Okaloosa County BOCC — August 5, 2014 — RFP #44-14 - LTD Insurance - Standard Insurance Proposal - Exhibit A — reading text

Commissioners. The following are our toll free numbers for each department: Disability: 800.368.1135 Life: 800.628.8600 Dental Customer Service and Policy Administration: 877.490.9991 Give the name, location and affiliation to your company of the agent or broker of record. Disclose commissions and all other remuneration that will be paid to the broker. Kevin Locht, Corporate Benefits of the Emerald Coast Fort Walton Beach, Florida Licensed agent Normal graded commissions scale. List 5 references of similarly sized current clients. Also, please list 3 references that terminated coverage. Please see the List of References form provided by Okaloosa County Board of County Commissioners for references of our current clients. For our terminated coverage references, please see the document titled Terminated Coverage References. Both of these are located in Section 3. . What is your current A. M. Best Rating or equivalent? The Standard’s current A.M. Best rating is A, “Excellent”. List your contact information should there be any questions regarding your proposal. Jarod Hayer, Senior Employee Benefits Consultant, will be available for any questions Okaloosa County Board of County Commissioners may have in regards to this proposal. 4350 West Cypress Suite 920 Tampa, FL 33607 813.878.0273 1. What is your rate for employee coverage? What is the rate for family coverage? Employee coverage: $24.25 per month Family coverage: $70.33 per month 2. Provide a detailed list of covered services. Please see the Benefit and Cost Summary Proposal located in the Cost Section of this binder. 3. Please describe how your reimbursement rate is calculated for in network and out of network charges. What are the reimbursement rates for the 5 most frequently performed services? Include rates for in network and out of network providers. In network services are reimbursed at the negotiated fee. Out of network services are reimbursed at 90th UCR. ADA |Description In Network|U&C 90th 120|Periodic Oral Evaluation-Established Patient 28 48 272|Bitewings - Two Radiographic Images 24 43 1110|Prophylaxis - Adult 60 85 2140|Amalgam - One Surface - Primary Or Permanent 77 132 2792|Crown - Semiprecious Metal - Full Cast 667 1085 3310|Endodontic Therapy, Anterior Tooth 504 797 4910|Periodontal Maintenance 85 137 7140|Extraction, Erupted Tooth Or Exposed Root 84 167 7210|Surgical Removal Of Erupted Tooth 149 277 4. Provide a list of current network providers, if applicable. Please see the attached supplemental material titled Dental Provider Directory. 5. Describe what steps you intend to take to increase network membership. The Standard will make a targeted recruiting push in Okaloosa County and the surrounding areas. We will find out who your top dentists are that are not in network and come up with a customized plan of recruitment. The plan will include both phone calls and personal visits to providers. 6. Fully disclose retiree coverage amounts and rates. The Same rates apply Employee coverage: $24.25 per month Family coverage: $70.33 per month rmati if Is: 1. What is your rate for $25,000 of term life coverage? Our Basic Life rate is $.11/$1000 2. State quoted Accidental Death and Dismemberment coverage amount and rates. Please include detailed information regarding this coverage. Our Basic AD&D rate is $25,000 at a cost of .02/$1000 3. List age bands and rates for life insurance coverage. Age Rate <30 .06 30 - 34 07 35 - 39 -10 40 - 44 A5 45-49 .26 50-54 41 55 — 59 56 60 - 64 93 65-69 1.45 70-74 2.34 15+ 4.66 4. What is the maximum guaranteed issue amount of life insurance you will offer? What is the maximum amount of insurance you will offer with evidence of insurability? Our Basic Life/AD&D will be maximum of $25,000 each. Additional Life/AD&D will be a maximum of $500,000 each with a $300,000 Guarantee Issue. 5. Describe your spouse and child life products if offered. Please see our Group Life Proposal and Cost Summary in Section 1, and our Group Life and Group Additional Life product brochures in Section 5 for more information about these products. 6. List age reduction amounts and age of reductions. Basic Life/AD&D: 65% at 65, 40% at 70, 25% at 75, 15% at 80. Additional Life/AD&D: 65% at 65, 40% at 70, 25% at 75, 15% at 80. 7. Are accelerated benefits included in this proposal? If so, describe. To assist terminally ill employees and their families, The Standard offers an accelerated benefit. It allows insured employees to receive up to 75 percent of their Life insurance benefits during their lifetimes (except where state statutes mandate otherwise), if they meet certain criteria. The employee must be enrolled in a plan which includes Waiver of Premium. They must qualify for Waiver of Premium and be diagnosed as terminally ill with a life expectancy of fewer than 12 months. The maximum accelerated benefit is 75 percent of the Life insurance in force, up to $500,000; the minimum is 10 percent of the insurance in force but not less than $5,000. Additionally, the individual must have at least $10,000 of insurance in force to accelerate the benefit. After we pay the accelerated benefit, we charge interest against the early payout, which will reduce the remaining amount due the beneficiary. If the insured lives longer than expected from the day they take their accelerated benefit to the date they die, the interest due may completely exhaust the remaining benefit for their beneficiary. To protect beneficiaries, The Standard will pay the greater of 10 percent of the original life insurance benefit prior to taking the Accelerated Benefit, or the remaining amount of insurance minus the interest charge. This 10 percent minimum benefit is not available in all states. 