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HomeMy WebLinkAboutR-2012-110 - Authorized an Agreement with Symetra Financial to Provide Specific & Aggregate Reinsurance Coverage in Connection with the City's Self-Funded Group Health Plan RESOLUTION NO. 2012-110 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF DANIA BEACH, FLORIDA, AUTHORIZING THE PROPER CITY OFFICIALS TO ENTER INTO AN AGREEMENT, WITH SYMETRA FINANCIAL TO PROVIDE SPECIFIC AND AGGREGATE REINSURANCE COVERAGE IN CONNECTION WITH THE CITY'S SELF-FUNDED GROUP HEALTH PLAN; PROVIDING FOR CONFLICTS; FURTHER, PROVIDING FOR AN EFFECTIVE DATE. WHEREAS,the City provides employees and retirees health coverage through an annual self-funded health coverage plan; and WHEREAS, the self-funded program operates through the use of two essential functions, being: 1) a third-party health administration network(AvMed), and 2) the provision of specific and aggregate reinsurance coverage; and WHEREAS, Rhodes Insurance solicited proposals for the City's health plan annual reinsurance coverage and recommends the proposal offered by Symetra Financial for the fiscal year beginning October 1, 2012; NOW,THEREFORE,BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF DANIA BEACH,FLORIDA: Section 1. That the proper City officials are authorized to execute documents pertaining to reinsurance underwritten by Symetra Financial to include specific reinsurance, not to exceed $131.89 per eligible employee, retiree or both, per month and $275.01 per family per month (at a specific medical and prescription maximum stop loss of$75,000.00); and Aggregate Reinsurance in an amount not to exceed$8.35 per eligible employee,retiree or both,per month. Section 2. The annual funding for the cost of the City's health benefit program reinsurance was planned to increase by an estimated 10% in the recommended budget and the Symetra Financial annual cost is estimated at $458,248.00, representing a cost increase of 11.27%, which cost shall be charged to the Health Insurance Fund Stop Loss Insurance Account, Account No. 501-1800-519-3110. Section 3. That all resolutions or parts of resolutions in conflict with this Resolution are repealed to the extent of such conflict. Section 4. That this Resolution shall be in force and take effect October 1, 2012. PASSED AND ADOPTED on August 28, 2012. ATTEST: LOUISE STILSON, CMC PATRICIA A. FLURY CITY CLERK MAYOR )'s Fnur err APPROVED AS D FO AND CORRECTNESS: THOMA,S J. SBRO CITY ATT Y 2 RESOLUTION#2012-110 e SYM-ETRA. FINANCIAL Symetra Life Insurance Company 777108th Avenue NE,Suite 1200 Bellevue,Washington 980044135 EXCESS LOSS SCHEDULE OF BENEFITS A. Participating Employer: City of Dania Beach Policy Number: 16-011669-00 Effective Date of Coverage: October 1,2010 Participating Employer Anniversary Date:October 1 st of each year beginning in 2011 Premium Due Date: Premium is due on the Effective Date of Coverage and the first of each month beginning with November 1,2010 Enrollment(at the beginning of the Policy Period): Single 46 Family 112 B. This Schedule of Benefits applies to the Policy Period:from 10-01-2012 to 10-01-2013 C. Individual Excess Loss Insurance mYes ❑No 1. Individual Deductible per Covered Unit $ 75,000 2. Altemate Individual Deductibles applicable? ❑Yes(See Excess Loss Alternate Reimbursement Endorsement) m No 3. Covered Expenses ❑Medical excluding all Prescription Drugs m Medical including Prescription Drugs defined as ONE of the following: m Rx Card and Mail Order ❑Rx Card Only ❑Rx Mail Omer Only OR ❑Rx as part of Medical Plan subject to a Deductible and Coinsurance m Other Capitation 4. Symetra's Reimbursement Percentage 100 %of Covered Expenses in excess of the Individual Deductible. 5. Individual Lifetime Reimbursement Maximum: Policy Period Reimbursement Maximum: Unlimited per Covered Unit Unlimited per Covered Family Unit 6. Premium Rates Covered Units Single $131.89 Family $275.01 LGC 8802 03/02 1 of 4 SYmetre•and ft Symeha Fm&wM bpo m eavice marks&Symelra Ufa Inkewm Comprry I I r' EXCESS LOSS SCHEDULE OF BENEFITS Applies to Policy Period:from 10-01-2012 to 10-01-2013 7. Reimbursement Option: Covered Expenses incurred on or after the Policy Effective Date and paid during the Policy Period with: Run-in Period 0 months Run-in Limit $ N/A Run-out Period 3 months Run-out Limit $ Unlimited 8. Individual Excess Loss Terminal Provision applicable? Yes No PP ❑ m 9. Individual Excess Loss Advantage Provision applicable?❑Yes m No 10. Individual Advantage Deductible applies toward the Aggregate Attachment Point?