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2005-049 Dental Insurance for Village Employees-Guardian Lifer RESOLUTION 49-2005 A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE OF NORTH PALM BEACH, FLORIDA, ACCEPTING THE PROPOSALS OF THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, TO PROVIDE THE VILLAGE WITH DENTAL INSURANCE FOR VILLAGE EMPLOYEES, WHICH PROPOSALS ARE ATTACHED TO THIS RESOLUTION AS EXHIBIT "A" AND MADE PART HEREOF; AUTHORIZING THE MAYOR AND VILLAGE CLERK TO EXECUTE SUCH DOCUMENTS AND AGREEMENTS NECESSARY TO IMPLEMENT THIS ACCEPTANCE; AND, PROVIDING FOR AN EFFECTIVE DATE. BE IT RESOLVED BY THE VILLAGE COUNCIL OF NORTH PALM BEACH, FLORIDA: Section 1. The Village Council of the Village of North Palm Beach, Florida, does hereby accept the proposals of The Guardian Life Insurance Company of America to provide the Village with dental insurance for Village employees, which proposals are attached to this resolution as Exhibit "A" and made part hereof. Section 2. The Mayor and Village Clerk are hereby authorized to execute such documents and agreements necessary to implement acceptance of The Guardian Life Insurance Company of America proposals. Section 3. This resolution shall take effect immediately upon its adoption. PASSED AND ADOPTED THIS 26th DAY OF M"~' nnnc ATTE:S,T; ,,~ ,.~ .~ ,;~ 0 VILLAGE CLERK u~•~. ~~. `~lJi{','f '~, (Village Seal)',, ,~ , , ,. , I i};{fit ~ ~ ~. ~. • F Guardian Proposal ~~~ ~ Your broker is: Kurt Gehring i 1505 FAi^nCHILD GARDENS SUITE 102 PALM BEACH GARDENS, FL 33410 ...__. _ _ PROPOSAL Preparedfor Village of North Palm Beach Teiepnone:' (561)744-4929 -. -- - -- --- -- - Email: kart@gheringgroua.com WHY GUARDIAN? ^ Ranked as a top writer of group insurance in the country by Employee Benefits Plan Review, Guardian is the employee benefits. caxrier_of choice for over 120,000 companies and covers over 6 million individuals nationwide.' ^ A mutually advantageous relationship. As one of the few remaining wholly owned mutual companies in today's competitive employee benefits market, you benefit from customer satisfaction, long-term vision, stability and financial strength. ^ As the 4th largest mutual company in the United States and a member of the Fortune 500, we're committed to your success. ^ We offer a full spectrum of high-quality, employer paid, contributory and employee-paid (voluntary) products. That's why our benefits experts are able to create the ideal package for most any group. ^ Combined coverage can help reduce overall premium rates and simplify administration -planholders get just one bill. In addition, packaging permits softer renewals of all product lines. ^ Regional Customer Response Units (CRU) make it their business to know your business. Providing all our customers with personalized support for claims, billing and administrative issues. _ ^ Our innovative worksite program takes care of the steps necessary to make sure your voluntary benefit offerings are a success. Our consultative approach and dedicated worksite services make enhancing any benefits package easy -for planholders and employees. ^ Our Employee Benefits Hotline is always available to support employees during the enrollment process. ^ With over 5,000 employees and almost 2,800 financial representatives in nearly 100 agencies, Guardian is the fourth largest mutual life insurance company in the United States. ^ By providing high performing financial products and services that reduce risk and increase assets, we help individuals and employers fulfill their responsibilities and build a better tomorrow. ^ Our culture is based on an unwavering belief in integrity and fair dealings, treating our clients and each other with dignity and respect. ^ A premier provider of quality financial products and services for over 140 years, Guardian has enjoyed outstanding financial strength and exemplary ratings from independent analysts, decade after decade.z ^ Guardian Benefits Manager -our self-service tool for planholders and employees -enables easy access to claims information and forms, as well as on-line billing and plan administration. ~ Employee Benefits Plan Review, May 2002, No. 11 z Financial information concerning The Guardian life Insurance Company of America as of 12/31/03 on a statutory basis: Admitted Assets = $21.7 Billion; Liabilities = $19.1 Billion (including $15.7 Billion of Reserves); and Surplus = $2.6 Billion. • Rates and premiums are based on the employee data submitted. Final rates and premiums are based on the plan and employeeldependent data provided on the enrollment forms. GUARDIAN' .. ~ ~ ..