; and WHEREAS, the primary source of revenue for the Plan consists of bi-weekly employer and participant contributions; and WHEREAS, it is imperative for Plan revenues to correspond with anticipated expenses; and WHEREAS, the City wishes to reward participation in sponsored activities that promote individual and group wellness, encourage employees to consider a consumer-driven health plan option and incent employee spouses to elect coverage through their own employers. NOW, THEREFORE, BE IT RESOLVED by the Carmel Board of Public Works and Safety as follows: Effective January 1, 2014, health insurance contribution rates for the City and for its Active Employees will be as stated on Attachment A, for Common Council Members as stated on Attachment B, for Retirees as stated on Attachment C and for COBRA participants as stated on Attachment D, all incorporated herein by this reference. BE IT FURTHER RESOLVED that the rates stated on Attachment A and Attachment B shall be adjusted for participants of the City’s wellness program, as outlined below: 1. The City has established a wellness program to complement its insurance plan. The program is open to all full-time Active Employees and Common Council Members. 2. Participation in the wellness program is voluntary; there is no penalty for opting out. 3. Effective January 1, 2014, any Active Employee or Common Council Member who participates in the 2014 wellness program shall be eligible for a $20 reduction to the standard 2014 bi-weekly rates, as listed on Attachment A or Attachment B, as applicable, as long as the participant continues to meet quarterly goals. 4. Active Employees and Common Council Members who do not participate in the wellness program, or who do not continue to meet quarterly goals, will not be eligible for a rate reduction. They will pay the standard rates listed on Attachment A or Attachment B, as applicable. BE IT FURTHER RESOLVED that participants who meet the stated requirements will be eligible for the incentives described below: 1. The City will make a bi-weekly contribution into the Health Savings Account (HSA) of an Active Employee or Common Council Member who elects to enroll in Plan A, in the following amounts: a. $23.08 for employee only coverage b. $30.77 for employee/spouse or employee child(ren) coverage c. $38.47 for family coverage A Retiree who elects to enroll in Plan A shall receive an equivalent amount by check, half in February and half in July. The HSA contribution amount will change if and when the participant’s level of coverage changes, and contributions will cease if coverage is cancelled or, in the case of an Active Employee or a Common Council Member, if the employment relationship is terminated. 2. The City will make a contribution into the Health Savings Account (HSA) or give a premium credit, as described below, for each Active Employee or Common Council Member whose: (a) spouse is enrolled in a City plan in 2013; (b) spouse is eligible for employer coverage through his or her own job or through a health insurance exchange; and (c) spouse elects his or her employer coverage or coverage through a health insurance exchange rather than City of Carmel coverage in 2014. The employee must provide documentation of the other coverage and verify that he or she is not legally separated and has not filed for divorce from the spouse to be eligible for this incentive. a. For a participant enrolled in Plan A, a bi-weekly contribution into the Health Savings Account (HSA) in the amount of $70.75 if the spouse opts out of both the City’s medical and dental plan, or $65.00 if the spouse opts out of the City’s medical plan but enrolls in the City’s dental plan. There will be no contribution if the spouse opts out of the City’s dental plan only. b. For a participant enrolled in Plan B, a bi-weekly premium credit in the amount of $65.00 for medical insurance plus $5.75 for dental insurance if the spouse opts out of both. If the spouse opts out of the City’s medical plan, but enrolls in the City’s dental plan, the credit will be $65.00. There will be no premium credit if the spouse opts out of the City’s dental plan only. The HSA contribution or premium credit will cease if the spouse re-enrolls in the City plan, if the Active Employee or Common Council Member cancels his or her coverage or if the employment relationship is terminated. CITY OF CARMEL, INDIANA