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HomeMy WebLinkAboutResolution - 2006-R0370 - Professional Services Contract For Consulting - Wachovia Insurance Services - 07_25_2006 (2)Resolution No. 2006-RO370 July 25, 2006 Item No. 6.8 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock, a Professional Services/Consulting Agreement for health benefits consulting services, by and between the City of Lubbock and Wachovia Insurance Services, Inc., and related documents. Said Agreement is attached hereto and marked as Exhibit "A" and incorporated in this resolution as if fully set forth herein and shall be included in the minutes of the City Council. Passed by the City Council this 25th day of July 2006. �DAVID A. ILLER, MAYOR ATTEST: Rebe a Garza, City Secretary APPROVED AS TO CONTENT: Leisa Hutcheson, Risk Manager APPROVED AS TO FORM: M. gs/ccdocs/Wachovia Ins. Services Amendment 8/25/ 2006 Resolution No. 2006-RO370 PROFESSIONAL SERVICES/ CONSULTING AGREEMENT THIS PROFESSIONAL SERVICES/CONSULTING AGREEMENT (this "Agreement") is entered into this day of July 25, 2006, by and between the City of Lubbock, Texas (the "City") and Wachovia Insurance Services — Dallas Office (the "Consultant"). WHEREAS, the City desires, pursuant to the terms and conditions of this Agreement, to engage the Consultant to perform the services set forth herein; and WHEREAS, the Consultant desires to perform the described services pursuant to the terms and conditions of this Agreement. NOW, THEREFORE, in consideration of the promises contained herein and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the City and the Consultant hereby agree as follows: 1. Services of Consultant. The Consultant shall serve as an independent contractor to provide the consulting services more particularly described in Exhibit "A", the City's Health Benefits Consulting Services — RFP 06-044-MA and the Consultant's response thereto, attached hereto and incorporated herein by reference for all purposes (the "Services"). 2. Services Provided by the City. The City, in its sole discretion, may provide (at the City's sole cost and expense) the Consultant with such administrative assistance as may be reasonably required by the Consultant for the performance of the Services. 3. Term. This Agreement shall commence upon the complete execution hereof and, except for the provisions of this Agreement which survive termination, shall remain in full force and effect as between the City and the Consultant with regard to the Services until July 25, 2007, with option to renew for two additional one year terms until July 25, 2009 (the "Completion Date"). The Consultant hereby agrees to fully perform all the Services by the Completion Date. 4. Compensation. As compensation for the Services, the City shall pay the Consultant the sum of Eighty Thousand Dollars ($80,000.00) annually (the "Compensation"). The Consultant acknowledges and agrees that the Compensation shall constitute full payment to the Consultant and shall include, without limitation, costs of all supplies, materials, equipment, travel expenses, lodging, meals and all other expenses of any kind or nature incurred by the Consultant in the performance of the Services. The Consultant acknowledges and agrees that the Compensation is a fixed sum which may only be adjusted in accordance with the terms and conditions of this Agreement and after written approval by the City. It is understood that Wachovia Insurance Services, Inc. will not receive commissions / compensation from the insurance carriers for the policies that it places for Client as described in Exhibit "A". It is understood that if, during the term of this agreement, Wachovia Insurance Services cannot place a policy described in Exhibit "A" on a non -commissions or fee basis, or if Wachovia Insurance Services is offered any other form of remuneration for placement of a policy, Wachovia Insurance Services will disclose the amount of commission, fee or remuneration to the City of Lubbock. 5. Payment. The Consultant shall provide the City with invoices for consulting fees, in a form acceptable to the City, on a monthly basis. Invoices which are acceptable to the City shall be paid within thirty (30) days of receipt. 6. Adiustment of Compensation and/or Completion Date. In the event of any occurrence wholly beyond the Consultant's control which is not reasonably anticipatable or any other cause which the City, in its sole discretion, determines justifies an adjustment to the Compensation or the Completion Date, the City shall in writing make such adjustments to the Compensation or the Completion Date as the City, in its sole discretion, may approve. 7. Independent Contractor Arrangement. The Consultant is serving as an independent contractor only, and this Agreement will in no way create any joint venture or employment relationship between the Consultant and the City. The Consultant shall have no authority to bind the City in any contract, agreement or otherwise. The City shall have no obligation to: (i) provide training to the Consultant; (ii) instruct the Consultant as to when, where, or how the Consultant is to work; (iii) hire or supervise or pay any assistants for the Consultant; or (iv) furnish the Consultant with tools, materials or equipment. The City shall have no obligation to withhold from the Compensation any taxes, FICA, or federal or state unemployment insurance premiums. The Consultant shall not accrue leave, retirement, insurance, bonding, retirement, profit-sharing or any other benefits which may or may not be afforded employees of the City. 8. Ownership/Use of Documents. Any report(s) and any other documents prepared by the Consultant with respect to the Services shall be the property of the City with all common law and statutory rights related thereto. The City shall have the right to use such documents for any purpose deemed appropriate by the City; provided however, the Consultant shall have no liability for any use of such documents by the City for any purpose unrelated to the Services. The Consultant shall provide the City with two copies of each document requested by the City in both hard copy and electronic form. THE CITY'S REVIEW, APPROVAL OR USE OF ANY AND ALL DOCUMENTS PREPARED BY THE CONSULTANT SHALL BE FOR THE CITY'S SOLE PURPOSE AND SHALL NOT IMPLY THE CITY'S REVIEW OF THE SAME, NOR OBLIGATE THE CITY TO REVIEW SAME FOR QUALITY, COMPLIANCE WITH ALL APPLICABLE STATUTES, CODES, RULES AND REGULATIONS OR OTHER LIKE MATTERS. ACCORDINGLY, NOTWITHSTANDING THAT ANY DOCUMENTS PREPARED BY THE CONSULTANT AND REVIEWED BY THE CITY OR ANY AGENT OR EMPLOYEE OF THE CITY, AND NOTWITHSTANDING ANY ADVICE OR ASSISTANCE WHICH MAY BE RENDERED TO THE CONSULTANT BY THE CITY OR THE CITY'S AGENTS OR EMPLOYEES, INCLUDING BUT NOT LIMITED TO THE: CITY'S DESIGNATED REPRESENTATIVES, THE CITY SHALL HAVE NO LIABILITY WHATSOEVER IN CONNECTION THEREWITH AND SHALL NOT BE RESPONSIBLE FOR ANY OMISSIONS OR ERRORS CONTAINED IN ANY SUCH DOCUMENT SUBMITTED TO THE CITY FOR REVIEW AND APPROVAL AND ANY SUCH CITY APPROVAL SHALL NOT CONSTITUTE A WAIVER OR RELEASE OF THE CONSULTANT HEREUNDER OR AS PROVIDED BY APPLICABLE LAW. THE PROVISIONS HEREOF AND THE ENFORCEMENT OF SUCH PROVISIONS SHALL SURVIVE THE TERMINATION OF THIS AGREEMENT. 9. Insurance. La)Unless otherwise agreed to in writing by the parties, the Consultant acknowledges and agrees that the City shall have no duty to obtain and maintain any insurance including, but not limited to, a workers' compensation insurance policy, for the benefit of the Consultant. (b)The Consultant hereby agrees to certificates of insurance in the types and amounts outlined in Exhibit "A" attached hereto. 10. Dispute Resolution. The City and the Consultant are fully committed to working with each other and agree to communicate regularly with each other at all times so as to avoid or minimize disputes or disagreements with respect to the Services to be performed by the Consultant pursuant to the terms of this Agreement. If disputes or disagreements do arise, the City and the Consultant each commit to resolve such disputes or disagreements in an amicable, professional, and expeditious manner so as to avoid unnecessary losses, delays, and disruptions to completion of the Services. The City and the Consultant will first attempt to resolve any disputes or disagreements at the field level through discussions between the parties' respective designated representatives. The Consultant shall continue to perform the Services and the City shall continue to satisfy its payment obligations to the Consultant pending the final resolution of any dispute or disagreement between the parties. 11. Governing Law. This Agreement shall be construed and enforced in accordance with the laws of the State of Texas. 12. Termination; Suspension. (a) By the City. The City may terminate this Agreement immediately upon any breach of this Agreement by the Consultant. The City may also terminate this Agreement upon sixty days (60) days written notice to the Consultant for the City's convenience and without cause. Upon written notice to the Consultant, the City may for its convenience and without cause suspend performance of the Services by the Consultant for a period not to exceed sixty (60) consecutive days. In the event of a suspension by the City, the City shall equitably adjust the Compensation and the Completion Date as set forth in Paragraph 7 above. (b) By the Consultant. The Consultant may terminate this Agreement if the City fails to pay the Consultant in compliance with Paragraph 3 herein. Provided, however, that the Consultant must have first given the City written notice of such failure to pay and the City must have failed to cure such nonpayment within sixty (60) days of receipt of such notice. The Consultant may also terminate this Agreement if the City suspends Consultant's performance of the Services for a period in excess of ninety (90) consecutive days. In the event of a termination of this Agreement, the City shall pay Consultant an amount equal to the value of the Services actually rendered to the City by the Consultant as of the date of such termination. 13. Indemnification. The Consultant shall indemnify and hold harmless the City, its elected and appointed officials, employees, agents and representatives (the "Indemnified Parties") from all losses, claims, liabilities, injuries, damages, actions or causes of action, and any costs and expenses, including, without limitation, reasonable attorney's fees, of any type or description, brought, asserted or made for or on account of any injuries or damages received or sustained by any person or persons (including, without limitation, one of the Indemnified Parties) or property, arising out of, relating to, or occasioned by the performance or lack of performance, errors, omissions, negligence or intentional acts of the Consultant, its agents, consultants, subcontractors or employees related to the Services and its duties and obligations under or pursuant to this Agreement, whether or not any other party contributes to such performance or lack of performance, errors, omissions, negligence or intentional acts of the Consultant, its agents, consultants, subcontractors or employees. Upon demand by the City, the Consultant shall diligently defend any indemnified matter relating to the Services and which is made or commenced against the City, whether alone or together with the Consultant or any other person, all at the Consultant's own cost and expense and by counsel to be approved by the City in the exercise of its reasonable judgment. In the alternative, at any time the City may elect to conduct its own defense through counsel selected by the City and at the cost and expense of the Consultant. Nothing in this Paragraph 13 shall limit or impair any rights or remedies of the City against the Consultant or any other person under any other provision of this Agreement or under applicable law. The Consultant shall not be required to indemnify the City if such indemnification would be a violation of a Texas statute. The terms of this Paragraph l3shall survive the termination of this Agreement. 14. Status of the Consultant. The Consultant hereby represents, promises and warrants to the City: that the Consultant is financially solvent and possesses sufficient experience, all required licenses, authority, personnel and working capital to complete the Services required under this Agreement. 15. Business Ethics Standards. The Consultant hereby acknowledges that it has reviewed the City's business ethics policy attached hereto in Exhibit "A" and incorporated herein by reference for all purposes. The Consultant represents to the City that it has not violated such standards in its dealings with the City and covenants that it will abide by such standards in the Consultant's performance of this Agreement. 16. Confidentiality. (a)The City considers all non-public information concerning the Services to be performed under the terms of this Agreement as well as any reports or other documentation related thereto to be confidential and proprietary unless otherwise expressly indicated in writing by the City to the Consultant. The Consultant shall not release any non-public information to any third party without the prior written consent of the City. (b) The Consultant and the City shall ensure compliance with federal regulations under the Health Insurance Portability and Accounting Act (HIPAA) regarding privacy of all protected health information (PHI) and shall take steps and do all things reasonably necessary to ensure that the terms of this Agreement, all , all information obtained during the term of this Agreement disclosed or made use of outside the business of such other party for the purposes of meeting. their obligations under this Agreement remains confidential; provided, however, that the foregoing shall not apply to information: (i) provided to voluntary accreditation agencies, government agencies or third party payors as required by Law or consented to by the affected party; ii reasonable required by health care providers providing health care services to Eligible Members; (iii) that either party can show was known to it prior to disclosure by the other party; or (iv) that is or becomes public knowledge through no fault of the party to whom the disclosure is made. 17. Assignment. The Consultant agrees that the duties and obligations of the Consultant under this Agreement are not assignable or transferable and the Consultant agrees not to subcontract any of the Services to be performed hereunder, without the prior written approval of the City. 18. Entire Agreement. This Agreement constitutes and expresses the entire agreement between the parties and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement shall not be amended or modified except by written instrument signed by both parties. 19. Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be deemed to be an original, and all of which, when taken together, shall constitute one and the same Agreement. a a v11 i111J AGREEMENT OR BY ANY CONDUCT OF ITS REPRESENTATIVES UNDER TATC a r_1D'V'rxxry r. A w" !I!\ TT?T .v i> a • •,t>t»,7 U RIGHT TO ASSERT ALL CLAIMS AND DEFENSES IN ANY LEGAL PROCEEDING. EXECUTED this day of Wachovia Insurance Services, Inc. By:—�022LL-A At"-L-L-Ij) Nam Title: CITY OF LUBBOCK David A. Mil r, Mayor ATTEST: Re ecca Garza, City Secretary APPROVED AS TO CONTENT: C-S C Z",-"" :f - Leisa Hutcheson, Risk Manager APPROVED AS TO FORM: rTo Knight, '` Assistant City Attorney Resolution No. 2006—RO370 RFP 06-044-MA Health Benefits Consulting Services SUBMIT TO: , CITY OF LUBBOCK ` CITY OF LUBBOCK, TEXAS Purchasing &Contract Management 1625 136 Street, Rm 204 REQUEST FOR Lubbock, Tx 79401-3830 AN EQUAL PROPOSAL CONTACT PERSON: OPPORTUNITY Marta Alvarez EMPLOYER #06-044-MA TEL: 806.775.2167 FAX: 806.775.2164 http://purchasing.cilubbock.tx.us TITLE: Health Benefits Consulting Services SUBMITTAL DEADLINE: July 6, 2006, 2:00 CST PRE PROPOSAL DATE, TIME AND LOCATION: June 22, 2006 @a 1 1:00 Any proposals received after the rime and date listed above, A.M., in the Purchasing Conference Room 204, Municipal Building, regardless ofthe modeofdelivey, shall be returned unopened. 1625 1P Street, Lubbock, Texas. RESPONDENT NAME: IF RETURNING AS A "NO RESPONSE", PLEASE STATE REASON. MAILING ADDRESS: CITY — STATE — ZIP: THE CITY OF LUBBOCK RESERVES THE RIGHT TO ACCEPT OR REJECT ANY AND ALL PROPOSALS IN WHOLE OR IN PART AND WAIVE ANY INFORMALITY IN THE COMPETITIVE PROPOSAL PROCESS. TELEPHONE NO: FURTHER, THE CITY RESERVES THE RIGHT TO ENTER INTO ANY CONTRACT DEEMED TO BE IN THE BEST INTEREST OF THE CITY. FAX NO: IT IS THE INTENT AND PURPOSE OF THE CITY OF LUBBOCK THAT THIS REQUEST PERMITS COMPETITIVE PROPOSALS. IT IS THE E-MAIL: OFFEROR'S RESPONSIBILITY TO ADVISE THE CITY OF LUBBOCK PURCHASING MANAGER IF ANY LANGUAGE, REQUIREMENTS, ETC., OR ANY COMBINATIONS THEREOF, INADVERTENTLY RESTRICTS OR FEDERAL TAX ID NO. OR SOCIAL SECURITY NO. LIMITS THE REQUIREMENTS STATED IN THIS RFP TO A SINGLE SOURCE. SUCH NOTIFICATION MUST BE SUBMITTED IN WRITING AND MUST BE RECEIVED BY THE PURCHASING MANAGER NO LATER THAN FIVE (5) BUSINESS DAYS PRIOR TO THE ABOVE SUBMITTAL DEADLINE. THE OFFEROR HEREBY ACKNOWLEDGES RECEIPT OF AND AGREES ITS PROPOSAL IS BASED ON ANY ADDENDA POSTED ON RFPDEPOT.COM The City of Lubbock Charter states that no officer or employee of the City can benefit from any contract, job, work or service for the municipality or be interested in the sale to the City of any supplies, equipment, material or articles purchased. Will any officer or employee of the City, or member of their immediate family, benefit from the award of this proposal to the above firm?_ YES NO IN COMPLIANCE WITH THIS SOLICITATION, THE UNDERSIGNED OFFEROR HAVING EXAMINED THE REQUEST FOR PROPOSAL, AND BEING FAMILIAR WITH THE CONDITIONS TO BE MET, HEREBY SUBMITS THE FOLLOWING. AN INDIVIDUAL AUTHORIZED TO BIND THE COMPANY MUST SIGN THE FOLLOWING SECTION. FAILURE TO EXECUTE THIS PORTION MAY RESULT IN PROPOSAL REJECTION. By my signature I certify that this offer is made without prior understanding, agreement, or connection with any corporation, firm, business entity, or person submitting an offer for the same materials, supplies, equipment, or service(s), and is in all respects fair and without collusion or fraud. I further agree that if the offer is accepted, the offeror will convey, sell, assign, or transfer to the City of Lubbock all right, title, and interest in and to all causes of action it may now or hereafter acquire under the Anti-trust laws of the United States and the State of Texas for price fixing relating to the particular commodity(s) or service (s) purchased or acquired by the City of Lubbock. At the City's discretion, such assignment shall be made and become effective at the time the City tenders final payment to the vendor. RFP-06-44-MA.doc Authorized Signature Print/Type Name RFP 06-044-MA Health Benefits Consulting Services Title Date THIS FORM MUST BE COMPLETED AND RETURNED WITH YOUR RESPONSE. RFP-06-44-MA.doc Resolution No. 2006—RO370 RFP 06-044-MA Health Benefits Consulting Services Health Benefits Consulting Services CITY OF LUBBOCK, TEXAS RFP #06-044-MA The City of Lubbock appreciates your time and effort in preparing your proposal. All offerors should familiarize themselves with the following INSTRUCTIONS TO OFFERORS and GENERAL REQUIREMENTS: I. INSTRUCTIONS TO OFFERORS 1 PROPOSAL DELIVERY, TIME & DATE 1.1 The City of Lubbock will receive written and sealed competitive proposals for Health Benefits Consulting Services until 2:00 p.m. CST, July 6, 2006, if date/time stamped on or before 2:00 at the office listed below. Any proposal received after the date and hour specified will be rejected and returned unopened to the offeror. Each proposal and supporting documentation must be in a sealed envelope or container plainly labeled in the lower left-hand corner: 'RFP #06-044-MA, Health Benefits Consulting Services" and the closing date and time. Offerors must also include their company name and address on the outside of the envelope or container. Proposals must be addressed to: Marta Alvarez, Interim Purchasing Manager City of Lubbock 1625 13th Street, Room 204 Lubbock, Texas 79401 1.2 Offerors are responsible for making certain proposals and proposed contracts are delivered to the Purchasing Department. Mailing of a proposal does not ensure that the proposal will be delivered on time or delivered at all. If offeror does not hand deliver proposal, we suggest that he/she use some sort of delivery service that provides a receipt. The City of Lubbock assumes no responsibility for errant delivery of proposals, including those relegated to a courier agent who fails to deliver in accordance with the time and receiving point specified. 1.3 Proposals will be accepted in person, by United States Mail, by United Parcel Service, or by private courier service. No proposals will be accepted by oral communication, telephone, electronic mail, telegraphic transmission, or telefacsimile transmission. THE CITY WILL NOT ACCEPT FAX PROPOSALS. 1.4 Proposals may be withdrawn prior to the above scheduled time set for closing. Alteration made before RFP closing must be initiated by offeror guaranteeing authenticity. 1.5 The City of Lubbock reserves the right to postpone the date and time for accepting proposals through an addendum. RFP-06-44-MA.doc 3 RFP 06-044-MA Health Benefits Consulting Services 2 PRE -PROPOSAL MEETING 2.1 For the purpose of familiarizing offerors with the requirements, answering questions, and issuing addenda as needed for the clarification of the Request for Proposal (RFP) documents, a pre -proposal meeting will be held at 11.00 a.m., June 22 2006 in the Purchasing Conference Room 204, Municipal Building, 1625 13'b Street, Lubbock, Texas. All persons attending the conference will be asked to identify themselves and the prospective offeror they represent. 2.2 It is the offerors responsibility to attend the pre -proposal meeting though the meeting is not mandatory. The City will not be responsible for providing information discussed at the pre -proposal meeting to offerors who do not attend the pre -proposal meeting. 2.3 The City of Lubbock does not discriminate against person with disabilities. City of Lubbock pre -proposal meetings are available to all persons regardless of disability. If you would lice information made available in a more accessible format or if you desire assistance, please contact the City of Lubbock ADA Coordinator, 1625 13th Street, (806)775-2018 at least forty-eight (48) hours in advance of the conference. 3 CLARIFICATION OF REQUIREMENTS 3.1 It is the intent and purpose of the City of Lubbock that this request permits competitive proposals. It is the offeror's responsibility to advise the City of Lubbock Purchasing Manager if any language requirements etc or any combinations thereof inadvertently restricts or limits the requirements stated in this RFP to a single source. Such notification must be submitted in writing and must be received by the City of Lubbock Purchasing Office no later than five (5) business days prior to the proposal closing date. A review of such notifications will be made. V 3.2 ALL REQUESTS FOR ADDITIONAL INFORMATION OR CLARIFICATION CONCERNING THIS REQUEST FOR PROPOSAL (RFP) MUST BE SUBMITTED IN WRITING NO LATER THAN FIVE (5) BUSINESS DAYS PRIOR TO THE PROPOSAL CLOSING DATE AND ADDRESSED TO: Marta Alvarez, Interim Purchasing Manager City of Lubbock 1625 130' Street Lubbock, Texas 79401 Fax: (806) 775-2164 Email: malvarez@mylubbock.us RFPDepot: http://www.RFPdepot.com 4 ADDENDA & MODIFICATIONS RFP-06-44-MA.doc RFP 06-044-MA Health Benefits Consulting Services 4.1 Any changes, additions, or clarifications to the RFP are made by ADDENDA information available over the Internet at http://w,,vw.RFpdeyot.com. We strongly suggest that you check for any addenda a _ of forty-eight hours in advance of the response deadline. BUSINESSES WITHOUT INTERNET ACCESS may use computers available at most public libraries. 4.2 Any offeror in doubt as to the true meaning of any part of the RFP or other documents may request an interpretation thereof from the Purchasing Department. At the request of the offeror, or in the event the Purchasing Department deems the interpretation to be substantive, the interpretation will be made by written addenda issued by the Purchasing Department. Such addenda issued by the Purchasing Department will be available over the Internet at _http://www.RFPdepot.com and will become part of the proposal package having the same binding effect as provisions of the original RFP. No verbal explanations or interpretations will be binding. In order to have a request for interpretation considered, the request must be submitted in writing and must be received by the City of Lubbock Purchasing Department no later than five (5) days prior to the proposal closing date. 4.3 The City does not assume responsibility for the receipt of any addendum sent to offerors. 5 EXAMINATION OF DOCUMENTS AND REQUIREMENTS 5.1 Each offeror shall carefully examine all RFP documents and thoroughly familiarize itself with all requirements prior to submitting a proposal to ensure that the proposal meets the intent of this RFP. 5.2 Before submitting a proposal, each offeror shall be responsible for making all investigations and examinations that are necessary to ascertain conditions and requirements affecting the requirements of this RFP. Failure to make such investigations and examinations shall not relieve the offeror from obligation to comply, in every detail, with all provisions and requirements of the Request for Proposal. 6 PROPOSAL COPIES 6.1 OFFEROR'S MUST SUBMIT THE ORIGINAL AND FIVE COPIES OF THE SEALED PROPOSAL TO THE PURCHASING DEPARTMENT PRIOR TO RESPONSE DUE DATE/TIME FAILURE TO SUBMIT THE ADDITIONAL COPIES MAY RESULT IN THE PROPOSAL BEING DECLARED UNRESPONSIVE. The original must be clearly marked "ORIGINAL" and the copies must be clearly marked "COPY" . 6.2 All proposals, responses, inquiries, or correspondence relating to or in reference to this RFP, and all electronic media, reports, charts, and other documentation submitted by offerors shall become the property of the City of Lubbock when received. 7 PROPOSAL PREPARATION COSTS RFP-06-44-MA.doc 5 RFP 06-044-MA Health Benefits Consulting Services 7.1 Issuance of this RFP does not commit the City of Lubbock, in any way, to pay any costs incurred in the preparation and submission of a proposal. 7.2 The issuance of this RFP does not obligate the City of Lubbock to enter into contract for any services or equipment. 7.3 All costs related to the preparation and submission of a proposal shall be paid by the proposer. S TRADE SECRETS, CONFIDENTIAL INFORMATION AND THE TEXAS PUBLIC INFORMATION ACT 8.1 If you consider any portion of your proposal to be privileged or confidential by statute or judicial decision, including trade secrets and commercial or financial information, clearly identify those portions. 8.2 Proposals will be opened in a manner that avoids disclosure of the contents to competing offerors and keeps the proposals secret during negotiations. All proposals are open for public inspection after the contract is awarded, but trade secrets and confidential information in the proposals are not open for inspection. 8.3 The City of Lubbock will honor your notations of trade secrets and confidential information and decline to release such information initially, but please note that the final determination of whether a particular portion of your proposal is in fact a trade secret or commercial or financial information that may be withheld from public inspection will be made by the Texas Attorney General or a court of competent jurisdiction. In the event a public information request is received for a portion of your proposal that you have marked as being confidential information, you will be notified of such request and you will be required to justify your legal position in writing to the Texas Attorney General pursuant to Section 552.305 of the Goverment Code. In the event that it is determined by opinion or order of the Texas Attorney General or a court of competent jurisdiction that such information is in fact not privileged and confidential under Section 552.110 of the Government Code and Section 252.049 of the Local Government Code, then such information will be made available to the requester. 8.4 Marking your entire proposal CONFIDENTIAL/PROPRIETARY is not in conformance with the Texas Open Records Act. 9 DISADVANTAGED BUSINESS ENTERPRISE (DBE) REQUIREMENTS 9.1 The City of Lubbock hereby notifies all offerors that in regard to any contract entered into pursuant to this RFP, Disadvantaged Business Enterprises (DBE's) will be afforded equal opportunities to submit proposals and will not be discriminated against on the grounds of race, color, sex, disability, or national origin in consideration of an award. 9.2 A DBE is defined as a small business concern which is at least 51% owned and controlled by one or more socially and economically disadvantaged individuals, or in the case of any publicly owned business, at least 51 % of the stock of which is owned by one ore more socially and economically disadvantaged individuals. Socially and RFP-06-44-MA.doe RFP 06-044-MA Health Benefits Consulting Services economically disadvantaged include Women, Black Americans, Hispanic Americans, Native Americans, Asian -Pacific Americans, and Asian -Indian Americans. 10 DELETED 11 CONFLICT OF INTEREST 11.1 The Offeror shall not offer or accept gifts or anything of value nor enter into any business arrangement with any employee, official or agent of the City of Lubbock 11.2 By signing their proposal, the offeror certifies and represents to the City the offeror has not offered, conferred or agreed to confer any pecuniary benefit or other thing of value for the receipt of special treatment, advantage, information, recipient's decision, opinion, recommendation, vote or any other exercise of discretion concerning this RFP. 12 ANTI -LOBBYING PROVISION 12.1 DURING THE PERIOD BETWEEN PROPOSAL SUBMISSION DATE AND THE CONTRACT AWARD, PROPOSERS, INCLUDING THEIR AGENTS AND REPRESENTATIVES, SHALL NOT DIRECTLY DISCUSS OR PROMOTE THEIR PROPOSAL WITH ANY MEMBER OF THE LUBBOCK CITY COUNCIL OR CITY STAFF EXCEPT IN THE COURSE OF CITY - SPONSORED INQUIRIES, BRIEFINGS, INTERVIEWS, OR PRESENTATIONS, UNLESS REQUESTED BY THE CITY. 12.2 This provision is not meant to preclude offerors from discussing other matters with City Council members or City staff. This policy is intended to create a level playing field for all potential offerors, assure that contract decisions are made in public, and to protect the integrity of the RFP process. Violation of this provision may result in rejection of the offeror's proposal. 13 AUTHORIZATION TO BIND SUBMITTER OF PROPOSAL Proposals must show vendor name and address of offeror. The original proposal must be manually signed by an officer of the company having the authority to bind the submitter to its provisions. Person signing proposal must show title or AUTHORITY TO BIND THEIR FIRM IN A CONTRACT. Failure to manually sign proposal will disqualify it. 14 ABOUT THIS DOCUMENT This document is a Request for Proposal. It differs from an Invitation to Bid in that the City of Lubbock is seeking a solution, as described in the following General Requirements section, not a bid/quotation meeting firm specifications for the lowest price. As such, the lowest price proposed will not guarantee an award recommendation. Sealed proposals will be evaluated based upon criteria formulated around the rrost important features of a product or service, of which quality, testing, references, availability or capability, may be overriding factors, and price may not be determinative in the issuance of a contract or award. The proposal evaluation criteria should be viewed as standards that measure how well an offeror's approach meets the desired requirements and needs of the City of Lubbock. Those criteria that will be used and RFP-06-44-MA.doc RFP 06-044-MA Health Benefits Consulting Services considered in evaluation for award are set forth in this document. The City will thoroughly review all proposals received The City will also utilize its best judgment when determining whether to schedule a pre -proposal conference (before proposals are accepted), or meetings with offerors (after receipt of all proposals). A Purchase Order/Contract will be awarded to a qualified offeror submitting the best proposal. The City reserves the right to select, and subsequently recommend for an award, the proposed service which best meets its required needs, quality levels, and budget constraints. 15 EVALUATION PROCESS 15.1 All proposals will be evaluated by an evaluation committee and may include senior management representatives, a financial officer, and/or an independent consultant. 15.2 Respondents to this RFP may be required to submit additional information that the City may deem necessary to further evaluate the offeror's qualifications. 15.3 The committee will evaluate and numerically score each proposal in accordance with the evaluation criteria included in the Request for Proposal. 15.4 The committee will arrive at a short list of the top respondents and these short-listed respondents may be scheduled for a structured oral presentation and interview. Such presentations will be at no cost to the City of Lubbock. At the end of the oral presentation and interview, the evaluation of the short-listed respondents will be completed. The oral interview may be recorded and/or videotaped. 16 SELECTION 16.1 Selection shall be based on the responsible offeror whose proposal is determined to be the most advantageous to the City of Lubbock considering the relative importance of evaluation factors included in this RFP. 16.2 NO INDIVIDUAL OF ANY USING DEPARTMENT HAS THE AUTHORITY TO LEGALLY AND/OR FINANCIALLY COMMIT THE CITY TO ANY CONTRACT, AGREEMENT OR PURCHASE ORDER FOR GOODS OR SERVICES, UNLESS SPECIFICALLY SANCTIONED BY THE REQUIREMENTS OF THIS REQUEST FOR PROPOSAL. 17 EQUAL EMPLOYMENT OPPORTUNITY Offeror agrees that it will not discriminate in hiring, promotion, treatment, or other terms and conditions cf employment based on race, sex, national origin, age, disability, or in any way violative of Title VII of 1964 Civil Rights Act and amendments, except as permitted by said laws. 18 NONAPPROPRIATION All funds for payment by the City under this contract are subject to the availability of an annual appropriation for this purpose by the City. In the event of non -appropriation of funds by the City Council of the City of Lubbock for the goods or services provided under the contract, the RFP-06-44-MA.doc 8 RFP 06-044-MA Health Benefits Consulting Services City will terminate the contract, without termination charge or other liability, on the last day of the then -current fiscal year or when the appropriation made for the then -current year for the goods or services covered by this contract is spent, whichever event occurs first. If at any time funds are not appropriated for the continuance of this contract, cancellation shall be accepted by the Seller on thirty (30) days prior written notice, but failure to give such notice shall be of no effect and the City shall not be obligated under this contract beyond the date of termination. 