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2004-032 Accepts EMI Proposal for TPA• RESOLUTION 32-2004 A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE OF NORTH PALM BEACH, FLORIDA, ACCEPTING THE PROPOSAL OF EMPLOYERS MUTUAL, INC., (EMI) TO PROVIDE THE VILLAGE WITH THIRD-PARTY ADMINISTRATIVE SERVICES FOR THE VILLAGE'S SELF-FUNDED MEDICAL, DENTAL AND FSA PLANS ESTABLISHED FOR VILLAGE EMPLOYEES, WHICH PROPOSAL IS ATTACHED TO THIS RESOLUTION AND MADE PART HEREOF; 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 proposal of Employers Mutual, Inc., (EMI) to provide the Village with third-party administrative services for the Village's self-funded medical, dental and FSA plans established for Village employees, which proposal is attached to this resolution and made part hereof. Section 2. This resolution shall take effect immediately upon its adoption. PASSED AND ADOPTED THIS 13th DAY OF MAY, 2004. at~~u~iu~~i<<, t R!! ~ i 1 f! ! ~ ,~ Y 7 (Vi~tlage Sea) ~ '. ' MA OR ~ `. ~` /! ~ a J / R !R~ \ ~ `t ATTEST: VILLAGE CLERK • • Employers Mutual, Inc. March 23, 2004 Village of North Palm Beach Attn: Shaukat Khan 501 US Highway One North Palm Beach, FL 33408 RE: RFP for TPA Services Dear Mr. Khan: We appreciate the opportunity to propose the continuation of our administrative services for the Village of North Palm Beach Self-Funded Health Plan as outlined in the enclosed proposal. We have addressed each component including network access, utilization management, re-insurance, prescription benefit services and other support services necessary for ongoing administration in the EMI processing system. For network access EMI proposes the continued use of Dimension Health in coordination with EMI's proprietary network as one fully integrated preferred provider network. Out of area coverage will be accessed through Beechstreet a national provider network. All administrative services including utilization management and FSA administration will be provided in-house on EMI's claims processing system from our local office based in Stuart, Florida. EMI has included a complete market analysis for medical stop loss options as outlined in section four (4). Pacific Life provided the most favorable overall pricing considering both premium rates and aggregate claim factors. With over 40 self-funded clients for both group health and workers compensation, EMI has extensive experience providing administrative services to local government entities such as municipalities, county governments, school districts and fire districts. In addition to our expanded network, we welcome the opportunity to continue to provide our self- funded administrative services to the employees of the Village of North Palm Beach. In the meantime we look forward to discussing our proposal in more detail and responding to any questions you may have. Sincerely, : - ~ _.. iin Davis ~• :/ • Vice President of Sales & Marketing LEE COUNTY JACKSONVILLE 2055 Central Avenue 1000 Riverside Avenue, Suite 400 Ft. Myers, Florida 33901 Jacksonville, Florida 32204 239.337.8133 • Fax: 239.337.8666 800.697.2235 • Fax: 904.598.5288 Visit us at www.emi-tpa.com Visit us at www.emitpa.com STUART 700 Central Parkway Stuart, Florida 34994 772.287.7650 800.431.2221 Fa~~72.287.1387 Visit us at www.emi-tpa.com • CLAIMS ADMINISTRATION PROPOSAL FORMS PROPOSER'S GENERAL INFORIl~ATION Name of Administrator: Employers Mutual Inc. (EMI) FEIN/SS#: 59-2989676 Address: 700 Central Parkway Stuart, FL 34994 Primary Contact: Jim Davis Telephone Numbers Daytime/After Hours: (800) 431-2221 ext 4450 (772) 287-7650 Email: JimD(a,EMI-TPA.com Fax: (772)287-1387 Website Address: www.EMI-TPA.com How many consecutive years has your organization operated as a medical claims administrator? 