Okaloosa County BOCC — August 19, 2014 — RFP #44-14 - Dental Insurance - MetLife Proposal - Exhibit A — reading text

Exhibit A Okaloosa County Board of County Commissioners MetLife ‘ MetLife Representative Larry Guarcello Account Executive 4010 W Boy Scout Boulevard Suite 950 Tampa, FL 33607 Phone Number: 813-673-3513 Fax Number: 800-578-6576 Email Address: Iguarcello@metlife.com Plan Effective Date 10/01/2014 Group Benefits Okaloosa County BOCC MetLife Group Benefits Proposal TABLE OF CONTENTS e Questionnaire Responses e Cost & Benefit Summary e Requested Signed Forms e MetLife Legal Response e MetLife Insurance Requirements MetLife Required Information: Proposals must include answers to the following questions. Required Information for Proposers on all Products: 1: 7. Give the location of the nearest company group sales and claims offices that will handle this contract. MetLife Dental Claims PO Box 981282 El Paso, TX 79998-1282 MetLife Group Sales Office 4010 W. Boyscout Blvd. Suite 950 Tampa, FL 33607 Give the name and location of the company group representative who will service this contract. Barbara Dzialowy, ACS , | Field Service Consultant / y {je \ MetLife ( a | a 4010 W. Boy Scout Blvd. ( S ’ Suite 950 , jo Tampa, FL. 33607 OY LY Direct: 813-673-3512 Cell: 813-240-5439 Fax: 866-277-3913 bdzialowy@metlife.com Will one or more claims handlers be assigned this contract in your claims office? We have a centralized single contact dedicated team to handle claims. Very experienced team with 10+ years average experience. Will toll free service be available from the entire county to your claims office or servicing agent? Yes 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, Ft. Walton Beach, FL — Broker and partner/client for many years. List 5 references of similarly sized current clients. Also, please list 3 references that terminated coverage. MetLife carefully protects our customers’ confidentiality and has agreed to limit sharing their policy as agreed to with our customers is to provide references only in instances where MetLife is selected as a finalist for the business being bid. If we are notified that we are selected as a finalist we will furnish the appropriate references. What is your current A. M. Best Rating or equivalent? MetLife Group Benefits Proposal 1 © 2014 METLIFE, INC. MetLife At (3/27/12) List your contact information should there be any questions regarding your proposal. Larry J. Guarcello Ill Account Executive MetLife - Group Benefit Sales 4010 Boy Scout Blvd STE 950 Tampa, FL 33607 813-841-1361 Cell 813-673-3513 Office 866-277-3913 Fax Required Information for Dental Insurance Proposals: 1. What is your rate for employee coverage? What is the rate for family coverage? Participating Covered Annual Rates Z Lives Volume Premium Coverage Dental Option 1 (Matching Current Plan) 2587891 Employer Sponsored Dental 885 $372,257 (per Employee Per Month) * Employee Only 526 $19.80 » Employee + Family 359 $57.40 Rates are guaranteed from October 1, 2014 - September 30, 2015 2™ year Rate Cap: The first year’s renewal rates will not be increased by more than 7.0% above the current rates. MetLife Group Benefits Proposal 2 © 2014 METLIFE, INC. MetLife Coverage Participating Covered Annual Rates Lives Volume Premium Dental Option 2 (Requested Plan 90" UCR) 2640424 Employer Sponsored Dental » Employee + Family 885 $391,961 (per Employee Per Month) * Employee Only 526 $20.84 359 $60.45 Rates are guaranteed from October 1, 2014 - September 30, 2015 rates. 2nd year Rate Cap: The first year’s renewal rates will not be increased by more than 7.0% above the current 2. Provide a detailed list of covered services. Class Description: All Active Full Time Employees TYPEA Benefits are payable immediately from the start date of an individual’s benefits Examinations 1 time in 6 months Examinations — Problem Focused Prophylaxis: Cleanings = 1 timein 12 months = _1timein6 months Sealants 1 per molar in 3 years for a child under age 17 = Space Maintainers = _No Limit for a child under age 19 * Fluoride = 2 times in 12 Months for a dependent child under age 14 = Full Mouth X-Rays = Once in 5 calendar years * Bitewing X-Rays = For achild under 19: 1 time in 12 months = Adult: 1 time in 12 months = Labs & Other Tests MetLife Group Benefits Proposal © 2014 METLIFE, INC. MetLife = Emergency Palliative Treatment * Periapical X-Rays * Other X-Rays TYPEB Benefits are payable immediately from the start date of an individual’s benefits = Consultations = _1in 12 months = Amalgam Fillings * 1 replacement per surface in 24 Months = Root Canal = 1 per tooth per lifetime « Periodontal Maintenance = 4 perio. Treatments in 1 calendar yr, includes 2 cleanings (total comb: 4) = Periodontal Surgery = __1 per quadrant in any 24 month period = Scaling & Root Planing = __1 per quadrant in any 12 month period = Repairs = _1in 12 months » _ Recementations = 1in12 months = General Anesthesia » Resin Composite Fillings(includes coverage for composite fillings on molars) « Pulpotomy « Pulp Capping * Pulp Therapy « Apexification & Recalcification = Periodontal Surgery — Soft & Connective Tissue Grafts * Periodontics — Non-Surgical = Oral Surgery: Simple Extractions * Oral Surgery: Surgical Extractions = Other Oral Surgery = General Services TYPE C Benefits are payable immediately from the start date of an individual's benefits = Prefabricated Crowns * 1 per tooth in 10 calendar years = Crown Buildups / Post Core * 1 per tooth in 5 calendar years = Dentures ® 1 in 5 calendar years » Immediate Temporary Dentures — * 1 replacement in 12 months Complete / Partial « Dentures — Rebases / Relines * _1in 24 months MetLife Group Benefits Proposal © 2014 METLIFE, INC. MetLife « Denture Adjustments = _1in12 months « Fixed Bridges * _1in5 calendar