Okaloosa County BOCC — August 5, 2014 — RFP #44-14 -Life and AD&D Insurance - Standard Insurance Proposal Exhibit A

Exhibit A Employee Benefits Corporate Elonafitn ct tho Emerald Coast, Proposal And Prepared for: Okaloosa County Board of Cost Summary cuca ) Pi i Group Life Insurance Standard Insurance Company TheStandard \ How The Standard’s Focused Expertise Can Benefit Your Business At Standard Insurance Company, group Life and Disability insurance aren't add-ons. They're our primary business. For you, our focused expertise means people who understand your needs and employee benefits that work harder to support your goals. From fast, responsive claims handling to flexible plan designs that help you control costs, we're here to partner with you for the long term. Our proactive approach and solutions can help reduce the workload for your HR team and help you maintain a more efficient and productive workplace. Key Reasons To Choose The Standard Partnership Focus With The Standard’s 40-plus fully-staffed sales and service offices across the country, you can count on a smooth, hassle-free transition, local account resources and personal, responsive service. We're here to minimize your administrative burden and simplify claim management. With access that works the way you work — online, phone or in person — we’re easy to reach and quick to follow through. Long-Term Perspective We've tailored this proposal to address your needs, today and for the long- term. Need more options? Just ask. We offer millions of possible plan design combinations. We also emphasize giving you the “right rate” from the beginning to avoid a big increase later. Proactive Approach We focus on helping employers prevent disabilities, increase employee well- being and maintain a more productive workplace through innovative solutions that deliver measurable results, including: + Industry-leading Workplace Possibilities™ program + Exclusive partnership with Health Advocate™ * Employee Assistance Program included with our LTD plans * Comprehensive Absence Management services ¢ Flexible Dental and Vision plans We Keep Our Promises At The Standard, doing the right thing for our customers is in our DNA. More than 100 years of history and our long track record of financial strength back up our commitment to you and your employees. Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Presented By: Corporate Benefits of the Emerald Coast, Basic Life and AD&D Plan 1 Covered Members An active employee of the Employer working 32 hours per week An active elected official employee of the Employer Class 1: Elected Officials including Supervisor of Elections Class 2: All other Members Plan Class 1 Class 2 Benefit Formula Flat $25,000 Flat $25,000 . To 65% at age 65; To 40% To 65% at age 65; To 40% pees Benefit at age 70; To 25% at age at age 70; To 25% at age 75; To 15% at age 80 75; To 15% at age 80 Guarantee Issue Full Benefit Full Benefit Employer Contribution | 100% 100% Cost Members Volume X Rate: Per $1,000 = Pronto remium All Eligible Life 706 $17,373,750 0.11 $1,911 AD&D 706 $17,373,750 0.02 $347 Total $2,258 e We provide policyholders with a 60-day notice of rate change. e The proposed rates are guaranteed for 36 months. Features e Waiver of Premium is included for those disabled prior to age 60. The schedule of age reductions will not apply while a member is on Waiver. Waiver ends at age 65. The Standard consolidates the filing and management of the Life Waiver of Premium and LTD claims if The Standard has both coverages. Plan Design e A Family Benefits Package is included. It provides extra AD&D benefits to help families transition due to the loss of an insured member. The package includes a Child Care Benefit (child care expense reimbursement for children under age 13); a Career Adjustment Benefit (education expense Standard Insurance Company 1381309 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Presented By: Corporate Benefits of the Emerald Coast, reimbursement for spouses); and a Higher Education Benefit (college expense reimbursement for children). e A Seat Belt Benefit and an Air Bag Benefit are included. These provide additional benefits (100% of AD&D benefit to $10,000 and 100% of AD&D benefit to $5,000, respectively) if a member dies as a result of an automobile accident while using a seat belt system and where the automobile's air bag deployed at the time of the accident. e Travel Assistance is included. This service provides plan participants with access to appropriate medical care and other emergency services whenever traveling at least 100 miles from home or in a foreign country for trips lasting up to 180 days. Travel Assistance offers a range of professional, 24- hour medical and legal assistance and coordination services. e An Accelerated Benefit is included. Terminally ill members may withdraw up to 75% of their Life benefit to a maximum of $500,000 (when Basic