By and through its Board of Public Works and Safety _________________________________ ________________________ James Brainard, Presiding Officer Date _________________________________ ________________________ Mary Ann Burke, Board Member Date _________________________________ ________________________ Lori Watson, Board Member Date ATTEST: _________________________________ ________________________ Diana Cordray, IAMC, Clerk-Treasurer Date Attachment A ACTIVE EMPLOYEES 2014 BI-WEEKLY HEALTH INSURANCE RATES SURCHARGES AND DISCOUNTS MAY BE APPLIED TO THE RATES BELOW Plan A (HDHP) Total Premium City Portion City % Employee Portion Employee % Employee Only $278.00 $236.00 85% $42.00 15% Employee/Spouse $642.00 $546.00 85% $96.00 15% Employee/Child(ren) $590.00 $502.00 85% $88.00 15% Employee/Family $964.00 $819.00 85% $145.00 15% Plan B (PPO) Total Premium City Portion City % Employee Portion Employee % Employee Only $327.00 $262.00 80% $65.00 20% Employee/Spouse $755.00 $607.00 80% $148.00 20% Employee/Child(ren) $694.00 $558.00 80% $136.00 20% Employee/Family $1,134.00 $912.00 80% $222.00 20% Dental Total Premium City Portion City % Employee Portion Employee % Employee Only $23.00 $17.25 75% $5.75 25% Employee/Spouse $43.00 $32.25 75% $10.75 25% Employee/Child(ren) $40.00 $30.00 75% $10.00 25% Employee/Family $60.00 $45.00 75% $15.00 25% Attachment B COMMON COUNCIL MEMBERS 2014 BI-WEEKLY HEALTH INSURANCE RATES SURCHARGES AND DISCOUNTS MAY BE APPLIED TO THE RATES BELOW Plan A (HDHP) Total Premium City Portion City % Employee Portion Employee % Employee Only $278.00 $208.50 75% $69.50 25% Employee/Spouse $642.00 $481.50 75% $160.50 25% Employee/Child(ren) $590.00 $442.50 75% $147.50 25% Employee/Family $964.00 $723.00 75% $241.00 25% Plan B (PPO) Total Premium City Portion City % Employee Portion Employee % Employee Only $327.00 $245.25 75% $81.75 25% Employee/Spouse $755.00 $566.25 75% $188.75 25% Employee/Child(ren) $694.00 $520.50 75% $173.50 25% Employee/Family $1,134.00 $850.50 75% $283.50 25% Dental Total Premium City Portion City % Employee Portion Employee % Employee Only $23.00 $17.25 75% $5.75 25% Employee/Spouse $43.00 $32.25 75% $10.75 25% Employee/Child(ren) $40.00 $30.00 75% $10.00 25% Employee/Family $60.00 $45.00 75% $15.00 25% Attachment C RETIREES 2014 MONTHLY HEALTH INSURANCE RATES SURCHARGES AND DISCOUNTS MAY BE APPLIED TO THE RATES BELOW Plan A (HDHP) Total Premium City Portion City % Employee Portion Employee % Retiree Only $603.00 $0.00 0% $603.00 100% Retiree/Spouse $1,391.00 $0.00 0% $1,391.00 100% Retiree/Child(ren) $1,279.00 $0.00 0% $1,279.00 100% Retiree/Family $2,089.00 $0.00 0% $2,089.00 100% Plan B (PPO) Total Premium City Portion City % Employee Portion Employee % Retiree Only $709.00 $0.00 0% $709.00 100% Retiree/Spouse $1,636.00 $0.00 0% $1,636.00 100% Retiree/Child(ren) $1,504.00 $0.00 0% $1,504.00 100% Retiree/Family $2,457.00 $0.00 0% $2,457.00 100% Dental Total Premium City Portion City % Employee Portion Employee % Retiree Only $50.00 $0.00 0% $50.00 100% Retiree/Spouse $94.00 $0.00 0% $94.00 100% Retiree/Child(ren) $87.00 $0.00 0% $87.00 100% Retiree/Family $130.00 $0.00 0% $130.00 100% Attachment D COBRA 2014 MONTHLY HEALTH INSURANCE RATES SURCHARGES AND DISCOUNTS MAY BE APPLIED TO THE RATES BELOW Plan A (HDHP) Total Premium City Portion City % Employee Portion Employee % Retiree Only $616.00 $0.00 0% $616.00 100% Retiree/Spouse $1,419.00 $0.00 0% $1,419.00 100% Retiree/Child(ren) $1,305.00 $0.00 0% $1,305.00 100% Retiree/Family $2,131.00 $0.00 0% $2,131.00 100% Plan B (PPO) Total Premium City Portion City % Employee Portion Employee % Retiree Only $724.00 $0.00 0% $724.00 100% Retiree/Spouse $1,669.00 $0.00 0% $1,669.00 100% Retiree/Child(ren) $1,535.00 $0.00 0% $1,535.00 100% Retiree/Family $2,507.00 $0.00 0% $2,507.00 100% Dental Total Premium City Portion City % Employee Portion Employee % Retiree Only $51.00 $0.00 0% $51.00 100% Retiree/Spouse $96.00 $0.00 0% $96.00 100% Retiree/Child(ren) $89.00 $0.00 0% $89.00 100% Retiree/Family $133.00 $0.00 0% $133.00 100% 1 Human Resources Memo To: Board of Public Works and Safety From: Barbara Lamb, Director of Human Resources Date: September 11, 2013 Re: Health Plan Amendment The September 18, 2013, Board of Public Works agenda includes the 2014 health insurance rate resolution and a health plan amendment. Please call me at 571-2471 if you have any