- ~..:•~~~~ ~ -..- The Guardian Life Insurance Company of America, New York, NY Your broker is: Kurt Gehring Dental ~ 11505 FAIRCHILD GARDENS SUITE 102 PALM BEACH GARDENS, FL 33410 _. _ _ PROPOSAL Prepared for Village of North Palm Beach Telephone: ' (561)744-4929 __ _ _.. - - - - - - Email , kart@gherinagroua.com -cJf~+~w b7iru~ , . t'fGw,r~ ~~l'fiC~ Contributory Pre-Paid Contributory Pre-Paid Census Notes RATES Employee Only . __ _ ._. $11.53 _ $13.09 86 Full Famil _ y _ $31.01 ' _ _ __ $34.43 88 _ _.. __.. _ ._.;..._ __ Monthly Premium $3,720.46 $4,155.58 Annual Premium x44,645.52 $49,866.96 Rate Guarantee 1 Year 1 Year PRIMARY BENEFITS Office Visit Copay $5 ' $5 Deductible Individual None None Deferred Services None None Child Age Limits 20 (26 if a full-time student) 20 (26 if a full-time student) Member responsible for Patient Member responsible for Patient Claim Payment. Basis _ _ _ _ _ Charge Charge __ Annual Maximum Unlimited Unlimited Network Managed DentalGuard Managed DentalGuard :, BENEFIT DETAIL ', PPD Patient Average ! PPD Patient Average ,Charge _ Charge Charge Charge Oral Exams _ _ $0 $25 $0 $25 Cleanings $0 I $55 $0 $55 $0 $75 $0 $75 X-Rays Full-Mouth Full-Mouth $10 $30 $10 $30 Sealants Per Tooth Per Tooth $10 $30 $10 $30 Fillings _ One Surface Amalgam _ _ __ _ One Surface Amalgam _ Continued... • Rates and premiums are based on the employee data submitted. Final rates and premiums are based on the plan and employee/dependent data provided on the enrollment forms. L:~ GUARDIAN` ' ' "- '~' `'"" '-'" ' The Guardian Life Insurance Company of America, New York, NY x Dental • _._ _.. PROPOSAL Prepared for Village of North Palm Beach BENEFIT DETAIL continued... Your broker is: ~ Kurt Gehring 11505 FAIRCHILD GARDENS SUITE 102 PALM BEACH GARDENS, FL 33410 Telephone:; (561)744-4929 Email: kurt@gheringgroua.com Contributory Pre-Paid Contributory Pre-Pa' Notes $50 $170 Denture Reline Chairside $80 $230 Repair & Maintenance of Crowns, Bridges & Dentures Denture Reline Laboratory $45 $170 Denture Reline Chairside $65 $230 Denture Reline Laboratory Anesthesia Not Covered Not Covered $165 $485 $135 $485 Anterior Anterior $265 $710 $230 $710 Root Canal Molar Molar Perio Surgery $290 $745 $255 $745 $65 $140 ! $55 $140 Scaling & Root Planing Per Quadrant Per Quadrant $10 $90 $10 $90 Simple Extractions Per Tooth Per Tooth $75 $200 $65 $200 Soft Tissue Impacted Soft Tissue Impacted $120 $295 $105 $295 Complex Extractions Fuli Bony Impacted Full Bony Impacted $330 $825 $290 $825 Complete Denture Complete Denture $385 $885 $335 $885 Bridges & Dentures Partial Denture Partial Denture $290 $690 $255 $690 Porcelain with Metal Porcelain with Metal $270 $715 $235 $715 Single Crowns Cast Metal Cast Metal $220 $565 $190 $565 2-surface inlay 2-surface inlay $235 $660 $200 $660 3-surface onlay 3-surface onlay $120 $280 $105 $280 Inlays, Onlays, Veneers Veneer Veneer Rates and premiums are bas ed on the employee data submitted. Continued... Final rates and premiums are based on the plan and employee/dependent data provided on the enrollment forms. GUARDIAN` "- '' -"" ''- ' The Guardian Life Insurance Company of America, New York, NY Dental _.__ __ _ _ PROPOSAL Prepared for Village of North Palm Beach Your broker is: I Kurt Gehring '; 11505 FAIRCHILD GARDENS SUITE 102 PALM BEACH GARDENS, FL 33410 Telephone:; (561)744-4929 Finail• I 4uri(tDnharinnnrnun nnn. Contributory Pre-Paid Contributory Pre-Pad _ Notes' `~ BENEFIT DETAIL continued... $2200 Not Applicable $2200 Not Applicable Comprehensive ortho for dep child Comprehensive ortho for dep child under 19 under 19 $2200 Not Applicable -' $2200 Not Applicable Comprehensive ortho for other Comprehensive ortho for other Orthodontia members members PLAN HIGHLIGHTS Pre-Paid Dental Plan The prepaid dental plan combines broad dental coverage with a number of cost-saving features. ^ No annual maximums ^ No deductibles ^ No claim forms ^ Specialty services available by referral ^ Member always knows out-of-pocket costs ^ No exclusions for pre-existing conditions • No monthly administrative fee ^ No participation requirements r No employer