19 PROTEST 19.1 All protests regarding the RFP process must be submitted in writing to the City Purchasing Manager within five (5) business days following the opening of proposals. This includes all protests relating to advertising of notices, deadlines, proposal opening, and all other related procedures under the Local Government Code, as well as any protest relating to alleged improprieties with the RFP process. This limitation does not include protests relating to staff recommendations as to award of contract. Protests relating to staff recommendations may be directed to the City Manager. All staff recommendations will be made available for public review prior to consideration by the City Council as allowed by law. 19.2 FAILURE TO PROTEST WITHIN THE TEN4E ALLOTTED SHALL CONSTITUTE A WAIVER OF ANY PROTEST. The City of Lubbock is aware of the time and effort you expend in preparing and submitting proposals to the City. Please let us know of any requirement causing you difficulty in responding to our Request for Proposal. We want to facilitate your participation so that all responsible firms can compete for the City's business. Awards should be made approximately two to six weeks after the opening date. If you have any questions, please contact the City of Lubbock Purchasing Manager at (806) 775-2572. RFP-06-44-MA.doc 9 RFP 06-044-MA Heath Benefits Consulting Services TABLE OF CONTENTS A. Introduction • Background Information • Benefits Offered and Current Vendors • Proposal Rules • Evaluation Criteria B. Scope of Services C. Format and Contents of Proposal ? Title Page ? Table of Contents • Technical Proposal • Qualification of Consultant • Price Proposal and Contract Fee D. Required Attachments • Disclosure Agreement • Disclosure Notice • Sample Contract E. Exhibits • City of Lubbock Plan Document • Schedule of Rates Active Health Retiree Dental Active Dental Retiree Health • Claims Information • Clinic Costs RFP-06-44-MA.doc 10 RFP 06-044-MA Health Benefits Consulting Services CITY OF LUBBOCK,TEXAS REQUEST FOR PROPOSAL HEALTH BENEFITS CONSULTING SERVICES A: INTRODUCTION BACKGROUND INFORMATION: The City of Lubbock, Texas, (hereafter referred to as "City") is requesting proposals from qualified providers of professional insurance consultant services to assist in the review and procurement of employee benefits plans, both City provided and voluntary employee plans. The City, like many organizations, has incurred dramatically increased costs for health insurance coverage. It is the City's desire to explore any and all avenues for containing total heath insurance costs, lowering the City's and member's contributions, if possible, while still providing a competitive and comprehensive package to eligible members. The City currently has 1887 active employees, 450 retirees and approximately 4600 total lives insured on its health insurance plan. BENEFITS OFFERED AND CURRENT VENDORS: MEDICAL BENEFITS — The City offers its employees, retirees and their eligible dependents a preferred provider organization (PPO) plan. Under this benefit there is also an Out -of -Area plan which provides for participants living in an area where there are no PPO Network Providers. The Out -of -Area plan is a traditional indemnity plan. Currently, there are 4,631 lives covered in the plan. The current vendor is HealthSmart Preferred Care. Our Third Party Administrator is American Administrative Group. For the 2006 plan year medical benefits remained unchanged from the prior coverage year. The City is a self -funded plan with individual stop loss of $175,000 per participant. Our minimum aggregate attachment point for 2006 is $18,845,756.62. Highmark Life and Casualty Group provide the City's stop loss and aggregate coverage. Additionally, the City has an Organ and Tissue Transplant Policy as part of our health plan. The policy is through AIG Life Insurance Company. The plan year is January 1 to December 31. The City is in the final year of renewals. PBM BENEFITS — Our current vendor for pharmacy benefits is MaxorPlus. Maxor has a network of over 44,300 chain and retail pharmacies. The contract term is annual with an option to renew for two (2) additional one (1) year terms. The contract began April 1, 2006. DENTAL BENEFITS — The City's dental benefits are 100% self -funded. Participants can go to the dentist of their choice. American Administrative Group is the claims payor for dental benefits. The plan year is January 1 to December 31. The City is in the final year of renewals. LIFE BENEFITS — The current vendor for life benefits is Standard Insurance Company. Every eligible full time City employee is provided $10,000 term life and AD&D coverage. The City pays for this coverage. The contract term is for three (3) years and expires December 1, 2007. OPTIONAL LIFE (VOLUNTARY) — Employees may purchase an amount equal to 1X, 2X or 3X their annual salary (rounded to the next highest $1,000 of benefit) to a maximum benefit RFP-06-44-MA.doc 11 RFP 06-044-MA Health Benefits Consulting Services of the lessor of $500,000. Dependent life is also available for the employee to purchase. A spouse may be covered for 100% of the employee's coverage in $5,000 increments up to $50,000. Dependent children ages 7 days to 6 months are covered for $1,500; ages 6 months to 19/25 years they may be covered in $2,500 increments up to $10,000. Standard Insurance Company is also the vendor for our voluntary life program. The contract term is for three (3) years and expires December 1, 2007. LONG TERM DISABILITY (VOLUNTARY) — The current vendor for this benefit is ING Employee Benefits. Two choices are offered to employees for long term disability benefits. The first plan is a 90 day elimination period which will provide 67% of an employee's base pay. The second plan is a 180 day elimination period providing 60% of an employee's base pay. The premiums are based on age, plan chosen and $100 of eligible salary. The contract term is January 1, 2005 through December 31, 2006 with 30% participation or December 31, 2007 with 50% participation and may be extended for an additional one (1) year term. SHORT TERM DISABILITY (SELF -FUNDED SICK LEAVE SHARING) — ING Employee Benefits is the vendor on this Advise to Pay Agreement. The purpose of this benefit is to assist all regular full time employees if a catastrophic illness or injury forces the employee to exhaust all leave time, lose compensation from the City and the situation presents a financial hardship to the employee. An employee must have at least 3 months continuous full time service with the City and be classified as a full time employee. The City has a complete Sick Leave Sharing Policy in their Personnel Policy Guidebook. The initial contract term was for January 1, 2005 to December 32, 1005. The Advise to Pay Agreement is automatically renewed for successive twelve (12) month periods until terminated. DEFERRED COMPENSATION (VOLUNTARY) — The City has two vendors for deferred compensation, ING and ICMA. FLEX PLAN (VOLUNTARY) — Our Flex Plan is administered by American Administrative Group. A Medical Reimbursement Account and Dependent Care Assistant Account are offered for enrollment. The plan year is January 1 to December 31. The City is in the final year of renewals. CANCER PLAN (VOLUNTARY) — EMC National Life Company provides the voluntary cancer product for City employees. Rates are based on coverage selected. The Payroll Deduction Agreement began October 19, 1995 and may be terminated at any time by either party with 90 days written notice. VISION (VOLUNTARY) — Coast to Coast 20/20 Select Vision Plan is administered by Forrest T. Jones Consulting Company. This is a discount plan for exams and hardware. The contract began December 1, 1999 and is renewed annually. PRE -PAID LEGAL (VOLUNTARY) — Legal Plans USA is our vendor for pre -paid legal services providing free legal consultations, free legal correspondence and reduced rates for other legal services. The effective date is December 1, 1999 and is automatically renewed annually. The agreement maybe terminated by either party with 60 days written notice. RFP-06-44-MA.doc 12 RFP 06-044-MA Health Benefits Consulting Services PERSONAL ACCIDENT INSURANCE (VOLUNTARY) — Personal Accident Insurance (PAI) is Accidental Death and Dismemberment Insurance. Coverage and rates are based on participant selection. The contract term is December 1, 2003 to November 30, 2006. PROPOSAL RULES: I. One original and five hard copies of sealed proposals must be submitted in writing (no facsimiles, please) at or before 2:00 P.M. on July 6, 2006 to Marta Alvarez, Purchasing Manager at the following address: City of Lubbock (806) 775-2572 P. O. Box 2000 Lubbock, Texas 79457 The sealed envelope must clearly state it is a Health Benefits Consulting Services 06-044-MA, and the date and time of the proposal closing. 2. If the proposal is contingent upon the City providing additional information such as claims history, completed applications, or is subject to any other conditions, such requirements must be stated clearly in the proposal. 3. We request all proposals remain valid without material change for at least 60 days after the due date noted in "l ." above. 4. It is understood and agreed, in the event the consultant cannot meet the terms and conditions agreed to in a signed proposal accepted by the City, then the City shall at its sole option have the right to cancel the contract on a pro-rata basis. 5. The contract period shall commence on or about July 27, 2006 and shall continue for a term of one year. After completion of the initial Contract term, the Contract may be renewed annually for two additional years. 6. The City may require proposers to give oral presentations in support of their proposals or to exhibit or otherwise demonstrate the information contained therein. Any and all expenses involved in making any presentation(s) will be at the expense of the proposer. 7. The City may award a contract on the basis of initial offers received, without discussions. Therefore, each initial offer should contain the proposer's best terms from a cost or price and technical standpoint 8. Each proposal will be reviewed to determine if the proposal is responsive to the submission requirements outlined in the RFP. A responsive proposal is one which follows the requirements of the RFP, includes all required documentation, is submitted in the format outlined in the RFP, is of a timely submission, and has the appropriate signatures as required on each document. Failure to comply with these requirements may deem your proposal non -responsive. The City reserves the right to use more than one Consultant in the placement of coverage. 9. Each proposer shall submit proof of insurance containing coverage for the following: General Liability Insurance $1,000,000 Professional Liability Insurance $1,000,000 Auto Liability Insurance (Any auto) $ 300,000 Workers' Compensation Statutory RFP-06-44-MA.doc 13 RFP 06-044-MA Health Benefits Consulting Services Upon award of the Contract to the successful proposer, the Consultant shall submit a Certificate of insurance naming the City as a primary additional insured on the General Liability Insurance and Auto Liability Insurance policies. All policies shall be endorsed to include a waiver of subrogation in favor of the City. EVALUATION CRITERIA: Broker Experience (30%) — The breadth of knowledge of municipal and/or large commercial accounts and proven ability to assist others with their plans will be considered. Service (30%) — The ability to provide an in depth analysis of the City's current plan, make innovative recommendations to reduce costs, provide services in an expeditious and professional fashion as verified by previous or current clients, the availability of qualified personnel within the offeror's organization, demonstrated accessibility to the marketplace. Financial Capacity (10%) — The capacity to provide coverage and services in the future with minimum risk to the City will be considered. Such measurements as Best and/or submitted certified financial statements may be used to measure this criteria. Price (30%) — The cost of the service requested and proposed. B. SCOPE OF SERVICES It is the intent of the City to obtain proposals for professional consulting services to assist in the analysis and implementation of the City's various insured and self -funded benefits programs. It is also the City's intent that the successful consultant shall put all lines of insurance or plans in place as outlined in "BENEFITS OFFERED AND CURRENT VENDORS' on January 1, 2007, unless another contract date is noted above. All plans and policies obtained through the successful consultant must be net of commission. Any deviation from this will be clearly stated in the proposer's quote. Consultant responsibilities shall include the following: • Assist in the creation and review of the goals and objectives of the benefit design. Recommend alternative benefit designs as dictated by emerging plan costs or benefit practices. Assist in developing the costs associated with various issues involving the benefit plans. • Advise and assist in reviewing the employees' benefits program on a continuing basis to ensure that those plans are in compliance with federal and state requirements and their adequacy of benefits with respect to other plans. Monitor and provide notification on pending or new legislation and changes in tax law, as well as benefits and funding trends that may affect the benefit program. Advise of market and like business benefit trends. • Advise and assist with (1) writing plan modifications and new plans, (2) assist in the amendment approval process and (3) submit written reports and other documents as required by the Federal and State Government. RFP-06-44-MA.doc 14 RFP 06-044-MA Health Benefits Consulting Services • Develop and prepare "Request for Proposal(s)" for benefit vendors. Review proposals and prepare a matrix outlining plan benefits, deficiencies and anticipated costs. Assist with contract negotiations. • Perform an operational review of benefit vendors, which would include the analysis of the following: o Claims procedure and office work flow; o Forms and communication process; o Training programs and employee evaluation process; o Exception processing; o Managed care; o Cost containment procedures; o Quality and quantity of procedural manuals provided to claims processing, customer service, etc.; o Internal audit system; o Evaluation of the security of records and data; o Evaluation of customer service, including communication of the plans, benefits, policies, procedures; and o Security and override procedures relating to approval of claims and access to records. • Advise and assist in reviewing contract renewals, plan documents, insurance policies and other documents for applicability, accuracy and consistency. • Prepare alternative funding analysis and conduct loss forecasts of claims reserves as requested. • Participate in the preparation and presentation of the monthly financial reports for the self -funded plans. Provide projected funding needs for upcoming fiscal year. • Maintain records of the financial and claims experience, condition, and progress of plans and provide quarterly reports. • Facilitate the communications and actions between the group and the benefits vendors. • Assist with the development of employee communication materials, including legislative updates that affect the employees. Help coordinate the design, editing, printing and production of those materials and giving advice and recommendations when necessary and appropriate. • Personal availability for meetings as required. At least quarterly, provide a backup service person that is knowledgeable about the employee benefits program. • Assist with adjudication of specific claims when requested. RFP-06-44-MA.doc 15 RFP 06-044-MA Health Benefits Consulting Services • Discuss and coordinate information with other consultants. • Provide liaison services between the group's employee benefits program and other benefit contractors, including coordination of reporting and assistance resolving claims. • Keep the City abreast of the activity on an aggregate basis with the member groups. • Disclose all fee costs associated with the plan. C. FORMAT AND CONTENTS OF PROPOSAL TITLE PAGE: The title page shall indicate "HEALTH BENEFITS CONSULTING SERVICES RFP" and show the name and address of the brokerage firm as well as the contact person for the firm, phone number, fax number and E-mail address. TABLE OF CONTENTS: The table of contents should outline in sequential order the major areas of the proposal, and all pages of the proposal, including the enclosures. The proposal must be clearly and consecutively numbered and correspond to the table of contents. TECBMCAL PROPOSAL: The technical proposal is a narrative that addresses the scope of work, the proposed approach to the work, the schedule of the work, and any other information called for by the RFP which the proposer deems relevant, including the following: 1. State the full name and home office address of your organization. Describe your organizational structure (e.g. publicly help corporation, private, non-profit, partnership, etc.). If it is incorporated, include the state in which it is incorporated. List the name and occupation of those individuals serving on your organization's board of directors, and list the name of any entity or person owning 10% or more of your organization. 2. List the name, title, telephone number, fax number and e-mail address of the contact person for this proposal. 3. Confirm that you are a licensed consultant or broker. Provide documentation. 4. Confirm that you serve as a consultant or broker, independently, and are not affiliated with any insurance company, third party administrative agency or provider network. 5. Describe your company's organization, philosophy, management and provide a brief history. Describe your contractual relationships, if any, with organizations necessary to your proposal's implementation (e.g. data information services). 6. How long has your organization been providing consulting services? 7. Provide the name(s) of the consultant(s) to perform the work for the City and a brief statement as to why each consultant is qualified to provide services. RFP-06-44-MA.doc 16 RFP 06-044-MA Health Benefits Consulting Services 8. Do you publish newsletters and other informative publications that are routinely provided to your clients? Have you prepared reviews of topics related to the benefits that are routinely provided to your clients? Provide sample copies. 9. Detail your ability to monitor regulatory and legislative developments at both the state and federal level and how this will be communicated to our members. 10. Outline your ability to provide expertise and experience in the areas of health benefit plan analysis and design. Explain in detail the types of analyses you have conducted relative to benefits analysis and design for a health plan with approximately 1900 employees. 11. Provide a recent example of the selection and implementation of a third party claims administrator for a health plan with approximately 4600 participants that was managed by your company. Detail how your company's experience and expertise benefited the client. 12. List three current clients for whom you provide services related to health plan benefits analysis and design. For each client, the list must specify the type of work performed by your company, the size of the client's group and the period of time retained as a client. One of the three must be the longest standing client; one must be the client with an approximate 1900 employee population and 450 retiree population; and the third must be the client for who the largest impact was achieved through your company's services. If two or more of these are met by the same client, list additional clients so that at least three clients are listed. For each client, include the name, title, address, fax number and phone number of a contact person who we may contact as a reference. 13. Describe the issues and challenges, as you view them, facing an employer with 1900 employees in regards to their benefit plan in the upcoming year and describe how your organization can assist. What makes your organization different than other organizations that may submit proposals for consideration? 14. Provide examples of communication materials developed and prepared by your organization for use in client's health benefit communication campaigns. 15. Do you have access or contacts to benefit providers in the retirement program market? How would you be able to provide brokerage services to our members in that area if the City determines that it is in everyone's best interest to separate them from our current plan? 16. How would you envision the relationship and communication between your company and the City? What would you expect as support from the City? 17. Does your organization have access to the carriers of the voluntary plans the City currently offers? What other carriers does your organization have access to? 18. Has your organization recommended other voluntary plans, or cancellation of voluntary plans, to your clients? On what basis do you make your recommendations of this nature? QUALIFICATIONS OF CONSULTANT: Describe in detail the qualifications of your company personnel specifically assigned, and supply a list of current clients for references with names of individuals who can be contacted by the City for discussion of your services to that client. PRICE PROPOSAL AND CONTRACT FEE: The price proposal and contract fee is a presentation of the proposer's total offering price including the cost for providing each component of the required good or services. (Please be RFP-06-44-MA.doc 17 RFP 06-044-MA Health Benefits Consulting Services reminded, and address the fact, that all policies/plans obtained through the consultant are net of commission.) Proposers should indicate the dollar amount that will be attributed to each policy/plan and each sub -contractor, if any. Proposers may use fonnats of their choice. RFP-06-44-MA.doc 18 RFP 06-044-MA Health Benefits Consulting Services D. REQUIRED ATTACHMENTS All of the following pages are required to be completed and attached to your proposal. RFP-06-44-MA.doc 19 RFP 06-044-MA Health Benefits Consulting Services Disclosure Agreement I certify that I nor, my company, any of its representatives, affiliates, contractors, or sub- contractors have or will receive in the future any fees, commissions, or compensation of any kind, including gratuities (IE meals, sporting tickets, gifts) from any 3rd party regarding any services I will provide or recommend to the City of Lubbock. This includes, but is not limited to compensation of any format from an insurance agent or broker, insurance carrier, PPO organizations, HMO organizations or any other party that I may recommend the City of Lubbock to select for insurance related coverages or services. I, my representatives, affiliates, contractors, and sub -contractors further agree to not accept any fees, salaries, commissions, income, compensation, or gratuities of any type for services regarding this RFP other than what is paid to me by the City of Lubbock. I further agree that I will return 100% of my fees for service to the City of Lubbock if I violate any of the above. The Offeror has read the foregoing Disclosure Agreement and fully understands it. Signed, sealed and delivered this day of , 20 SIGNATURE: Signature Date STATE OF TEXAS COUNTY OF This instrument was acknowledged before me on this day of , 2006, by Notary Public, State of Texas My commission expires: RFP-06-44-MA.doc 20 RFP 06-044-MA Health Benefits Consulting Services Disclosure Notice Does your organization currently or have you ever received any fees or funds from any other vendor or payee that you currently have a relationship with, pay claims to or on behalf of, including but not limited to any vendor associated currently or in the past with the City of Lubbock? Complete the following chart. Include any type of funds received (percentage or administrative fees, percentage of rebates, fees for data transfer, percentage of savings, consulting fees, access fees, encounter fees, prompt payment discounts, referral fees, bonuses, commissions, etc.). This issue is of utmost importance to the City of Lubbock. Full disclosure is required. Failure to disclose this information can result in your proposal being disqualified or our contract terminated. Third Party Yes No Detail to any Yes Response HealthCare Provider(s) (Hospitals or physicians) Pharmacy Benefit Managers Network Administrators Utilization Review/Management Company Laboratories/Ancillary Providers Consultants, Brokers, Agents, Lobbyist Insurance Companies/Carriers Any other party other than the employer SAMPLE CONTRACT RFP 06-044-MA Health Benefits Consulting Services Please attach a sample contract for Health Benefits Consulting Services between your company and the City. RFP 06-044-MA Health Benefits Consulting Services E. EXHIBITS RFP 06-044-MA Health Benefits Consulting Services PLAN DOCUMENT AND SUNIlVIARY PLAN DESCRIPTION FOR CITY OF LUBBOCK EMPLOYEE BENEFIT PLAN PLAN EFFECTIVE DATE: January 1, 2004 PLAN RESTATEMENT DATE: January 1, 2006 RFP 06-044-MA Health Benefits Consulting Services TABLE OF CONTENTS INTRODUCTION............................................................................................ Error! Bookmark not defined. ELIGIBILITY, FUNDING, EFFECTIVE DATE AND TERMINATION PROVISIONS.........................................2 OPENENROLLMENT..................................................................................................................................9 SCHEDULEOF BENEFITS..........................................................................................................................10 MEDICALBENEFITS.................................................................................................................................19 COSTMANAGEMENT SERVICES.............................................................................................................. 26 DEFINEDTERMS...................................................................................................................................... 30 PLANEXCLUSIONS.................................................................................................................................. 37 DENTALBENEFITS...................................................................................................................................40 HOWTO SUBMIT A CLAIM.......................................................................................................................44 COORDINATIONOF BENEFITS................................................................................................................48 THIRD PARTY RECOVERY PROVISION.....................................................................................................51 COBRA CONTINUATION OPTIONS...........................................................................................................53 RESPONSIBILITIES FOR PLAN ADMINISTRATION..................................................................................58 HIPAAPRIVACY RULE.............................................................................................................................. 61 GENERAL PLAN INFORMATION...............................................................................................................64 INTRODUCTION This document is a description of City of Lubbock Employee Benefit Plan (the Plan). No oral interpretations can change this Plan. The Plan described is designed to protect Plan Participants against certain catastrophic health expenses. Coverage under the Plan will take effect for an eligible Employee and designated Dependents when the Employee and such Dependents satisfy the Waiting Period and all the eligibility requirements of the Plan. The Employer reserves the right to terminate, suspend, discontinue or amend the Plan at any time and for any reason. Changes in the Plan may occur in any or all parts of the Plan including benefit coverage, deductibles, maximums, copayments, exclusions, limitations, definitions, eligibility and the like. Failure to follow the eligibility or enrollment requirements of this Plan may result in delay of coverage or no coverage at all. Reimbursement from the Plan can be reduced or denied because of certain provisions in the Plan, such as coordination of benefits, subrogation, exclusions, timeliness of COBRA elections, utilization review or other cost management requirements, lack of Medical Necessity, lack of timely filing of claims or lack of coverage. These provisions are explained in summary fashion in this document; additional information is available from the Plan Administrator at no extra cost. The Plan will pay benefits only for the expenses incurred while this coverage is in force. No benefits are payable for expenses incurred before coverage began or after coverage terminated. An expense for a service or supply is incurred on the date the service or supply is furnished. If the Plan is terminated, amended, or benefits are eliminated, the rights of Covered Persons are limited to Covered Charges incurred before termination, amendment or elimination. This document summarizes the Plan rights and benefits for covered Employees and their Dependents and is divided into the following parts: Eligibility, Funding, Effective Date and Termination. Explains eligibility for coverage under the Plan, funding of the Plan and when the coverage takes effect and terminates. Schedule of Benefits. Provides an outline of the Plan reimbursement formulas as well as payment limits on certain services. Benefit Descriptions. Explains when the benefit applies and the types of charges covered. Cost Management Services. Explains the methods used to curb unnecessary and excessive charges. This part should be read carefully since each Participant is required to take action to assure that the maximum payment levels under the Plan are paid. Defined Terms. Defines those Plan terms that have a specific meaning. Plan Exclusions. Shows what charges are not covered. Claim Provisions. Explains the rules for filing claims and the claim appeal process. Coordination of Benefits. Shows the Plan payment order when a person is covered under more than one plan. Third Party Recovery Provision. Explains the Plan's rights to recover payment of charges when a Covered Person has a claim against another person because of injuries sustained. COBRA Continuation Options. Explains when a person's coverage under the Plan ceases and the continuation options which are available. ERISA Information. Explains the Plan's structure and the Participants' rights under the Plan. ELIGIBILITY, FUNDING, EFFECTIVE DATE AND TERMINATION PROVISIONS A PIan Participant should contact the Plan Administrator (City of Lubbock) to obtain additional information, free of charge, about Plan coverage of a specific benefit, particular drug, treatment, test or any other aspect of Plan benefits or requirements. ELIGIBUffI'Y Eligible Classes of Employees. All Active and Retired Employees of the Employer. Eligibility Requirements for Employee Coverage. A person is eligible for Employee coverage from the first day that he or she: (1) is a Full -Time, Active Employee of the Employer. An Employee is considered to be Full -Time if he or she normally works at least40 hours per week and is on the regular payroll of the Employer for that work. (2) is a Retired Employee of the Employer. Retired Employees will be eligible for coverage only if they are eligible for coverage when they are Employees and choose to remain eligible for coverage under this Plan after they become a Retired Employee. An Employee who retires and declines the opportunity to remain eligible under the Plan will no longer be eligible as a Retired Employee. A Retired Employee may not regain either medical or dental coverage if coverage is terminated at any time during retirement. Enrollment in Medicare Parts A and B is required, in order for a retiree who is age 65 or above to be eligible for, or to continue, coverage under this Plan. A surviving spouse of a retired City of Lubbock Employee may retain coverages after the covered Retired Employee's death. Retired Employees are eligible for dental benefits. (3) is in a class eligible for coverage. (4) completes the employment Waiting Period of one full pay period as an Active Employee or first of the month after reaching retiring status for Retired Employees. A "Waiting Period" is the time between the first day of employment and the first day of coverage under the Plan. The Waiting Period is counted in the Pre -Existing Conditions exclusion time. Eligible Classes of Dependents. A Dependent is any one of the following persons: (1) A covered Employee's Spouse and unmarried children from birth to the limiting age of 25 years. When a child reaches the limiting age, coverage will end on the last day of the child's birthday month. The term "Spouse" shall mean the person recognized as the covered Employee's husband or wife under the laws of the state where the covered Employee lives. The Plan Administrator may require documentation proving a legal marital relationship. The term "children" shall include natural children of the Employee, adopted children or children placed with a covered Employee in anticipation of adoption, or Foster Children Step -children may also be included as long as a natural parent remains married to the Employee. The Plan Administrator may require documentation of Legal Guardianship. Grandchildren shall also be included provided the Plan Participant has Legal Guardianship of the children. The Plan Administrator will require documentation proving Legal Guardianship of grandchildren. If a covered Employee is the Legal Guardian of an unmarried child or children, these children may be enrolled in this Plan as covered Dependents. The Plan Administrator may require documentation proving Legal Guardianship. 2 The phrase "child placed with a covered Employee in anticipation of adoption" refers to a child whom the Employee intends to adopt, whether or not the adoption has become final, who has not attained the age of 18 as of the date of such placement for adoption. The term "placed" means the assumption and retention by such Employee of a legal obligation for total or partial support of the child in anticipation of adoption of the child. The child must be available for adoption and the legal process must have commenced. Any child of a Plan Participant who is an alternate recipient under a qualified medical child support order shall be considered as having a right to Dependent coverage under this Plan. A participant of this Plan may obtain, without charge, a copy of the procedures governing qualified medical child support order (QMCSO) determinations from the Plan Administrator. (2) A covered Dependent child who reaches the limiting age and is Totally Disabled, incapable of self-sustaining employment by reason of mental or physical handicap, primarily dependent upon the covered Employee for support and maintenance and unmarried. The Plan Administrator may require, at reasonable intervals during the two years following the Dependent's reaching the limiting age, subsequent proof of the child's Total Disability and dependency. After such two-year period, the Plan Administrator may require subsequent proof not more than once each year. The Plan Administrator reserves the right to have such Dependent examined by a Physician of the Plan Administrator's choice, at the Plan's expense, to determine the existence of such incapacity. These persons are excluded as Dependents: other individuals living in the covered Employee's home, but who are not eligible as defined; the legally separated or divorced former Spouse of the Employee; any person who is on active duty in any military service of any country; or any person who is covered under the Plan as an Employee. If a person covered under this Plan changes status from Employee to Dependent or Dependent to Employee, and the person is covered continuously under this Plan before, during and after the change in status, credit will be given for deductibles and all amounts applied to maximums. If both mother and father are Employees, their children will be covered as Dependents of the mother or father, but not of both. Eligibility Requirements for Dependent Coverage. A family member of an Employee will become eligible for Dependent coverage on the first day that the Employee is eligible for Employee coverage and the family member satisfies the requirements for Dependent coverage. At any time, the Plan may require proof that a Spouse or a child qualifies or continues to qualify as a Dependent as defined by this Plan. FUNDING Cost of the Plan. City of Lubbock pays the entire cost of Employee coverage under this Plan. The covered Employees pay for coverage for their Dependents. The enrollment application for coverage will include a payroll deduction authorization. This authorization must be filled out, signed and returned with the enrollment application. The level of any Employee contributions is set by the Plan Administrator. The Plan Administrator reserves the right to change the level of Employee contributions. PRE-EXISTING CONDITIONS NOTE: The length of the Pre -Existing Conditions Limitation may be reduced or eliminated if an eligible person has Creditable Coverage from another health plan. An eligible person may request a certificate of Creditable Coverage from his or her prior plan within 24 months after losing coverage and the Employer will assist any eligible person in obtaining a certificate of Creditable Coverage from a prior plan. A Covered Person will be provided a certificate of Creditable Coverage if he or she requests one either before losing coverage or within 24 months of coverage ceasing. If, after Creditable Coverage has been taken into account, there will still be a Pre -Existing Conditions Limitation imposed on an individual, that individual will be so notified. Covered charges incurred under Medical Benefits for Pre -Existing Conditions are not payable unless incurred 12 consecutive months, or 18 months if a Late Enrollee after the person's Enrollment Date. This time may be offset if the person has Creditable Coverage from his or her previous plan. A Pre -Existing Condition is a condition for which medical advice, diagnosis, care or treatment was recommended or received within six months prior to the person's Enrollment Date under this Plan. Genetic Information is not a condition. Treatment includes receiving services and supplies, consultations, diagnostic tests or prescribed medicines. In order to be taken into account, the medical advice, diagnosis, care or treatment must have been recommended by, or received from, a Physician. The Pre -Existing Condition does not apply to pregnancy, to a newborn child who is covered under this Plan within 31 days of birth, or to a child who is adopted or placed for adoption before attaining age 18 and who, as of the last day of the 31-day period beginning on the date of the adoption or placement for adoption, is covered under this Plan. A Pre -Existing Condition exclusion may apply to coverage before the date of the adoption or placement for adoption. The prohibition on Pre -Existing Condition exclusion for newborn, adopted, or pre -adopted children does not apply to an individual after the end of the first 63-day period during all of which the individual was not covered under any Creditable Coverage. ENROLLMENT Enrollment Requirements. An Employee must enroll for coverage by filling out and signing an enrollment application along with the appropriate payroll deduction authorization. The covered Employee must also enroll any Dependents when Dependent coverage is requested. Enrollment Requirements for Newborn Children. A newborn child of a covered Employee who has Dependent coverage is not automatically enrolled in this Plan. Charges for covered nursery care will be applied toward the Plan of the newborn child. If the newborn child is required to be enrolled and is not enrolled in this Plan on a timely basis, as defined in the section "Timely Enrollments" following this section, there will be no payment from the Plan and the covered parent will be responsible for all costs. Charges for covered routine Physician care will be applied toward the Plan of the newborn child. If the newborn child is required to be enrolled and is not enrolled in this Plan on a timely basis, there will be no payment from the Plan and the covered parent will be responsible for all costs. If the child is required to be enrolled and is not enrolled within 31 days of birth, the enrollment will be considered a Late Enrollment. TIMELY OR LATE ENROLLMENT (1) Timely Enrollment - The enrollment will be "timely" if the completed form is received by the Plan Administrator no later than 31 days after the person becomes eligible for the coverage, either initially or under a Special Enrollment Period. 