20 vears Agent/Broker Firm: N/A (if applicable) Agent/Broker Account Representative: N/A Telephone Numbers Daytime/After Hours: N/ Email: N/A • Fax: N/A 44 CLIENT REFERENCES 1. Indicate the number of currently contracted Florida based employers, your organization provides TPA services to. 41 Florida Clients 2. Indicate the number of currently contracted public-sector employers in the State of Florida your organization provides TPA services to. 21 Public Sector Clients 3. List a minimum of three (3) current clients and one (1) prior client with similar size and/or industry as the Village, with the following information: • Client Name • Contact Name and Title • Address • Phone and Fax • Dates of Client Relationship • Number of Employees • Services Provided City of Fort Pierce George Bergalis, Risk Manager 100 North US Highway One Fort Pierce, FL 34954 Phone (772) 460-2200 ext. 332 Fax (772) 489-2594 October 2002 through present 365 Employees Medical, Prescription Drugs and Dental Administration City of Stuart Marie Fertitta, Human Resources 121 S W 1~~lagler Avenue Stuart, FL 34994 Phone (772) 288-531 S Fax (772) 600-1226 October 1986 through present 247 Employees Medical, Prescription Drugs, Dental and Flexible Spending Administration 4J COST INFORMATION Monthlv Administrative Service Fees for the 12 month period beginning July 1, 2004: Cost Per Per Elemeat - Employee Family Claims Administration Medical $14.00 N/A Utilization Management Included in N/A Above Medical Case Management Included in N/A Above Network Access Fee $4.25 N/A (EMI/Dimensions Plusl 20% 20% National Wrap Around of Saving of Saving (Beechstreet) Dental Administration Included in N/A Above Commissions N/A N/A COBRA/ Included in N/A HIPAA Above Total: $18.25 N/A Additional costs for variable expenses associated with implementation and administration of plan • Variable Expense Item Cost Basis Start-up Costs N/A Actuarial Services Pass Through to Client Case Management Hourly Rate N/A FSA Administration (Per Account Per Month) $4.25 46 Fort Pierce Utilities Authority Douglas Giel, Director of Human Resources 500 Boston Avenue Fort Pierce, FL 34950 Phone (772) 466-1600 ext. 3265 Fax (772) 429-2035 January 2003 through present 270 Employees Medical, Prescription Drugs, Dental and Flexible Spending Administration City of Lakeland Karen Lukhaub, Risk Manager 520 North Lake Parker Avenue Lakeland, FL 33801 Phone (863) 834-6799 Fax (863}834-6743 October 1992 through December 2002 2,342 Employees Medical and Flexible Spending Administration 4. How many total employees and members are you currently processing medical claims on? 55,000 Employees 92,000 Members • 47 SERVICES INFORMATION 1. Where is the location of the claims payment facility that will service this account? Village of North Palm Beach will be handled our of our Stuart Florida location. a. Is a toll free number available if not local? (800 431-2221 b. Will the Village be assigned a dedicated claims processor? Yes X No c. Indicate the name of the account representative that will service this account. Lynne Brentnall, Account Manager 2. Do you provide Flexible Spending Accounts (FSA) Administration in-house? Yes X No 3. Explain how your organization will coordinate with managed care network(s). EMI proposes the continued use of the Dimension Health Network to support both the PPO and EPO plan options. Effective July 1, 2004, EMI will enhance the current Dimension Health Network component to include EMI's proprietary network inclusive of all Treasure Coast counties (Martin, St. Lucie, Indian River and Okeechobee). EMI is pleased to announce the addition of the Dimension "Plus" product, which allows for a minimum of an additional 15% discount off all in-network hospital charges at most Dimension contracted facilities. Further, to expand EMI's Network, we have contracted with all HCA facilities located throughout South Florida. It is EMI's intent to offer these two components (EMI Network & Dimension Health Network) as one fully integrated network proprietary to EMI members. For coverage required outside of the local network service area, network coverage will be accessed through Beechstreet, a national provider network. In addition; FMI will. coordinate any potential transplant cases; when needed; through a "Center of Excellence" network to obtain the most favorable pricing for these services. 