Life and any Additional Life are combined). e AdminEASE service is included. These time-saving online tools are the fastest, easiest and most secure way to administer your plan. e Portability of insurance is included. This lets terminating members continue their dependents life amount without providing evidence of insurability with the continuation of their life amount. If AD&D is included in the plan it may also be ported. e ARepatriation Benefit is included. It provides an additional benefit to help pay for the expenses of transporting a member's body when the member dies more than 200 miles from home. e The plan includes E-Contract Document service for efficient, convenient online contract document delivery. Printed documents are available on request. Certificates must be distributed to insured members. Note: Under ERISA, plan administrators may deliver Summary Plan Descriptions/certificates electronically, but must implement measures to ensure participants actually receive them. Please consult legal counsel to clarify your delivery or recordkeeping requirements. Assumptions e Proposed rate includes electronic documents. Conditions e This is not our customary age reduction schedule. As an employer, you are responsible for determining that the schedule you have requested complies with the ADEA. We assume that you have made that determination. e The rates assume billing is centralized in one location. e The proposed rates assume coverage currently in force. Additional Information For additional information on the available features and benefits of Life and Accidental Death & Dismemberment Insurance from The Standard, click here: http://www.standard.com/eforms/6958.pdf Standard Insurance Company 1381309 4 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Additional Life Plan 1 Covered Members Presented By: Corporate Benefits of the Emerald Coast, An active employee of the Employer working 32 hours per week An active elected official employee of the Employer Plan Benefit Formula Increments of $25,000 to a maximum of $500,000 with a minimum of $25,000 Rounding Nearest $1 Minimum Benefit $25,000 Age Based Benefit Reduction To 65% at age 65; To 40% at age 70; To 25% at age 75; To 15% at age 80 Guarantee Issue $300,000 Employer Contribution 0% e For coverage to become effective on 10/01/2014, the greater of 20% of eligible members or 10 members must enroll. Cost . Monthly Members Age Rate: Per $1,000 X Volume Premium All Enrolled 41 <= 29 0.060 $1,075,000 $65 13 30-34 0.070 $1,500,000 $105 33 35-39 0.100 $3,700,000 $370 28 40-44 0.150 $4,050,000 $608 55 45-49 0.260 $6,500,000 $1,690 58 50-54 0.410 $6,325,000 $2,590 60 55-59 0.560 $5,525,000 $3,094 34 60-64 0.930 $3,550,000 $3,302 8 65-69 1.450 $306,500 $444 5 70-74 2.340 $149,000 $349 0 75 4.660 $0 $0 Total $12,617 e We provide policyholders with a 60-day notice of rate change. Standard Insurance Company 1381309 5 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Presented By: Corporate Benefits of the Emerald Coast, Features Waiver of Premium is included for those disabled prior to age 60. The schedule of age reductions will not apply while a member is on Waiver. Waiver ends at age 65. The Standard consolidates the filing and management of the Life Waiver of Premium and LTD claims if The Standard has both coverages. Plan Notes An Accelerated Benefit is included. Terminally ill members may withdraw up to 75% of their Life benefit to a maximum of $500,000 (when Basic Life and any Additional Life are combined). Travel Assistance is included. This service provides plan participants with access to appropriate medical care and other emergency services whenever traveling at least 100 miles from home or in a foreign country for trips lasting up to 180 days. Travel Assistance offers a range of professional, 24- hour medical and legal assistance and coordination services. Portability of insurance is included. This lets terminating members continue their dependents life amount without providing evidence of insurability with the continuation of their life amount. If AD&D is included in the plan it may also be ported. The members’ benefit amounts under the current plan are carried forward to this plan. We require evidence of insurability for members who are eligible under the current plan but are not enrolled. We require evidence of insurability for members who enroll more than 31 days after they are first eligible for coverage. Elective increases require evidence of insurability. Evidence of insurability is required in order to increase elected benefit amounts from the current plan to this plan. Conditions Rates assume 44% enrollment. Additional Life can only be purchased in conjunction with Basic Life. No increases without evidence of insurability for those whose evidence of insurability was not approved by us under any policy issued by us to the policyholder or an employer covered under the policy Until