4 If two Employees (husband and wife) are covered under the Plan and the Employee who is covering the Dependent children terminates coverage, the Dependent coverage may be continued by the other covered Employee with no Waiting Period as long as coverage has been continuous. (2) Late Enrollment - An enrollment is "late" if it is not made on a "timely basis" or during a Special Enrollment Period. Late Enrollees and their Dependents who are not eligible to join the Plan during a Special Enrollment Period may join only during open enrollment. If an individual loses eligibility for coverage as a result of terminating employment or a general suspension of coverage under the Plan, then upon becoming eligible again due to resumption of employment or due to resumption of Plan coverage, only the most recent period of eligibility will be considered for purposes of determining whether the individual is a Late Enrollee. The time between the date a Late Enrollee first becomes eligible for enrollment under the Plan and the first day of coverage is not treated as a Waiting Period. Coverage begins on first of the month following Open Enrollment. Late Enrollees will be subject to an 18 month pre-existing condition offset by the Covered Person's certificate of creditable coverage. SPECIAL ENROLLMENT PERIODS The enrollment date for anyone who enrolls under a Special Enrollment Period is the first date of coverage. Thus, the time between the date a special enrollee first becomes eligible for enrollment under the Plan and the first day of coverage is not treated as a Waiting Period. (1) Individuals losing other coverage. An Employee or Dependent who is eligible, but not enrolled in this Plan, may enroll if each of the following conditions is met: (a) The Employee or Dependent was covered under a group health plan or had health insurance coverage at the time coverage under this Plan was previously offered to the individual. (b) If required by the Plan Administrator, the Employee stated in writing at the time that coverage was offered that the other health coverage was the reason for declining enrollment. (c) The coverage of the Employee or Dependent who had lost the coverage was under COBRA and the COBRA coverage was exhausted, or was not under COBRA and either the coverage was terminated as a result of loss of eligibility for the coverage (including as a result of legal separation, divorce, death, termination of employment or reduction in the number of hours of employment) or employer contributions towards the coverage were terminated. (d) The Employee or Dependent requests enrollment in this Plan not later than 31 days after the date of exhaustion of COBRA coverage or the termination of coverage or employer contributions, described above. Coverage will begin no later than the first day of the first calendar month following the date the completed enrollment form is received. If the Employee or Dependent lost the other coverage as a result of the individual's failure to pay premiums or required contributions or for cause (such as making a fraudulent claim), that individual does not have a Special Enrollment right. (2) Dependent beneficiaries. If: (a) The Employee is a participant under this Plan (or has met the Waiting Period applicable to becoming a participant under this Plan and is eligible to be enrolled under this Plan but for failure to enroll during a previous enrollment period), and (b) A person becomes a Dependent of the Employee through marriage, birth, adoption or placement for adoption, then the Dependent (and if not otherwise enrolled, the Employee) may be enrolled under this Plan as a covered Dependent of the covered Employee. In the case of the birth or adoption of a child, the Spouse of the covered Employee may be enrolled as a Dependent of the covered Employee if the Spouse is otherwise eligible for coverage. The Dependent Special Enrollment Period is a period of 31 days and begins on the date of the marriage, birth, adoption or placement for adoption. The coverage of the Dependent enrolled in the Special Enrollment Period will be effective: (a) in the case of marriage, as of the date of marriage; (b) in the case of a Dependent's birth, as of the date of birth; or (c) in the case of a Dependent's adoption or placement for adoption, the date of the adoption or placement for adoption. EFFECTIVE DATE Effective Date of Employee Coverage. An Employee will be covered under this Plan as of the first day that the Employee satisfies all of the following: (1) The Eligibility Requirement. (2) The Active Employee Requirement. (3) The Enrollment Requirements of the Plan. Active Employee Requirement. An Employee must be an Active Employee (as defined by this Plan) for this coverage to take effect. Effective Date of Dependent Coverage. A Dependent's coverage will take effect on the day that the Eligibility Requirements are met; the Employee is covered under the Plan; and all Enrollment Requirements are met. TERMINATION OF COVERAGE When coverage under this Plan stops, Plan Participants will receive a certificate that will show the period of coverage under this Plan. Please contact the Plan Administrator for further details. When Employee Coverage Terminates. Employee coverage will terminate on the earliest of these dates (except in certain circumstances, a covered Employee may be eligible for COBRA continuation coverage. For a complete explanation of when COBRA continuation coverage is available, what conditions apply and how to select it, see the section entitled COBRA Continuation Options): (1) The date the Plan is terminated. (2) The last day of the calendar month in which the covered Employee ceases to be in one of the Eligible Classes. This includes death or termination of Active Employment of the covered Employee. (See the COBRA Continuation Options.) Continuation During Periods of Employer -Certified Leave of Absence or Layoff. A person may remain eligible for a limited time if Active, full-time work ceases due to leave of absence or layoff. This continuance will end as follows: For leave of absence or layoff only: the end of the 12 calendar month period that next follows the month in which the person last worked as an Active Employee. 6 While continued, coverage will be that which was in force on the last day worked as an Active Employee. However, if benefits reduce for others in the class, they will also reduce for the continued person. Continuation During Family and Medical Leave. Regardless of the established leave policies mentioned above, this Plan shall at all times comply with the Family and Medical Leave Act of 1993 as promulgated in regulations issued by the Department of Labor. During any leave taken under the Family and Medical Leave Act, the Employer will maintain coverage under this Plan on the same conditions as coverage would have been provided if the covered Employee had been continuously employed during the entire leave period. If Plan coverage terminates during the FMLA leave, coverage will be reinstated for the Employee and his or her covered Dependents if the Employee returns to work in accordance with the terms of the FMLA leave. Coverage will be reinstated only if the person(s) had coverage under this Plan when the FMLA leave started, and will be reinstated to the same extent that it was in force when that coverage terminated. For example, Pre -Existing Conditions limitations and other Waiting Periods will not be imposed unless they were in effect for the Employee and/or his or her Dependents when Plan coverage terminated. Rehiring a Terminated Employee. A terminated Employee who is rehired will be treated as a new hire and be required to satisfy all Eligibility and Enrollment requirements. However, if the Employee is returning to work directly from COBRA coverage, this Employee does not have to satisfy any employment waiting period or Pre -Existing Conditions provision. Employees on Military Leave. Employees going into or returning from military service may elect to continue Plan coverage as mandated by the Uniformed Services Employment and Reemployment Rights Act under the following circumstances. These rights apply only to Employees and their Dependents covered under the Plan before leaving for military service. (1) The maximum period of coverage of a person under such an election shall be the lesser of. (a) The 18 month period beginning on the date on which the person's absence begins; or (b) The day after the date on which the person was required to apply for or return to a position or employment and fails to do so. (2) A person who elects to continue health plan coverage may be required to pay up to 102% of the full cost under the Plan, except a person on active duty for 30 days or less cannot be required to pay more than the Employee's share, if any, for the coverage. (3) An exclusion or Waiting Period may not be imposed in connection with the reinstatement of coverage upon reemployment if one would not have been imposed had coverage not been terminated because of service. However, an exclusion or Waiting Period may be imposed for coverage of any Illness or Injury determined by the Secretary of Veterans Affairs to have been incurred in, or aggravated during, the performance of uniformed service. When Dependent Coverage Terminates. A Dependent's coverage will terminate on the earliest of these dates (except in certain circumstances, a covered Dependent may be eligible for COBRA continuation coverage. For a complete explanation of when COBRA continuation coverage is available, what conditions apply and how to select it, see the section entitled COBRA Continuation Options): (1) The date the Plan or Dependent coverage under the Plan is terminated. (2) The date that the Employee's coverage under the Plan terminates for any reason including death. The Dependents of an Employee who dies during the course of their duty may remain eligible for coverage if they had existing coverage under this Plan at the time of the Employee's death. (3) The date a covered Spouse loses coverage due to loss of dependency status. (See the COBRA Continuation Options.) (4) On the last day of the calendar month that a Dependent child ceases to be a Dependent as defined by the Plan. (See the COBRA Continuation Options.) (5) The end of the period for which the required contribution has been paid if the charge for the next period is not paid when due. OPEN ENROLLMENT OPEN ENROLLMENT During the annual open enrollment period, which starts on the 15th of November and ends on the 15th of December each year, Employees and their Dependents who are Late Enrollees will be able to enroll in the Plan. Benefit choices for Late Enrollees made during the open enrollment period will become effective first of the month following Open Enrollment. Plan Participants will receive detailed information regarding open enrollment from their Employer. SCHEDULE OF BENEFITS Verification of Eligibility 1-800-658-9777 Call this number to verify eligibility for Plan benefits before the charge is incurred. MEDICAL BENEFITS All benefits described in this Schedule are subject to the exclusions and limitations described more fully herein including, but not limited to, the Plan Administrator's determination that: care and treatment is Medically Necessary; that charges are Usual and Reasonable; that services, supplies and care are not Experimental and/or Investigational. The meanings of these capitalized terms are in the Defined Terms section of this document. Note: The following services must be precertified or reimbursement from the Plan may be reduced. If the Covered Person does not receive authorization as explained in this section, the benefit payment will be reduced by $250. This penalty will not apply when a Covered Person utilizes a Network Provider. See the Cost Management section for further details. The attending Physician does not have to obtain precertification from the Plan for prescribing a maternity length of stay that is 48 hours or less for a vaginal delivery or 96 hours or less for a cesarean delivery. All outpatient IV therapies Back surgery Breast surgery Bypass surgery Cardiac catheterization Cardiac pacemaker implant Cataract removal Chemotherapy Cholecystectomy (removal of gall bladder) Coronary arteriography Dialysis Dilation and curettage of uterus Ear surgery Facial and jaw surgery Hemorrhoid removal Hernia repair Hip surgery Home Health Home infusion therapy Hospice care Hysterectomy (removal of uterus) Knee surgery Ligation & stripping of varicose veins Mental illness treatment Nose surgery Prostatectomy Serious mental illness treatment Substance abuse treatment Toe & foot surgery Tonsillectomy and/or adenoidectomy Transfers to another facility or transfers to or from a specialty unit within a facility Please see the Cost Management section in this booklet for details. The Plan is a plan that contains a network Preferred Provider Organization (PPO or Network Provider). For further Network Provider information, including contact information, please refer to the Employee ID Card. 10 This Plan has entered into an agreement with certain Hospitals, Physicians and other health care providers, which are called Network Providers. Because these Network Providers have agreed to charge reduced fees to persons covered under the Plan, the Plan can afford to reimburse a higher percentage of their fees. Therefore, when a Covered Person uses a Network Provider, that Covered Person will receive a higher payment from the Plan than when a Non -network Provider is used. It is the Covered Person's choice as to which Provider to use. Under the following circumstances, the higher in -Network benefits will be made for non -Network services: If a Covered Person has no choice of Network Providers for the treatment they are seeking within the PPO service area. If a Covered Person is out of the PPO service area and has a Medical Emergency requiring immediate care. If a Covered Person does not live within a radius of 75 miles of a PPO facility. Additional information about this option, as well as a list of Network Providers, will be given to Plan Participants, at no cost, and updated as needed. Deductibles/Copayments payable by Plan Participants Deductibles/Copayments are dollar amounts that the Covered Person must pay before the Plan pays. A deductible is an amount of money that is paid once a Calendar Year per Covered Person. Typically, there is one deductible amount per Plan and it must be paid before any money is paid by the Plan for any covered services. Each January l st, a new deductible amount is required. However, covered expenses incurred in, and applied toward the individual deductible in October, November and December will be applied to the individual deductible in the next Calendar Year as well as the current Calendar Year. Deductibles do not accrue toward the 100% maximum out-of-pocket payment. A copayment is a smaller amount of money that is paid each time a particular service is used. Typically, there may be copayments on some services and other services will not have any Copayments. Copayments do not accrue toward the 100% maximum out-of-pocket payment. NETWORK PROVIDERS I NON -NETWORK OUT -OF AREA PROVIDERS MAJOMUM LIFETIME BENEFIT AMOUNT $1,000,000 Note: The maximums listed below are the total for Network and Non -Network expenses. For example, if a maximum of 60 days is listed twice under a service, the Calendar Year maximum is 60 days total which may be split between Network and Non -Network providers. Amm� $500 Per Covered Person $500 $1,000 Per Family Unit $1000 $2,000 $1000 The Calendar Year deductible is waived for the following Covered Charges: - Skilled Nursing Facility- In -Network, Out -of -Area - Home Health Care - In -Network, Out -of -Area - Hospice — In -Network, Out -of -Area - Routine Well Adult and Child Care — Out -of -Area - Required Childhood Immunizations - Office Surgery— In -Network - Other Die nostic Medical Services— In -Network Ev ... ,. ,,, ,, ,,.., ,. ,.<F..._ _ .-`. ✓.,v S."''n ,:!�fu�,' -... a%�. �YJ .c �fo�,.. a t"%_i burp" �<-� Physician visits 1$25.00 50% after deductible 80% after deductible 11 NETWORK PROVIDERS NON -NETWORK OUT -OF AREA PROVIDERS Ancillary charges $25.00 50% after deductible 80% after deductible performed after the day of the Physician's office visit Ancillary charges $25.00 50% after deductible 80% after deductible associated with Routine Well Adult and Child Care performed after the day of the office visit Emergency room facility $75.00 $75.00 80% after deductible charges Mental Disorders $25.00 50% after deductible 80% after deductible Outpatient — Physic ian/Consultant visits 30 visit Calendar Year maximum Serious Mental Illness $25.00 50% after deductible 80% after deductible Outpatient — Physician/Consultant visits 60 visit Calendar Year maximum Second or Third Surgical $25.00 50% after deductible 80% after deductible Opinions Routine Well Adult and $25.00 50% after deductible 80% Child Care Per Covered Person $2,000 $12,000 $2,000 Per Family Unit $4,000 $24 000 $4 000 The Plan will pay the designated percentage of Covered Charges until out-of-pocket amounts are reached, at which time the Plan will pay 100% of the remainder of Covered Charges for the rest of the Calendar Year unless stated otherwise. The following charges do not apply toward the out-of-pocket maximum and are never paid at 100%. Deductible(s) Cost containment penalties Co a ents ';.. ... 4 � ... a � Eligible Medical Expense (EME) is the maximum allowable amount that will be eligible for a particular Covered Service as determined by the Plan in accordance the Plan reimbursement schedule. See Eligible Medical Expense in the Defined Terms section. Second or Third Surgical 100% after copayment 50% after deductible 80% after deductible Opinions Pre -Admission Testing 80% after deductible 50% after deductible 80% after deductible inpatient and outpatient Outpatient/Ambulatory 80% after deductible 50% after deductible 80% after deductible Surgical Procedures 12 NETWORK PROVIDERS NON -NETWORK OUT -OF -AREA PROVIDERS Dialysis — Outpatient 80% after deductible 80% after Network 80% after deductible Inpatient Hospital None $200 $100 deductible per confinement Room and Board 80% after deductible 50% after deductible 80% after deductible Limited to the semiprivate Limited to the semiprivate Limited to the semiprivate room rate room rate room rate Intensive Care Unit 80% after deductible 50% after deductible 80% after deductible Limited to the Hospital's Limited to the Hospital's Limited to the Hospital's ICU Charge ICU Charge ICU Char e Emergency/Treat-ment 80% after copayment 80% after copayment 80% after deductible Room (services rendered within 48 hours of an accident or medical emergency) Emergency/Treat-ment 80% after deductible Room (services rendered within 48 hours of an accident or medical emergency) 80% after deductible 1 80% after deductible Skilled Nursing Facility 100% 50% 100% Limited to the facility's Limited to the facility's Limited to the facility's semiprivate room rate semiprivate room rate semiprivate room rate $10,000 Calendar Year $5,000 Calendar Year $10,000 Calendar Year inpatient visits M/u after deductible 50% after deductible 80% after deductible Office visits (including 100°/o after copayment 501/o after deductible 80% after deductible ancillary charges performed in the same day as the Physician's office visit) The copayment benefit does not apply to any service requiring precertification or chiropractic benefits. Ancillary charges 100% after copayment 50% after deductible 80% after deductible performed after the day of the Physician's office visit The copayment benefit does not apply to any service requiring precertifi cation or chiropractic benefits. 13 NETWORK PROVIDERS NON -NETWORK OUT-OFAREA PROVIDERS Office Sure 80% 50% after deductible 80% after deductible Diagnostic Procedures — 80% after deductible 50% after deductible 80% after deductible limited to: All knee/shoulder arthroscopies, Bone Scan, Cardiac Stress Test, CT Scan, Carotid Ultrasounds, MRI, Myelogram, PET Scan, and Endoscopic Procedures Other Diagnostic 1000/0 50% after deductible 80% after deductible Medical Services (Freestanding facility) Other Outpatient 80% after deductible 50% after deductible 80% after deductible Services and Supplies Allergy Testing and 80% after deductible 50% after deductible 80% after deductible Treatment Sure 80% after deductible 501/o after deductible 80% after deductible Home Health Care 1000/0 501/o after deductible 100% $10,000 Calendar Year $5,000 Calendar Year $10,000 Calendar Year maximum maximum maximum Outpatient Private Duty 801/o after deductible 50% after deductible 80% after deductible Nursing Hospice Care 1000/0 50% after deductible 1000/0 $20,000 inpatient and $10,000 inpatient and $20,000 inpatient and outpatient Lifetime outpatient Lifetime outpatient Lifetime maximum maximum maximum Ambulance Service 801/o after deductible 50% after deductible 80% after deductible Jaw Joint/TMJ (Coverage 801/o after deductible 50% after deductible 80% after deductible excluded after Covered Person's 19'' birthday except orthognathic surgery for treatment of temporomandibular joint disorders and conditions of temporomandibular joint disorders) Speech and Hearing 80% after deductible 50% after deductible 80% after deductible Services Includes hearing aids (limited to $1,000 per 36- monthperiod) Home Infusion Thera 80% after deductible 50% after deductible 80% after deductible Durable Medical 80% (rental up to purchase 50% (rental up to purchase 80% (rental up to Equipment price) after deductible price) after deductible purchase price) after deductible Prosthetics 801/o after deductible 50% after deductible 80% after deductible Orthotics 801/o after deductible 501/o after deductible 80% after deductible Spinal Manipulation 80% after deductible Not Covered 80% after deductible Chiropractic $1,000 Calendar Year $1,000 Calendar Year maximum maximum 14 NETWORK PROVIDERS NON -NETWORK OUT -OF AREA PROVIDERS Physical Medicine 80% after deductible 50% after deductible 80% after deductible Service which includes $2,000 Calendar Year $2,000 Calendar Year $2,000 Calendar Year physical and occupational maximum maximum maximum therapy Inpatient 80% after deductible 50% after deductible 80% after deductible 30 day Calendar Year 15 day Calendar Year 30 day Calendar Year maximum maximum maximum Outpatient - 1001/6 after copayment 50% after deductible 80% after deductible Physician/Consultant visits Outpatient - 80% after deductible 50% after deductible 80% after deductible Facility/Outpatient Professional Provider Calendar Year maximum for all Outpatient combined 30 visits 15 visits 30 visits � '� „^ .' ,ems y "' e�. . r. , s, ;, �,'y` n .�' ... W Inpatient 80% after deductible 50% after deductible 80% after deductible 45 day Calendar Year 45 day Calendar Year 45 day Calendar Ye ar maximum maximum maximum Outpatient - 100% after copayment 50% after deductible 80% after deductible Physician/Consultant visits Outpatient - 80% after deductible 50% after deductible 80% after deductible Facility/Outpatient Professional Provider 60 visit Calendar Year maximum for all Ou atient combined CREW ' Inpatient 801/o after deductible 50% after deductible 80% after deductible Outpatient 80% after deductible 50% after deductible 80% after deductible Inpatient / Outpatient Combined 2 separate series of 2 separate series of 2 separate series of treatment Lifetime treatment Lifetime treatment per Lifetime maximum maximum Imaximurn NOW Routine Well Adult Care 100% after copayment 150010 after deductible 80% Includes: office visits, routine physical examination, prostate screening and cancer exam, routine mammography, colorectal cancer screenings annual hearing test, annual vision test and immunizations/flu shots. Annual limit for Mammogram: 1 per Calendar Year Age 35 or older Routine Well Newborn 801/o after deductible 50% after deductible 80% after deductible Care Routine Well Child Care 100% after copayment 50% after deductible 80% 15 NETWORK PROVIDERS NON -NETWORK 7-OF-AREA PROVIDERS Includes: office visits, routine physical examination, annual hearing test and annual vision test. Includes immunizations for children ages 6 and older. Required Childhood 1000/0 1000/0 100% Immunizations — for children up to age 6 Covered immunizations are: Diphtheria, Hemophilus influenza type b, Hepatitis B, Measles, Mumps, Pertussis, Polio, Rubella, Tetanus, Varicella, and any other immunizations required by law. Ancillary charges 100% after copayment 50% after deductible 80% after deductible associated with the Routine Well Adult and Child Care performed after the day of the office visit Human organ and tissue benefits are provided by a separate policy, as explained in full in the AIG LIFE Organ & Tissue Transplant Policy. All eligible Employees and their eligible Dependents requiring human organ and tissue transplant services will have transplant -related charges covered under this separate AIG LIFE policy, according to its terms and conditions, from the time of their evaluation through 365 days post transplant operation. All transplant -related medical benefits incurred after this specified period of coverage as well as all transplant related charges ineligible under the separate policy will revert to the terms and conditions of health coverage under this health plan document. Organ Transplants 80% after deductible 501/o after deductible 80% after deductible Pregnancy 80% after deductible 50% after deductible 80% after deductible Dependent daughters are covered Newborn Nursery Charges will be applied to Newborn's own deductible and co- insurance All maternity expenses and treatment in progress as of the effective date of this Plan and currently covered under this Plan, that is being provided by a BC BS network physician or facility, will continue to be eligible for payment at the Network benefit level until the post partum follow up is complete. 16 PRESCRIPTION DRUG BENEFIT Pharmacy Option (up to a 30-day supply) Generic drug Copayment........................................ Preferred Brand Name drugs Copayment ......................... Non -Preferred Brand Name drugs ...................................................... $15.00 ...................................................... $30.00 Copayment............................................................ Mail Order Prescription Drug Option (up to a 90-day supply) Generic drug Copayment............................................................ Preferred Brand Name drugs ............................. $50.00 Copayment................................................................... Non -Preferred Brand Name drugs ........................ $38.00 .................. $75.00 Copayment.............................................................................................. $125.00 Please Note: If a generic drug is available and the prescription order does not permit the use of the generic alternative or if the Covered Person chooses a brand name drug, the Covered Person will pay the Brand Name drugs copayment plus the difference between the cost of the brand name drug and the generic drug. This provision applies to the Pharmacy Option and Mail Order Option. Participating pharmacies have contracted with the Plan to charge Covered Persons reduced fees for covered Prescription Drugs. Medco Health is the administrator of the pharmacy drug plan. The copayment amount is not a covered charge under the medical plan. For additional information about coverage and exclusions, please contact Medco Health. 17 DENTAL BENEFITS Calendar Year deductible, perperson.................................................................... perFamily Unit.............................................................. The deductible applies to these Classes of Service: Class B Services - Basic Class C Services - Major Dental Percentage Payable Class A Services - Preventive...................................................................... Class B Services - Basic............................. ........................... $75.00 ........................... $225.00 .. .................................................... Class C Services - Major................................................................................. Class D Services - Orthodontia. _... Orthodontia coverage is only available up to age 25. Maximum Benefit Amount For other than Class D-Orthodontia: Per person per Calendar 50% Year........................................................................................................ $1,200 For Class D-Orthodontia: Lifetime maximum per person ..................................... ................... $1,000 18 MEDICAL BENEFITS Medical Benefits apply when Covered Charges are incurred by a Covered Person for care of an Injury or Sickness and while the person is covered for these benefits under the Plan. DEDUCTIBLE Deductible Amount. This is an amount of Covered Charges for which no benefits will be paid. Before benefits can be paid in a Calendar Year a Covered Person must meet the deductible shown in the Schedule of Benefits. This amount will not accrue toward the 100% maximum out-of-pocket payment. Deductible Three Mouth Carryover. Covered expenses incurred in, and applied toward the individual deductible in October, November and December will be applied toward the individual deductible in the next Calendar Year. Family Unit Limit. When the maximum amount shown in the Schedule of Benefits has been incurred by members of a Family Unit toward their Calendar Year deductibles, the deductibles of all members of that Family Unit will be considered satisfied for that year. BENEFIT PAYMENT Each Calendar Year, benefits will be paid for the Covered Charges of a Covered Person that are in excess of the deductible and any copayments. Payment will be made at the rate shown under reimbursement rate in the Schedule of Benefits. No benefits will be paid in excess of the Maximum Benefit Amount or any listed limit of the Plan. OUT-OF-POCKET L1MIT Covered Charges are payable at the percentages shown each Calendar Year until the out-of-pocket limit shown in the Schedule of Benefits is reached. Then, Covered Charges incurred by a Covered Person will be payable at 100% (except for the charges excluded) for the rest of the Calendar Year. When a Family Unit reaches the out-of-pocket limit, Covered Charges for that Family Unit will be payable at 100% (except for the charges excluded) for the rest of the Calendar Year. M[A7OMUM BENEFIT AMOUNT The Maximum Benefit Amount is shown in the Schedule of Benefits. It is the total amount of benefits that will be paid under the Plan for all Covered Charges incurred by a Covered Person. COVERED CHARGES Covered charges are the Usual and Reasonable Charges that are incurred for the following items of service and supply. These charges are subject to the benefit limits, exclusions and other provisions of this Plan. A charge is incurred on the date that the service or supply is performed or furnished. (1) Hospital Care. The medical services and supplies furnished by a Hospital or Ambulatory Surgical Center or a Birthing Center. Covered charges for room and board will be payable as shown in the Schedule of Benefits. After 48 observation hours, a confinement will be considered an inpatient confinement. Room charges made by a Hospital having only private rooms will be covered at the average private room rate. Charges for an Intensive Care Unit stay are payable as described in the Schedule of Benefits. (2) Coverage of Pregnancy. The Usual and Reasonable Charges for the care and treatment of Pregnancy are covered the same as any other Sickness. 