contribution required SUMMARY OF PLAN LIMITATIONS AND EXCLUSION X Except For limited emergency X This plan provides pre-paid dental X Only those services listed in the plan services, benefits will be provided for benefits through a network of are covered. services provided by the primary care participating general dentists and dentist selected by the member. The specialty care dentists. X Certain services are subject to member must pay the primary care annual or other periodic limitations. dentist a patient charge for most X All covered services must be covered services. No benefits will be provided by the member's Primary X Where orthodontic benefits are paid for treatment by a specialist Care Dentist. Specialty care ~ specifically included, the plan unless the patient is referred by his services are covered only when provides for one course of or her primary care dentist and the referred by the member's Primary comprehensive treatment per referral is approved by the plan. Care Dentist and approved in lifetime, per member. advance by Managed DentalGuard. Continued.... Rates and premiums are based on the • employee data submitted. Fin al rates and premiums are based on the plan and employeeldependent data provided on the enrollment forms. GUARDIAN- .. ..- ~..:-~~~~ ~ •..- .. The Guardian Life Insurance Company of America, New York, NY Dental _. PROPOSAL Prepared for Village of North Palm Beach Your broker is: Kurt Gehring 11505 FAIRCriiLD GARDENS SUITE 102 PALM BEACH GARDENS,fL33410 ___ __ ._ Telephone:; (561)744-4929 Email: ,' kort@aheringnroup.com SUMMARY OF PLAN LIMITATIONS AND EXCLUSION continued... X The Managed DentalGuard plan X The services, exclusions and X GP-I-MDG1, et al. does not provide orthodontic benefits limitations listed above do not if comprehensive orthodontic constitute a contract and are a treatment or retention is in progress summary only. The Managed as of the member's effective date DentalGuard plan documents are the under the Managed DentalGuard final arbiter of coverage. plan. • Rates and premiums are based on the employee data submitted. Final rates and premiums are based on the plan and employeeldependent data provided on the enrollment forms. GUARDIAN' .. ~ ~ ..- ~,.:-~~~~ ~ •..- The Guardian Life Insurance Company of America, New York, NY Guardian Proposal ~ ~~ __ _ _ _. ......_.. . PROPOSAL Prepared for Viilage of North Palm Beach WHY GUARDIAN? Your broker is: Kurt Gehring ___ i 1505 FAIRCHILD GARDENS SUITE 102 PALM BEACH GARDENS, FL 33410 Telephone: ~ (561)744-4929 Email: ' kart@gheringgroup.com ^ Ranked as a top writer of group insurance in the country by Employee Benefits Plan Review, Guardian is the employee benefits carrier of choice for over 120,000 companies and covers over 6 million individuals nationwide.' ^ A mutually advantageous relationship. As one of the few remaining wholly owned mutual companies in today's competitive employee benefits market, you benefit from customer satisfaction, long-term vision, stability and financial strength. r As the 4th largest mutual company in the United States and a member of the Fortune 500, we're committed to your success. ^ We offer a full spectrum of high-quality, employer paid, contributory and employee-paid (voluntary) products. That's why our benefits experts are able to create the ideal package for most any group. ^ Combined coverage can help reduce overall premium rates and simplify administration -planholders get just one bill. In addition, packaging permits softer renewals of all product lines. ^ Regional Customer Response Units (CRU) make it their business to know your business. Providing all our customers with personalized support for claims, billing and administrative issues. ^ Our innovative worksite program takes care of the steps necessary to make sure your voluntary benefit offerings are a success. Our consultative approach and dedicated worksite services make enhancing any benefits package easy -for planholders and employees. r Our Employee Benefits Hotline is always available to support employees during the enrollment process. ^ With over 5,000 employees and almost 2,800 financial representatives in nearly 100 agencies, Guardian is the fourth largest mutual life insurance company in the United States. ^ By providing high performing financial products and services that reduce risk and increase assets, we