questions about these two documents. There will be no increase in employer or employee health insurance rates for 2014. Rates will be the same as in 2013. In addition to listing standard rates, the resolution includes incentives for employees actively participating in the wellness program, electing the high deductible health plan and moving their spouses off the City plan. Effective October 1, 2013, the plan will be using the Cigna preferred provider network. All other changes in the amendment are effective January 1, 2014. Those changes are summarized below; some are based on requirements of the Affordable Care Act and others are designed to enhance the fiscal stability of the plan and promote individual responsibility for personal health care costs. Compliance issues include:  Deleting all reference to pre-existing conditions. There will no longer be any restriction on benefits for pre-existing conditions.  Including copays in the Plan B annual out-of-pocket maximum.  Adding a provision for coverage of certain clinical trials.  Adding emergency contraceptives as an eligible benefit. Plan design issues include:  Deleting coverage for surgical weight loss treatment, bereavement counseling; laser eye surgery and treatment of temporomandibular joint disorder (TMJ).  Changing annual Plan B deductibles to:  $750 individual in-network  $1,500 family in-network  Page 2  $1,500 individual out-of-network  $3,000 family out-of-network  Deleting the carryover deductible.  Changing annual Plan B out-of-pocket maximums to:  $1,500 individual in-network  $3,000 family in-network to  $3,000 individual out-of-network  $6,000 family out-of-network  Changing Plan B copays to:  Physician Charges for Office Visit $50  Outpatient Psychiatric/Substance Abuse Care $50  Chiropractic Care $50  Retail Health Clinic Visit $25  Allergy Shots $20 per injection  Ambulance Charges $100 per trip  Emergency Room Facility  Rx Pharmacy (30-day brand formulary)  Rx Pharmacy (30-day brand non-formulary)  Rx Mail Order (90-day brand formulary)  Rx Pharmacy (90-day brand non-formulary) $250 in-network and out-of-network $60 $100 $120 $200  Eliminating the emergency room physician copay; services will fall under deductible.  Raising the precertification penalty to $500.  Requiring the use of generic drugs unless no generic is available or a participant’s providers requires a brand drug.  Clarifying eligibility requirements for retirees and dependents to specify that Medicare is only disqualifying if the individual is eligible for Medicare by reason of age. Health Plan Amendment 1 THIRTEENTH AMENDMENT TO THE CITY OF CARMEL EMPLOYEE HEALTH BENEFIT PLAN WHEREAS, the City of Carmel (“Plan Sponsor”), by action of its governing body, adopted the City of Carmel Employee Health Benefit Plan (the “Plan”) effective February 1, 1992, and subsequently modified the Plan by a full restatement effective January 1, 2004, and twelve amendments to the restated Plan; and WHEREAS, Plan Sponsor wishes to amend the restated Plan; and WHEREAS, authority to amend the Plan is granted therein. NOW, THEREFORE, effective October 1, 2013, the Plan is amended as follows. 1. The definition of Preferred provider Organization (PPO) is amended to read as follows: The contracting organization responsible for negotiating reduced rates for services rendered by providers in the organization. Benefits for PPO services are paid as stated in the Schedule of Medical Benefits. Effective January 1, 2014, the Plan is amended as follows. 1. The following will no longer be covered expenses under the Plan; reference to these benefits is deleted from the SCHEDULE OF MEDICAL BENEFITS (Plan A and Plan B) and from the DESCRIPTION OF MEDICAL BENEFITS.  Surgical Weight Loss Treatment  Bereavement Counseling  Laser Eye Surgery  Prescription Drugs under the medical plan; prescription drugs will be eligible expenses only through the prescription drug plan  Treatment of Temporomandibular Joint Disorder (TMJ) 2. Under SCHEDULE OF MEDICAL BENEFITS (Plan B) the Calendar Year Deductibles are amended to: Preferred Non-Preferred Individual Deductible $750 $1,500 Family Deductible $1,500 $3,000 3. Under SCHEDULE OF MEDICAL BENEFITS (Plan B) the Deductible Carryover is deleted. 