19 Group health plans generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). (3) Skilled Nursing Facility Care. The room and board and nursing care furnished by a Skilled Nursing Facility will be payable if and when: (a) the patient is confined as a bed patient in the facility; (b) the attending Physician certifies that the confinement is needed for further care of the condition that caused the Hospital confinement; and (c) the attending Physician completes a treatment plan which includes a diagnosis, the proposed course of treatment and the projected date of discharge from the Skilled Nursing Facility. Covered charges for a Covered Person's care in these facilities is limited to the covered daily maximum shown in the Schedule of Benefits. (4) Physician Care. The professional services of a Physician for surgical or medical services. (a) Charges for multiple surgical procedures will be a covered expense subject to the following provisions: (i) If bilateral or multiple surgical procedures are performed by one (1) surgeon, benefits will be determined based on the Usual and Reasonable Charge that is allowed for the primary procedures; 50% of the Usual and Reasonable Charge will be allowed for each additional procedure performed through the same incision. Any procedure that would not be an integral part of the primary procedure or is unrelated to the diagnosis will be considered "incidental" and no benefits will be provided for such procedures; (ii) If multiple unrelated surgical procedures are performed by two (2) or more surgeons on separate operative fields, benefits will be based on the Usual and Reasonable Charge for each surgeon's primary procedure. If two (2) or more surgeons perform a procedure that is normally performed by one (1) surgeon, benefits for all surgeons will not exceed the Usual and Reasonable percentage allowed for that procedure; and (iii) If an assistant surgeon is required, the assistant surgeon's covered charge will not exceed 20% of the surgeon's Usual and Reasonable allowance. (5) Private Duty Nursing Care. The private duty nursing care by a licensed nurse (R.N., L.P.N. or L.V.N.). Covered charges for this service will be included to this extent: (a) Inpatient Nursing Care. Charges are covered only when care is Medically Necessary or not Custodial in nature and the Hospital's Intensive Care Unit is filled or the Hospital has no Intensive Care Unit. (b) Outpatient Nursing Care. Charges are covered only when care is Medically Necessary and not Custodial in nature. The only charges covered for Outpatient nursing care are those shown below, under Home Health Care Services and Supplies. Outpatient private duty nursing care on a 24-hour-shift basis is not covered. (6) Home Health Care Services and Supplies. Charges for home health care services and supplies are covered only for care and treatment of an Injury or Sickness when Hospital or Skilled Nursing Facility confinement 20 would otherwise be required. The diagnosis, care and treatment must be certified by the attending Physician and be contained in a Home Health Care Plan. Benefit payment for nursing, home health aide and therapy services is subject to the Home Health Care limit shown in the Schedule of Benefits. A home health care visit will be considered a periodic visit by either a nurse or therapist, as the case may be, or four hours of home health aide services. (7) Hospice Care Services and Supplies. Charges for hospice care services and supplies are covered only when the attending Physician has diagnosed the Covered Person's condition as being terminal, determined that the person is not expected to live more than six months and placed the person under a Hospice Care Plan. Covered charges for Hospice Care Services and Supplies are payable as described in the Schedule of Benefits. (8) Other Medical Services and Supplies. These services and supplies not otherwise included in the items above are covered as follows: (a) Local Medically Necessary professional land or air ambulance service. A charge for this item will be a Covered Charge only if the service is to the nearest Hospital or Skilled Nursing Facility where necessary treatment can be provided unless the Plan Administrator finds a longer trip was Medically Necessary. (b) Treatment of acquired brain injury. Covered charges for the following services, medically necessary as a result of or related to an acquired brain injury: cognitive rehabilitative therapy; cognitive communication therapy; neurocognitive therapy and rehabilitation; neurobehavioral, neurophysiological, neuropsychological and psychophysiological testing or treatment; neurofeedback therapy; remediation; post -acute transition services; and community reintegration services. The following definitions apply to this benefit: Acquired brain injury means a neurological insult to the brain, which is not hereditary, congenital or degenerative. The injury to the brain occurred after birth and results in a change in neuronal activity, which results in an impairment of physical functioning, sensory processing, cognition or psychosocial behavior. Cognitive communication therapy means services designed to address modalities of comprehensive and expression, including understanding, reading, writing and verbal expression of information. Cognitive rehabilitation therapy means services designed to address therapeutic cognitive activities, based on an assessment and understanding of the individual's brain -behavioral deficits. Community reintegration services means services that facilitate the continuum of care as an affected individual transitions into the community. Neurobehavioral testing means an evaluation of the history of neurological and psychiatric difficulty, current symptoms, current mental status and premorbid history, including the identification of problematic behavior and the relationship between behavior and the variables that control behavior. This may include interviews of the individual, family and others. Neurobehavioral treatment means interventions that focus on behavior and the variables that control behavior. Neurocognitive rehabilitation means services designed to assist cognitively impaired individuals to compensate for deficits in cognitive functioning by rebuilding cognitive skills and/or developing compensatory strategies and techniques. 21 Neurocognitive therapy means services designated to address neurological deficits in informational processing and to facilitate the development of higher level cognitive abilities. Neurofeedback therapy means services that utilize operant conditioning learning procedure based on electroencephalography (EEG) parameters and that are designed to result in improved mental performance and behavior and stabilized mood. Neurophysiological testing means an evaluation of the functions of the nervous system. Neurophysiological treatment means interventions that focus on the functions of the nervous system. Neuropsychological testing means the administering of a comprehensive battery of tests to evaluate neurocognitive, behavioral and emotional strengths and weaknesses and their relationship to normal and abnormal central nervous system functioning. Neuropsychological treatment means interventions designed to improve or minimize deficits in behavioral and cognitive processes. Post -acute transition services means services that facilitate the continuum of care beyond the initial neurological insult through rehabilitation and community reintegration. Psychophysiological testing means an evaluation of the interrelationships between the nervous system and other bodily organs and behavior. Psychophysiological treatment means interventions designed to alleviate or decrease abnormal physiological responses of the nervous system due to behavioral or emotional factors. Remediation means the process or processes of restoring or improving a specific function. Services means the work of testing, treatment and providing therapies to an individual with an acquired brain injury. Therapy means the scheduled remedial treatment provided through direct interaction with the individual to improve a pathological condition resulting from an acquired brain injury. (c) Anesthetic; oxygen; blood and blood derivatives that are not donated or replaced; intravenous injections and solutions. Administration of these items is included. (d) Cardiac rehabilitation as deemed Medically Necessary provided services are rendered (a) under the supervision of a Physician; (b) in connection with a myocardial infarction, coronary occlusion or coronary bypass surgery; (c) initiated within 12 weeks after other treatment for the medical condition ends; and (d) in a Medical Care Facility as defined by this Plan. (e) Radiation or chemotherapy and treatment with radioactive substances. The materials and services of technicians are included. (f) Initial contact lenses or glasses required following cataract surgery (g) Rental of durable medical or surgical equipment if deemed Medically Necessary. These items may be bought rather than rented, with the cost not to exceed the fair market value of the equipment at the time of purchase, but only if agreed to in advance by the Plan Administrator. (h) Medically Necessary services for care and treatment of jaw joint conditions, including Temporomandibular Joint syndrome. (i) Laboratory studies. 22 (j) Treatment of Mental Disorders and Substance Abuse Covered charges for care, supplies and treatment of Mental Disorders and Substance Abuse will be limited as follows: All treatment is subject to the benefit payment maximums shown in the Schedule of Benefits. Physician's visits are limited to one treatment per day. Psychiatrists (M.D.), psychologists (Ph.D.), counselors (Ph.D.) or Masters of Social Work (M.S. W.) may bill the Plan directly. Other licensed mental health practitioners must be under the direction of and must bill the Plan through these professionals. (k) Injury to or care of mouth, teeth and gums. Charges for Injury to or care of the mouth, teeth, gums and alveolar processes will be Covered Charges under Medical Benefits only if that care is for the following oral surgical procedures: Excision of tumors and cysts of the jaws, cheeks, lips, tongue, roof and floor of the mouth. Emergency repair due to Injury to sound natural teeth. Charges must occur within 24 months of the accidental injury. Surgery needed to correct accidental injuries to the jaws, cheeks, lips, tongue, floor and roof of the mouth. Excision of benign bony growths of the jaw and hard palate. External incision and drainage of cellulitis. Incision of sensory' sinuses, salivary glands or ducts. Removal of impacted teeth. Reduction of dislocations and excision of temporomandibular joints (TMJs). No charge will be covered under Medical Benefits for dental and oral surgical procedures involving orthodontic care of the teeth, and periodontal disease. Dentures and preparing the mouth for the fitting of or continued use of dentures are not covered except for the following conditions: if tooth loss is related to, or necessitated by medical treatment of a covered illness or injury. (l) Occupational therapy by a licensed occupational therapist. Therapy must be ordered by a Physician, result from an Injury or Sickness and improve a body function. Covered expenses do not include recreational programs, maintenance therapy or supplies used in occupational therapy. (m) HUMAN ORGAN & TISSUE TRANSPLANT BENEFITS Human organ and tissue benefits are provided by a separate policy, as explained in full in the AIG LIFE Organ & Tissue Transplant Policy. All eligible Employees and their eligible Dependents requiring human organ and tissue transplant services will have transplant -related charges covered under this separate AIG LIFE policy, according to its terms and conditions, from the time of their evaluation through 365 days post transplant operation. All transplant -related medical benefits incurred after this specified period of coverage as well as all transplant related charges ineligible under the separate policy will revert to the terms and conditions of health coverage under this health plan document. Benefits available for Human Organ and Tissue Transplants are subject to the following: 23 the Employee or Dependent is eligible for medical benefits under the group's plan document the Employee or Dependent meets all the terms and conditions outlined in the AIG LIFE Organ and Tissue policy / certificate the Employee or Dependent does not have a pre-existing condition as defined in the AIG LIFE Organ and Tissue Policy / Certificate Those Employees and their Dependents who are initially excluded from human organ and tissue transplant coverage under the AIG LIFE Organ & Tissue Transplant policy (due to a pre-existing condition) will continue to receive health care benefits as they relate to transplantation according to the terms and conditions of the company health plan document until eligible for benefits under the separate AIG LIFE policy. The transplant must be performed to replace an organ or tissue. Charges for obtaining donor organs or tissues are Covered Charges under the Plan when the recipient is a Covered Person. When the donor has medical coverage, his or her plan will pay first. The benefits under this Plan will be reduced by those payable under the donor's plan. Donor charges include those for: evaluating the organ or tissue; removing the organ or tissue from the donor; and transportation of the organ or tissue from within the United States and Canada to the place where the transplant is to take place. (n) The initial purchase, fitting and repair of orthotic appliances such as braces, splints or other appliances which are required for support for an injured or deformed part of the body as a result of a disabling congenital condition or an Injury or Sickness. (o) Physical therapy by a licensed physical therapist. The therapy must be in accord with a Physician's exact orders as to type, frequency and duration and for conditions which are subject to significant improvement through short-term therapy. (p) Prescription Drugs (as defined). (q) Routine Preventive Care. Covered charges under Medical Benefits are payable for routine Preventive Care as described in the Schedule of Benefits. Charges for Routine Well Adult Care. Routine well adult care is care by a Physician that is not for an Injury or Sickness. Charges for Routine Well Child Care. Routine well child care is routine care by a Physician that is not for an Injury or Sickness. (r) The initial purchase, fitting and repair of fitted prosthetic devices which replace body parts. (s) Reconstructive Surgery. Correction of abnormal congenital conditions and reconstructive mammoplasties will be considered Covered Charges. This mammoplasty coverage will include reimbursement for: (i) reconstruction of the breast on which a mastectomy has been performed, 24 00 surgery and reconstruction of the other breast to produce a symmetrical appearance, and (Iii) coverage of prostheses and physical complications during all stages of mastectomy, including lymphedemas, in a manner determined in consultation with the attending Physician and the patient. (t) Speech therapy by a licensed speech therapist. Therapy must be ordered by a Physician and follow either: (i) surgery for correction of a congenital condition of the oral cavity, throat or nasal complex (other than a frenectomy) of a person; (ii) an Injury; or (iii) a Sickness that is other than a learning or Mental Disorder. (u) Spinal Manipulation/Chiropractic services by a licensed M.D., D.O. or D.C. (v) Sterilization procedures. (w) Surgical dressings, splints, casts and other devices used in the reduction of fractures and dislocations. (x) Coverage of Well Newborn Nursery/Physician Care. Charges for Routine Nursery Care. Routine well newborn nursery care is care while the newborn is Hospital -confined after birth and includes room, board and other normal care for which a Hospital makes a charge. This coverage is only provided if a parent is a Covered Person who was covered under the Plan at the time of the birth and the newborn child is an eligible Dependent and is neither injured nor ill. The benefit is limited to Usual and Reasonable Charges for nursery care for the first 5 days after birth while the newborn child is Hospital confined as a result of the child's birth. Charges for covered routine nursery care will be applied toward the Plan of the newborn child. Group health plans generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). Charges for Routine Physician Care. The benefit is limited to the Usual and Reasonable Charges made by a Physician for routine pediatric care for the first 5 days after birth while the newborn child is Hospital confined. Charges for covered routine Physician care will be applied toward the Plan of the newborn child. (y) Diagnostic x-rays. 25 COST MANAGEMENT SERVICES Cost Management Services Phone Number Please refer to the Employee ID card for the Cost Management Services phone number. The patient or family member must call this nurrber to receive certification of certain Cost Management Services. This call must be made at least in advance of services being rendered or within 2 business days after an emergency. Any reduced reimbursement due to failure to follow cost management procedures will not accrue toward the 100% maximum out-of-pocket payment. UTILIZATION REVIEW Utilization review is a program designed to help insure that all Covered Persons receive necessary and appropriate health care while avoiding unnecessary expenses. The program consists of: (a) Precertification of the Medical Necessity for the following non -emergency services before Medical and/or Surgical services are provided: All outpatient IV therapies Back surgery Breast surgery Bypass surgery Cardiac catheterization Cardiac pacemaker implant Cataract removal Chemotherapy Cholecystectomy (removal of gall bladder) Coronary arteriography Dialysis Dilation and curettage of uterus Ear surgery Facial and jaw surgery Hemorrhoid removal Hernia repair Hip surgery Home Health Home infusion therapy Hospice care Hysterectomy (removal of uterus) Knee surgery Ligation & stripping of varicose veins Mental illness treatment Nose surgery Prostatectomy Serious mental illness treatment Substance abuse treatment Toe & foot surgery Tonsillectomy and/or adenoidectomy Transfers to another facility or transfers to or from a specialty unit within a facility (b) Retrospective review of the Medical Necessity of the listed services provided on an emergency basis; 26 (c) Concurrent review, based on the admitting diagnosis, of the listed services requested by the attending Physician; and (d) Certification of services and planning for discharge from a Medical Care Facility or cessation of medical treatment. The purpose of the program is to determine what charges may be eligible for payment by the Plan. This program is not designed to be the practice of medicine or to be a substitute for the medical judgment of the attending Physician or other health care provider. If a particular course of treatment or medical service is not certified, it means that either the Plan will not pay for the charges or the Plan will not consider that course of treatmnt as appropriate for the maximum reimbursement under the Plan. The patient is urged to find out why there is a discrepancy between what was requested and what was certified before incurring charges. The attending Physician does not have to obtain precertification from the Plan for prescribing a maternity length of stay that is 48 hours or less for a vaginal delivery or 96 hours or less for a cesarean delivery. In order to maximize Plan reimbursements, please read the following provisions carefully. Here's how the program works. Precertification. Before a Covered Person enters a Medical Care Facility on a non -emergency basis or receives other listed medical services, the utilization review administrator will, in conjunction with the attending Physician, certify the care as appropriate for Plan reimbursement. A non -emergency stay in a Medical Care Facility is one that can be scheduled in advance. The utilization review program- is set in motion by a telephone call from the Covered Person or provider. Contact the utilization review administrator at the telephone number on your ID card at least before services are scheduled to be rendered with the following information: - The name of the patient and relationship to the covered Employee - The name, Social Security number and address of the covered Employee - The name of the Employer - The name and telephone number of the attending Physician - The name of the Medical Care Facility, proposed date of admission, and proposed length of stay The diagnosis and/or type of surgery The proposed rendering of listed medical services If there is an emergency admission to the Medical Care Facility, the patient, patient's family member, Medical Care Facility or attending Physician must contact the utilization review administrator within 2 business days of the first business day after the admission. The utilization review administrator will determine the number of days of Medical Care Facility confinement or use of other listed medical services authorized for payment. Failure to follow this procedure may reduce reimbursement received from the Plan. If the Covered Person does not receive authorization as explained in this section, the benefit payment will be reduced by $250. This penalty will not apply when a Covered Person utilizes a Network Provider. Concurrent review, discharge planning. Concurrent review of a course of treatment and discharge planning from a Medical Care Facility are parts of the utilization review program. The utilization review administrator will monitor the Covered Person's Medical Care Facility stay or use of other medical services and coordinate with the attending Physician, Medical Care Facilities and Covered Person either the scheduled release or an extension of the Medical Care Facility stay or extension or cessation of the use of other medical services. 27 If the attending Physician feels that it is Medically Necessary for a Covered Person tar receive additional services or to stay in the Medical Care Facility for a greater length of time than has been precertified, the attending Physician must request the additional services or days. SECOND AND/OR THIRD OPINION PROGRAM Certain surgical procedures are performed either inappropriately or unnecessarily. In some cases, surgery is only one of several treatment options. In other cases, surgery will not help the condition. In order to prevent unnecessary or potentially harmful surgical treatments, the second and/or third opinion program fulfills the dual purpose of protecting the health of the Plan's Covered Persons and protecting the financial integrity of the Plan. Benefits will be provided for a second (and third, if necessary) opinion consultation to determine the Medical Necessity of an elective surgical procedure. An elective surgical procedure is one that can be scheduled in advance; that is, it is not an emergency or of a life -threatening nature. The patient may choose any board -certified specialist who is not an associate of the attending Physician and who is affiliated in the appropriate specialty. While any surgical treatment is allowed a second opinion, the following procedures are ones for which surgery is often performed when other treatments are available. Appendectomy Hernia surgery Cataract surgery Hysterectomy Cholecystectomy Mastectomy surgery (gall bladder removal) Deviated septum Prostate surgery (nose surgery) Hemorrhoidectomy Salpingo-oophorectomy (removal of tubes/ovaries) PREADMISSION TESTING SERVICE Spinal surgery Surgery to knee, shoulder, elbow or toe Tonsillectomy and adenoidectomy Tympanotomy (inner ear) Varicose vein ligation The Medical Benefits percentage payable will be for diagnostic lab tests and x-ray exams when: (1) performed on an outpatient basis within seven days before a Hospital confinement; (2) related to the condition which causes the confinement; and (3) performed in place of tests while Hospital confined. Covered charges for this testing will be payable at 80% for In -Network services and 50% for Out -of -Network services even if tests show the condition requires medical treatment prior to Hospital confinement or the Hospital confinement is not required. 28 CASE MANAGEMENT Case Management is a program whereby a case manager monitors patients and explores, discusses and recommends coordinated and/or alternate types of appropriate Medically Necessary care. The case manager consults with the patient, the family and the attending Physician in order to develop a plan of care for approval by the patient's attending Physician and the patient. This plan of care may include some or all of the following: — personal support to the patient; -- contacting the family to offer assistance and support; -- monitoring Hospital or Skilled Nursing Facility; -- determining alternative care options; and -- assisting in obtaining any necessary equipment and services. Case Management occurs when this alternate benefit will be beneficial to both the patient and the Plan The case manager will coordinate and implement the Case Management program by providing guidance and information on available resources and suggesting the most appropriate treatment plan. The Plan Administrator, attending Physician, patient and patient's family must all agree to the alternate treatment plan. Once agreement has been reached, the Plan Administrator will direct the Plan to reimburse for Medically Necessary expenses as stated in the treatment plan, even if these expenses normally would not be paid by the Plan. Note: Case Management is a voluntary service. There are no reductions of benefits or penalties if the patient and family choose not to participate. Each treatment plan is individually tailored to a specific patient and should not be seen as appropriate or recommended for any other patient, even one with the same diagnosis. 29 DEFINED TERMS The following terms have special meanings and when used in this Plan will be capitalized Active Employee is an Employee who is on the regular payroll of the Employer and who has begun to perform the duties of his or her job with the Employer on a full-time basis. Ambulatory Surgical Center is a licensed facility that is used mainly for performing outpatient surgery, has a staff of Physicians, has continuous Physician and nursing care by registered nurses (R.N.$) and does not provide for overnight stays. Birthing Center means any freestanding health facility, place, professional office or institution which is not a Hospital or in a Hospital, where births occur in a home -like atmosphere. This facility must be licensed and operated in accordance with the laws pertaining to Birthing Centers in the jurisdiction where the facility is located. The Birthing Center must provide facilities for obstetrical delivery and short-term recovery after delivery; provide care under the full-time supervision of a Physician and either a registered nurse (R.N.) or a licensed nurse -midwife; and have a written agreement with a Hospital in the same locality for immediate acceptance of patients who develop complications or require pre- or post -delivery confinement. Calendar Year means January 1 st through December 31 st of the same year. Chiropractic Care/Spinal Manipulation means skeletal adjustments, manipulation or other treatment in connection with the detection and correction by manual or mechanical means of structural imbalance or subluxation in the human body. Such treatment is done by a Physician to remove nerve interference resulting from, or related to, distortion, misalignment or subluxation of, or in, the vertebral column. COBRA means the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended. Cosmetic Dentistry means dentally unnecessary procedures. Covered Person is an Employee, Retiree or Dependent who is covered under this Plan. Creditable Coverage includes most health coverage, such as coverage under a group health plan (including COBRA continuation coverage), HMO membership, an individual health insurance policy, Medicaid or Medicare. Creditable Coverage does not include coverage consisting solely of dental or vision benefits. Custodial Care is care (including room and board needed to provide that care) that is given principally for personal hygiene or for assistance in daily activities and can, according to generally accepted medical standards, be performed by persons who have no medical training. Examples of Custodial Care are help in walking and getting out of bed; assistance in bathing, dressing, feeding; or supervision over medication which could normally be self-administered. Dentist is a person who is properly trained and licensed to practice dentistry and who is practicing within the scope of such license. Durable Medical Equipment means equipment which (a) can withstand repeated use, (b) is primarily and customarily used to serve a medical purpose, (c) generally is not useful to a person in the absence of an Illness or Injury and (d) is appropriate for use in the home. Eligible Medical Expense (EME) means the maximum allowable amount the Plan will pay for a particular Covered Service as determined by the Plan in accordance with the Plan reimbursement schedule. In -Network providers have agreed to accept the Plan's reimbursement as payment in full for Covered Services, less any applicable copayment deductible or coinsurance, whereas Non -Network providers have not. Eligible Plan Participants who use the services of Non -Network providers will receive no benefit payments or reimbursement for charges in excess of the Plan's reimbursement schedule for any Covered 30 Services. In no event will the Plan pay more than the maximum payment allowance established in the Plan's reimbursement schedule. Eligible Medical Expenses are determined by the following: Physician charges: Medicare Allowable based on Resource Based Relative Value Scale (RBRVS) Facility charges: Medicare Allowable based on Resource Based Relative Value Scale (RBRVS) Employee means a person who is an Active, regular Employee of the Employer, regularly scheduled to work for the Employer in an Employee/Employer relationship. For the purposes of this Plan, City Councilmen will be considered Employees of the Employer. Employer is City of Lubbock Enrollment Date is the first day of coverage or, if there is a Waiting Period, the first day of the Waiting Period. ERISA is the Employee Retirement Income Security Act of 1974, as amended. Experimental and/or Investigational means services, supplies, care and treatment which does not constitute accepted medical practice properly within the range of appropriate medical practice under the standards of the case and by the standards of a reasonably substantial, qualified, responsible, relevant segment of the medical and dental community or government oversight agencies at the time services were rendered. The Plan Administrator must make an independent evaluation of the experimental/nonexperimental standings of specific technologies. The Plan Administrator shall be guided by a reasonable interpretation of Plan provisions. The decisions shall be made in good faith and rendered following a detailed factual background investigation of the claim and the proposed treatment. The decision of the Plan Administrator will be final and binding on the Plan. The Plan Administrator will be guided by the following principles: (1) if the drug or device cannot be lawfully marketed without approval of the U.S. Food and Drug Administration and approval for marketing has not been given at the time the drug or device is furnished; or (2) if the drug, device, medical treatment or procedure, or the patient informed consent document utilized with the drug, device, treatment or procedure, was reviewed and approved by the treating facility's Institutional Review Board or other body serving a similar function, or if federal law requires such review or approval; or (3) if Reliable Evidence shows that the drug, device, medical treatment or procedure is the subject of on -going phase I or phase II clinical trials, is the research, experimental, study or Investigational arm of on -going phase III clinical trials, or is otherwise under study to determine its maximum tolerated dose, its toxicity, its safety, its efficacy or its efficacy as compared with a standard means of treatment or diagnosis; or (4) if Reliable Evidence shows that the prevailing opinion among experts regarding the drug, device, medical treatment or procedure is that further studies or clinical trials are necessary to determine its maximum tolerated dose, its toxicity, its safety, its efficacy or its efficacy as compared with a standard means of treatment or diagnosis. Reliable Evidence shall mean only published reports and articles in the authoritative medical and scientific literature; the written protocol or protocols used by the treating facility or the protocol(s) of another facility studying substantially the same drug, service, medical treatment or procedure; or the written informed consent used by the treating facility or by another facility studying substantially the same drug, device, medical treatment or procedure. Drugs are considered Experimental if they are not commercially available for purchase and/or they are not approved by the Food and Drug Administration for general use. Family Unit is the covered Employee or Retiree and the family members who are covered as Dependents under the Plan. 31 Foster Child means an unmarried child under the limiting age shown in the Dependent Eligibility Section of this Plan for whom a covered Employee has assumed a legal obligation. All of the following conditions mu st be met: the child is being raised as the covered Employee's; the child depends on the covered Employee for primary support; the child lives in the home of the covered Employee; and the covered Employee may legally claim the child as a federal income tax deduction. A covered Foster Child is n1 a child temporarily living in the covered Employee's home; one placed in the covered Employee's home by a social service agency which retains control of the child; or whose natural parent(s) may exercise or share parental responsibility and control. Genetic Information means information about genes, gene products and inherited characteristics that may derive from an individual or a family member. This includes information regarding carrier status and information derived from laboratory tests that identify mutations in specific genes or chromosomes, physical medical examinations, family histories and direct analysis of genes or chromosomes. Home Health Care Agency is an organization that meets all of these tests: its main function is to provide Home Health Care Services and Supplies; it is federally certified as a Home Health Care Agency; and it is licensed by the state in which it is located, if licensing is required. Home Health Care Plan must meet these tests: it must be a formal written plan made by the patient's attending Physician which is reviewed at least every 30 days; it must state the diagnosis; it must certify that the Home Health Care is in place of Hospital confinement; and it must specify the type and extent of Home Health Care required for the treatment of the patient. Home Health Care Services and Supplies include: part-time or intermittent nursing care by or under the supervision of a registered nurse (R.N.); part-time or intermittent home health aide services provided through a Home Health Care Agency (this does not include general housekeeping services); physical, occupational and speech therapy; medical supplies; and laboratory services by or on behalf of the Hospital. Hospice Agency is an organization where its main function is to provide Hospice Care Services and Supplies and it is licensed by the state in which it is located, if licensing is required. Hospice Care Plan is a plan of terminal patient care that is established and conducted by a Hospice Agency and supervised by a Physician. Hospice Care Services and Supplies are those provided through a Hospice Agency and under a Hospice Care Plan and include inpatient care in a Hospice Unit or other licensed facility, home care, and family counseling during the bereavement period. Hospice Unit is a facility or separate Hospital Unit, that provides treatment under a Hospice Care Plan and admits at least two unrelated persons who are expected to die within six months. Hospital is an institution which is engaged primarily in providing medical care and treatment of sick and injured persons on an inpatient basis at the patient's expense and which fully meets these tests: it is accredited as a Hospital by the Joint Commission on Accreditation of Healthcare Organizations or the American Osteopathic Association Healthcare Facilities Accreditation Program; it is approved by Medicare as a Hospital; it maintains diagnostic and therapeutic facilities on the premises for surgical and medical diagnosis and treatment of sick and injured persons by or under the supervision of a staff of Physicians; it continuously provides on the premises 24-hour-a-day nursing services by or under the supervision of registered nurses (R.N.$); and it is operated continuously with organized facilities for operative surgery on the premises. The definition of "Hospital" shall be expanded to include the following: A facility operating legally as a psychiatric Hospital or residential treatment facility for mental health and licensed as such by the state in which the facility operates. A facility operating primarily for the treatment of Substance Abuse if it meets these tests: maintains permanent and full-time facilities for bed care and full-time confinement of at least 15 resident patients; has a Physician in regular attendance; continuously provides 24-hour a day nursing service by a registered nurse (R.N.); has a 32 full-time psychiatrist or psychologist on the staff, and is primarily engaged in providing diagnostic and therapeutic services and facilities for treatment of Substance Abuse. Illness means a bodily disorder, disease, physical sickness or Mental Disorder. Illness includes Pregnancy, childbirth, miscarriage or complications of Pregnancy. Injury means an accidental physical Injury to the body caused by unexpected external means. Intensive Care Unit is defined as a separate, clearly designated service area which is maintained within a Hospital solely for the care and treatment of patients who are critically ill. This also includes what is referred to as a "coronary care unit" or an "acute care unit." It has: facilities for special nursing care not available in regular rooms and wards of the Hospital; special life saving equipment which is immediately available at all times; at least two beds for the accommodation of the critically ill; and at least one registered nurse (R.N.) in continuous and constant attendance 24 hours a day. Late Enrollee means a Plan Participant who enrolls under the Plan other than during the first 31-day period in which the individual is eligible to enroll under the Plan or during a Special Enrollment Period. Legal Guardian means a person recognized by a court of law as having the duty of taking care of the person and managing the property and rights of a minor child. Lifetime is a word that appears in this Plan in reference to benefit maximums and limitations. Lifetime is understood to mean while covered under this Plan. Under no circumstances does Lifetime mean during the lifetime of the Covered Person. Medical Care Facility means a Hospital, a facility that treats one or more specific ailments or any type of Skilled Nursing Facility. Medical Emergency means a sudden onset of a condition with acute symptoms requiring immediate medical care and includes such conditions as heart attacks, cardiovascular accidents, poisonings, loss of consciousness or respiration, convulsions or other such acute medical conditions. Medically or Dentally Necessary care and treatment is recommended or approved by a Physician or Dentist; is consistent with the patient's condition or accepted standards of good medical and dental practice; is medically proven to be effective treatment of the condition; is not performed mainly for the convenience of the patient or provider of medical and dental services; is not conducted for research purposes; and is the most appropriate level of services which can be safely provided to the patient. All of these criteria must be met; merely because a Physician recommends or approves certain care does not mean that it is Medically Necessary. The Plan Administrator has the discretionary authority to decide whether care or treatment is Medically Necessary. Medicare is the Health Insurance For The Aged and Disabled program under Title XVIII of the Social Security Act, as amended. Mental Disorder means any disease or condition, regardless of whether the cause is organic, that is classified as a Mental Disorder in the current edition of International Classification of Diseases published by the U.S. Department of Health and Human Services or is listed in the current edition of Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. Morbid Obesity is a diagnosed condition in which the body weight exceeds the medically recommended weight by either 100 pounds or is twice the medically recommended weight for a person of the same height, age and mobility as the Covered Person. No -Fault Auto Insurance is the basic reparations provision of a law providing for payments without determining fault in connection with automobile accidents. 