❑Yes m No 11. Individual Excess Loss Transplant Provision❑Yes m No D. Aggregate Excess Loss Insurance m Yes❑ No 1. Covered Expenses: ❑Medical excluding all Prescription Drugs m Medical including Prescription Drugs defined as ONE of the following: ®Rx Card and Mail Order ❑ Rx Card Only ❑ Rx Mail Order Only OR ❑Rx as part of Medical Plan subject to a Deductible and Coinsurance ❑Vision ❑Dental ❑Short-Term Disability m Other Capitation 2. Aggregate Attachment Point will be set by Symetra. 3. Symetra's Reimbursement Percentage 100 %of Covered Expenses in excess of the Aggregate Attachment Point. 4. Aggregate Reimbursement Maximum per Policy Period $ 1,000,000 5. Monthly Aggregate Accommodation Provision applicable? ❑Yes m No 6. Reimbursement Option: Covered Expenses incurred on or after the Policy Effective Date and paid during the Policy Period with: Run-in Period 0 months Run-in Limit $ N/A Run-out Period 3 months Run-out Limit $ Unlimited LGC 8802 03/02 2 of 4 r EXCESS LOSS SCHEDULE OF BENEFITS Applies to Policy Period:from 10-01-2012 to 1MI-2013 7. Minimum Aggregate Attachment Point _90-%of the first Monthly Aggregate Attachment Point x 12 8. Monthly Aggregate Attachment Factors Covered Units Single $1,280.45 Family 9. Aggregate Excess Loss Terminal Provision applicable? []Yes ®No 10.Aggregate Excess Loss premium$ 8.35 Paid: per employee per month E. Medical Conversion Privilege Oyes m No F. Endorsements Included ®Individual Excess Loss Advance Funding Endorsement ❑Excess Loss Alternate Reimbursement Endorsement G.Additional Information Claims determined to be eligible under the Employee Benefit Plan in final and binding external review by independent review organizations(IROs)will also be deemed Covered Expenses under the Policy. Claim exception requests pending and under IRO review at the end of the Policy Period will continue to be considered for coverage. LGC 8802 03/02 3 of 4 EXCESS LOSS SCHEDULE OF BENEFITS Applies to Policy Period: from 10-01-2012 to 10-01-2013 H. Associated Companies Name Effective Date Termination Date NIA 1 LGC 8802 03/02 4 of 4 I i SYM E T RA RETIREMENT I BENEFITS I LIFE Consumer privacy statement Symetra is serious about keeping your personal information private and secure.This notice of our privacy policy explains how we use and protect your information. Syrnetra does not sell or rent information about you to others. WHERE WE GET INFORMATION The information vie get about You conies from different sources and may include: ABOUT YOU r name,address and Social • Information that you give to us on applications or other fomis such as you Security number. • information from your transactions with us,our affiYated companies or our business partners.This includes products and services you have purchased from us or infounabon about your payment history or Bairns. • Information we receive from consumer reporting agencies to confine or add to facts given by you.Data collected by a reporting agency may be kept by them and later shared with athers who use these reports.It will be given to others only as allowed by federal and state Fair Credit Reporting Acts. • Information we receive from your insurance agent,broker or financial advisor.This may include updated information about your policy or account. SNARING INFORMATION In order to conduct our business and offer you the products and services that you may want,we may share your information within the Symetra family of companies. We do not disclose your information to anyone else unless allowed or required by law.The law allows us to share your financial information with our affiliates or third parties outside the Symetra family of companies to service,market or undervi to our products and services to you.You cannot prevent these disclosures. We may share your information with insurance agents,brokers and financial advisors who sell our products and services.We may also share your information with financial institutions that we have joint marketing agreements with to sell our products and services. Working with these businesses allows us to pmvide you with a broader selection of insurance and investment products and services from our companies.These businesses sign a contract with us to keep your information prorate and secure and to use it only for the services we request. MEDICAL INFORMATION We obtain or share medical information only in connection with specific products and services.This may include urldwwriting a life insurance policy,processing a daim or any other use that we disclose to you