4. Under SCHEDULE OF MEDICAL BENEFITS (Plan B) Out-Of-Pocket Maximums are amended to: Preferred Non-Preferred Individual $1,500 $3,000 Family $3,000 $6,000 The out-of-pocket maximum includes deductibles, copays and coinsurance. The following items do not apply toward the calendar year out-of-pocket expense maximum:  charges in excess of reasonable and customary, except as otherwise stated herein;  penalties incurred for failing to obtain precertification/utilization review; Health Plan Amendment 2  expenses for services and supplies not eligible under this Plan; and  charges that exceed Plan limits in dollar amounts or visits, as stated herein. When the participant utilizes BOTH preferred and non-preferred providers during the calendar year, the maximum out-of-pocket expense will not exceed the non-preferred provider maximum. 5. Under SCHEDULE OF MEDICAL BENEFITS (Plan B) copays are amended as follows: Physician Charges for Office Visit $50 Outpatient Psychiatric and Substance Abuse Care $50 Chiropractic Care $50 Retail Health Clinic Visit $25 Allergy Shots $20 per injection Ambulance Charges $100 per trip Emergency Room Facility $250 in-network and out-of-network 6. Under SCHEDULE OF MEDICAL BENEFITS (Plan B) the Emergency Room Physician benefit is amended as follows: EMERGENCY ROOM PHYSICIAN Copay Applies: Deductible Applies: 80% No Yes 80% No Yes 7. Under SCHEDULE OF MEDICAL BENEFITS (Plan A and Plan B) Penalty for Failure to Precertify is amended to read as follows: Failure to precertify a planned surgery or hospital admission (or to retroactively certify an emergency surgery or admission), as detailed under Cost Containment Procedures, will cause eligible expenses to be reduced by a penalty of $500 per occurrence. The penalty will not count towards the satisfaction of the participant’s out-of-pocket maximum. 8. Under COST CONTAINMENT PROCEDURES the introductory paragraph, Precertification Requirements and Notification Procedure for Precertification are amended to read as follows: PRECERTIFICATION Plan cost containment procedures include a precertification requirement when any participant is anticipating or planning an inpatient hospital admission or an inpatient or outpatient surgery. Time requirements for precertification are: 1. If the hospital admission or surgery is scheduled in advance, the provider must initiate precertification at least five (5) business days prior to the date of the admission or surgery. 2. In the case of an emergency hospital admission or surgery, the provider must initiate retroactive certification no later than two (2) business days after the surgery or admission date. The provider—not the participant—must call for precertification, using the number listed on the participant’s insurance card. It is the participant’s responsibility to ensure that the provider follows required precertification procedures. The amount of the penalty, which is shown in the Schedule of Medical Benefits, will apply to each non- compliance occurrence. The precertification requirement shall be waived for all hospital admissions and surgeries outside of the United States. Health Plan Amendment 3 This Plan conforms to the procedures, protocols and methodologies of the contracted pre-certification vendor. PRECERTIFICATION DOES NOT GUARANTEE PAYMENT OR ELIGIBILITY 9. Under PREFERRED AND NON-PREFERRED PROVIDERS, Exceptions to Non-Preferred Level of Benefits is amended to read as follows: EXCEPTIONS TO NON-PREFERRED LEVEL OF BENEFITS Under the following circumstances only, services and supplies rendered by a non-preferred provider shall be payable at the preferred provider level of benefits: 1. If a participant requires emergency transport by ambulance and/or emergency medical treatment. Charges for the ambulance, emergency room or immediate care facility, physicians and related services, including radiology, anesthesiology and pathology, will be covered as preferred provider charges. If the participant is admitted to a hospital after emergency treatment, eligible hospital charges will be covered as preferred provider charges. 2. If a participant uses a preferred facility or practice, but the provider who performs the services and bills for the services is not a member of the preferred provider organization. Or, if a participant uses a physician in the preferred provider organization, but the facility or practice that bills for the service is not a member of the preferred provider organization. 