48 4. Describe your organization's method of data exchange and controls used to insure accurate transfer of data from utilization review and medical case management firm. EMI has an in-house Utilization Review and Case Management department. Case notes are entered into the claims system and adjusters have real time access to medical notes, pre-certifications, authorizations and referrals. ~. Explain how your system identifies claims with medicai case management potential? Claims with medical case management potential are identified by the severity of the diagnosis. 6. Do you provide in-house Utilization Management Services? Yes X No 7. A.re you currently contracted as an approved TPA with Dimension Health Network? Yes X No 8. Do you require a specific bank? Yes_No X If yes, indicate bank name. 9. Will you allow the Client to perform an audit of your Administration? Yes X No 10. What is your turn around time for the last twelve months? 10 business days/14 calendar days 11. Do you accept electronic claims? Yes X No_. If so, what percentage is auto-adjudicated? 35% 12. Do you provide any of the following online access? a.) Eligibility verification? Yes X No_ b.) Claims Inquiry? Yes X No Claims not yet paid? Yes X No c.) Deductible/out of pocket accumulators? Yes X No_ d.) FSA balances and transactions? Yes X No_ e.) Qnline reports? Yes X No **See samples located in the Website section. 49 13. Provide the name and address of the organizations providing the following services: a. Provider Network(s) Medical Organization: EMI Contact: Sandra Shull Phone: (800) 431-2221 ext. 4441 Address: 700 Central Parkway, Stuart FL 34994 Organization: Dimension Health Contact: Chuck Lindgren Phone: (800) 483-4992 Address: Laurel Court, 15500 New Barn Road Ste 101 Miami Lakes FL 33104 b. ivledical Case Management Organization: EMI Contact: Kav Rishe Phone: (800) 431-2221 ext. 4474 Address: 700 Central Parkway, Stuart FL 34994 c. Utilization Review Organization: EMI Contact: Kav Rishe Phone: (800) 431-2221 ext. 4474 Address: 700 Central Parkway, Stuart FL 34994 d. Managed Drug and Mail Order Program Organization: Pharmacare/United Provider Services Contact: Keith Dunavant Phone: (800) 618-4877 Address: 700 Central Parkway,. Stuart FL 34994 • 50 • MANAGED CARE NETWORK 1. Explain how the Village employees will have access to network providers on a statewide basis? As explained in detail in the Services Information section question number 3, EMI will offer comprehensive network coverage through the integration of the EMI Proprietary Network and Dimension Health Network with Beechstreet as the national wrap-around. 2. Please provide a detailed explanation concerning your specific reasons for proposing the provider network listed. EMI has thoroughly researched available participating provider networks throughout South Florida, as well as the entire state of Florida. EMI has identified the Dimension Health Network and the EMI Proprietary Network as the most competitive network options available to self-funded employers in South Florida. The two fully integrated network components provide the most comprehensive coverage based on the total number of providers, as well as the most favorable fee schedules and discounted services. 3. Will claims be re-priced in-house by the Claims Administrator, or sent to the network for re-pricing? Repricing is handled in-house. 