33 Out -of -Area covers Plan Participants who reside outside of the Plan Service Area (Plan Service Area is defined as the geographical area designated by the Employer which determines eligibility for PPO benefits) and therefore do not have access to Network Providers. Outpatient Care and/or Services is treatment including services, supplies and medicines provided and used at a Hospital under the direction of a Physician to a person not admitted as a registered bed patient; or services rendered in a Physician's office, laboratory or X-ray facility, an Ambulatory Surgical Center, or the patient's home. Physician means a Doctor of Medicine (M.D.), Doctor of Osteopathy (D.O.), Doctor of Dental Surgery (D.D.S.), Doctor of Podiatry (D.P.M.), Doctor of Chiropractic (D.C.), Audiologist, Certified Nurse Anesthetist, Licensed Professional Counselor, Licensed Professional Physical Therapist, Master of Social Work (M.S. W.), Midwife, Occupational Therapist, Optometrist (O.D.), Physiotherapist, Psychiatrist, Psychologist (Ph.D.), Speech Language Pathologist and any other practitioner of the healing arts who is licensed and regulated by a state or federal agency and is acting within the scope of his or her license. Plan means City of Lubbock Employee Benefit Plan, which is a benefits plan for certain employees of City of Lubbock and is described in this document. Plan Administrator is the City of Lubbock Plan Participant is any Employee, Retiree or Dependent who is covered under this Plan. Plan Year is the 12-month period beginning on either the effective date of the Plan or on the day following the end of the first Plan Year which is a short Plan Year. A Pre -Existing Condition is a condition for which medical advice, diagnosis, care or treatment was recommended or received within six months prior to the person's Enrollment Date under this Plan. Genetic Information is not a condition. Treatment includes receiving services and supplies, consultations, diagnostic tests or prescribed medicines. In order to be taken into account, the medical advice, diagnosis, care or treatment must have been recommended by, or received from, a Physician. The Pre -Existing Condition does not apply to pregnancy, to a newborn child who is covered under this Plan within 31 days of birth, or to a child who is adopted or placed for adoption before attaining age 18 and who, as of the last day of the 31-day period beginning on the date of the adoption or placement for adoption, is covered under this Plan. A Pre -Existing Condition exclusion may apply to coverage before the date of the adoption or placement for adoption. The prohibition on Pre -Existing Condition exclusion for newborn, adopted, or pre -adopted children does not apply to an individual after the end of the first 63-day period during all of which the individual was not covered under any Creditable Coverage. Pregnancy is childbirth and conditions associated with Pregnancy, including complications. Preferred Provider Organization/PPO/Network Provider means a group of medical providers who, as a group or individually, agree to provide services or treatment to Covered Persons under the PIan at negotiated rates as a cost containment measure for the Employer and participating Employees. Contact the Plan Administrator for current name and address of participating providers. Prescription Drug means any of the following: a Food and Drug Administration -approved drug or medicine which, under federal law, is required to bear the legend: "Caution: federal law prohibits dispensing without prescription"; injectable insulin; hypodermic needles or syringes, but only when dispensed upon a written prescription of a licensed Physician. Such drug must be Medically Necessary in the treatment of a Sickness or Injury. Serious Mental Illness means any of the eight major diagnostic categories; schizophrenia. Paranoid and other psychotic disorders, Bipolar disorders, Major depressive disorders, and Schizo -affective disorders, Pervasive developmental disorders, Obsessive -Compulsive disorders, and Depression in childhood and adolescence. Resource Based Relative Value Scale (RBRVS) refers to a specific standardized scale of healthcare charges that bases relative values on a computation of total work, practice cost, and malpractice cost involved in performing a procedure. These 34 three elements of the value are modified by a geographic index. After the geographic modification, the three values are summed to reach a single value. The single value is then multiplied by a conversion factor, determined by Congress, to arrive at a charge. Retired Employee is a former Active Employee of the Employer who was retired while employed by the Employer under the formal written plan of the Employer and elects to contribute to the Plan the contribution required from the Retired Employee. A Retired Employee must be eligible to retire under the Texas Municipal Retirement System or the Firemen's Relief and Retirement Fund and be employed by the Employer for five (5) consecutive years; or be approved for disability retirement under the Texas Municipal Retirement System or Firemen's Relief and Retirement Fund. Eligible to retire means eligible to draw an annuity from the Texas Municipal Retirement System or the Firemen's Relief and Retirement Fund at the time of termination from the Employer. Members of the City Council will be considered a Retired Employee if they have served in - office for at least five (5) years. Sickness is a person's Illness, disease or Pregnancy (including complications). Skilled Nursing Facility is a facility that fully meets all of these tests: (1) It is licensed to provide professional nursing services on an inpatient basis to persons convalescing from Injury or Sickness. The service must be rendered by a registered nurse (R.N.) or by a licensed practical nurse (L.P.N.) under the direction of a registered nurse. Services to help restore patients to self -care in essential daily living activities must be provided. (2) Its services are provided for compensation and under the full-time supervision of a Physician. (3) It provides 24 hour per day nursing services by licensed nurses, under the direction of a full-time registered nurse. (4) It maintains a complete medical record on each patient. (5) It has an effective utilization review plan. (6) It is not, other than incidentally, a place for rest, the aged, drug addicts, alcoholics, mental retardates, Custodial or educational care or care of Mental Disorders. (7) It is approved and licensed by Medicare. This term also applies to charges incurred in a facility referring to itself as an extended care facility, convalescent nursing home, rehabilitation hospital, long-term acute care facility or any other similar nomenclature. Spinal Manipulation/Chiropractic Care means skeletal adjustments, manipulation or other treatment in connection with the detection and correction by manual or mechanical means of structural imbalance or subluxation in the human body. Such treatment is done by a Physician to remove nerve interference resulting from, or related to, distortion, misalignment or subluxation of, or in, the vertebral column. Substance Abuse is regular excessive compulsive drinking of alcohol and/or physical habitual dependence on drugs. This does not include dependence on tobacco and ordinary caffeine -containing drinks. Temporomandibular Joint (TMJ) syndrome is the treatment of jaw joint disorders including conditions of structures linking the jaw bone and skull and the complex of muscles, nerves and other tissues related to the temporomandibular joint. Care and treatment shall include, but are not limited to orthodontics, crowns, inlays, physical therapy and any appliance that is attached to or rests on the teeth. Total Disability (Totally Disabled) means: In the case of a Dependent child, the complete inability as a result of Injury or Sickness to perform the normal activities of a person of like age and sex in good health. Usual and Reasonable Charge is a charge which is not higher than the usual charge made by the provider of the care or supply and does not exceed the usual charge made by most providers of like service in the same area. This test will consider 35 the nature and severity of the condition being treated. It will also consider medical complications or unusual circumstances that require more time, skill or experience. The Plan will reimburse the actual charge billed if it is less than the Usual and Reasonable Charge. The Plan Administrator has the discretionary authority to decide whether a charge is Usual and Reasonable. For Non -Network provider and facility charges, Usual and Reasonable Charge is considered to mean Eligible Medical Expense (EME) or Usual and Reasonable Charge, whichever is less. W PLAN EXCLUSIONS Note: All exclusions related to Dental are shown in the Dental Plan. For all Medical Benefits shown in the Schedule of Benefits, a charge for the following is not covered: (1) Abortion. Services, supplies, care or treatment in connection with an abortion unless the life of the mother is endangered or when medically required. (2) Acupuncture. Charges for acupuncture or acupressure treatment. (3) Adolescent Behavior Disorders. Any services or supplies provided for the treatment of adolescent behavior disorders, including conduct disorders and oppositional disorders. (4) Artificial Insemination. Charges for artificial insemination (5) Chelation Therapy. services or supplies rendered to any Covered Person as, or in conjunction with, chelation therapy, except for the treatment of acute metal poisoning. (6) Complications of non -covered treatments. Care, services or treatment required as a result of complications from a treatment not covered under the Plan are not covered. Complications from a non -covered abortion are covered. (7) Cosmetic Surgery. Charges incurred as a result of or in relation to cosmetic surgery. (8) Custodial care. Services or supplies provided mainly as a rest cure, maintenance or Custodial Care. (9) Educational or vocational testing. Services for educational or vocational testing or training. (10) Environmental Sensitivity. Services or supplies rendered to any Covered Person primarily for: Environmental Sensitivity testing or treatment Clinical Ecology testing or treatment; or Inpatient allergy testing or treatment; (11) Excess charges. The part of an expense for care and treatment of an Injury or Sickness that is in excess of the Usual and Reasonable Charge or the Eligible Medical Expense. (12) Exercise programs. Exercise programs for treatment of any condition, except for Physician -supervised cardiac rehabilitation, occupational or physical therapy covered by this Plan. (13) Experimental or not Medically Necessary. Care and treatment that is either Experimental/Investigational or not Medically Necessary. (14) Eye care. Radial keratotomy or other eye surgery to correct refractive disorders. Also, routine eye examinations, including refractions, lenses for the eyes and exams for their fitting. This exclusion does not apply to aphakic patients and soft lenses or sclera shells intended for use as corneal bandages or as may be covered under the well adult or well child sections of this Plan. (15) Foot care. Treatment of weak, strained, flat, unstable or unbalanced feet, metatarsalgia or bunions (except open cutting operations), and treatment of corns, calluses or toenails (unless needed in treatment of a metabolic or peripheral -vascular disease). A fungal (mycotic) infection of the toenail will be covered if there is: Clinical evidence of mycosis of the toenail; 37 Medical evidence that the patient has a marked limitation of ambulation requiring active treatment of the foot or, in the case of a non -ambulatory patient, has a condition that is likely to result in significant medical complications in the absence of such treatment; and Excision of a nail without using an injectable or general anesthetic. (16) Foreign travel. Care, treatment or supplies out of the U.S. if travel is for the sole purpose of obtaining medical services. (17) Government coverage. Care, treatment or supplies furnished by a program or agency funded by any government. This does not apply to Medicaid or when otherwise prohibited by law. (18) Hair loss. Care and treatment for hair loss including wigs, hair transplants or any drug that promises hair growth, whether or not prescribed by a Physician. (19) Hearing aids and exams. Charges for services or supplies in connection with hearing aids or exams for their fitting, except as may be listed as covered in the schedule of benefits this Plan. (20) Hospital employees. Professional services billed by a Physician or nurse who is an employee of a Hospital or Skilled Nursing Facility and paid by the Hospital or facility for the service. (21) Illegal drugs or medications. Services, supplies, care or treatment to a Covered Person for Injury or Sickness resulting from that Covered Person's voluntary taking of or being under the influence of any controlled substance, drug, hallucinogen or narcotic not administered on the advice of a Physician. Expenses will be covered for Injured Covered Persons other than the person using controlled substances and expenses will be covered for Substance Abuse treatment as specified in this Plan. This exclusion does not apply if the Injury resulted from an act of domestic violence or a medical (including both physical and mental health) condition. (22) Impotence. Care, treatment, services, supplies or medication in connection with treatment for impotence unless to be determined to be organic or because the condition is the result of an injury or use of a prescribed medication. (23) Infertility. Care, supplies, services and treatment for infertility, artificial insemination, or in vitro fertilization. (24) No charge. Care and treatment for which there would not have been a charge if no coverage had been in force. (25) Non -emergency Hospital admissions. Care and treatment billed by a Hospital for non -Medical Emergency admissions on a Friday or a Saturday. This does not apply if surgery is performed within 24 hours of admission. (26) Non-prescription drugs. Charges for non-prescription drugs, vitamins, nutritional supplements, or special diets. (27) No obligation to pay. Charges incurred for which the Plan has no legal obligation to pay. (28) No Physician recommendation. Care, treatment, services or supplies not recommended and approved by a Physician; or treatment, services or supplies when the Covered Person is not under the regular care of a Physician. Regular care means ongoing medical supervision or treatment which is appropriate care for the Injury or Sickness. (29) Not specified as covered. Non-traditional medical services, treatments and supplies which are not specified as covered under this Plan. (30) Obesity. Care and treatment of obesity, weight loss or dietary control whether or not it is, in any case, a part of the treatment plan for another Sickness. 38 (31) Occupational. Care and treatment of an Injury or Sickness that is occupational -- that is, arises from work for wage or profit including self-employment. (32) Personal comfort items. Personal comfort items or other equipment, such as, but not limited to, air conditioners, air -purification units, humidifiers, electric heating units, orthopedic mattresses, blood pressure instruments, scales, elastic bandages or stockings, nonprescription drugs and medicines, and first -aid supplies and nonhospital adjustable beds. (33) Plan design excludes. Charges excluded by the Plan design as mentioned in this document. (34) Relative giving services. Professional services performed by a person who ordinarily resides in the Covered Person's home or is related to the Covered Person as a Spouse, parent, child, brother or sister, whether the relationship is by blood or exists in law. (35) Replacement braces. Replacement of braces of the leg, arm, back, neck, or artificial arms or legs, unless there is sufficient change in the Covered Person's physical condition to make the original device no longer functional. (36) Routine care. Charges for routine or periodic examinations, screening examinations, evaluation procedures, preventive medical care, or treatment or services not directly related to the diagnosis or treatment of a specific Injury, Sickness or pregnancy -related condition which is known or reasonably suspected, unless such care is specifically covered in the Schedule of Benefits. (37) Services before or after coverage. Care, treatment or supplies for which a charge was incurred before a person was Covered under this Plan or after coverage ceased under this Plan. (38) Sex changes. Care, services or treatment for non -congenital transsexualism, gender dysphoria or sexual reassignment or change. This exclusion includes medications, implants, hormone therapy, surgery, medical or psychiatric treatment. (39) Sleep disorders. Care and treatment for sleep disorders unless deemed Medically Necessary. (40) Social Services. Charges for any medical social services, except as provided for under Hospice Care services. (41) Smoking cessation. Care and treatment for smoking cessation programs, including smoking deterrent patches, unless Medically Necessary due to a severe active lung Illness such as emphysema or asthma. (42) Surgical sterilization reversal. Care and treatment for reversal of surgical sterilization. (43) TMJ. Any treatment of the temporomandibular (jaw) joint, or jaw related neuromuscular conditions with oral appliances or splints, physical therapy, or alteration of the occlusal relationship of the teeth or jaws to eliminate pain or dysfunction of the temporomandibular joint and all adjacent muscles and nerves after the Covered Person's 190'birthday. Orthognathic surgery for treatment of temporomandibular joint disorders and conditions of temporomandibular joint disorders will still be eligible for coverage after the Covered Person's 19fl' birthday. (44) Travel or accommodations. Charges for travel or accommodations, whether or not recommended by a Physician, except for ambulance charges as defined as a covered expense. (45) War. Any loss that is due to a declared or undeclared act of war. 39 DENTAL BENEFITS This benefit applies when covered dental charges are incurred by a person while covered under this Plan. DEDUCTIBLE Deductible Amount. This is an amount of dental charges for which no benefits will be paid. Before benefits can be paid in a Calendar Year, a Covered Person must meet the deductible shown in the Schedule of Benefits. Deductible Three Month Carryover. Covered expenses incurred in, and applied toward the individual deductible in October, November and December will be applied toward the individual deductible in the next Calendar Year. Family Unit Limit. When the dollar amount shown in the Schedule of Benefits has been incurred by members of a Family Unit toward their Calendar Year deductibles, the deductibles of all members of that Family Unit will be considered satisfied for that year. BENEFIT PAYMENT Each Calendar Year benefits will be paid to a Covered Person for the dental charges in excess of the deductible amount. Payment will be made at the rate shown under Dental Percentage Payable in the Schedule of Benefits. No benefits will be paid in excess of the Maximum Benefit Amount. MA3MVIUM BENEFIT AMOUNT The Maximum dental benefit amount is shown in the Schedule of Benefits. DENTAL CHARGES Dental charges are the Usual and Reasonable Charges made by a Dentist or other Physician for necessary care, appliances or other dental material listed as a covered dental service. A dental charge is incurred on the date the service or supply for which it is made is performed or furnished. However, there are times when one overall charge is made for all or part of a course of treatment. In this case, the Claims Supervisor will apportion that overall charge to each of the separate visits or treatments. The pro rata charge will be considered to be incurred as each visit or treatment is completed. COVERED DENTAL SERVICES Class A Services: Preventive and Diagnostic Dental Procedures The limits on Class A services are for routine services. If dental need is present, this Plan will consider for reimbursement services performed more frequently than the limits shown. (1) Routine oral exams. Limit of 2 per Covered Person each Calendar Year. (2) Professional cleaning. Limit of 2 per Covered Person each Calendar Year. (3) One bitewing x-ray series every 6 months. (4) One full mouth x-ray every 36 months. (5) Fluoride treatments for covered Dependent children under age 19. Limit of 2 fluoride treatments per Covered Person each Calendar Year. 40 (6) Emergency palliative treatment for pain. (7) Sealants on the occlusal surface of a permanent posterior tooth (once per Lifetime per tooth) for Dependent children under age 14. Class B Services: Basic Dental Procedures (1) Dental x-rays not included in Class A. (2) Oral surgery. Oral surgery is limited to removal of teeth, preparation of the mouth for dentures and removal of tooth -generated cysts of less than 1/4 inch. (3) Periodontics (gum treatments). (4) Endodontics (root canals). (5) Extractions. This service includes local anesthesia and routine post -operative care. (6) Space maintainers for Covered Persons under 19 years of age. (7) Recementing bridges, crowns or inlays. (S) Fillings, other than gold. (9) General anesthetics, upon demonstration of Medical Necessity. (10) Antibiotic drugs. Class C Services: Major Dental Procedures (1) Gold restorations, including inlays, onlays and foil fillings. The cost of gold restorations in excess of the cost for amalgam, synthetic porcelain or plastic materials will be included only when the teeth must be restored with gold. (2) Installation of crowns. (3) Installing precision attachments for removable dentures. (4) Installing partial, full or removable dentures to replace one or more natural teeth. This service also includes all adjustments made during 6 months following the installation. (5) Addition of clasp or rest to existing partial removable dentures. (6) Initial installation of fixed bridgework to replace one or more natural teeth. (7) Repair of crowns, bridgework and removable dentures. (S) Rebasing or relining of removable dentures. Limit 1 service every 36 months. (9) Replacing an existing removable partial or full denture or fixed bridgework; adding teeth to an existing removable partial denture; or adding teeth to existing bridgework to replace newly extracted natural teeth. However, this item will apply only if one of these tests is met: (a) The existing denture or bridgework was installed at least five years prior to its replacement and cannot currently be made serviceable. 41 (b) The existing denture is of an immediate temporary nature. Further, replacement by permanent dentures is required and must take place within 12 months from the date the temporary denture was installed. Class D Services: Orthodontic Treatment and Appliances This is treatment to move teeth by means of appliances to correct a handicapping malocclusion of the mouth. These services are available for Covered Persons under age 25 and include preliminary study, including x-rays, diagnostic casts and treatment plan, active treatments and retention appliance. Payments for comprehensive full -banded orthodontic treatments are made in installments. PREDETERMINATION OF BENEFITS Before starting a dental treatment for which the charge is expected to be $300 or more, a predetermination of benefits form must be submitted. A regular dental claim form is used for the predetermination of benefits. The covered Employee fills out the Employee section of the form and then gives the form to the Dentist. The Dentist must itemize all recommended services and costs and attach all supporting x-rays to the form. The Dentist should send the form to the Claims Supervisor at this address: American Administrative Group, Inc. P.O. Box 53070 Lubbock, Texas 79453 1-800-658-9777 The Claims Supervisor will notify the Dentist of the benefits payable under the Plan. The Covered Person and the Dentist can then decide on the course of treatment, knowing in advance how much the Plan will pay. If a description of the procedures to be performed, x-rays and an estimate of the Dentist's fees are not submitted in advance, the Plan reserves the right to make a determination of benefits payable taking into account alternative procedures, services or courses of treatment, based on accepted standards of dental practice. If verification of necessity of dental services cannot reasonably be made, the benefits may be for a lesser amount than would otherwise have been payable. Many dental conditions can be treated in more than one way. This Plan has an "alternate treatment" clause which governs the amount of benefits the Plan will pay for treatments covered under the Plan. If a patient chooses a more expensive treatment than is needed to correct a dental problem according to accepted standards of dental practice, the benefit payment will be based on the cost of the treatment which provides professionally satisfactory results at the most cost-effective level. For example, if a regular amalgam filling is sufficient to restore a tooth to health, and the patient and the Dentist decide to use a gold filling, the Plan will base its reimbursement on the Usual and Reasonable Charge for an amalgam filling. The patient will pay the difference in cost. EXCLUSIONS A charge for the following is not covered: (1) Administrative costs. Administrative costs of completing claim forms or reports or for providing dental records. 42 (2) Broken appointments. Charges for broken or missed dental appointments. (3) Crowns. Crowns for teeth that are restorable by other means or for the purpose of Periodontal Splinting. (4) Excluded under Medical. Services that are excluded under Medical Plan Exclusions. (5) Hygiene. Oral hygiene, plaque control programs or dietary instructions. (6) Implants. Implants, including any appliances and/or crowns and the surgical insertion or removal of implants. (7) Medical services. Services that, to any extent, are payable under any medical expense benefits of the Plan. (8) No listing. Services which are not included in the list of covered dental services. (9) Orthognathic surgery. Surgery to correct malpositions in the bones of the jaw. (10) Personalization. Personalization of dentures. (11) Replacement. Replacement of lost or stolen appliances. (12) Splinting. Crowns, fillings or appliances that are used to connect (splint) teeth, or change or alter the way the teeth meet, including altering the vertical dimension, restoring the bite (occlusion) or are cosmetic. 43 HOW TO SUBMIT A CLAIM Benefits under this Plan shall be paid only if the Plan Administrator decides in its discretion that a Covered Person is entitled to them. When a Covered Person has a Claim to submit for payment that person must: (1) Obtain and complete a group claim transmittal form from the Personnel Office or the Plan Administrator. (2) Complete the Employee portion of the form. ALL QUESTIONS MUST BE ANSWERED. (3) Have the Physician or Dentist complete the provider's portion of the form. (4) For Plan reimbursements, attach bills for services rendered. ALL BILLS MUST SHOW: - Name of Plan - Employee's name - Name of patient - Name, address, telephone number of the provider of care - Diagnosis - Type of services rendered, with diagnosis and/or procedure codes - Date of services - Charges (5) Send the above to the Claims Supervisor at this address: American Administrative Group, Inc. P.O. Box 53070 Lubbock, Texas 79453 I-800-658-9777 WHEN CLAIMS SHOULD BE FILED Claims should be filed with the Claims Supervisor within 365 days of the date charges for the service were incurred. Benefits are based on the Plan's provisions at the time the charges were incurred. Claims filed later than that date may be declined or reduced unless: (a) it's not reasonably possible to submit the claim in that time The Claims Supervisor will determine if enough information has been submitted to enable proper consideration of the claim. If not, more information may be requested from the claimant. The Plan reserves the right to have a Plan Participant seek a second medical opinion. CLAIMS PROCEDURE Following is a description of how the Plan processes Claims for benefits. A Claim is defined as any request for a Plan benefit, made by a claimant or by a representative of a claimant, that complies with the Plan's reasonable procedure for making benefit Claims. The times listed are maximum times only. A period of time begins at the time the Claim is filed. Decisions will be made within a reasonable period of time appropriate to the circumstances. "Days" means calendar days. There are different kinds of Claims and each one has a specific timetable for either approval, payment, request for further information, or denial of the Claim. If you have any questions regarding this procedure, please contact the Plan Administrator. 44 The definitions of the types of Claims are: Urgent Care Claim A Claim involving Urgent Care is any Claim for medical care or treatment where using the timetable for a non -urgent care determination could seriously jeopardize the life or health of the claimant; or the ability of the claimant to regain maximum function; or in the opinion of the attending or consulting Physician, would subject the claimant to severe pain that could not be adequately managed without the care or treatment that is the subject of the Claim. A Physician with knowledge of the claimant's medical condition may determine if a Claim is one involving Urgent Care. If there is no such Physician, an individual acting on behalf of the Plan applying the judgment of a prudent layperson who possesses an average knowledge of health and medicine may make the determination. In the case of a Claim involving Urgent Care, the following timetable applies: Notification to claimant of benefit determination 72 hours Insufficient information on the Claim, or failure to follow the Plan's procedure for filing a Claim: Notification to claimant, orally or in writing 24 hours Response by claimant, orally or in writing 48 hours Benefit determination, orally or in writing 48 hours Ongoing courses of treatment, notification of: Reduction or termination before the end of treatment 72 hours Determination as to extending course of treatment 24 hours If there is an adverse benefit determination on a Claim involving Urgent Care, a request for an expedited appeal may be submitted orally or in writing by the claimant. All necessary information, including the Plan's benefit determination on review, may be transmitted between the Plan and the claimant by telephone, facsimile, or other similarly expeditious method. Pre -Service Claim A Pre -Service Claim means any Claim for a benefit under this Plan where the Plan conditions receipt of the benefit, in whole or in part, on approval in advance of obtaining medical care. These are, for example, Claims subject to pre -certification. Please see the Cost Management section of this booklet for further information about Pre -Service Claims. In the case of a Pre -Service Claim, the following timetable applies: Notification to claimant of benefit determination 15 days Extension due to matters beyond the control of the Plan 15 days Insufficient information on the Claim: Notification of 15 days Response by claimant 45 days Notification, orally or in writing, of failure to follow the Plan's 5 days procedures for filing a Claim 45 Ongoing courses of treatment: Reduction or termination before the end of the treatment Request to extend course of treatment Review of adverse benefit determination Reduction or termination before the end of the treatment Request to extend course of treatment Post -Service Claim 15 days 15 days 15 days per benefit appeal 15 days 15 days A Post -Service Claim means any Claim for a Plan benefit that is not a Claim involving Urgent Care or a Pre -Service Claim; in other words, a Claim that is a request for payment under the Plan for covered medical services already received by the claimant. In the case of a Post -Service Claim, the following timetable applies: Notification to claimant of benefit determination 30 days Extension due to matters beyond the control of the Plan 15 days Extension due to insufficient information on the Claim 15 days Response by claimant following notice of insufficient 45 days information Review of adverse benefit determination 30 days per benefit appeal Notice to claimant of adverse benefit determinations Except with Urgent Care Claims, when the notification may be orally followed by written or electronic notification within three days of the oral notification, the Plan Administrator shall provide written or electronic notification of any adverse benefit determination. The notice will state, in a manner calculated to be understood by the claimant: (1) The specific reason or reasons for the adverse determination. (2) Reference to the specific Plan provisions on which the determination was based. (3) A description of any additional material or information necessary for the claimant to perfect the Claim and an explanation of why such material or information is necessary. (4) A description of the Plan's review procedures and the time limits applicable to such procedures. This will include a statement of the claimant's right to bring a civil action under section 502 of ERISA following an adverse benefit determination on review. (5) A statement that the claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claim. (6) If the adverse benefit determination was based on an internal rule, guideline, protocol, or other similar criterion, the specific rule, guideline, protocol, or criterion will be provided free of charge. If this is not practical, a statement will be included that such a rule, guideline, protocol, or criterion was relied upon in making the adverse benefit determination and a copy will be provided free of charge to the claimant upon request. 