coverage has been in force for 2 years, death which results from suicide or other intentional self- inflicted injury is not covered (in force for 1 year in CO, MO and ND; not available in WA.) The proposed rates assume that only participants are included in the census provided. This is not our customary age reduction schedule. As an employer, you are responsible for determining that the schedule you have requested complies with the ADEA. We assume that you have made that determination. The rates assume billing is centralized in one location. The proposed rates assume coverage currently in force. Standard Insurance Company 1381309 6 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Additional AD&D Plan 1 Presented By: Corporate Benefits of the Emerald Coast, A benefit on the Additional Life Plan Covered Members An active employee of the Employer working 32 hours per week An active elected official employee of the Employer Plan Increments of $25,000 to a Benefit Formula maximum of $500,000 with a minimum of $25,000 Rounding Nearest $1 Minimum Benefit $25,000 , To 65% at age 65; To 40% acta a Beneht at age 70; To 25% at age 75; To 15% at age 80 Employer Contribution | 0% Cost Members Volume X Rate: Per$1,000 = Prana All Enrolled AD&D 305 $32,680,500 0.020 $654 Total $654 Standard Insurance Company 1381309 7 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 : Presented By: Corporate Benefits of the Emerald Coast, Spouse Dependents Life Plan 1 Covered Members An active employee of the Employer working 32 hours per week An active elected official employee of the Employer Plan Benefit Formula Increments of $5,000 Rounding Up to next $0 Maximum Benefit $250,000 Minimum Benefit $5,000 To 65% at age 65; To 40% at age 70; To 25% at age 75; To 15% at age 80 Guarantee Issue $25,000 Employer Contribution | 0% Age Based Benefit Reduction e Spouse age based on Member's age. Cost Members Age Rate: Per $1,000 xX Volume = pronase remium All Enrolled 0) <= 29 0.060 $0 $0 4 30-34 0.070 $125,000 $9 8 35-39 0.100 $175,000 $18 7 40-44 0.150 $175,000 $26 11 45-49 0.260 $425,000 $111 24 50-54 0.410 $725,000 $298 27 55-59 0.560 $850,000 $476 15 60-64 0.930 $450,000 $419 1 65-69 1.450 $25,000 $36 2 70-74 2.340 $20,000 $47 0 75+ 4.660 $0 $0 Total $1,440 e We provide policyholders with a 60-day notice of rate change. Standard Insurance Company 1381309 8 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Presented By: Corporate Benefits of the Emerald Coast, Features Portability of insurance is included. This lets terminating members continue their dependents life amount without providing evidence of insurability with the continuation of their life amount. If AD&D is included in the plan it may also be ported. Dependents Life insurance continues automatically, without premium payment, for five months after the death of the insured member. Plan Notes We require evidence of insurability for spouses who enroll more than 31 days after they are first eligible for coverage. The plan includes a conversion option. The members' benefit amounts under the current plan are carried forward to this plan. Evidence of insurability is required in order to increase elected benefit amounts from the current plan to this plan. Waiver of Premium and Accelerated Benefit provisions are not included. Conditions Rates assume 20% enrollment. Until coverage has been in force for two years (one year in Colorado, Missouri and North Dakota), death which results from suicide or other intentional self-inflicted injury is not covered. This exclusion does not apply to plans written in Washington. Time insured under the current plan will be credited toward this time period. Member must be enrolled in Additional Life to enroll in the Spouse Life plan. Spouse Life can't exceed 50% of member's enrolled benefit for Additional Life. No increases without evidence of insurability for those whose evidence of insurability was not approved by us under any policy issued by us to the policyholder or an employer covered under the policy We will require evidence of insurability in order to increase the benefit amount for any member whose evidence of insurability was not approved by us under any policy issued by us to the policyholder or to an employer covered under the policy. Evidence of insurability is required in order to increase elected benefit amounts from the current plan to this plan. The proposed rates assume that only participants are included in the census provided. Standard Insurance Company 1381309 9 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Child Dependents Life Plan 1 Covered Members Presented By: Corporate Benefits of the Emerald Coast, An active employee of the Employer working 32 hours per week An active elected official employee of the Employer working 0 hours per week Plan Child Benefit Formula: Under 6 Increments of months $1,000 Child Benefit Formula: 6 months or | Increments of more $1,000 Maximum Benefit $10,000 Minimum Benefit $1,000 Cost Rates: Per $1,000 : : . . Elective: Paid by each . Composite: Paid for each | Required: Paid for each A Members: member member with dependents member‘electing coverage All Enrolled $0.20 $0.20 $0.20 e We provide policyholders with a 60-day notice Features of rate change. e Portability of insurance is included. This lets terminating members continue their dependents life amount without providing evidence of insurability with the continuation of their life amount. If AD&D is included in the plan it may also be ported. e Dependents Life insurance continues automatically, without premium payment, for five months after the death of the insured member. Plan Notes e The plan includes a conversion option. e The members' benefit amounts under the current plan are carried forward to this plan. Standard Insurance Company 1381309 10 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Presented By: Corporate Benefits of the Emerald Coast, Conditions e Rates assume 20% enrollment. e Member must be enrolled in Additional Life to enroll in the Child Life plan. e Child Life can't exceed 100% of member's enrolled benefit for Additional Life. e We require evidence of insurability for children who are eligible under the current plan but are not enrolled. e Elective increases require evidence of insurability. e No increases without evidence of insurability for those whose evidence of insurability was not approved by us under any policy issued by us to the policyholder or an employer covered under the policy e The proposed rates assume that both participants and non-participants are included in the census provided. e We will require evidence of insurability in order to increase the benefit amount for any member whose evidence of insurability was not approved by us under any policy issued by us to the policyholder or to an employer covered under the policy. e Evidence of insurability is required in order to increase elected benefit amounts from the current plan to this plan. e Evidence of insurability is required in order to increase elected benefit amounts from the current plan to this plan. e Dependents coverage includes unmarried child(ren) from live birth through age 20, or through age 24 if the child is a full-time registered student. Standard Insurance Company 1381309 11 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Presented By: Corporate Benefits of the Emerald Coast, Producer Compensation Disclosure We recognize the valuable role of Insurance advisors, consultants and brokers ("producers") in helping their clients design an employee benefits program, and we support reasonable and fair compensation for these services. Producers may be eligible to receive compensation from The Standard. Any questions regarding the compensation connected with this proposal should be directed to the producer. Please visit our website at www.standard.com/compensation/eb/ to view our normal commission scales. If this proposal is quoted with a non-standard scale or override it is noted below. An override if noted is compensation paid in addition to or in lieu of commissions. Please consult with your producer for details. Non-standard commission scale: N/A Override: N/A Unless participation is declined by the producer or client, contingent compensation is additional compensation that may also be paid and is contingent on the satisfaction of one or more minimum requirements, such as a specified amount of new premium volume or persistency in connection with the producer's block of business. For information about our customary producer rewards program visit www.standard.com/compensation/eb/. Some producers may have a contingent compensation arrangement that differs from our customary program. Please consult with your producer for additional details. Additionally, fees for administrative, marketing or consulting services may apply. If applicable, fees are noted below. Fees: N/A Standard Insurance Company 1381309 12 Employee Benefits Proposal and Cost Summary Prepared for Okaloosa County Board of County Commissioners on May 9, 2014 Proposed Effective Date of October 1, 2014 Presented By: Corporate Benefits of the Emerald Coast, We appreciate the opportunity to provide you with this benefit and cost summary proposal from The Standard. This document outlines certain important features of the group insurance coverages available. This is not a contract or an offer to contract for such coverages. Detailed information about other important features of the coverage proposed is available on request. Just ask your broker/consultant or Standard representative. A completed application must be submitted before a group can be considered for coverage. Insurance will be effective after the application is accepted by The Standard. If approved, we will issue a contract containing our customary language. It will not duplicate existing policy