before the information is collected. ABOUT INDEPENDENT The irldepemde nf insurance agents,brokers and financial advisors who sell our products and servloes are INSURANCE AGENTS,BROKERS not our employees and are not subject to our privacy policy. WL ADVISORS m use this information AND FINANC not have.The information about that we do Y aY, They may have received personal m You their about th prate differently than we do.Contact your agent,broker or advisor lo learn rtare privacy SYM-1013 4112 KEEPMG YOUR PERSONAL We protect your personal information in a variety of ways. INFORMATION SAFE We maintain physical,administrative and technical safeguards to protect this information from unauthorized access. Employees receive training to protect personal information and are au#atned to access this information only when they have a business need to do so.We expect the agents,brokers and advisors who sell our products and services to maintain a high regard for privacy and to safeguard customer information. We follow your state law when it protects your privacy more than federal law. ACCURACY OF YOUR We need accurate information to provide you with the best possible service. INFORMATION If you need to update your information or if the information we have about you is inaccurate or incomplete, please contact us.Please be sure to include your name and policy number or contract number. • By telephone.You can call us at the telephone number shown on your account statement or on other information we have sent to you.You can also call us at I-M786-3872. • In writing.You can write to us at the address shown on your account statement or on other information we have sent to you.You can also write to us at: PO Box 34090,Seattle,WA 9812441690 You can also request a copy of the information that we have about you in our files to make sure it is correct. You must make your request in writing and send it to the address shown on your policy or contract or to the address shown above.Within 30 business days of receiving your request,we will send you the information. We will advise you of any person or group to whom we have given the information during the last two years. If you believe the information about you in our files is wrong,you can notify us in writing.We will review your file and respond to you within 30 business days.If we agree with you,we will change our records.This change WN become part of the file.It will be sent to those that received inaccurate imWmation from us.It will also be included in any later disclosures to others. If we disagree with you,we will explain why.You can provide us with a statement explaining why you believe the information is wrong.This statement will become part of the file.It will be sent to 0=9 that received the disputed information from us.It will also be included in any later disclosures to others. PRIVACY AND This notice also applies to our websites.If you would like more information about our webske privacy SYMETRKS WESSITES and security practices,go to www.symetra.com and ckk on the Privacy link. THE SYMETRA FAMILY This notice applies to the following companies: OF COMPANIES • Symetra life Insurance Company • Symetra Investment Management,Inc. • Symetra National Life Insurance Company . Symetra Investment Services,Inc. • First Symetra National Life Insurance • Symetra Mutual Funds Trust Company of New York,New York,NY • Symetra Securities,Inc. • Symetra Assigned Benefits Service Company • Clearscape Funding Corporation S" a Rnwou cmpmum S Y M E T R A 'a te,w seoo"4E�135 a 1200 RETIREMENT BENEFITS I LIFE WWWAYIvidniii,,m SYM-1013 4/12 s Symatrs is a r•pikarad R•Ivia mark of SymatrB txa Insurance Canpany. I Sytre Life Insurance Company Mailing address: Y M-E T RA, M 10meeei Avenue NE,Suite 1200 Symetra Life Insurance Company FINANCIAL Bellevue,WA 98004-5135 Group Division P 14800-428-7784 PO Box 34690 www.symetra.com Seattle,WA 98124-1690 Re: Information for IRS Form 5500 Dear Participating Employer: As an Excess Loss policyholder with Symetra Life Insurance Company, we understand that you may need to file a Form 5500. We are happy to provide you with the information you need upon request(pursuant to ERISA§103(ax2)). If, at the end of your plan year, you need information so that you can file Form 5500, please email your request to erisab-svmetra.com or contact us at 1-800 426-7784. Sincerely, Symetra Life Insurance Company Group Accounting Services i i LG-12022 7/08 SymebaS and the Symetra Financial logo are registered service marks of Symetra Life Insurance Company.