46 (7) If the adverse benefit determination is based on the Medical Necessity or Experimental or Investigational treatment or similar exclusion or limit, an explanation of the scientific or clinical judgment for the determination, applying the terms of the Plan to the claimant's medical circumstances, will be provided. If this is not practical, a statement will be included that such explanation will be provided free of charge, upon request. Appeals When a claimant receives an adverse benefit determination, the claimant has 180 days following receipt of the notification in which to appeal the decision. A claimant may submit written comments, documents, records, and other information relating to the Claim. If the claimant so requests, he or she will be provided, free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claim. The period of time within which a benefit determination on review is required to be made shall begin at the time an appeal is filed in accordance with the procedures of the Plan. This timing is without regard to whether all the necessary information accompanies the filing. A document, record, or other information shall be considered relevant to a Claim if it: (1) was relied upon in making the benefit determination; (2) was submitted, considered, or generated in the course of making the benefit determination, without regard to whether it was relied upon in making the benefit determination; (3) demonstrated compliance with the administrative processes and safeguards designed to ensure and to verify that benefit determinations are made in accordance with Plan documents and Plan provisions have been applied consistently with respect to all claimants; or (4) constituted a. statement of policy or guidance with respect to the Plan concerning the denied treatment option or benefit. The review shall take into account all comments, documents, records, and other information submitted by the claimant relating to the Claim, without regard to whether such information was submitted or considered in the initial benefit determination. The review will not afford deference to the initial adverse benefit determination and will be conducted by a fiduciary of the Plan who is neither the individual who made the adverse determination nor a subordinate of that individual. If the determination was based on a medical judgment, including determinations with regard to whether a particular treatment, drug, or other item is Experimental, Investigational, or not Medically Necessary or appropriate, the fiduciary shall consult with a health care professional who was not involved in the original benefit determination. This health care professional will have appropriate training and experience in the field of medicine involved in the medical judgment. Additionally, medical or vocational experts whose advice was obtained on behalf of the Plan in connection with the initial determination will be identified. 47 COORDINATION OF BENEFITS Coordination of the benefit plans. Coordination of benefits sets out rules for the order of payment of Covered Charges when two or more plans — including Medicare -- are paying. When a Covered Person is covered by this Plan and another plan, or the Covered Person's Spouse is covered by this Plan and by another plan or the couple's Covered children are covered under two or more plans, the plans will coordinate benefits when a claim is received. The plan that pays first according to the rules will pay as if there were no other plan involved. The secondary and subsequent plans will pay the balance due up to 100% of the total allowable expenses. Benefit plan. This provision will coordinate the medical and dental benefits of a benefit plan. The term benefit plan means this Plan or any one of the following plans: (1) Group or group -type plans, including franchise or blanket benefit plans. (2) Blue Cross and Blue Shield group plans. (3) Group practice and other group prepayment plans. (4) Federal government plans or programs. This includes Medicare. (5) Other plans required or provided by law. This does not include Medicaid or any benefit plan like it that, by its terms, does not allow coordination. (6) No Fault Auto Insurance, by whatever name it is called, when not prohibited by law. Allowable charge. For a charge to be allowable it must be a Usual and Reasonable Charge and at least part of it must be covered under this Plan. In the case of HMO (Health Maintenance Organization) or other in -network only plans: This Plan will not consider any charges in excess of what an HMO or network provider has agreed to accept as payment in full. Also, when an HMO or network plan is primary and the Covered Person does not use an HMO or network provider, this Plan will not consider as an allowable charge any charge that would have been covered by the HMO or network plan had the Covered Person used the services of an HMO or network provider. In the case of service type plans where services are provided as benefits, the reasonable cash value of each service will be the allowable charge. Automobile limitations. When medical payments are available under vehicle insurance, the Plan shall pay excess benefits only, without reimbursement for vehicle plan deductibles. This Plan shall always be considered the secondary carrier regardless of the individual's election under PIP (personal injury protection) coverage with the auto carrier. Benefit plan payment order. When two or more plans provide benefits for the same allowable charge, benefit payment will follow these rules. (1) Plans that do not have a coordination provision, or one like it, will pay first. Plans with such a provision will be considered after those without one. (2) Plans with a coordination provision will pay their benefits up to the Allowable Charge: (a) The benefits of the plan which covers the person directly (that is, as an employee, member or subscriber) ("Plan A") are determined before those of the plan which covers the person as a dependent ("Plan B"). (b) The benefits of a benefit plan which covers a person as an Employee who is neither laid off nor retired are determined before those of a benefit plan which covers that person as a laid -off or Retired 48 Employee. The benefits of a benefit plan which covers a person as a Dependent of an Employee who is neither laid off nor retired are determined before those of a benefit plan which covers a person as a Dependent of a laid off or Retired Employee. If the other benefit plan does not have this rule, and if, as a result, the plans do not agree on the order of benefits, this rule does not apply. (c) The benefits of a benefit plan which covers a person as an Employee who is neither laid off nor retired or a Dependent of an Employee who is neither laid off nor retired are determined before those of a plan which covers the person as a COBRA beneficiary. (d) When a child is covered as a Dependent and the parents are not separated or divorced, these rules will apply: (i) The benefits of the benefit plan of the parent whose birthday falls earlier in a year are determined before those of the benefit plan of the parent whose birthday falls later in that year; (ii) If both parents have the same birthday, the benefits of the benefit plan which has covered the patient for the longer time are determined before those of the benefit plan which covers the other parent. (e) When a child's parents are divorced or legally separated, these rules will apply: (i) This rule applies when the parent with custody of the child has not remarried. The benefit plan of the parent with custody will be considered before the benefit plan of the parent without custody. (ii) This rule applies when the parent with custody of the child has remarried. The benefit plan of the parent with custody will be considered first. The benefit plan of the stepparent that covers the child as a Dependent will be considered next. The benefit plan of the parent without custody will be considered last. (iii) This rule will be in place of items (i) and (ii) above when it applies. A court decree may state which parent is financially responsible for medical and dental benefits of the child. In this case, the benefit plan of that parent will be considered before other plans that cover the child as a Dependent. (iv) If the specific terms of the court decree state that the parents shall share joint custody, without stating that one of the parents is responsible for the health care expenses of the child, the plans covering the child shall follow the order of benefit determination rules outlined above when a child is covered as a Dependent and the parents are not separated or divorced. (v) For parents who were never married to each other, the rules apply as set out above as long as paternity has been established. (f) If there is still a conflict after these rules have been applied, the benefit plan which has covered the patient for the longer time will be considered first. When there is a conflict in coordination of benefit rules, the Plan will never pay more than 50% of allowable charges when paying secondary. (3) Medicare will pay primary, secondary or last to the extent stated in federal law. When Medicare is to be the primary payer, this Plan will base its payment upon benefits that would have been paid by Medicare under Parts A and B, regardless of whether or not the person was enrolled under both of these parts. (4) If a Plan Participant is under a disability extension from a previous benefit plan, that benefit plan will pay first and this Plan will pay second. 49 Claims determination period. Benefits will be coordinated on a Calendar Year basis. This is called the claims determination period. Right to receive or release necessary information. To make this provision work, this Plan may give or obtain needed information from another insurer or any other organization or person. This information may be given or obtained without the consent of or notice to any other person. A Covered Person will give this Plan the information it asks for about other plans and their payment of allowable charges. Facility of payment. This Plan may repay other plans for benefits paid that the Plan Administrator determines it should have paid. That repayment will count as a valid payment under this Plan. Right of recovery. This Plan may pay benefits that should be paid by another benefit plan. In this case this Plan may recover the amount paid from the other benefit plan or the Covered Person. That repayment will count as a valid payment under the other benefit plan. Further, this Plan may pay benefits that are later found to be greater than the allowable charge. In this case, this Plan may recover the amount of the overpayment from the source to which it was paid. 50 THIRD PARTY RECOVERY PROVISION RIGHT OF SUBROGATION AND REFUND When this provision applies. The Covered Person may incur medical or dental charges due to Injuries which may be caused by the act or omission of a Third Party or a Third Party may be responsible for payment. In such circumstances, the Covered Person may have a claim against that Third Party, or insurer, for payment of the medical or dental charges. Accepting benefits under this Plan for those incurred medical or dental expenses automatically assigns to the Plan any rights the Covered Person may have to Recover payments from any Third Party or insurer. This Subrogation right allows the Plan to pursue any claim which the Covered Person has against any Third Party, or insurer, whether or not the Covered Person chooses to pursue that claim. The Plan may make a claim directly against the Third Party or insurer, but in any event, the Plan has a lien on any amount Recovered by the Covered Person whether or not designated as payment for medical expenses. This lien shall remain in effect until the Plan is repaid in full. The Covered Person: (1) automatically assigns to the Plan his or her rights against any Third Party or insurer when this provision applies; and (2) must repay to the Plan the benefits paid on his or her behalf out of the Recovery made from the Third Party or insurer. In addition to, neither the Plan nor the Company shall be responsible for any of the Covered Individual's attorney's fees or the costs of the Covered Individual's litigation. Amount subject to Subrogation or Refund. The Covered Person agrees to recognize the Plan's right to Subrogation and reimbursement. These rights provide the Plan with a 100%, first dollar priority over any and all Recoveries and funds paid by a Third Party to a Covered Person relative to the Injury or Sickness, including a priority over any claim for non -medical or dental charges, attorney fees, or other costs and expenses. Accepting benefits under this Plan for those incurred medical or dental expenses automatically assigns to the Plan any and all rights the Covered Person may have to recover payments from any Responsible Third Party. Further, accepting benefits under this Plan for those incurred medical or dental expenses automatically assigns to the Plan the Covered Person's Third Party Claims. Notwithstanding its priority to funds, the Plan's Subrogation and Refund rights, as well as the rights assigned to it, are limited to the extent to which the Plan has made, or will make, payments for medical or dental charges as well as any costs and fees associated with the enforcement of its rights under the Plan. The Plan reserves the right to be reimbursed for its court costs and attorneys' fees if the Plan needs to file suit in order to Recover payment for medical or dental expenses from the Covered Person. Also, the Plan's right to Subrogation still applies if the Recovery received by the Covered Person is less than the claimed damage, and, as a result, the claimant is not made whole. In addition, the Plan shall not be responsible for any of the Covered Person's attorney's fees or the costs of the Covered Person's litigation. When a right of Recovery exists, the Covered Person will execute and deliver all required instruments and papers as well as doing whatever else is needed to secure the Plan's right of Subrogation as a condition to having the Plan make payments. In addition, the Covered Person will do nothing to prejudice the right of the Plan to Subrogate. Conditions Precedent to Coverage. The Plan shall have no obligation whatsoever to pay medical or dental benefits to a Covered Person if a Covered Person refuses to cooperate with the Plan's reimbursement and Subrogation rights or refuses to execute and deliver such papers as the Plan may require in furtherance of its reimbursement and Subrogation rights. Further, in the event the Covered Person is a minor, the Plan shall have no obligation to pay any medical or dental benefits incurred on account of Injury or Sickness caused by a responsible Third Party until after the Covered Person or his authorized legal representative obtains valid court recognition and approval of the Plan's 100%, first dollar reimbursement and Subrogation rights on all Recoveries, as well as approval for the execution of any papers necessary for the enforcement thereof, as described herein. Defined terms: "Covered Person" means anyone covered under the Plan, including minor dependents. 51 "Recover," "Recovered," "Recovery" or "Recoveries" means all monies paid to the Covered Person by way of judgment, settlement, or otherwise to compensate for all losses caused by the Injury or Sickness, whether or not said losses reflect medical or dental charges covered by the Plan. "Recoveries" further includes, but is not limited to, recoveries for medical or dental expenses, attorneys' fees, costs and expenses, pain and suffering, loss of consortium, wrongful death, lost wages and any other recovery of any form of damages or compensation whatsoever. "Refund" means repayment to the Plan for medical or dental benefits that it has paid toward care and treatment of the Injury or Sickness. "Subrogation" means the Plan's right to pursue and place a lien upon the Covered Person's claims for medical or dental charges against the other person. "Third Party" means any Third Party including another person or a business entity. Recovery from another plan under which the Covered Person is covered. This right of Refund also applies when a Covered Person Recovers under an uninsured or underinsured motorist plan (which will be treated as Third Party coverage when reimbursement or Subrogation is in order), homeowner's plan, renter's plan, medical malpractice plan or any liability plan. Rights of Plan Administrator. The Plan Administrator has a right to request reports on and approve of all settlements. 52 COBRA CONTINUATION OPTIONS A federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), requires that most employers sponsoring a group health plan ("Plan") offer Employees and their families covered under their health plan the opportunity for a temporary extension of health coverage (called "COBRA continuation coverage") in certain instances where coverage under the Plan would otherwise end. This notice is intended to inform Plan Participants and beneficiaries, in summary fashion, of the rights and obligations under the continuation coverage provisions of COBRA, as amended and reflected in final and proposed regulations published by the Department of the Treasury. This notice is intended to reflect the law and does not grant or take away any rights under the law. Complete instructions on COBRA, as well as election forms and other information, will be provided by the Plan Administrator to Plan Participants who become Qualified Beneficiaries under COBRA. Note: Special COBRA rights apply to employees who have been terminated or experienced a reduction of hours and who qualify for a trade readjustment allowance or alternative trade adjustment assistance under a federal law called the Trade Act of 1974. These employees must have made petitions for certification to apply for TAA on or after November 4, 2002. The employees, if they do not already have COBRA coverage, are entitled to a second opportunity to elect COBRA coverage for themselves and certain family members, but only within a limited period of 60 days or less and only during the six months immediately after their group health plan coverage ended. Any employee who qualifies or may qualify for assistance under this special provision should contact his or her Plan Administrator for further information. What is COBRA continuation coverage? COBRA continuation coverage is group health plan, coverage that an employer must offer to certain Plan Participants and their eligible family members (called "Qualified Beneficiaries") at group rates for up to a statutory -mandated maximum period of time or until they become ineligible for COBRA continuation coverage, whichever occurs first. The right to COBRA continuation coverage is triggered by the occurrence of one of certain enumerated events that result in the loss of coverage under the terms of the employer's Plan (the "Qualifying Event"). The coverage must be identical to the Plan coverage that the Qualified Beneficiary had immediately before the Qualifying Event, or if the coverage has been changed, the coverage must be identical to the coverage provided to similarly situated active employees who have not experienced a Qualifying Event (in other words, similarly situated nonCOBRA beneficiaries). Who is a Qualified Beneficiary? In general, a Qualified Beneficiary is: (i) Any individual who, on the day before a Qualifying Event, is covered under a Plan by virtue of being on that day either a covered Employee, the Spouse of a covered Employee, or a Dependent child of a covered Employee. If, however, an individual is denied or not offered coverage under the Plan under circunstances in which the denial or failure to offer constitutes a violation of applicable law, then the individual will be considered to have had the Plan coverage and will be considered a Qualified Beneficiary if that individual experiences a Qualifying Event. 00 Any child who is born to or placed for adoption with a covered Employee during a period of COBRA continuation coverage. If, however, an individual is denied or not offered coverage under the Plan under circumstances in which the denial or failure to offer constitutes a violation of applicable law, then the individual will be considered to have had the Plan coverage and will be considered a Qualified Beneficiary if that individual experiences a Qualifying Event. (iii) A covered Employee who retired on or before the date of substantial elimination of Plan coverage which is the result of a bankruptcy proceeding under Title 1 t of the U.S. Code with respect to the Employer, as is the Spouse, surviving Spouse or Dependent child of such a covered Employee if, on the day before the bankruptcy Qualifying Event, the Spouse, surviving Spouse or Dependent child was a beneficiary under the Plan. The term "covered Employee" includes not only common-law employees (whether part-time or full-time) but also any individual who is provided coverage under the Plan due to his or her performance of services for the employer sponsoring the Plan (e.g., self-employed individuals, independent contractor, or corporate director). 53 An individual is not a Qualified Beneficiary if the individual's status as a covered Employee is attributable to a period in which the individual was a nonresident alien who received from the individual's Employer no earned income that constituted income from sources within the United States. If, on account of the preceding reason, an individual is not a qualified beneficiary, then a Spouse or Dependent child of the individual is not considered a Qualified Beneficiary by virtue of the relationship to the individual. A domestic partner is not a Qualified Beneficiary. Each Qualified Beneficiary (including a child who is born to or placed for adoption with a covered Employee during a period of COBRA continuation coverage) must be offered the opportunity to make an independent election to receive COBRA continuation coverage. What is a Qualifying Event? A Qualifying Event is any of the following if the Plan provided that the Plan participant would lose coverage (i.e., cease to be covered under the same terms and conditions as in effect immediately before the Qualifying Event) in the absence of COBRA continuation coverage: W The death of a covered Employee. 00 The termination (other than by reason of the Employee's gross misconduct), or reduction of hours, of a covered Employee's employment. (iii) The divorce or legal separation of a covered Employee from the Employee's Spouse. (iv) A covered Employee's enrollment in the Medicare program. (v) A Dependent child's ceasing to satisfy the Plan's requirements for a Dependent child (e.g., attainment of the maximum age for dependency under the Plan). (A) A proceeding in bankruptcy under Title 11 of the U.S. Code with respect to an Employer from whose employment a covered Employee retired at any time. If the Qualifying Event causes the covered Employee, or the Spouse or a Dependent child of the covered Employee, to cease to be covered under the Plan under the same terms and conditions as in effect immediately before the Qualifying Event (or in the case of the bankruptcy of the Employer, any substantial elimination of coverage under the Plan occurring within 12 months before or after the date the bankruptcy proceeding commences), the persons losing such coverage become Qualified Beneficiaries under COBRA if all the other conditions of the COBRA law are also met. Any increase in contribution that must be paid by a covered Employee, or the Spouse, or a Dependent child of the covered Employee, for coverage under the Plan that results from the occurrence of one of the events listed above is a loss of coverage. The taking of leave under the Family and Medical Leave Act of 1993 ("FMLA") does not constitute a Qualifying Event. A Qualifying Event occurs, however, if an Employee does not return to employment at the end of the FMLA leave and all other COBRA continuation coverage conditions are present. If a Qualifying Event occurs, it occurs on the last day of FMLA leave and the applicable maximum coverage period is measured from this date (unless coverage is lost at a later date and the Plan provides for the extension of the required periods, in which case the maximum coverage date is measured from the date when the coverage is lost.) Note that the covered Employee and family members will be entitled to COBRA continuation coverage even if they failed to pay the employee portion of premiums for coverage under the Plan during the FMLA leave. What is the election period and how long must it last? An election period is the time period within which the Qualified Beneficiary can elect COBRA continuation coverage under the Employer's Plan. A Plan can condition availability of COBRA continuation coverage upon the timely election of such coverage. An election of COBRA continuation coverage is a timely election if it is made during the election period. The election period must begin not later than the date the Qualified Beneficiary would lose coverage on account of the Qualifying Event and must not end before the date that is 60 days after the later of the date the Qualified Beneficiary would lose coverage on account of the Qualifying Event or the date notice is provided to the Qualified Beneficiary of her or his right to elect COBRA continuation coverage. Is a covered Employee or Qualified Beneficiary responsible for informing the Plan Administrator of the occurrence of a Qualifying Event? In general, the Employer or Plan Administrator must determine when a Qualifying Event has occurred. »� However, each covered Employee or Qualified Beneficiary is responsible for notifying the Plan Administrator of the occurrence of a Qualifying Event that is: (i) A Dependent child's ceasing to be a Dependent child under the generally applicable requirements of the Plan. (ii) The divorce or legal separation of the covered Employee. The Plan is not required to offer the Qualified Beneficiary an opportunity to elect COBRA continuation coverage if the notice is not provided to the Plan Administrator within 60 days after the later of. the date of the Qualifying Event, or the date the Qualified Beneficiary would lose coverage on account of the Qualifying Event. Is a waiver before the end of the election period effective to end a Qualified Beneficiary's election rights? If, during the election period, a Qualified Beneficiary waives COBRA continuation coverage, the waiver can be revoked at any time before the end of the election period. Revocation of the waiver is an election of COBRA continuation coverage. However, if a waiver is later revoked, coverage need not be provided retroactively (that is, from the date of the loss of coverage until the waiver is revoked). Waivers and revocations of waivers are considered made on the date they are sent to the Employer or Plan Administrator, as applicable. When may a Qualified Beneficiary's COBRA continuation coverage be terminated? During the election period, a Qualified Beneficiary may waive COBRA continuation coverage. Except for an interruption of coverage in connection with a waiver, COBRA continuation coverage that has been elected for a Qualified Beneficiary must extend for at least the period beginning on the date of the Qualifying Event and ending not before the earliest of the following dates: (i) The last day of the applicable maximum coverage period. (ii) The first day for which Timely Payment is not made to the Plan with respect to the Qualified Beneficiary. (iii) The date upon which the Employer ceases to provide any group health plan (including successor plans) to any Employee. (iv) The date, after the date of the election, that the Qualified Beneficiary first becomes covered under any other Plan that does not contain any exclusion or limitation with respect to any pre-existing condition, other than such an exclusion or limitation that does not apply to, or is satisfied by, the Qualified Beneficiary. (v) The date, after the date of the election, that the Qualified Beneficiary first enrolls in the Medicare program (either part A or part B, whichever occurs earlier). (4) In the case of a Qualified Beneficiary entitled to a disability extension, the later of: (a) (i) 29 months after the date of the Qualifying Event, or (ii) the first day of the month that is more than 30 days after the date of a final determination under Title 11 or XVI of the Social Security Act that the disabled Qualified Beneficiary whose disability resulted in the Qualified Beneficiary's entitlement to the disability extension is no longer disabled, whichever is earlier; or (b) the end of the maximum coverage period that applies to the Qualified Beneficiary without regard to the disability extension. The Plan can terminate for cause the coverage of a Qualified Beneficiary on the same basis that the Plan terminates for cause the coverage of similarly situated nonCOBRA beneficiaries, for example, for the submission of a fraudulent claim. In the case of an individual who is not a Qualified Beneficiary and who is receiving coverage under the Plan solely because of the individual's relationship to a Qualified Beneficiary, if the Plan's obligation to make COBRA continuation coverage available to the Qualified Beneficiary ceases, the Plan is not obligated to make coverage available to the individual who is not a Qualified Beneficiary. What are the maximum coverage periods for COBRA continuation coverage? The maximum coverage periods are based on the type of the Qualifying Event and the status of the Qualified Beneficiary, as shown below. 55 (i) In the case of a Qualifying Event that is a termination of employment or reduction of hours of employment, the maximum coverage period ends 18 months after the Qualifying Event if there is not a disability extension and 29 months after the Qualifying Event if there is a disability extension. (ii) In the case of a covered Employee's enrollment in the Medicare program before experiencing a Qualifying Event that is a termination of employment or reduction of hours of employment, the maximum coverage period for Qualified Beneficiaries other than the covered Employee ends on the later of. (a) 36 months after the date the covered Employee becomes enrolled in the Medicare program; or (b) 18 months (or 29 months, if there is a disability extension) after the date of the covered Employee's termination of employment or reduction of hours of employment. (iii) In the case of a bankruptcy Qualifying Event, the maximum coverage period for a Qualified Beneficiary who is the retired covered Employee ends on the date of the retired covered Employee's death. The maximum coverage period for a Qualified Beneficiary who is the Spouse, surviving Spouse or Dependent child of the retired covered Employee ends on the earlier of the date of the Qualified Beneficiary's death or the date that is 36 months after the death of the retired covered Employee. (iv) In the case of a Qualified Beneficiary who is a child born to or placed for adoption with a covered Employee during a period of COBRA continuation coverage, the maximum coverage period is the maximum coverage period applicable to the Qualifying Event giving rise to the period of COBRA continuation coverage during which the child was born or placed for adoption. (v) In the case of any other Qualifying Event than that described above, the maximum coverage period ends 36 months after the Qualifying Event. Under what circumstances can the maximum coverage period be expanded? If a Qualifying Event that gives rise to an 18- month or 29-month maximum coverage period is followed, within that 18- or 29-month period, by a second Qualifying Event that gives rise to a 36-months maximum coverage period, the original period is expanded to 36 months, but only for individuals who are Qualified Beneficiaries at the time of both Qualifying Events. In no circumstance can the COBRA maximum coverage period be expanded to more than 36 months after the date of the first Qualifying Event. How does a Qualified Beneficiary become entitled to a disability extension? A disability extension will be granted if an individual (whether or not the covered Employee) who is a Qualified Beneficiary in connection with the Qualifying Event that is a termination or reduction of hours of a covered Employee's employment, is determined under Title II or XVI of the Social Security Act to have been disabled at any time during the first 60 days of COBRA continuation coverage. To qualify for the disability extension, the Qualified Beneficiary must also provide the Plan Administrator with notice of the disability determination on a date that is both within 60 days after the date of the determination and before the end of the original 18- month maximum coverage. Can a Plan require payment for COBRA continuation coverage? Yes. For any period of COBRA continuationi coverage, a Plan can require the payment of an amount that does not exceed 102% of the applicable premium except the Plan may require the payment of an amount that does not exceed 150% of the applicable premium for any period of COBRA continuation coverage covering a disabled qualified beneficiary that would not be required to be made available in the absence of a disability extension. A group health plan can terminate a qualified beneficiary's COBRA continuation coverage as of the first day of any period for which timely payment is not made to the Plan with respect to that qualified beneficiary. Must the Plan allow payment for COBRA continuation coverage to be made in monthly installments? Yes. The Plan is also permitted to allow for payment at other intervals. What is Timely Payment for payment for COBRA continuation coverage? Timely Payment means payment that is made to the Plan by the date that is 30 days after the first day of that period. Payment that is made to the Plan by a later date is also considered Timely Payment if either under the terms of the Plan, covered Employees or Qualified Beneficiaries are allowed until that later date to pay for their coverage for the period or under the terms of an arrangement between the Employer and 56 the entity that provides Plan benefits on the Employer's behalf, the Employer is allowed until that later date to pay for coverage of similarly situated nonCOBRA beneficiaries for the period. Notwithstanding the above paragraph, a Plan cannot require payment for any period of COBRA continuation coverage for a Qualified Beneficiary earlier than 45 days after the date on which the election of COBRA continuation coverage is made for that Qualified Beneficiary. Payment is considered made on the date on which it is sent to the Plan. If Timely Payment is made to the Plan in an amount that is not significantly less than the amount the Plan requires to be paid for a period of coverage, then the amount paid will be deemed to satisfy the Plan's requirement for the amount to be paid, unless the Plan notifies the Qualified Beneficiary of the amount of the deficiency and grants a reasonable period of time for payment of the deficiency to be made. A "reasonable period of time" is 30 days after the notice is provided. A shortfall in a Timely Payment is not significant if it is no greater than the lesser of $50 or 10% of the required amount. Must a qualified beneficiary be given the right to enroll in a conversion health plan at the end of the maximum coverage period for COBRA continuation coverage? If a Qualified Beneficiary's COBRA continuation coverage under a group health plan ends as a result of the expiration of the applicable maximum coverage period, the Plan must, during the 180- day period that ends on that expiration date, provide the Qualified Beneficiary with the option of enrolling under a conversion health plan if such an option is otherwise generally available to similarly situated nonCOBRA beneficiaries under the Plan. If such a conversion option is not otherwise generally available, it need not be made available to Qualified Beneficiaries. 57 RESPONSIBILITIES FOR PLAN ADMINISTRATION PLAN ADMINISTRATOR. City of Lubbock Employee Benefit Plan is the benefit plan of City of Lubbock, the Plan Administrator, also called the Plan Sponsor. It is to be administered by the Plan Administrator in accordance with the provisions of ERISA. An individual may be appointed by City of Lubbock to be Plan Administrator and serve at the convenience of the Employer. If the Plan Administrator resigns, dies or is otherwise removed from the posiion, City of Lubbock shall appoint a new Plan Administrator as soon as reasonably possible. The Plan Administrator shall administer this Plan in accordance with its terms and establish its policies, interpretations, practices, and procedures. It is the express intent of this Plan that the Plan Administrator shall have maximum legal discretionary authority to construe and interpret the terms and provisions of the Plan, to make determinations regarding issues which relate to eligibility for benefits, to decide disputes which may arise relative to a Plan Participant's rights, and to decide questions of Plan interpretation and those of fact relating to the Plan. The decisions of the Plan Administrator will be final and binding on all interested parties. Service of legal process may be made upon the Plan Administrator, DUTIES OF THE PLAN ADMINISTRATOR (1) To administer the Plan in accordance with its terms. (2) To interpret the Plan, including the right to remedy possible ambiguities, inconsistencies or omissions. (3) To decide disputes which may arise relative to a Plan Participant's rights. (4) To prescribe procedures for filing a claim for benefits and to review claim denials. (5) To keep and maintain the Plan documents and all other records pertaining to the Plan. (6) To appoint a Claims Supervisorto pay claims. (7) To perform all necessary reporting as required by ERISA. (S) To establish and communicate procedures to determine whether a medical child support order is qualified under ERISA Sec. 609. (9) To delegate to any person or entity such powers, duties and responsibilities as it deems appropriate. PLAN ADMINISTRATOR COMPENSATION. The Plan Administrator serves without compensation; however, all expenses for plan administration, including compensation for hired services, will be paid by the Plan. FIDUCIARY. A fiduciary exercises discretionary authority or control over management of the Plan or the disposition of its assets, renders investment advice to the Plan or has discretionary authority or responsibility in the administration of the Plan. FIDUCIARY DUTIES. A fiduciary must carry out his or her duties and responsibilities for the purpose of providing benefits to the Employees and their Dependent(s), and defraying reasonable expenses of administering the Plan. These are duties which must be carried out: (1) with care, skill, prudence and diligence under the given circumstances that a prudent person, acting in a like capacity and familiar with such matters, would use in a similar situation; (2) by diversifying the investments of the Plan so as to minimize the risk of large losses, unless under the circumstances it is clearly prudent not to do so; and (3) in accordance with the Plan documents to the extent that they agree with ERISA. 