HomeMy WebLinkAboutResolution - 2021-R0432 - Contract 14820 with Dearborn National Life Insurance - SelerixBenSelect 10.26.21Resolution No. 2021-RO432
Item No. 7.21
October 26, 2021
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute
for and on behalf of the City of Lubbock, the renewal of Contract 14820, by and between the
City of Lubbock and Dearborn National Life Insurance to enhance services by adding the
SelerixBenSelect (Selerix) benefits administration system, and related documents. Said
Contract is attached hereto 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 on October 26, 2021
A EST:
�) t A k& �X
Rebecca Garza, City Secretary
APPRAS TO CONTENT:
Clifton Beck, Director of Human Resources
TO FORM:
DANIEL M. POPE, MAYOR
City Attorney
cedocs/RES.Contract-Dearbom National Life Ins.
October 12, 2021
Resolution No. 2021-R0432
OW61ue.CrosslllueShieldol"Iesas
September 17, 2021
Group Name: City of Lubbock
Group Number: GFZ03192
Proposed Effective Date: January 1, 2022
Proposal is valid for 60 days following proposed eHectlye date
Coverages: Basic Life/AD&D, Voluntary life/AD&D, Voluntary Long -Term Disability, and Voluntary Accident.
Requested Commission Changes: Change commissions on all coverages listed above to a flat 6%.
Enhance current contract to include SelerlxBenSelect online enrollment services.
Impact to Rates: No impact to the current rates below.
Basic Life - Actives
$0.035/$1,010
Retiree Life - Prior to 4/11988
$0,060
/ $1,000
Retiree Life - On or After 4/1/1998
$3.060
1 $1,000
Basic AD&D
$0.012
/ $1,000
Voluntary Life - Actives
Under Age 30
$0.05
$$1,000
Age 30 to 34
$0.06 1
$$1,000
Age 35 to 39
$0.07 /
$1,000
Age 40 to 44
$0.10 /
$1,000
Age 45 to 49
$0.15 /
$1,000
Age 50 to 54
$0.23 /
$1,000
Age 55 to 59
$0.43 /
$1,000
Age 60 to 64
$0.66 / $1,000
Age 65 to 69
$1.21 /
$1,000
Age 70 to 74
$2.06 /
$1,000
Age 75 to 79
$2.06 /
$1,000
Age 80 and Above
$2.06 /
$1,000
Voluntary Life - Retirees
Under Age 30
$0.11 / $1,000
Age 30 to 34
$0.12 / $1,000
Age 35 to 39
0.17 / $1.000
Age 40 to 44
$0.26 / 1,000
Age 45 to 49
$0.44 / $1,000
Age 50 to 54
$0.78 / $1,000
Age 55 to 59
$1.27 / $1,000
Age 60 to 64
$1.44 / $1.000
Age 65 to 69
$2.38 / $1,000
Age 70 to 74
$4.12 / $1,000
75 to 79
$6.20 / $1,000
Age 80 and Above
$9.75 / $1,000
701 E. 32nd Street, Suite 300 1 Lombard,IL60148
Insurance products issued by Dearborn Life Insurance Company, 701 E. 22nd St, Suite 300, Lombard, It 6014& Blue Crass and Blue Shield of Texas is the trade name
of Dearborn Life Insurance Company, an Independent licensee of the Blue Cross and Blue Shield Association. BLUE CROW, BLUE SHIELD' and the Cross and shield
Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
09 131oeCross 131tieShield ol— esas
Voluntary Spouse Life - Actives
0.80 15,000
Voluntary Child Life -Actives
$0.50 / $2,500
Voluntary Dependent Life - Retiree
$1.25 Per Unit
Voluntary AD&D
Individual Plan
$0.025 /
$1,000
Family Plan
$0.0381$1,000
Voluntary Long -Term Disability Option 1
Under Age 25
$0.14 / 100 MCP
Age 25 to 29
$0.161$100 MCP
Age 30 to 34
$0.17
/ $100 MCP
Age 35 to 39
$0.18
I $100 MCP
Age 40 to 44
$0.251$100
MCP
Age 45 to 49
$0.31
/ $100 MCP
Age 50 to 54
$0.421$100
MCP
Age 55 to 59
$0.64
I $100 MCP
Age 60 and Above
$0.791$100 MCP
Voluntary Long -Term Disability Option 2
Under Age 25
$0.16
/ 100 MCP
Age 25 to 29
$0.181$100
MCP
Age 30 to 34
$0.201$100
MCP
Age 35 to 39
$0.21
I $100 MCP
Age 40 to 44
$0.281$100
MCP
Age 45 to 49
0.36 I 100 MCP
Age 50 to 54
$0.49
I 100 MCP
Age 55 to 59
$0.741
100 MCP
Age 60 and Above
$0.91
I $100 MCP
Voluntary Accident
Employee Only
1
$4.63 PEPM
Employee+Spouse
$7.84 PEPM
Employee+Child
$8.52 PEPM
Family
$13.56 PEPM
NOTE: All other plan provisions will remain unchanged.
Ancillary Account Manager: Tonja Shastid Phone N: 972-996-9352
Policyholder Authorized Signature: Date:
701 E. 22nd Street, Suite 300 1 Lombard,I1-60148
October 26, 2021
Insurance products Issued by Dearborn Life Insurance Company, 701 E.22nd St. Suite 300, Lombard, 11.60148. Blue Cross and Blue Shield of Texas is the trade name
of Dearborn Life Insurance Company, an independent licensee of the Blue Cross and Blue Shield Association. BLUE CROSS', BLUE SHIELD' and the Cross and Shleld
Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of Independent Blue Cross and Blue Shield Plans.