HomeMy WebLinkAboutInv# 166817346 - Fidelity Security Life Insurance Company - 06/30/2025 (2)SUMMARY INVOICE FOR:
INVOICE NUMBER:
SUBGROUP ID:
GROUP ID:
BILLING PERIOD:June, 2025
The City of Dania Beach
5000543
1001
166817346
FULL MONTH
COVERAGE TIER COUNT RATE TOTAL
Benefit Level 1
Employee Only 127 $4.39 $557.53
Employee + 1 63 $8.33 $524.79
Employee + Family 59 $12.24 $722.16
FULL MONTH TOTAL $1,804.48
RETROACTIVE ADJUSTMENTS
Retro 05/2025 $12.24
RETRO ADJUSTMENT TOTAL $12.24
CURRENT BILLING PERIOD TOTAL $1,816.72
FIDELITY SECURITY LIFE INSURANCE CO.
PO BOX 632530
CINCINNATI OH 45263-2530
Remit To:
GROUP ID:
SUBGROUP ID:
INVOICE NUMBER:
TOTAL INVOICE AMOUNT DUE:
5000543
1001
166817346
$1,816.72
THE CITY OF DANIA BEACH
LINDA GONZALEZ
100 W. DANIA BEACH BLVD.
DANIA BEACH FL 33004
PAYMENT IS DUE IN FULL UPON RECEIPT
THE INVOICE CALCULATION IS BASED ON MEMBERSHIP AS OF 05/20/25
PLEASE DETACH AND RETURN
Forwarding Service Requested
THE CITY OF DANIA BEACH
LINDA GONZALEZ
100 W. DANIA BEACH BLVD.
DANIA BEACH FL 33004
7,591
EyeMed
4000 LUXOTTICA PL
MASON OH 45040-8114
J661 [7,591] 4 of 7
[DM-BS]
20250527B06J6613300 38195
6/27/25
N-00200 93-33087 Rev 0912
FACTS WHAT DOES Fidelity Security Life Insurance Company, Fidelity Security Life
Insurance Company of New York (NY Only) and Affiliates
DO WITH YOUR PERSONAL INFORMATION?
Why?Financial companies choose how they share your personal information. Federal law gives
consumers the right to limit some but not all sharing. Federal law also requires us to tell you
how we collect, share, and protect your personal information. Please read this notice
carefully to understand what we do.
What?The types of personal information we collect and share depend on the product or service you
have with us. This information can include:
Social Security number and transaction history
medical information and insurance claim information
assets and checking account information
When you are no longer our customer, we continue to share your information as described in
this notice.
How?All financial companies need to share customers’ personal information to run their everyday
business. In the section below, we list the reasons financial companies can share their
customers’ personal information; the reasons Fidelity Security Life Insurance Company and
Affiliates choose to share; and whether you can limit this sharing.
Reasons we can share your personal information Does Fidelity Security
Life share?
Can you limit this
sharing?
For our everyday business purposes -
such as to process your transactions, maintain your
account(s), respond to court orders and legal
investigations, or report to credit bureaus
Yes No
For our marketing purposes -
to offer our products and services to you
Yes No
For joint marketing with other financial companies
Yes No
For our affiliates’ everyday business purposes -
information about your transactions and experiences
Yes No
For our affiliates’ everyday business purposes -
information about your creditworthiness
No We don’t share
For our affiliates to market to you
No We don’t share
For nonaffiliates to market to you
No We don’t share
Questions?Call 800-648-8624 or go to www.fslins.com or www.ftj.com
J661 [7,591] 5 of 7
[DM-BS]
20250527B06J6613300 300044
Page 2
Who we are
Who is providing this notice?Fidelity Security Life Insurance Company and Affiliates including our
Administrative, Insurance and Financial Service Providers.
What we do
How does Fidelity Security Life
Insurance Company and Affiliates
protect my personal information?
To protect your personal information from unauthorized access and use,
we use security measures that comply with federal law. These measures
include computer safeguards and secured files and buildings.
These physical, electronic and procedural safeguards were created to
protect your information. We also limit employee access as
appropriate.
How does Fidelity Security Life
Insurance Company and Affiliates
collect my personal information?
We collect your personal information, for example, when you
apply for insurance or pay insurance premiums
file an insurance claim or give us your contact information
show your driver’s license
We also collect your personal information from others, such as credit
bureaus, affiliates, or other companies.
Why can’t I limit all sharing?Federal law gives you the right to limit only
sharing for affiliates’ everyday business purposes - information
about your creditworthiness
affiliates from using your information to market to you
sharing for nonaffiliates to market to you
State laws and individual companies may give you additional rights to
limit sharing.
Definitions
Affiliates Companies related by common ownership or control. They can be
financial and nonfinancial companies.
Our affiliates include Fidelity Security Life Insurance Company of
New York, Forrest T. Jones & Company, Inc., Forrest T. Jones
Consulting Company and National Pension & Group Consultants, Inc.
Nonaffiliates Companies not related by common ownership or control. They can be
financial and nonfinancial companies.
Fidelity Security Life Insurance Company does not share with
nonaffiliates so they can market to you.
Joint marketing A formal agreement between nonaffiliated financial companies that
together market financial products or services to you.
Our joint marketing partners include insurance agencies, broker
dealers and investment advisor firms.
Other important information