help individuals and employers fulfill their responsibilities and build a better tomorrow. ^ Our. culture is based on an unwavering belief in integrity and fair dealings, treating our clients and each other with dignity and respect. ^ A premier provider of quality financial products and services for over 140 years, Guardian has enjoyed outstanding financial strength and exemplary ratings from independent analysts, decade after decade.z ^ Guardian Benefits Manager -our self-service tool for planholders and employees -enables easy access to claims information and forms, as well as on-line billing and plan administration. ' Employee Benefits Plan Review, May 2002, No. 11 2 Financial information concerning The Guardian Life Insurance Company of America as of 12/31/03 on a statutory basis: Admitted Assets = $21.7 Billion; Liabilities = $19.1 Billion (including $15.7 Billion of Reserves); and Surplus = $2.6 Billion. • Rates and premiums are based on the employee data submitted. Final rates and premiums are based on the plan and employee/dependent data provided on the enrollment forms. GUARDIAN' .. ~ ~ ..- ~•.:-~~~~ ~ --.- The Guardian Life Insurance Company of America, New York, NY ?~ ' 3. • y. Your broker is: ! Kurt Gehring Denta! : 11505 FAIRCHILD GARDENS SUITE i 2 u PALM BEACH GARDENS, FL 33410 PROPOSAL Prepared for VIIIage Of NOrth Palm B@8Ch Telephone: ; __ .. __.. (561)744-4929 _ __. - - - _ __ mai : urt oherinagroup.com Non-Contributory Network Non-Contributory Networ ~ Access Plan Access Plan `- ensus i Notes RATES Employee Only $24.74 $20.88 86 See Rates Notes Full Family $76.08 $60.94 88 Monthly Premium _ __ __ $8,822.68 $7,158.40 AnnuafPremium $105,872.16 $85,900.80 Rate Guarantee 1 Year 1 Year PRIMARY BENEFITS In Network Out of Network , In Network i' Out of Network, Deductible See Primary Individual _.....___ $50 Inclusive ' , $100 Inclusive Benefits Notes Family Limit _ .... 3 per family 3 per famil Waived For Preventive Preventive Not Waived Not Waived Coinsurance Preventive 100% 100% 100% ; 100% Basic 80% 80% ! 80% " 80% Major _ 50 /° 50% 50% 50% Orthodontia 50% 50% I 50% 50% Deferred Services None Nnne • Rates and premiums are based on the employee data submitted. Final rates and premiums are based on the plan and employee/dependent data provided on the enrollment forms. 1~` GUARDIAN- .. ~ ~ ..- ~..:-~~~~ ~ -..- The Guardian Life Insurance Company of America, New York, NY Your broker is: Kurt Gehring Dental • 11505 FAIRCHILD GARDENS SUITE 102 PALM BEACH GARDENS, FL 33410 Telephone: (561)744-4929 PROPOSAL Prepared far Village of North Palm Beach Email: ' kurtC~gherinaarouo.com (;'hibv~~'l't~~,"C=h_ ~~f' C(j4~h-"~~ r~et ~i lv, Non.-Contributory Network Non-Contributory Network Accessplan Access Plan'> :' Notes BENEFIT DETAIL Oral Exams Preventive (once/6 mos.) Preventive (once/6 mos.) Cleanings Preventive (once/6 mos.) Preventive (once/6 mos.) Preventive (Full-mouth series Preventive (Full-mouth series X-Rays once/60 mos.) once/60 mos.) Sealants Preventive Preventive Basic (Fillings include posterior Fillings __ __ __ __ composites) Basic Repair & Maintenance of Crowns, Bridges & ,Dentures Basic Basic Anesthesia Basic Basic __, Root Canal Basic Basic Perio Surgery _ _ _ Basic_ _ Basic Scaling & Root Planing __ Basic _ ___. _ _ . Basic .. ___ Simple Extractions __ Basic Basic Complex Extractions Basic Basic i Bridges & Dentures Major ! Major Single Crowns _ Major _ __ _.. Major _ __... Inlays, Onlays, Veneers Major ~ Major Orthodontia Orthodontia Orthodontia Rates and premiums are based on the employee data submitted. Final rates and premiums are based on the plan and employeeldependent data provided on the enrollment forms. GUARDIAN' - ' •'' '' ~='"" -~- The Guardian Life Insurance Company of America, New York, NY z.. , , Your broker is: ' Kurt Gehring • ~J Dental PROPOSAL Prepared for Village of North Palm Beach PLAN HIGHLIGHTS With our Maximum Rollover feature, a part of a covered person's unused annual maximum maybe rolled over for use in future years. If during a benefit year a covered person both: submits at least one claim for covered services; and receives less than $500 in benefits, then $250 ($350 i(a covered person using only PPO providers during the benefit year) will be rolled over for future use. The covered person's personal Maximum Rollover account may never exceed $1000. The covered