3. If a participant uses a preferred provider to perform radiology and pathology (laboratory) tests, but the tests are interpreted by a service provider outside the preferred provider organization. 4. If a participant uses an operating surgeon and surgical facility (if applicable) that are preferred providers, but the assistant surgeon and/or anesthesiologist is a not a member of the preferred provider organization. 10. In compliance with the Affordable Care Act, all language pertain to preexisting health conditions is deleted, including SCHEDULE OF MEDICAL BENEFITS (Plan A and Plan B, Pre-existing Condition Limitation), PREEXISTING CONDITION LIMITATION, DESCRIPTION OF MEDICAL BENEFITS (introductory paragraph), DESCRIPTION OF PRESCRIPTION DRUG BENEFITS (first line), ELIGIBILITY PROVISIONS (Open Enrollment, Termination of Employee Coverage, Termination of Dependent Coverage), CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA) CONTINUATION OF COVERAGE (Election of Coverage, End of Continuation Coverage, Termination of Coverage), COORDINATION OF BENEFITS (Order of Benefit Determination), CLAIMS INFORMATION (Pending a Claim) and DEFINITIONS (Late Enrollee, Preexisting Condition) 11. In compliance with the Affordable Care Act, the following section is added to DESCRIPTION OF MEDICAL BENEFITS: CLINICAL TRIALS Charges made for routine patient services associated with clinical trials approved and sponsored by the federal government for life-threatening conditions or diseases, as mandated by the Affordable Care Act (ACA). The following criteria must be met, which list is intended to comply with the requirements of the ACA and may be updated in accordance with amendments to the Act or its regulatory provisions: 1. the clinical trial is listed on the National Institutes of Health website www.clinicaltrials.gov as being sponsored by the federal government; Health Plan Amendment 4 2. the trial investigates a treatment for a life-threatening condition or disease and: (1) the person has failed standard therapies for the disease; (2) cannot tolerate standard therapies for the disease; or (3) no effective non-experimental treatment for the disease exists; 3. the person meets all inclusion criteria for the clinical trial and is not treated “off-protocol”; 4. the trial is approved by the institutional review board of the institution administering the treatment; and 5. coverage will not be extended to clinical trials conducted at non-participating facilities if a person is eligible to participate in a covered clinical trial from a participating provider. 12. In compliance with the Affordable Care Act, under DESCRIPTION OF MEDICAL BENEFITS the last sentence of the Contraceptives section is deleted. Emergency contraceptives will be an eligible expense. 13. Under DESCRIPTION OF MEDICAL BENEFITS, Weight Loss Treatment is amended to read as follows: Charges for non-surgical weight loss treatment, but only for participants with a body mass index (BMI) of thirty (30) kilograms per meter squared or higher. Eligible weight loss expenses shall include only those expenses that are medically necessary, including office visits, laboratory tests and prescription drugs. (Prescription drugs for weight loss will be covered under the prescription drug benefit.) Bariatric surgery will NOT be considered an eligible expense. Other ineligible expenses include, but are not limited to, food, food replacements, dietary supplements, weight loss group membership fees, exercise or fitness classes, gym membership fees and other costs related to diet and exercise. 14. Under SCHEDULE OF PRESCRIPTION DRUG BENEFITS (Plan A) the first paragraph is amended to read as follows: Participant pays 100% of all prescription charges until deductible is met; Plan pays 100% of all eligible prescription expenses thereafter. Plan will pay only for generic drugs (after participant meets deductible) unless there is no generic equivalent or a brand drug is required by participant’s provider. If a generic is available, a Participant who elects to use a brand drug as a matter of preference will be responsible for the difference in cost between the brand and the generic prescription. 15. Under SCHEDULE OF PRESCRIPTION DRUG BENEFITS (Plan B) the following paragraph is added: Plan will pay only for generic drugs under the copay arrangement detailed below, unless there is no generic equivalent or a brand drug is required by participant’s provider. If a generic is available, a Participant who elects to use a brand drug as a matter of preference will be responsible for the brand copayment plus the difference in cost between the brand and the generic prescription. 