years Inlays / Onlays /Crowns 1 replacement per tooth in 5 calendar years Implant Services . * 1 per tooth position in 5 calendar years « Implant Repairs = 1 per tooth in 12 months = _ Implant Supported Prosthetic = 1 per tooth in 5 calendar years * _ Tissue Conditioning ® _1in 36 months * Occlusal Adjustments =» _1in12 months = Harmful Habit Appliances = Occlusal Guards / Bruxism Appliances Orthodontics Benefits are payable immediately from the start date of an individual’s benefits * Orthodontic Diagnostics = Orthodontic Treatment 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. When a provider becomes a member of MetLife's PDP Plus network, they agree to accept a fee schedule that is discounted off of "community average,” generally 15-45 percent. PPO claims are submitted in the same manner as indemnity claims. Our claims payment system automatically computes the correct fee according to the plan schedule of benefits. Out of network claims are paid in accordance to the plan design and the applicable R&C allowance for the applicable zip code. MetLife’s Claim payment system utilizes data accumulated through internal claim processing to establish reasonable and customary (R&C) charges. Plan sponsors can specify the reasonable and customary (R&C) percentage. MetLife typically uses the 90th percentile; however, the 80th, 70th, 51st and 99th percentiles are also available. Please note the plan sponsor's choice has pricing implications. MetLife's quote assumed the R&C would be the 90th percentile as requested by the customer, for out-of-network services. For out-of-network claims, the employee is responsible for charges in excess of reasonable and customary (R&C) fees. MetLife Group Benefits Proposal 5 © 2014 METLIFE, INC. MetLife Attached is a list of MetLife’s Top 60 Dental Procedures for Area Code 325: (I provided for 80" & 90" percentiles. Top 60 Dental Procedures.xisx 4. Provide a list of current network providers, if applicable. To ensure that employees have the most current provider information, MetLife makes our directories available via the Internet or by use of the automated telephone system. Members may also call customer service for assistance locating a provider in their areas. For telephone inquiries, employees are asked to enter a social security number and zip code of the area for which the directory is needed. A directory of up to 215 participating network dentists in the selected zip code and surrounding area can be faxed immediately or mailed the next business day. Our online provider directories include provider name, address, telephone number, specialty, languages spoken in the dental practice, whether or not the provider is accepting new patients, and the name of the dental school from which the dentist graduated. They also include a map and driving directions to the practice. 5. Describe what steps you intend to take to increase network membership. The initial provider selection process used by MetLife focuses on soliciting as many dentists in a given area that have the best utilization patterns as possible. We make every attempt to ensure that an adequate number of specialists are solicited in each major dental specialty area. Generally, this would means that 18 to 23 percent of the network will be comprised of specialists. The focus is to solicit high volume providers already providing services to customers. When there is a shortage of available dentists in a given area, efforts to provide access become more strategic. The MetLife Dental Network Development Team considers the following approaches for delivering appropriate provider access: e Identifying, contacting and soliciting all area group dental practices. If this approach is successful, it generally allows us to provide access to several dental specialties in one location; e Identifying where the employees are currently receiving dental care and contacting those providers. This approach allows us the opportunity to increase PDP Plus savings while helping to eliminate patient disruption; e Identifying whether there are practice management companies in an area, planning to move into an area, or would be willing to move into an area. The Network Development Team would research this as an option. ‘ If the need for available dentists in a given area is critical, other alternatives may also be necessary. All solicited prospective dentists are required to undergo a full application and credentialing process before being admitted into the network. MetLife Group Benefits Proposal 6 © 2014 METLIFE, INC. MetLife 6. Fully disclose retiree coverage amounts and rates. Participating Covered Annual Coverage Rates 3 Lives Volume Premium Dental Option 1 2587891 Employer Sponsored Dental 885 $372,257 (per Employee Per Month) = Employee Only n26 anuien = Employee + Family 359 $57.40 Rates are guaranteed from October 1, 2014 - September 30, 2015 rates. 2" year Rate Cap: The first year’s renewal rates will not be increased by more than 7.0% above the current Dental Option 2 2640424 Employer Sponsored Dental 885 $391,961 (per Employee Per Month) = Employee Only 526 $20.84 = Employee + Family 359 $60.45 MetLife Group Benefits Proposal © 2014 METLIFE, INC. MetLife Participating Covered Annual Rates Lives Volume Premium Coverage Rates are guaranteed from October 1, 2014 - September 30, 2015 2™ year Rate Cap: The first year’s renewal rates will not be increased by more than 7.0% above the current rates. MetLife Group Benefits Proposal 8 © 2014 METLIFE, INC. MetLife Required Information for Life Insurance Proposals: 1. What is your rate for $25,000 of term life coverage? NA 2. State quoted Accidental Death and Dismemberment coverage amount and rates. Please include detailed information regarding this coverage. NA 3. List age bands and rates for life