58 THE NAMED FIDUCIARY. A "named fiduciary" is the one named in the Plan. A named fiduciary can appoint others to carry out fiduciary responsibilities (other than as a trustee) under the Plan. These other persons become fiduciaries themselves and are responsible for their acts under the Plan. To the extent that the named fiduciary allocates its responsibility to other persons, the named fiduciary shall not be liable for any act or omission of such person unless either: (1) the named fiduciary has violated its stated duties under ERISA in appointing the fiduciary, establishing the procedures to appoint the fiduciary or continuing either the appointment or the procedures; or (2) the named fiduciary breached its fiduciary responsibility under Section 405(a) of ERISA. CLAIMS SUPERVISOR IS NOT A FIDUCIARY. A Claims Supervisor is not a fiduciary under the Plan by virtue of paying claims in accordance with the Plan's rules as established by the Plan Administrator. FUNDING THE PLAN AND PAYMENT OF BENEFITS The cost of the Plan is funded as follows: For Employee Coverage: Funding is derived solely from the funds of the Employer. For Dependent Coverage: Funding is derived from contributions made by the covered Employees. Benefits are paid directly from the Plan through the Claims Supervisor. PLAN IS NOT AN EMPLOYMENT CONTRACT The Plan is not to be construed as a contract for or of employment. CLERICAL ERROR Any clerical error by the Plan Administrator or an agent of the Plan Administrator in keeping pertinent records or a delay in making any changes will not invalidate coverage otherwise validly in force or continue coverage validly terminated. An equitable adjustment of contributions will be made when the error or delay is discovered. If, due to a clerical error, an overpayment occurs in a Plan reimbursement amount, the Plan retains a contractual right to the overpayment. The person or institution receiving the overpayment will be required to return the incorrect amount of money. In the case of a Plan Participant, if it is requested, the amount of overpayment will be deducted from future benefits payable. AMENDING AND TERMINATING THE PLAN If the Plan is terminated, the rights of the Plan Participants are limited to expenses incurred before termination. The Employer intends to maintain this Plan indefinitely; however, it reserves the right, at any time, to amend, suspend or terminate the Plan in whole or in part. This includes amending the benefits under the Plan or the Trust agreement (if any). CERTAIN PLAN PARTICIPANTS RIGHTS UNDER ERISA Plan Participants in this Plan are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA specifies that all Plan Participants shall be entitled to: Examine, without charge, at the Plan Administrator's office, all Plan documents and copies of all documents governing the Plan, including a copy of the latest annual report (form 5500 series) filed by the Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration. Obtain copies of all Plan documents and other Plan information upon written request to the Plan Administrator. The Plan Administrator may make a reasonable charge for the copies. 59 Continue health care coverage for a Plan Participant, Spouse, or other dependents if there is a loss of coverage under the Plan as a result of a qualifying event. Employees or dependents may have to pay for such coverage. Review this summary plan description and the documents governing the Plan or the rules governing COBRA continuation coverage rights. Reduction or elimination of exclusionary periods of coverage for Pre -Existing Conditions under this group health Plan, if an Employee or dependent has Creditable Coverage from another plan. The Employee or dependent should be provided a certificate of Creditable Coverage, free of charge, from the group health plan or health insurance issuer when coverage is lost under the plan, when a person becomes entitled to elect COBRA continuation coverage, when COBRA continuation coverage ceases, if a person requests it before losing coverage, or if a person requests it up to 24 months after losing coverage. Without evidence of Creditable Coverage, a Plan Participant may be subject to a Pre -Existing Conditions exclusion for 12 months (18 months for Late Enrollees) after the Enrollment Date of coverage. If a Plan Participant's claim for a benefit is denied or ignored, in whole or in part, the participant has a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules. Under ERISA, there are steps a Plan Participant can take to enforce the above rights. For instance, if a Plan Participant requests a copy of Plan documents or the latest annual report from the Plan and does not receive them within 30 days, he or she may file suit in a federal court. In such a case, the court may require the Plan Administrator to provide the materials and to pay the Plan Participant up to $110 a day until he or she receives the materials, unless the materials were not sent because of reasons beyond the control of the Plan Administrator. If the Plan Participant has a claim for benefits which is denied or ignored, in whole or in part, the participant may file suit in state or federal court. In addition, if a Plan Participant disagrees with the Plan's decision or lack thereof concerning the qualified status of a medical child support order, he or she may file suit in federal court. In addition to creating rights for Plan Participants, ERISA imposes obligations upon the individuals who are responsible for the operation of the Plan. The individuals who operate the Plan, called "fiduciaries" of the Plan, have a duty to do so prudently and in the interest of the Plan Participants and their beneficiaries. No one, including the Employer or any other person, may fire a Plan Participant or otherwise discriminate against a Plan Participant in any way to prevent the Plan Participant from obtaining benefits under the Plan or from exercising his or her rights under ERISA. If it should happen that the Plan fiduciaries misuse the Plan's money, or if a Plan Participant is discriminated against for asserting his or her rights, he or she may seek assistance from the U.S. Department of Labor, or may file suit in a federal court. The court will decide who should pay court costs and legal fees. If the Plan Participant is successful, the court may order the person sued to pay these costs and fees. If the Plan Participant loses, the court may order him or her to pay these costs and fees, for example, if it finds the claim or suit to be frivolous. If the Plan Participant has any questions about the Plan, he or she should contact the Plan Administrator. If the Plan Participant has any questions about this statement or his or her rights under ERISA or the Health Insurance Portability and Accountability Act (HIPAA), that Plan Participant should contact either the nearest area office of the Employee Benefits Security Administration, U.S. Department of Labor listed in the telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, at 200 Constitution Avenue, N.W., Washington, DC 20210. A HIPAA PRIVACY RULE The City of Lubbock Employee Benefit Plan ("Health Plan") complies with the requirements of the Health Insurance Portability and Accountability Act ("HIPAA") and it's implementing regulations ("HIPAA Privacy Rule") by establishing the extent to which the Plan Sponsor will receive, use and/or disclose Protected Health Information ("PHI"). (1) Health Plan's Designation of Person/Entity to Act on its Behalf The Plan has determined that it is a group health plan within the meaning of the HIPAA Privacy Rule, and the Health Plan designates the Plan Sponsor to take all actions required to be taken by the Health Plan in connection with the HIPAA Privacy Rule. (2) Definitions All terms defined in the HIPAA Privacy Rule, shall have the meaning set forth therein. The following additional definitions apply to the provisions set forth in this Amendment. Health Plan means the City of Lubbock Employee Benefit Plan. Plan Documents mean the Health Plan's governing documents and instruments (i.e., the documents under which the Health Plan was established and is maintained), including but not limited to the City of Lubbock Employee Benefit Plan Document. Plan Sponsor means "plan sponsor" as defined at section 3(16)(B) of ERISA, 29 U.S.C. § 1002(16)(B). The Plan sponsor is City of Lubbock (3) Certification of Compliance by Plan Sponsor Except as provided below with respect to the Health Plan's disclosure of summary health information, the Health Plan will disclose Protected Health Information to the Plan Sponsor, or permit the disclosure of Protected Health Information to the Plan Sponsor by a health insurance issuer or HMO with respect to the Health Plan, only upon receipt of a certification by the Plan sponsor that: the Plan Documents have been amended to establish the permitted and required uses and disclosures of such information by the Plan sponsor, consistent with the HIPAA Privacy Rule, and the Plan Documents have been amended to incorporate the provisions set forth in this Amendment, and the Plan Sponsor agrees to comply with the provisions as modified by this Amendment. (4) Health Plan Is Disclosure of Individuals' Protected Health Information to Plan Sponsor The Health Plan (and any business associate acting on behalf of the Health Plan), or any health insurance issuer or HMO servicing the Health Plan, will disclose individuals' Protected Health Information to the Plan Sponsor only to permit the Plan Sponsor to carry out plan administration functions. Such disclosure will be consistent with the provisions of this Amendment. All disclosures of the Protected Health Information of the Health Plan's individuals by the Health Plan's business associates, health insurance issuer, or HMO to the Plan Sponsor will comply with the restrictions and requirements set forth in this Amendment and in the HIPAA Privacy Rule. The Health Plan (and any business associate acting on behalf of the Health Plan), may not disclose, and may not permit a health insurance issuer or HMO to disclose, individuals' Protected Health Information to the Plan Sponsor for employment -related actions and decisions or in connection with any other benefit or employee benefit plan of the Plan Sponsor. 61 The Plan Sponsor will not use or further disclose individuals' Protected Health Information other than as described in the Plan Documents and permitted by the HIPAA Privacy Rule. The Plan Sponsor will ensure that any agent(s), including a subcontractor, to whom it provides individuals' Protected Health Information received from the Health Plan (or from the Health Plan's health insurance issuer or HMO), agrees to the same restrictions and conditions that apply to the Plan Sponsor with respect to such Protected Health Information. The Plan Sponsor will not use or disclose individuals' Protected Health Information for employment -related actions and decisions or in connection with any other benefit or employee benefit plan of the Plan Sponsor. The Plan Sponsor will report to the Health Plan any use or disclosure of Protected Health Information that is inconsistent with the uses or disclosures provided for in the Plan Documents (as amended) and in the HIPAA Privacy Rule, of which the Plan sponsor becomes aware. (5) Health Plan's Disclosure of Summary Health Information and Enrollment Information to the Plan Sponsor The Health Plan (or a health insurance issuer or HMO with respect to the Health Plan) may disclose summary health information to the Plan Sponsor, if the Plan sponsor requests the summary health information for the purpose of: obtaining premium bids for providing health insurance coverage under the Health Plan, or modifying, amending, or terminating the Health Plan. The Health Plan (or a health insurance issuer or HMO with respect to the Health Plan) may disclose enrollment and disenrollment information to the Plan Sponsor. (6) Disclosure of Individuals' Protected Health Information by Plan Sponsor The Plan Sponsor will make the Protected Health Information of the individual who is the subject of the Protected Health Information available to such individual in accordance with the HIPAA Privacy Rule. The Plan Sponsor will make individuals' Protected Health Information available for amendment and incorporate any amendments to individuals' Protected Health Information in accordance with the HIPAA Privacy Rule. The Plan Sponsor will make and maintain an accounting so that it can make available those disclosures of individuals' Protected Health Information that it must account for in accordance with the HIPAA Privacy Rule. The Plan Sponsor will make its internal practices, books and records relating to the use and disclosure of individuals' Protected Health Information received from the Health Plan available to the U.S. Department of Health and Human Services for purposes of determining compliance with the HIPAA Privacy Rule. The Plan Sponsor will, if feasible, return or destroy all individuals' Protected Health Information that it still maintains in any form after such information is no longer needed for the purpose for which the use or disclosure was made. Additionally, the Plan Sponsor will not retain copies of such Protected Health Information after such information is no longer needed for the purpose for which the use or disclosure was made. If, however, such return or destruction is not feasible, the Plan Sponsor will limit further uses and disclosures to those purposes that make the return or destruction of the information infeasible. The Plan sponsor will ensure that the required adequate separation, described in paragraph 7 below, is established and maintained. 62 (7) Adequate Separation In accordance with the HIPAA Privacy Rule, the following employees or classes of employees or workforce members under the control of the Plan Sponsor may be given access to individuals' Protected Health Information received from the Health Plan or from a health insurance issuer or HMO servicing the Health Plan: Benefit Staff Accounting Privacy Officer This list reflects the employees, classes of employees, or other workforce members of the Plan Sponsor who receive individuals' Protected Health Information relating to payment under, health care operations of, or other matters pertaining to plan administration functions that the Plan Sponsor provides for the Health Plan. These individuals will have access to individuals' Protected Health Information solely to perform these identified functions. For any use or disclosure of individuals' Protected Health Information in violation of, or noncompliance with, the provisions of this Amendment, they will be subject to disciplinary action and/or sanctions pursuant to the Plan Sponsor's employee discipline and termination procedures. Any suspected occurrences of improper use or disclosure of PHI may be reported to the Health Plan's Privacy Officer at phone number (806) 775-2312. The Plan sponsor will promptly report any such breach, violation, or noncompliance to the Health Plan and will cooperate with the Health Plan to correct the violation or noncompliance, to impose appropriate disciplinary action and/or sanctions, and to mitigate any deleterious effect of the violation or noncompliance. 63 GENERAL PLAN INFORMATION TYPE OF ADMINISTRATION The Plan is a self -funded group health Plan and the administration is provided through a Third Party Claims Supervisor. The funding for the benefits is derived from the funds of the Employer and contributions made by covered Employees. The Plan is not insured. PLAN NAME City of Lubbock Employee Benefit Plan PLAN NUMBER: 502 TAX ID NUMBER 75-600059 PLAN EFFECTIVE DATE: January 1, 2004 PLAN RESTATEMENT DATE: January 1, 2006 PLAN YEAR ENDS: December 31 st EMPLOYER INFORMATION City of Lubbock Post Office Box 2000 1625 13 Street, City Manager's Office Lubbock, Texas 79401 806-775-2317 PLAN ADMINISTRATOR City Manager City of Lubbock Post Office Box 2000 1625 13 Street, City Manager's Office Lubbock, Texas 79401 806-775-2317 NAMED FIDUCIARY City Manager City of Lubbock Post Office Box 2000 1625 13 Street, City Manager's Office Lubbock, Texas 79401 AGENT FOR SERVICE OF LEGAL PROCESS City Manager City of Lubbock Post Office Box 2000 1625 13 Street, City Manager's Office Lubbock, Texas 79401 64 CLAIMS SUPERVISOR American Administrative Group, Inc. P.O. Box 53070 Lubbock, Texas 79453 1-800-658-9777 M. RFP #06-044-MA, Health Benefits Consulting Services BY THIS AGREEMENT, City of Lubbock Employee Benefit Plan is hereby adopted as shown. IN WITNESS WHEREOF, this instrument is executed for City of Lubbock on or as of the day and year first below written. BY City of Lubbock Date Witness Date 06-044-MARFP.doc 66 City Paid Employee Only Medical Claims Administration Stop Loss Transplant Rider Insurance Reserve Total RFP #06-044-MA, Health Benefits Consulting Services Schedule of Rates 2006 Monthly Rates - Active Medical 18% Budget -18% Insureds 12/I5 Specific -15/12 Aggregate nh $374.46 22.75 10.71 3.89 92.35 $504.16 Bi-weekly $172.83 10.50 4.94 1.79 42.62 $232.68 Spouse Claims $524.25 $241.96 Administration 0.00 0.00 Stop Loss 14.14 6.52 Transplant Rider 5.07 2.34 Insurance Reserve -308.57 -142.41 Total $234.89 $108.41 Children Claims $524.25 $241.96 Administration 0.00 0.00 Stop Loss 14.14 6.52 Transplant Rider 5.07 2.34 Insurance Reserve -358 28 Total $185.18 165 35 $85.47 Fami1X Claims $524.25 $241.96 Administration 0 00 $0 00 Stop Loss 14.14 $6.52 Transplant Rider 5.07 $2.34 Insurance Reserve -223.90 4103.33 Total $319.56 $147.49 Cobra Monthly Single $514.35 Single/Dependents $1,069.20 06-044-MARFP.doc 67 RFP #06-044-MA, Health Benefits Consulting Services 2006 Monthly Rates - Retiree Dental 11% BUDGET -11% SUBSCRIBERS Monthly Retiree Dental Claims $21.15 Administration 2.95 Insurance Reserve -1.90 Total $22.20 ouse Claims $29.60 Administration 0.00 Insurance Reserve -14.53 Total $15.07 Children Claims $29.60 Administration 0.00 Insurance Reserve -17. 7 Total $12.03 Famiy Claims $29.60 Administration 0.00 Insurance Reserve -3.09 Total $26.51 06-044-MARFP.doc 68 RFP #06-044-MA, Health Benefits Consulting Services 06-044-MARFP.doc 69 Cily Paid Employee Only Dental Claims Administration Insurance Reserve Total RFP #06-044-MA, Health Benefits Consulting Services 2006 Monthly Rates - Active Dental I I% BUDGET -11% SUBSCRIBERS Monthly 521.15 2.95 11-82 $35.92 B-Weekly $9.76 $1.36 5.46 $16.58 S ouse Claims $29.60 S 13.66 Administration 0.00 $0.00 Insurance Reserve -14.53 - La Total $15.07 $6.95 Children Claims $29.60 $13.66 Administration 0.00 $0.00 Insurance Reserve -17.57 - 8.11 Total $12.03 $5.55 Family Claims $29.60 $13.66 Administration 0.00 $0.00 Insurance Reserve-3.09 1.4 Total $26.51 $12.23 Cobra Monthly Single $40,58 Single/Dependents $70.77 06-044-MARFP.doc 70 RFP #06-044-MA, Health Benefits Consulting Services 2006 Monthly Rates - Retiree Medical 18% Budget -18% Insureds Monthly Retiree Medical Claims $374.46 Administration 22.75 Stop Loss 10.71 Transplant Rider 3.89 Insurance Reserve -139.55 Total $272.26 Retiree/Spouse Claims $524.25 Administration 0.00 Stop Loss 14.14 Transplant Rider 5.07 Insurance Reserve ' 0 •57 Total $234.89 Retiree/Child Claims $524.25 Administration 0.00 Stop Loss 14.14 Transplant Rider 5.07 Insurance Reserve -358.28 Total $185.18 Retiree/Family Claims $524.25 Administration 0.00 Stop Loss 14.14 Transplant Rider 5.07 Insurance Reserve-223.90 Total $319.56 Medicare Claims $374.46 Administration 22.75 Stop Loss 10.71 Transplant Rider 3.89 Insurance Reserve -255.13 Total $156.68 Medicare/Spouse Claims $524.25 Administration 0.00 Stop Loss 14.14 Transplant Rider 5.07 Insurance Reserve-377.48 Total $165.98 06-044-MARFP.doc 71 RFP #06-044-MA, Health Benefits Consulting Services Claims Information (please download document from rfpdepot website). Clinic Cost (please download document from rfpdepot webs ite). 06-044-MARFP.doc 72 RFP #06-044-MA, Health Benefits Consulting Services CITY OF LUBBOCK INSURANCE REQUIREMENT AFFIDAVIT To Be Completed by Bidder And Attached to Bid Submittal I, the undersigned Bidder, certify that the insurance requirements contained in this bid document have been reviewed by me with the below identified Insurance Agent/Broker. If I am awarded this contract by the City of Lubbock, I will be able to, within ten (10) days after being notified of such award by the City of Lubbock, famish a valid insurance certificate to the City meeting all of the requirements defined in this bid/proposal. Contractor (Signature) Contractor (Print) CONTRACTOR'S NAME: (Print or Type) CONTRACTOR'S ADDRESS: Name of Agent/Broker: Address of Agent/Broker: City/State/Zip: Agent/Broker Telephone Number: ( ) Date: NOTE TO CONTRACTOR If the time requirement specified above is not met, the City has the right to reject this bid/proposal and award the contract to another contractor. If you have any questions concerning these requirements, please contact the Purchasing Manager for the City of Lubbock at (806) 775-2165. 06-044-MARFP.doc 73 RFP #06-044-MA, Health Benefits Consulting Services SUSPENSION AND DEBARMENT CERTIFICATION Federal Law (A-102 Common Rule and OMB Circular A 110) prohibits non -Federal entities from contracting with or malting sub -awards under covered transactions to parties that are suspended or debarred or whose principals are suspended or debarred. Covered transactions include procurement contracts for goods or services equal to or in excess of $25,000 and all non -procurement transactions (e.g., sub -awards to sub -recipients). Contractors receiving individual awards of $25,000 or more and all sub -recipients must certify that their organization and its principals are not suspended or debarred by a Federal agency. Before an award of $25,000 or more can be made to your firm, you must certify that your organization and its principals are not suspended or debarred by a Federal agency. I, the undersigned agent for the firm named below, certify that neither this firm nor its principals are suspended or debarred by a Federal agency. COMPANY NAME: Signature of Company Official: Date Signed: Printed name of company official signing above: 06-044-MARFP.doc 74 Proposal for City of Lubbock in Response to Health Benefits Consulting Services RFP Presented by: Stan Self Joella Mullin Senior Consultant Dallas Practice Leader Wachovia Insurance Services 5956 Sherry Lane, Suite 2000 Dallas, TX 75225 (214) 365-4755 stan.self@wachovia.com Douglas Sanford Co -Chief Executive Officer Sanford Insurance Agency 6303 Indiana Ave Lubbock, Texas 79413 (806) 792-5564 sanfordd@sanins.com WACHO"I'A INSURANCE SERWCES Table of Contents iovia ELI / References ract Fee Ns WAGWOVrA 2 INSURANCE SERWCES Introduction to Wachovia Wachovia Insurance Service (WIS) is owned by Wachovia Corporation, a publicly traded company on the New York Stock Exchange (WB). Wachovia is the fourth largest bank holding company in the U.S. based on assets ($500 billion). We have over 95,000 employees and for the second consecutive year ranked in the Top 10 Best Places to Work by Working Mother magazine and Top 50 Companies for Diversity, by Diversity, Inc. magazine. Business Ethics magazine named Wachovia to its annual list of "100 Best Corporate Citizens" in its Spring, 2004 issue. Wachovia Insurance Services (WIS) ranks in the top ten insurance brokers in the U.S. We have 46 offices in 23 states and employ over 1800 insurance professionals. Our expertise is in the property and casualty and employee benefits fields. Our firm placed over $3 billion in premiums last year. Our local office in Dallas, TX employs 50 employees, 42 of which are in Property and Casualty Fields. The Dallas office generated approximately $10 million in revenue in 2005. Our office was established locally in 1992 and was formerly known as McDonald & Company. McDonald & Company was acquired in 1999 by Palmer & Cay which was acquired by Wachovia Corporation in 2005. Awards and Recognition • Rated as the nation's top bank by Business Week (April 2004) • Business Ethics magazine named Wachovia to its annual list of "100 Best Corporate Citizens" in its April 2004 issue • The only financial services company recognized in the 2004 Customer First Awards by Fast Company magazine • Top 10 Best Places to Work by Working Mother magazine for the third consecutive year • Top 50 Companies for Diversity by Diversity, Inc. magazine for the third consecutive year Community Involvement Building and sustaining communities together. Lending a helping hand when it's needed. Through shared commitment and knowledge with our community partners, we can achieve uncommon things, together. Wachovia is committed to building strong and vibrant communities, improving quality of life, and making a positive difference where we live and work. We focus resources and employee talents on two key priorities: • Improving education • Strengthening neighborhoods WACHOVIA o 0 3 INSUPANCE SERVICES OPEN f f E--w Tml or l sTm Introduction to Wachovia Employer Solutions has a passion for education and learning. Recognizing that no one professional can know everything, all Employer Solutions employees participate in one or more practice groups. The groups meet every other week at a minimum and create educational presentations, tools, and share best practices with the entire group monthly. We are currently pursuing a very aggressive and exciting campaign to integrate our local practice groups within our national practice group network. Practice Groups with Subject Matter Experts ■ Stay current ■ Report to team every two weeks �AT.ACHOVIA 4 INSURANCE SERVICE S Introduction to Wachovia Employer Solutions consists of the following units: Group Consulting is the largest Employer Solutions unit. Our consulting team consists of a Practice Leader, a Senior Consultant, an Associate Consultant and Client Service Representatives who are responsible for the overall strategy and execution of client action plans. The Practice Leader has the responsibility of making sure that our clients are placed with a team of professionals that can best serve each specific client's needs. Internally we believe that this structure promotes healthy competition and exposure to multiple ideas. • The support teams have to be at their best because they are always auditioning for new business. • The Practice Leader works with multiple teams. This environment is a great benefit because it allows exposure to our full intellectual capital. Our Group Consulting team is supported by the following teams within Employer Solutions. After our initial planning session, we may determine that it is necessary to engage additional employees from other teams. Benefits Administration wraps voice -to -voice call center and fulfillment services around client or third party benefits management systems to enhance the benefits administration and communication experience for clients and their employees. Executive Benefits specializes in solutions for executives and highly compensated employees to protect and accumulate wealth including individual disability, non -qualified and other savings plans, buy sell and key man arrangements, and medical reimbursement plans. HR Consulting is available to supplement client HR departments by providing management training, policy and procedure development or review, and other "on -call" or special project work. Technical Proposal 1. State the full name and home office address of your organization. Describe your organizational structure (e.g. publicly held corporation, private, non-profit, partnership, etc.). If it is incorporated, include the state in which it is incorporated List the name and occupation of those individuals serving on your organization's board of directors, and list the name of any entity or person owning 10% or more of your organization. Wachovia Corporation 301 South College Street, Suite 4000 Charlotte, North Caroline 28288-0013 Wachovia Corporation is a public held corporation incorporated in North Carolina. The Board of Directors are listed below. John D. Baker II President and Chief Executive Officer, Florida Rock Industries, Inc. Jacksonville, Florida James S. Balloun Private Investor Atlanta, Georgia Robert J. Brown Chairman and Chief Executive Officer, B&C Associates, Inc. High Point, North Carolina Peter C. Browning Non -executive Chairman, Nucor Corporation Charlotte, North Carolina WACHOVIA 6 INSURANCE SERVICES John T. Casteen III President, University of Virginia Charlottesville, Virginia William H. Goodwin Jr. Chairman, CCA Industries, Inc. Chairman, Chief Executive Officer and Chief Operating Officer, The Riverstone Group, LLC Richmond, Virginia Robert A. Ingram Vice Chairman Pharmaceuticals, GlaxoSmithKline plc Research Triangle Park, North Carolina Donald M. James Chairman and Chief Executive Officer, Vulcan Materials Company Birmingham, Alabama. Mackey J. McDonald Chairman, President and Chief Executive Officer, VF Corporation Greensboro, North Carolina Joseph Neubauer Chairman and Chief Executive Officer, ARAMARK Corporation Philadelphia, Pennsylvania Technical Proposal %VACIROVZA 7 INSURANCE SERVICES Lloyd U. Noland III Chairman Emeritus, Noland Company Newport News, Virginia Van L. Richey President and Chief Executive Officer, American Cast Iron Pipe Company Birmingham, Alabama Ruth G. Shaw President and Chief Executive Officer, Duke Power Company, Duke Energy Corporation Charlotte, North Carolina Lanty L. Smith Lead Independent Director, Wachovia Corporation Chairman, Soles Brower Smith & Co. Greensboro, North Carolina G. Kennedy Thompson Chairman, President and Chief Executive Officer Wachovia Corporation Charlotte, North Carolina John C. Whitaker Jr Chairman and Chief Executive Officer, Inmar, Inc. Winston-Salem, North Carolina Technical Proposal WACHOV A $ 7NSL7R NICE SERVICES Technical Proposal Dona Davis Young Chairman, President and Chief Executive Officer, The Phoenix Companies, Inc. Hartford, Connecticut Z List the name, title, telephone number, fax number and e-mail address of the contact person for this proposal Stan Self, Senior Consultant Wachovia Insurance Services (214) 365-4755 — phone (469) 232-0726 — fax 3. Confirm thatyou are a licensed consultant or broker. Provide documentation. This is confirmed. License documentation is shown as an attached exhibit. 4. Confirm that you serve as a consultant or broker, independently, and are not affiliated with any insurance company, third party administrative agency or provider network. This is confirmed. 5. Describe your company's organization, philosophy, management and provide a brief history. Describe your contractual relationships, if any, with organizations necessary to your proposal's implementation (e.g. data information services). The Wachovia Philosophy of Service is Based on Three Key Themes: Distinctive Knowledge — We have a foundation of knowledge that helps us form a unique perspective, which produces solutions that match your needs. Human Understanding — We respect and value you. We listen to your concerns and strive to understand your needs. We always have your best interests at heart. Sense of Purpose — We practice professionalism with a purpose. We take ownership of your needs and satisfy or exceed them in a manner that best suits your goals. We succeed when you do. Wachovia Insurance Services partners with Ingenix to provide the ingenix eSuite Reporting. TM These services provide insight on costs and trends that will help your clients better manage their programs, develop strategies, and make informed decisions through: • An integrated data warehouse • Client -specific report packages • Normative comparisons • Standard reports and ad hoc reporting with drill down capabilities 5 .. Technical Proposal 6. How long has your organization been providing consulting services? Wachovia Insurance Services, formerly Palmer and Cay, has been providing brokerage and consulting services since 1868. 7. Provide the name(s) of the consultant(s) to perform the work for the City and a brief statement as to why each consultant is qualified to provide services. Joella Mullin — Sr. Vice President, Practice Leader, Stan Self — Sr. Consultant, Andrea Davenport — Associate Consultant. Other members of our national team of resource leaders will, from time to time, support the local consulting team. Please refer to the "Qualifications of Consultant" section for summarized biographies on each of these individuals. 8. Do you publish newsletters and other informative publications that are routinely provided to your clients? Have you prepared reviews of topics related to the benefits that are routinely provided to your clients? Provide sample copies. Yes. Newsletters and subject briefs are provided regularly to our clients. Samples are provided as exhibits to this proposal. 9. Detail your ability to monitor regulatory and legislative developments at both the state and federal level and how this will be communicated to our members. Wachovia Insurance Services maintains a staff of ERISA attorneys and support paralegal staff to keep our consultants and our clients apprised of all relevant legislative and regulatory activity both for national and state policy. 