16. Under SCHEDULE OF PRESCRIPTION DRUG BENEFITS (Plan B) the copays are amended as follows: Pharmacy Copay: (each prescription fill, see dispensing limitations) Generic Formulary Drugs $10 per 30-day supply (or portion thereof) Brand Name Formulary Drugs $60 per 30-day supply (or portion thereof) Health Plan Amendment 5 Non-Formulary Drugs $100 per 30-day supply (or portion thereof) Covered Percentage after Copay 100% Dispensing Provision: Up to a maximum of a 90-day supply Prescription Drug Card copays are not eligible expenses under the medical Plan. NOTE: There is no charge to participants for any prescribed generic FDA-approved oral contraceptive. Mail Order Copay: (each prescription fill, see dispensing limitations) Generic Formulary Drugs $20 per 90-day supply (or portion thereof) Brand Name Formulary Drugs $120 per 90-day supply (or portion thereof) Non-Formulary Drugs $200 per 90-day supply (or portion thereof) Covered Percentage after Copay 100% Dispensing Provision: Up to a maximum of a 90-day supply Mail Order Program copays are not eligible expenses under the medical Plan. 17. Under PRESCRIPTION DRUG EXCLUSIONS, #5 is amended to read as follows: 5. Charges for experimental or investigational drugs, including compound medications for non-FDA approved use, unless such drugs are covered under the Clinical Trial provisions of the Description of Medical Benefits. 18. Under DENTAL EXCLUSIONS, #7 is amended to read as follows: 7. Charges for the diagnosis and treatment of temporomandibular joint disorder. 19. Under ELIGIBILITY PROVISIONS (Termination of Employee Coverage), #5 is amended to read as follows: 5. the date the employee becomes eligible for Medicare due to having attained the age of 65, if covered as a retiree or an early retiree, or as the spouse of an employee who dies in the line of duty; or 20. Under ELIGIBILITY PROVISIONS (Termination of Employee Coverage), the final paragraph is amended to read as follows: Proof of loss of coverage shall be provided as necessary. 21. Under ELIGIBILITY PROVISIONS (Termination of Dependent Coverage), #8 is amended to read as follows: 8. the date the dependent becomes eligible for Medicare due to having attained the age of 65, if the employee is covered as a retiree or an early retiree; Health Plan Amendment 6 22. Under ELIGIBILITY PROVISIONS (Termination of Dependent Coverage), the second to last paragraph is amended to read as follows: Proof of loss of coverage shall be provided as necessary 23. ELIGIBILITY PROVISIONS (Dependent Spouse of a Retiree) is amended to read as follows: The spouse of an employee who qualifies as a retiree or an early retiree (hereinafter jointly referred to as “retiree”) may continue to be enrolled in the Plan after the retiree becomes eligible for Medicare due to having attained the age of 65 or dies. Coverage may be continued until the date the spouse becomes eligible for Medicare due to having attained the age of 65, provided that the spouse makes timely payment of the required contributions. Other dependents already in the Plan at the time of the retiree’s Medicare eligibility or death may remain in the Plan, but no new dependents may be added. 24. Under GENERAL PLAN EXCLUSIONS, #13 is amended to read as follows: 13. Charges for services and supplies that are either experimental or investigational, unless such services and supplies are covered under the Clinical Trials provision of the Description of Medical Benefits. 25. Under CLAIMS INFORMATION (Pending a Claim) #3 is amended to read as follows: 3. when the claim is being subrogated. 26. The following DEFINITIONS are deleted in their entirety: Late Enrollee, Preexisting Condition and Temporomandibular Joint Disorder. In all other respects the Plan remains unchanged. CITY OF CARMEL, INDIANA By and through its Board of Public Works and Safety _________________________________ ________________________ James Brainard, Presiding Officer Date _________________________________ ________________________ Mary Ann Burke, Board Member Date _________________________________ ________________________ Lori Watson, Board Member Date ATTEST: _________________________________ ________________________ Diana Cordray, IAMC, Clerk-Treasurer Date