8. Are repatriation benefits included in this proposal? Yes, The Standard will pay a Repatriation benefit when: ¢ A Life insurance Benefit is payable due to the insured employee's death, e Death occurred more than 200 miles from the insured employee's primary place of residence, and e Expenses are incurred to transport the remains to a mortuary near the primary place of residence. This feature will cover expenses incurred in transporting the remains to a mortuary near the insured's primary place of residence. The maximum benefit will be the lesser of $5,000 or 10% of the Life Insurance Benefit. The Standard will provide the Repatriation Benefit at no additional premium as part of your Group Life Insurance plan. 9. Is there a waiver of premiums in your proposal? If so, describe. Yes, The Standard has included Waiver of Premiums in our Life proposal. Waiver of Premium Benefit: Insurance will continue without payment of premiums while a member is totally disabled if: * They became totally disabled while insured under the group policy and under the age of 60; * They have completed their waiting period of 180 consecutive days beginning on the date they became totally disabled; and ¢ They have given us satisfactory Proof of Loss. Waiver of premium ends on the earliest of: * The date the member ceases to be totally disabled; * 90 days after the date we mail the member a request for additional proof of loss, if it is not given; e The date the member fails to attend an examination or cooperate with the examiner; ¢ With respect to the amount of insurance which an insured has converted, the effective date of the individual life insurance policy issued to the insured; and e The date the member reaches age 65. 10. Fully disclose retiree coverage amounts, rates and reductions. Our quote does not include retirees on Life Insurance as we have been informed there are no retirees on Life Insurance. If The County would like a retiree Life Insurance plan, The Standard would be willing to discuss providing them with one. We would need more information before coming up with a retiree plan design and rate, however. Required Information for Long Term Disability Insurance Proposals: 1. What is your proposed coverage amount and what is the rate for this coverage? Basic long term disability- Employer paid- 50% of the employee's salary to 5 years, $3500 max per month, 180 days wait. Buy-up option, 60% of the employee’s salary to SSNRA, $5000 max per month, 180 Day wait, employee paid. Basic long term rate is $3.50/Per Member. Buy-up rate is $2.99/Per Member. 2. What are the maximum and minimum benefit payment amounts? $3500, Min $100. Buy-up max is $5000, Min $100 3. List payments that will offset these disability payments. The following is a list of frequently used offsets: ¢ Employer-paid compensation (e.g. salary continuation, sick leave, etc.). Pension/Retirement (private or public). Social Security (disability, dependents, retirement). State disability. Subrogation (if allowed by the state of situs for the policy). Third party liability (if allowed by the state of situs where the policy). Unemployment compensation. Work earnings. Workers’ compensation (temporary and/or permanent) or other forms of work-related remuneration for a disability. ¢ Other group disability benefits 4. Describe your waiver of premium policy. LTD premium will be waived once LTD benefits become payable. 5. Describe your survivor benefits if applicable. All LTD policies issued by Standard include a Survivors Benefit provision. This provision stipulates that a benefit will be paid to the spouse and/or child of a claimant who dies while LTD Benefits are payable. (In order to be eligible for this benefit, a child must be under age 25 and unmarried.) The Survivors Benefit provides a lump sum payment equal to 3 times the claimant's maximum monthly LTD Benefit, not integrated with Deductible Income (Social Security, SDI, PERS, etc.). 6. Describe your own occupation policy. Our current policy reads: A. Own Occupation Definition of Disability During the Benefit Waiting Period and the Own Occupation Period you are required to be Disabled only from your Own Occupation. You are Disabled from your Own Occupation if, as a result of Physical Disease, Injury, Pregnancy or Mental Disorder: 1. You are unable to perform with reasonable continuity the Material Duties of your Own Occupation, and 2. You suffer a loss of at least 20% in your Indexed Predisability Earnings when working in your Own Occupation. Note: You are not Disabled merely because your right to perform your Own Occupation is restricted, including a restriction or loss of license. During the Own Occupation Period you may work in another occupation while you meet the Own Occupation Definition Of Disability. However, you will no longer be Disabled when your Work Earnings from another occupation meet or exceed 80% of your Indexed Predisability Earnings. Your Work Earnings may be Deductible Income. See Return To Work Provisions and Deductible Income. Own Occupation means any employment, business, trade, profession, calling or vocation that involves Material Duties of the same general character as the occupation you are regularly performing for your Employer when Disability begins. In determining your Own Occupation, we are not limited to looking at the way you perform your job for your Employer, but we may also look at the way the occupation is generally performed in the national economy. If your Own Occupation involves the rendering of professional services and you are required to have a professional or occupational license in order to work, your Own Occupation is as broad as the scope of your license. Material Duties means the essential tasks, functions and operations, and the skills, abilities, knowledge, training and experience, generally required by employers from those engaged in a particular occupation that cannot be reasonably modified or omitted. In no event will we consider working an average of more than 40 hours per week to be a Material Duty. After the Own Occupation period, the applicable Definition of Disability is an Any Occupation definition in which one must be