10. Outline your ability to provide expertise and experience in the areas of health benefit plan analysis and design. Explain in detail the types of analyses you have conducted relative to benefits analysis and design for a health plan with approximately 1900 employees. It is our experience that most benefits plans are the cumulative result of problems that have risen and been solved over time. Rarely do we find strategic direction, supported by senior management and a budget that is consistent with corporate culture. All our activities are driven by the individual client action plan incorporating your scope of work. The plan is the result of an annual comprehensive strategic planning session which covers a broad range of issues from corporate culture to COBRA administration. The crafting and execution of these action plans is the core of the WIS value proposition. Accordingly, our review process covers at a minimum: ✓ What do we need to know about your culture? Employee population? HR challenges? ✓ Do your benefit plans support your culture? Does your new hire kit and other employee communications reflect it? ✓ Why do you offer benefits? Can you articulate your commitment to your employees? Have you? ✓ Is the commitment the same for all employees? Have you profiled your most productive, hard to replace employees? WACHOVIA 10 INSURANCE SERVICES Technical Proposal ✓ Do employees understand and appreciate the plans? How do you know? ✓ Do the plans cover all risks equally? (or are they all about healthcare at the expense of income protection) ✓ Are the networks as efficient as possible? How do you know? What is driving cost? How do you know? ✓ Do employees know how to be better consumers of healthcare? Do they care? ✓ Do your employees want to learn how to be healthier? Does it matter? ✓ What tax tools do you provide to help employees handle otherwise unreimbursed expenses? ✓ How do you fund the plans? Why? How are they running? Compared to what? ✓ How integrated and efficient are your medical, sick leave, vacation, STD, LTD and FMLA plans? Could there be gaps or overlaps? ✓ What are the best mediums for communicating with your employees? How involved are spouses? ✓ Do employees know the actual gross costs of the plans? (Prior to getting a COBRA notice) ✓ How do you get employees on and off the plans? Is it working? How much effort is it taking? ✓ Where applicable, are you in compliance with state and federal mandates? Is it important? ✓ What about dental, vision, legal, financial planning? ✓ Who pays for all of this? Is it affordable to the employee? To the City? What is affordable? What are the thresholds? As a result of these sessions, we come up with a direction and multi -year plan. They may also include: ✓ Benchmarking of the benefit levels and contributions ✓ An employee survey ✓ Data mining project to determine cost drivers and to model plan design savings ✓ Creating and driving a strategic benefits communication campaign and a wellness campaign ✓ Electronic enrollment and eligibility application ✓ Compliance review and monitoring including plan documents, SPDs and 5500 assistance. Wachovia Insurance Services has the capability and resources to include services beyond the required Scope of Work. ✓ HR Consulting Services ✓ Financial planning as an employee benefit ✓ Contribution strategy modeling We then add the more routine activities of a brokerage or consulting engagement; ✓ Pre and post renewal planning sessions ✓ End of year stop loss strategy session ✓ Annual focus group session ✓ Annual review of plan and planning session for next year ✓ Ongoing plan and contract review and modeling Optionally, and priced separately, we may pursue: ✓ A claim or eligibility audit ✓ Benefits Administration WACHO V'IA 0 D 11 INSURANCE SERVICES Technical Proposal We then add responsible parties, due dates, and sign off on our plan. Just as important, it is our practice to provide detailed minutes of every client meeting which include all material discussions, decisions, commitments, responsible parties, and due dates. That is the way we do business, and we are religious about it. We would start this process immediately upon you selecting Wachovia Insurance Services.This planning and execution process is perhaps our most important unique competitive advantage. The steps that are undertaken within each relevant task are outlined in the tables below. Strategic Planning Service Description A. I Conduct Strategic Planning Session B. Produce Annual Plan C. I Stewardship Reporting Service Description A Analyze claim experience to identify large claims and trends Comments Planning Sessions typically result in the discovery of multiple initiatives the client wishes to implement. We weave these initiatives along with normal brokering activities into the Annual Plan. We assign responsible parties and deadlines then execute the plan. The Stewardship Report is designed to make sure WIS stays accountable for fulfillment of the plan. Comments Financial projections are the heart of the technical Analyze claim utilization data and identify areas services that WIS provides to our clients. In this B. of over -utilization, including recommendations area, we will work with you and your internal staff for cost management opportunities to continually monitor the financial integrity of the plan in relation to projections. C.Laccounting ticipated financial impacts for making benefit design D. negotiate year-end financial E nding alternatives as appropriate for F. analyze trends affecting client G. Assist with internal budgeting and meetings with financial groups 12 While projections are subject to change based on claim activity, inflation, medical advances and regulatory pressures, our goal is to continuously keep you involved and updated on the status of the plan relative to projections. We will also review any year-end carrier accounting ensuring that a proper accounting of all your funds is made. We utilize Intelligence on Health (i on health) for health plan data mining. iW.ACHOVYA INSURANCE SERVICES Carrier Marketing Service Description A Develop marketing objectives and evaluation criteria B. Prepare specifications, provide competitive analysis I of proposals and make recommendations C. Facilitate all carrier interviews/presentations with client D. IAs necessary, market for new products for cost competitiveness or service improvement Provide assistance in the areas of implementation, E. communication, enrollment meetings, contractibooklet review and carrier monitoring Technical Proposal Comments Changing carriers or vendors is never an easy process, and our focus is to always monitor the relationship to ensure things proceed in the fashion consistent with your objectives and carrier commitments. However, from time to time, bidding out plans becomes required. The need for competitive bidding can be brought about by the need to check bid costs, resolve service issues that cannot be resolved by performance guarantees, or to introduce additional choices or new benefit programs. Once the bidding has been conducted and finalist interviews have occurred, we will assist in the implementation of the new product or vendor. Financial/Accounting Services Service Description Comments A Analyze claim experience to identify large claims Financial projections are the heart of the technical and trends services that WIS provides to our clients. In this area, Analyze claim utilization data and identify areas of we will work with you and your internal staff to B. over -utilization, including recommendations for continually monitor the financial integrity of the plan in cost management opportunities relation to projections. C. Provide anticipated financial impacts for making While projections are subject to change based on claim changes in benefit design activity, inflation, medical advances and regulatory pressures, our goal is to continuously keep you involved D. Review & negotiate year-end financial accounting and updated on the status of the plan relative to projections. [G. Analyze funding alternatives as appropriate for client We will also review any year-end carrier accounting . Identify & analyze trends affecting client ensuring that a proper accounting of all your funds is made. Assist with internal budgeting and meetings with financial groups We utilize Intelligence on Health (i on health) for health plan data mining. WACHO.A. 0 13 INSL ANCE SERVICES IN ���� Technical Proposal Renewal Analysis & Negotiation Service Description Comments A. Establish renewal objectives The renewal process is an integral part of the overall financial service provided to you. We are able to B. Request early notification from carriers C. Analyze & negotiate carrier renewal to meet client's objectives independently project costs and negotiate each and every aspect of the renewal (projected claims, reserves, network fees, administration, etc.). Using an analytical approach assures realistic and effective negotiation. D. Develop cost projections for benefit plan design changes E. Propose benefit changes The establishment of performance guarantees F. Communicate renewal & negotiations to client enables you to annually review the service and performance levels provided by the selected carriers and vendors. By including this review as part of the renewal process, financial and service levels receive the same level of importance. G. Offer contribution strategies which reflect client's human resource and budgetary objectives H. Establish performance guarantees !' ACHOMEA. 14 INSURANCE SERVICES Legislative and Market Information Service Description A. I Inform client on legislative compliance issues B. Conduct periodic seminars on pertinent I legislative topics I C I Monitor insurance companies for financial I solvency D. Assist in contract/legislative interpretations, legal compliance E. Review SPD's for compliance F. Review insurance contracts for accuracy G Prepare Welfare and Flex 5500s G. (if required) H. IAssistance with ERISA questions, COBRA, HIPAA, etc. Provide periodic bulletins addressing pertinent I. issues such as healthcare reform, statutory updates, flex benefits and managed care Technical Proposal Comments WIS's legal compliance group serves as both an internal and external resource. They keep the consultants current on legislative issues, and are available to review specific legislative implications that affect your plan. Our services also include contract and SPD review, as well as updating you on changes in interpretation that may affect the guidance they deliver to employees. WIS does not practice law; documents should be reviewed by outside counsel. Having stated this, we believe that our service in this area makes the external review process cleaner and more efficient. We understand benefits from the client standpoint; our goal is to make sure the legal requirements of the plan are met in language that is readily understood by all parties. WACHOV A 15 INSURANCE SERVICES Communications and Enrollment Support Service Description A. Review employee communication B. Assist in the identification of interactive Web - based Communication resource C. Assist in Health Fair initiatives D. Facilitate open enrollment meetings E. Provide Train the Trainer counseling F. Develop and provide Benefits Statements (Optional — Separate Fee) G. Develop and administer employee surveys (Optional — Separate Fee) Develop basic print communication from H. enrollment guides to overall summaries (Professional communications materials can be provided under a separate fee) Technical Proposal Comments Your investment in your employee benefits program is significant and needs to be understood and appreciated by your employees. We assist you with annual and ongoing communications — design, drafting, and presentation. WACHOVL4 , 16 7NSURA NCIE SFHWCES Technical Proposal 11. Provide a recent example of the selection and implementation of a third party claims administrator for a health plan with approximately 4600 participants that was managed by your company. Detail how your company's experience and expertise benefited the client. ABC -Independent School District TPA Implementation Client had several issues that needed to be strategically addressed for 2006. Issues: High pregnancy complications rate Carve out vendors not coordinating together (PBM, EAP, Lab Network, UM) High claim rates with low plan designs Low network discounts, with no discounts for certain specialists Poor reporting/ coordinating capability offered by current TPA No disease management programs Solution: We Marketed the TPA, Disease Management, PBM, EAP/Behavioral Health, Wellness programs. Emphasis on ability to integrate with other vendors, customized programs and resources targeted at client problems, and costs. After marketing and considering all the options available to the client we chose to keep the current TPA but required them to start exchanging data with the PBM, EAP, DM vendors and our data warehouse. We changed networks to Aetna Signature Network and already seeing savings in the first qtr of 2006. We added a DM vendor with a strong Pre -natal program, new EAPBH vendor and kept the current PBM and Wellness vendors. The client now has vendors who are focused in their areas providing a custom cost effective solution for the client. We meet with all of the vendors quarterly to update and coordinate efforts to deliver an integrated solution for the client. 12. List three current clients for whom you provide services related to health plan benefits analysis and design. For each client, the list must specify the type of work performed by your company, the size of the client's group and the period of time retained as a client. One of the three must be the longest standing client; one must be the client with an approximate 1900 employee population and 450 retiree population; and the third must be the client for who the largest impact was achieved through your company's services. If two or more of these are met by the same client, list additional clients so that at least three clients are listed. For each client, include the name, title, address, fax number and phone number of a contact person who we may contact as a reference. Please refer to the "Qualifications of Consultant / References" section of the proposal for the relevant references. WACHOVTA 17 IzvSURANCF SERVIEC 4 S M-EI�-� Technical Proposal 13. Describe the issues and challenges, as you view them, facing an employer with 1900 employees in regards to their benefit plan in the upcoming year and describe how your organization can assist. What makes your organization different than other organizations that may submit proposals for consideration? The challenges that all employers face center around the sharply angled trend line of medical and pharmaceutical inflation. With 1,900 employees, the City can be thought of as a large employer, especially in a market the size of Lubbock. Local providers must regard the City as one of the regions top payers, and this clout should not be discounted. Beyond plan design changes that shift expense to employees and their dependents, a number of innovative organizations are moving to address the root cause of much of this excessive inflation in health care. As employers look to drive patient behavior to better manage personal health, local providers, especially hospitals often are able to play a more proactive role. Tapping into these organizations can produce resources for wellness initiatives, hands-on disease management for chronic condition patients, preventive care and more. The visibility that they gain provides solid rationale for their enthusiastic involvement. Whether working with local providers for interactive patient outreach, or fine tuning plan design, a comprehensive understanding of plan utilization is essential. Wachovia Insurance Services works with detailed claims data from claims administrators and pharmacy benefit managers to create reports that reveal the pure drivers of cost. Working with our data mining partners, we are able to ascertain the waste within practice patterns and where more aggressive utilization management and/or education can have an impact. Wachovia Insurance maintains clinical management and actuarial teams that separate theory from reality. The changes recommended have been tested against what is truly achievable and what actual financial impact can be expected. Our expert resources keep us grounded and keep our clients in a conservatively aggressive posture. 14. Provide examples of communication materials developed and prepared by your organization for use in client's health benefit communication campaigns Full time communications specialist are in place at Wachovia Insurance to provide any level of assistance in developing customized communications campaigns. Samples are provided as exhibits to this proposal. WACROVIA 18 INSURANCE SERVICES Technical Proposal 15. Do you have access or contacts to benefit providers in the retirement program market? How would you be able to provide brokerage services to our members in that area if the City determines that it is in everyone's best interest to separate them from our current plan? Yes, Wachovia Insurance Services has contacts with providers in the retirement program market. We would provide the same type of due diligence, marketing and implementation as we would for your active employees. 16. How would you envision the relationship and communication between your company and the City? What would you expect as support from the City? The following Service Model spells out our desired relationship for day to day interaction with our clients. Service Description Comments [A. Respond to daily questions Assist on claims problems, billing questions, policy interpretation & other carrier issues WIS will assist you in the outlined areas assuring vendor relationships are effective. We have C. Confn-m plan design coverage questions excellent working relationships with carriers and vendors and are able to intercede when necessary D. Monitor vendor services to ensure services are being provided appropriately and that you are obtaining professional and timely E. Analyze all documents before presenting to support. client F. Manage performance contracts WACHOVTA 19 INSURANCE SERVICES Technical Proposal In an on -going capacity, our service model is extended to a full partnership with our clients as described below. Service Description Comments A. Keep client advised of any new products We will meet regularly with you to talk about the plan. During these meetings, we will discuss the regulatory climate, comment on issues we have B. Hold mid -year projection meetings to update status of plan performance experienced with our other clients, talk about new products and benefit offerings, and comment on the Maintain overall picture of client's goals & C. objectives and assist in having benefit plans financial performance of the plan. meet those objectives Of equal importance will be the discussions D. Anticipate issues before they become problems revolving around your needs. We believe we can be of the most value to our client when we understand your needs, not just in the benefits Review or complete benchmarking & survey E. information used to determine plan arena, but in other aspects of your organization as competitiveness & strategies well. 17. Does your organization have access to the carriers of the voluntary plans the City currently offers? What other carriers does your organization have access to? Wachovia Insurance Services has access to all carriers of voluntary benefit plans. We have a fully -staffed department that provides assistance with marketing, selection, communication and implementation of only voluntary benefits. All of this staff specialize in this field. 18. Has your organization recommended other voluntary plans, or cancellation of voluntary plans, to your clients? On what basis do you make your recommendations of this nature? Yes, Wachovia Insurance Services has both recommended and cancelled voluntary plans for our clients. Our voluntary benefits unit along with your service team evaluate the positive and negative qualities of each plan and each carrier. We also review service performance and financial stability. WACHO tom. 20 INSURANCE SERiTICES Qualifications of Consultant Biographies Stan Self 24,yrs Senior COnsvlrwa 214.365.4733 stmrself Andrea Davenportsyrs Associate Consultant 214-365-4742 a *eadavenport Kim Ursery 3yrs Amanda Aguilar 4yrs Idministrative,twslant _ Client Service Representative 214-365-4716 214-36$ 4733 kiat.arsery anamcagaikq National Resources Frasier Ives C—PGance yrs Diane Boxley ACnavialServices - 20 Melissa Tobler Climcalstraegies 10 Steve Maike Pharmacist Teresa Freeman Communications Mary Mosqueds Work Life Sohatons =Lackey Steve Farris6 Wor�fsitelo+ yrs yrs toyrs 19 ws 8+yrs 13 yrs 21 INSURA►NCE SERVICES Joella Mullin Vice President Practice Leader Dallas, TX Biography Joella brings over 27 years of employee benefits consulting experience to her position of Practice Leader in our Dallas office. Joella's background includes: Management, consulting and sales with a major risk management/consulting firm as the Practice Leader for Middle Market Employee Benefits, Middle Market Practice Leader for Benefits and P&C and as Business Development Director; Large account consulting with the largest privately owned consulting firm in Dallas; Public entity and higher education health and welfare consulting and claims system and procedures auditing for a large accounting firm; and Underwriting, policy issue and marketing with a large insurance carrier. Joella has expertise in all phases of employee benefit health and welfare consulting, including strategic planning, plan design, funding arrangements, renewal negotiations, plan marketing, contribution analysis, network review, utilization data review and analysis and claims systems and procedures auditing. Joella has a Bachelors Degree in Political Science and Computer Science from East Texas State. She is a member of SHRM and Dallas/Ft. Worth Business Group on Health. She has completed 5 courses in the Certified Employee Benefit Specialist program. WACHOViA. 22 INStTRANCE SER CES Stan Self Senior Consultant 23 Biography Stan Self most recently held the position of Senior Client Manager at CIGNA HealthCare. During his 24 year career in employee benefits, Stan has focused on large corporate and public entity employers with special emphasis in managed care. Among the public sector employers that he has served are Fort Worth ISD, City of Dallas, Irving ISD, City of Mesquite, Birdville ISD, Parkland Hospital, State of Louisiana, Commonwealth of Kentucky, Galveston ISD and City of Kerrville. Higher education employer clients have included Texas A & M University, University of Houston and Vernon College. Stan attended Abilene Christian University, Lamar University and University of Houston. He is in the process of earning the Certified Employee Benefits Specialist (CEBS) designation with 5 of the requisite 10 courses and exams completed. WACHOVIA INSURANCE SERVICES Andrea Davenport Associate Consultant Dallas, TX Biography Andrea brings several years of benefits consulting experience to her position of Associate Consultant in our Dallas office. Andrea's background includes: Consulting and marketing experience for both Middle and Large Market Employee Benefits Large account consulting with the largest privately owned consulting firm in Kansas City, Missouri Andrea has experience in all areas of employee benefit health and welfare consulting, including renewal negotiations, plan marketing, contribution analysis and network review. Andrea has a Bachelors Degree in Marketing Management from Southwest Missouri State University. WA.CHO''V°IA 24 INSURANCE SER`WCES Melissa Tobler Vice President Clinical Strategies Consultant Milwaukee, WI Biography Melissa is a Vice President, Clinical Strategies Consultant. Melissa has been a registered nurse for over twenty years, during which time she has actively been involved in developing and overseeing case management, utilization review, quality assurance/improvement, and disease management strategies for insurance plans, vendors, and employers. Melissa is a patient advocate who has created win -win solutions for groups and employees, balancing the needs of the individual with the fiscal responsibilities of the group. Melissa's key areas of expertise include: Utilization and outcome data analysis and interpretation to assist clients in identifying and understanding clinical needs within their population. This analysis is the first step towards building a customized solution to meet each client's needs. Strategic planning within the total benefits design model for medical care management strategies, including those targeted at utilization review, large case management, disability, wellness, disease management, EAP, predictive modeling, health risk assessments, and behavioral health. Evaluation of vendor activities, strategies, and outcomes pre and post program implementation. Assistance in implementing medical care management strategies, with a special focus on outreach initiatives to the member. Prior to joining Wachovia, Melissa was the Director of Disease Management Product Development for APS Healthcare, Inc. WACHOVIA 25 INSURANCE SERVICES Steve Maike Pharmacy Benefit Consultant Milwaukee, WI Biography EDUCATION Bachelor of Pharmacy University of Wisconsin School of Pharmacy Madison, Wisconsin PROFESSIONAL CERTIFICATIONS Registered Pharmacist (State of Wisconsin) SUMMARY OF EXPERIENCE Prior to joining Wachovia, Steve served as Director of Pharmacy Programs for APS Healthcare where he led a clinical and operational staff managing the pharmacy programs for multiple health plans and provided pharmacy benefit consulting services to numerous clients. Steve became involved in the infancy stages of home infusion therapy as a founder of a regional home infusion company in the mid 1980's where he served as Operations Director for 8 years. Steve's interaction with managed care led to a position managing the capitated infusion therapy and mail order programs at BCBS of WI. His experience also includes; Manager of Clinical Pharmacy Programs and Director of Pharmacy Programs for BCBS of WI owned companies. At Wachovia, Steve will work closely with our clinical consulting practice to provide pharmacy benefit consulting to our clients. In this role he will promote pharmacy program content that supports client health & productivity initiatives. WACHOVYA, ZNSLTR"Cl@ SERVICES Teresa Freeman Communications Atlanta, GA 27 Biography Teresa is in the Atlanta office of Wachovia. She is a seasoned benefits consulting professional with over 10 years of in-depth experience in the development and delivery of employer benefit programs and 9 years of financial underwriting experience. Her expertise includes the redesign of benefit programs to meet the financial goals of the organization, program implementation, development of employee communications and ongoing financial analysis of the programs. Teresa is adept in developing creative solutions, project planning, and program assessments which are tied to the business objectives for the organization. Teresa's specific experience includes 9 years of group insurance underwriting experience with Confederation Life Insurance Company and 5 years with William M. Mercer, Inc. as a Principal. Teresa has extensive experience in conducting data analysis, claims forecasting, flexible benefit plans, financial analysis for all group benefit programs and employee communications. She has served as the Project Manager in multiple public and private sector client projects. Some of her prior projects include assisting large multi -national organizations with the review, marketing and implementation of their benefit programs, consolidation and standardization of programs for multi -site national organizations, the assistance to several regional HMOs in the selection of a Third Party Administrator and the design, development and implementation of all employee communication materials. Teresa received her Degree of Business Administration from Clayton State College. WACHO V'TA INSURANCE SER ICES Mary Mosquesa Principal, Work Life Solutions Chesterfield, MO Biography Ms. Mosqueda is a Principal and Work/Life Practice Leader in the St. Louis office of Palmer & Cay. She has over 12 years experience in compensation, human resources and work/life programs including development and design of both public and private sector salary management systems, performance management and incentive plans. Prior to joining Wachovia, Ms. Mosqueda was CEO of a work/life consulting firm, Work/Life Solutions. Ms. Mosqueda also worked for the University of Missouri -St. Louis. Among the clients Ms. Mosqueda has served are Anheuser-Busch Companies, Inc., Central Bank, The Council of State Governments, Culpeper County, Hospice of the Bluegrass, Inc., Jackson Products, Mary Engelbreit Studios, MasterCard International, SBC Communications, Stafford County, St. Louis Public Library, TrustMark Corporation, United Methodist Family Services, Virginia Housing Development Authority, Yamaha Motor and Manufacturing Corporation. Ms. Mosqueda graduated from Rockhurst College in Kansas City with a Bachelor of Arts in Business Communication with emphasis in Public Speaking. Ms. Mosqueda is a member of the Alliance for Work/Life Professionals, the Employee Benefits Association of St. Louis, and WorldatWork. Ms. Mosqueda also is a member of the WorldatWork Compensation Advisory Board. WACHOVIA 28 INSURANCE SERWCFS Steven L. Farish, HIA Vice President Worksite National Practice Leader Columbia, SC Biography Steve Farish is a Vice President and National Practice Leader for Worksite Marketing for Wachovia Insurance Services, Inc. His responsibilities include serving as the primary point of contact to WIS brokers and bankers for their client's Voluntary Worksite Benefits needs. Steve has been affiliated with Wachovia since 2005, performing in various capacities prior to joining Wachovia Insurance Services. He served as a Managing Partner with Palmer & Cay for 9 years where he was responsible for the management of the health and welfare offices in South Carolina and Wachovia Worksite. Prior to that, Steve served as Regional Sales Manager for Provident Life & Accident Insurance Company where he served in various capacities for 19 years. Steve is a graduate of Presbyterian College with a BS degree in Biology. He has obtained his HIA from Health Insurance Association of America, his GEBS from CEBS and is currently enrolled in the LTCP program. Steve resides in Columbia, SC with his wife Nancy and their three children. W.ACxo`TA 29 INSURANCE SERVICES Sanford Insurance Agency Biographies Douglas Sanford, CIC Co -CEO, Commercial Lines Sales Douglas Stanford is Co -Chief Executive Officer of Sanford Insurance Agency and a principal (owner). He has been a full time employee of Sanford since June of 1970. He graduated from Vanderbilt University in 1970 and obtained his Certified Insurance Councilor designation in 1985. He is a Licensed Risk Manager. Douglass has been the lead agent or co -agent on accounts such as the City of Lubbock, Covenant Health System, Glass Control, Inc., Texas Tech University, Brandon & Clark and other complex accounts. Douglas has been published in Rough Notes and Texas Insurance Journal magazines and was a speaker at the National Association of Independent Insurers National Underwriting Conference in April on "The Return to Traditional Underwriting." Douglas is a past president of the Independent Insurance Agents of Texas and is past Texas National Director of the Independent Insurance Agents and Brokers of America. Douglas has been a member of Texas Tech Continuing Education Staff, teaching insurance principles for Executive Directors of Non -Profit Organizations. Working with Senator Duncan, Douglas successfully petitioned for a change in the Charitable Immunity Act of Texas to allow the benefits of the act to reach more organizations. Douglas testified before Congressional Committees in the process. WACHOVTA 30 INSURANCE SERWCI@S s5c,nFo�d Sanford Insurance Agency Rhonda Thomack, ACSR, CIC Biographies Assistant VP, Group Health Insurance Sales Rhonda Thomack joined the agency in 1984 specializing in Personal Lines Insurance as a Customer Service Representative. She received her Accredited Customer Service Representative designation (ACSR) for Personal Lines in 1990. In January of 1994, Rhonda was promoted to Personal Lines Producer. She expanded her horizons into Commercial Lines small business insurance while continuing sales in Personal Lines. In 1997, Rhonda received her ACSR accreditation in Commercial Lines. Rhonda was promoted to Employee Benefits Producer in 1997. She has the resources to access several major insurance companies specializing in employee products including major medical, life, dental and disability coverages. Rhonda has served on the board of the Lubbock Area Association of Health Underwriters in several capacities, and received the designation of Certified Insurance Counselor in 2003. In December 2004, Rhonda was promoted to an officer at Sanford Insurance Agency. She is our Assistant Vice President and Employee Benefits Manager. One of the strengths of our Benefits Department includes two licensed customer service representatives working in the office to assist our clients. Cindy Shook and Darlene Gill have many years of experience in the Life and Health insurance industry as well as a friendly and helpful attitude. Education is continuous. We attend seminars to keep us up to speed with company changes, new products, and COBRA compliance. Our client base varies from small to large. We encourage employees to contact us if there is a question or problem. We also take a hands on approach to assist with claims. WACHOVY 31 ]NSURANCE SERVICES References Plano Independent School District — 6,150 Covered Employees 6301 Chapel Hill Blvd. Plano, TX 75093 (469) 752-4755 Becky Garrett, Director of Benefits and Risk Client since 2005 for Health & Welfare Brokerage Consulting Services Walco International, Inc. — 685 Employees 520 South Main Street Grapevine, TX 76051 (817) 601-3038 Kathy Hassenpflug, Vice President - Human Resources Client since 2001 for Health & Welfare Brokerage Consulting Services Sanden International (U.S.A.), Inc. — 640 Covered Employees 601 South Sanden Blvd. Wylie, TX 75089 (972) 442-8514 Stephanie Caraway, Human Resource Manager Client since 2002 for Health & Welfare Brokerage Consulting Services Ennis, Inc. — 6,235 Covered Employees 2441 Presidential Pkwy. Midlothian, TX 76065 (972) 775-9818 Richard Maresh, Human Resources Director Client since 2004 for Health & Welfare Brokerage Consulting Services ACHOVIA 32 INSURANCF, r►,.t" FR-WCES Sanford Insurance Agency Client References Brandon & Clark, Inc. Ellis Kight, Controller 806-771-5618 City of Lubbock Leisa Hutcheson, Insurance/Risk Management 806-775-2277 Covenant Health System Christine Newman, Manager Workers' Compensation 806-725-1011 D&L Masonry, Inc. Bill Sisson, President 806-795-3141 Glass Control, Inc. Jim Lupton, President/Vice President, Risk Management 714-347-7561 South Plains Compost Wayne Schilling, President 806-745-3559 Texas Medical Liability Trust Don Chow, Vice President Marketing 512-425-5933 Texas Tech University Steve Bryant, Director/Risk Management 806-742-3031 Center for Orthopedic Surgery Seth Crouch, Administrator 806-797-4985 Covenant Medical Group Hillcrest Family Health Clinic Lubbock Diagnostic Radiology Lubbock Surgical Associates Neurosurgical Associates Scott Laboratories Southwest Diagnostic Clinic S.W.A.T. West Texas Pediatric Associates Sanford Insurance Agency Client References James Burrell, MD, Administrator 806-725-9966 Terry Witter, Administrator 254-754-2600 Joe Maddux, Administrator 806-792-2767 Allison Mooney, Administrator 806-771-2222 David Langston, Administrator 806-797-2222 Dana Rains, Administrator 806-785-0777 Brad White, Administrator 806-771-5550 Chad Southard, Administrator 806-788-8503 Margaret Bennett, Administrator 806-780-6868 WAGHO A 34 INSURANCE SERVICES ■ ■ Price Proposal and Contract Fee $3.08 2006/2007 2300 Per Employee $7,084 Per Month $85,000 Annually Per Month $3.08 2007/2008 2300 Per Employee $7,084 Per Month $85,000 Annually Per Month 12008/2009 I 2300 I Not to exceed 5% I Not to exceed 5% I Not to exceed 5% increase increase increase We have confidence that we will meet your expectations and help you provide the most comprehensive benefits to your employees at the best possible price. We are willing to put a portion of our compensation at risk to ensure your satisfaction. The suggested performance review criteria will be based on input from the City. WACHOVIA 35 INSURANCE SERVICES Compensation Policy Transparency regarding our sources of income is critical to maintaining the confidence of our clients. Wachovia Insurance Services, Inc. receives the majority of its remuneration for insurance placement or related services from commissions paid by insurance companies or fees paid by the client. All forms of our compensation are described below. -Commission Commissions are paid to us by the insurer for the placement or renewal of insurance policies, day-to-day servicing of the account, claims handling and other services. Commission rates differ by type of policy and insurer. -Fee Fees we receive from the client are agreed to in writing by us and the client for the placement of insurance, account servicing, claims handling, and other client services. If the client pays us a fee, we will receive no other compensation from the insurer without written consent of the client. -Interest Wachovia Insurance Services receives interest income on insurance monies in our bank accounts. If we finance or assist with the financing of your insurance premiums, Wachovia Insurance Services may receive income from the premium finance company. -Expense Reimbursement / Administrative Service Fee Occasionally, insurance companies will pay Wachovia Insurance Services' fees to provide services on their behalf for the client. These services can include policy issuance, record retention, risk control, or other services not reflected in normal policy commission rates. No such fees will be accepted for services on behalf of this agreement with City of Lubbock. Wachovia Insurance Services does not accept contingent, profit sharing, override, or incentive - based compensation. We voluntarily discontinued all such arrangements in 2004. In the event insurance is placed through a Wachovia Insurance Services -affiliated company, including wholesale insurance brokers E-Risk or Besso, that entity may also receive compensation. If you have any questions or require more information regarding our compensation for the placement of insurance or other client services, please contact your client executive or local office manager. We will disclose to our clients, upon request, all commission or other compensation we receive while acting on our clients' behalf. Y ACHOVIA INSUP.ANCE SEIE WCES Resolution No. 2006-R0370 Additional Services , Finally, in addition to our core and value-added Health & Welfare consulting services, you will have access to the following consulting resources: • Full data mining and subsequent analytical reporting • Compensation Consulting • Human Resource Consulting • Healthcare Actuarial Services Consulting • Executive Benefits and Compensation Consulting • Deferred Compensation Consulting • Communications Consulting Additional compensation will be required for these areas and is discussed during our annual planning meeting. WACHO'VIA 37 INSUP.ANCE SFIMC.EP, WACI" OVI.A. INSURANCE SEEWCES L nford