person's personal Maximum Rollover account is used for additional coverage when his or her annual maximum is exhausted. ^ We will send each employee an annual statement to let him or know what's in his or her personal Maximum Rollover account. IMPORTANT NOTES Rates Notes Rates assume participation of 100% of eligible employees. Primary Benefits Notes Dental Network Access Plan (NAP) With a NAP Plan, benefits are paid at the same coinsurance percentages in-network and out-of-network. In-network benefits are based on a negotiated PPO fee schedule; out-of-network benefits are based on local UCR charges. While employees retain complete freedom of choice, the employee benefits by using an in-network dentist because our significant PPO discounts result in less out-of-pocket expenses. Therefore, annual maximums stretch further if the employee sees a PPO dentist because the PPO dentist's lower fees-per-service enables the employee to receive more services during the year than if he or she visited an out-of-network dentist. Our line of Enhanced NAP plans can further trim premiums and encourage employees to take advantage of in-network savings by including provisions that: set deductibles higher for out-of-network care than in-network care; waive deductibles for in-network preventive services, but not the out-of-network preventive deductible; and have a lower annual max for out-of-network care than in-network care. Telephone: Email: i 1505 FAiRCi-iILD GARDENS SUITE 102 PALM BEACH GARDENS, FL 33410 (561)744-4929 kurt@aherinagroua.com Orthodontia, when covered, is for With over 67,000 DentalGuard Preferred The list of dental services shown is not dependent children who are less than age dentist locations nationwide, finding a exhaustive. Final plan documents will 19 when active appliance is first placed. network dentist is easy! show exactly what is covered and excluded. Rates and premiums are based on the employee data submitted. Final rates and premiums are based on the plan and employee/dependent data provided on the enrollment forms. !7 GUARDIAN' .. ~ ..- ~,.:-~~~~ ~ -..- ~ . The Guardian Life Insurance Company of America, New York, NY Your broker is: ; Kurt Gehring i i505 FAIRCHILD GARDENS ~@~~~0 SUITE 102 • PALM BEACH GARDENS, FL 33410 Villa e of North Palm Beach Telephone: (561)744-4929 PROPOSAL Prepared for g -- _. Email: , kurt@aherinaaroua.com SUMMARY OF PLAN LIMITATIONS AND EXCLUSION X Coverage is limited to charges that ^ Replacing a lost, stolen or • The replacement of extracted or are necessary to prevent, diagnose missing appliance or prosthetic missing third molars/wisdom or treat dental disease, defect or device; or making a spare teeth. injury. Depending on plan type, appliance or device. deductibles, waiting periods, per ^ Treatment of congenital or service frequency limitations and ^ Treatment needed due to: a) an developmental malformations , payment limits may apply. on-the-job orjob-related injury; , or the replacement of or b) a condition for which congenitally missing teeth. X This plan does not pay for: benefits are payable by ^ Any restoration procedure, Workers' Com ensation or p ^ Evaluations and consultations appliance or dental prosthesis similar laws. for non-covered services; used solely to: a) alter vertical r Treatment for which no charge detailed and extensive oral evaluations dimension; b) restore or is made. . maintain occlusion, except to ^ Any procedure performed in the extent that this plan covers ^ Replacing an appliance or conjunction with, as part of or orthodontic treatment; c) splint prosthetic device with a like related to anon-covered or stabilize teeth for periodontal appliance or device, unless: a) procedure. reasons; d) treat a condition it is al least ten years old and caused by abrasion or attrition; can't be made usable; or b) it is ^ Any procedure not specifically or e) treat disturbances of the damaged while in the covered listed as a covered benefit. temporomandibularjoint (TMJ). person's mouth in an injury ^ Cosmetic or experimental suffered while insured, and treatments. can't be fixed. Rates and premiums are based on the employee data submitted. Final rates and premiums are based on the plan and employeeldependent data provided on the enrollment forms. 1~ GUARDIAN' .. ~ ~ ..- ~..:-~~~~ ~ -..- The Guardian Life Insurance Company of America, New York, NY