language, if any. The group contract will contain provisions and defined terms not described in this Benefit and cost summary proposal. The group contract will control if there are discrepancies between it and this proposal. The proposed premium rate and plan design for each coverage are based on the underwriting data received by The Standard. Final premium rates and plan provisions will be determined by The Standard on the basis of: applicable state laws, policyholder contributions, confirmation of occupations, the actual composition of the group of persons who will become insured, and our current underwriting rules and practices. This benefit and cost summary proposal expires on August 7, 2014, unless replaced or withdrawn by The Standard. Standard Insurance Company 1381309 13 Required Information: Proposals must include answers to the following questions. Required Inf donifore all Products: 1. Give the location of the nearest company group sales and claims offices that will handle this contract. Group Office: 4350 West Cypress Suite 920 Tampa, FL 33607 Life & Disability Claims Office: Employee Benefits Department 900 SW Fifth Avenue Portland, OR 97204 Dental Claims Office: Dental claims are processed and customer service is provided from our office in Lincoln, Nebraska or the satellite claims offices in Wayne, Nebraska and San Antonio, Texas. Give the name and location of the company group representative who will service this contract. Your Account Manager, Alison Brogan, is located in our Tampa Florida office located at: 4350 West Cypress Suite 920 Tampa, FL 33607 Toll free: 800.325.5757 Direct number: 813.878.0286 Will one or more claims handlers be assigned this contract in your claims office? Life/LTD: Yes. Okaloosa County Board of County Commissioners’ account will be assigned to a specific LTD and Life claim team. Our claim teams are designated not dedicated. This allows your organization to have team members who are intimately familiar with your program, but also allows for ample coverage. Dental: The claims customer service team is trained to handle the specific contract provisions of the account. The customer doesn’t have to wait for an assigned team member to handle their questions because all members of the team have been trained to assist. Will toll free service be available from the entire county to your claims office or servicing agent? Yes, Customer Service Representatives will be available to the employees of Okaloosa County Board of County 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 ir i D Lin : 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 1 . 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 15 45-49 .26 50-54 41 55-59 56 60 - 64 93 65 - 69 1.45 70-74 2.34 75+ 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 LLife insurance Benefit is payable due to the insured employee's death, * Death occurred more than 200 miles from the insured employee's primary place of residence, and ¢ 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; * 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 * 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 unable to perform all occupations. 7. Describe your pre-existing condition exclusions, if any. A pre-existing condition means a mental or physical condition, whether diagnosed or not, for which the member has consulted a physician, received medical treatment or services; or taken prescribed drugs or medications during the 90-day period just before the member’s coverage becomes effective. The member is not covered for a disability caused or contributed to by a pre-existing condition or medical or surgical treatment of a pre-existing condition, unless on the date of disability the member had been continuously insured under the group policy for the entire 12-month exclusion period, and was actively at work for at least one full day after the end of the exclusion period. We have included the policy language for Preexisting Conditions below: Definition Preexisting Condition means a mental or physical condition whether or not diagnosed or misdiagnosed: A. For which you have done or for which a reasonably prudent person would have done any of the following: 1. Consulted a physician or other licensed medical professional; 2. Received medical treatment, services or advice; 3. | Undergone diagnostic procedures, including self-administered procedures; 4. Taken prescribed drugs or medications; B. Which, as a result of any medical examination, including routine examination, was discovered or suspected; at any time during the 90-day period just before your insurance becomes effective. Under the Continuity of Coverage provision, time served under the prior plan is credited toward satisfying the Pre-existing Condition exclusion under The Standards plan. If benefits are approved, Benefits will be paid under the terms of the new group policy or the prior plan, whichever is less.