4. Is provider network information available on the Internet? Yes X No If Yes, indicate website address www.emi-tpa.com, www.dimensionhealth com www beechstreet com 5. Please indicate the participating hospitals located in Palm Beach County. Jupiter Medical Center Palm Beach Gardens Medical Center (;ocri C~mantan >`~Ied:Cal Center St. Mary's Hospital Wellington Regional Medical Center Columbia Hospital JFK Medical Center Glades General Hospital • Bethesda Memorial Hospital Delray Medical Center ~, J1 Boca Raton Community Hospital West Boca Medical Center • 6. Does your network provide coverage in Martin and St. Lucie County? Please explain: Yes, the network contains coverage throughout the Treasure Coast inclusive of Martin, St. Lucie, Indian River and Okeechobee counties. The hospitals available through the network in these counties are, Martin Memorial South, Martin Memorial North, St. Lucie Medical Center, Lawnwood Regional, Indian River Memorial and Okeechobee Raulerson Hospital. In this area, the network coverage includes all specialties with a total of 590 providers. 7. Attach a copy of your current provider directory for Palm Beach, Martin and St. Lucie Counties. See Participating Provider Network Section. • 52 • SAMPLING OF NEGOTIATED HOSPITAL PAYMENTS BY LOCAL uncprT e r .c Complete using the most current data available. Indicate if coverage is based on _ per diems and confirm the per diem amount and any outliers that may apply. Indicate if your allowance is based on DRGs. If based on a percentage of Medicare, indicate the percentage or percentile utilized. If based on a percentage of billed charges, please indicate and show the percentage allowed. SURGICAL SCENERIO: Cholecystectomy ICD-9-CM Diagnosis: 574.5 CPT-4 Code for Surgery: 47611 - Authorized Stay: 3 days EMI Participating Provider Network Hos ital Negotiated Fee EPO O tion Negotiated Fee PPO O tion Palm Beach Gardens Refer to Dimension Below Refer to Dimension Below St. Mary's Refer to Dimension Below Refer to Dimension Below Columbia Medical Center $5,600.00 $5,600.00 Martin Memorial Hos ital 50% Discount $35% Discount St. Lucie Medical Center $4,540.00 $5,075.00 Jupiter Medical Center Refer to Dimension Below Refer to Dimension Below Other (identif ) SAMPLING OF PPO PHYSICAN ALLOWABLES CPT Description Negotiated Fee EPO O tion Negotiated Fee PPO O tion 88305 Surgical Pathology Level IV $97.12 $97.12 70553 MRI -Brain $1126.92 $1126.92 71020 Chest X-Ray, 2 Views $36.66 $36.66 95004 Aller y Tests -Scratch $4.44 $4.44 53 • 78465 Myocardial Perfusion Ima in $552.02 $552.02 27447 Total Knee Re lacement $1549.11 $1549.11 17000 Descruction Skin Lesion $63.00 $63.00 29881 Knee Arthoscopy/Meniscus $623.21 $623.21 95117 Allergy Injections 2+ $20.10 $20.10 66984 Remove Cataract $687.35 $687.35 43239 ~ Upper GI Endoscopy, Bio s $345.87 $345.87 45378 Diagnostic Colonosco $40.08 $450.08 11100 Biopsy of Skin Lesion $78.87 $78.87 93000 Routine ECG $27.40 $27.40 80050 General Health Panel $14.77 $14.77 Dimension Health Network Hos ital Negotiated Fee EPO O tion Negotiated Fee PPO O tion Palm Beach Gardens $2,550.00 $2,550.00 St. Ma 's $2,850.00 $2,850.00 Columbia Medical Center Refer to EMI Above Refer to EMI Above Martin Memorial Hos ital Refer to EMI Above Refer to EMI Above St. Lucie Medical Center Refer to EMI Above Refer to EMI Above Jupiter Medical Center $3,051.00 $3,051.00 Other (identif SAMPLING OF PPO PHYSICAN ALLOWABLES CPT Description Negotiated Fee Negotiated Fee EPO O tion PPO O tion 88305 Surgical Pathology $80.00 $80.00 Level IV 70553 MRI -Brain $1351.36 $1351.36 54 l 71020 ~ Chest X-Ray, 2 Views $44.01 $44.01 95004 Allergy Tests -Scratch $5.28 $5.28 78465 Myocardial Perfusion Ima in $662.42 $662.42 27447 Total Knee Replacement $1,991.06 $1,991.06 ~ 17000 Descruction Skin Lesion $59.47 $59.47 29881 Knee Arthosco /Meniscus $753.83 $753.83 95117 ~ Ailergy injections 2+ $24.45 $24.45 66984 Remove Cataract $882.12 $882.12 43239 ~ Upper GI Endoscopy, Bio s $291.32 $291.32 45378 Diagnostic Colonosco $403.15 $403.15 11100 Biopsy of Skin Lesion $82.01 $82.01 93000 Routine ECG $35.38 $35.38 80050 I General Health Panel I $21.00 ~ $21.00 9. Indicate the costs/fees associated with your proposed prescription drug program: a. Discount percentage off the AWP for retail card Brand minus 14% Generic MAC Pricing b. Discount percentage off the AWP for mail order Brand minus 18% Generic minus 48% or MAC c. Dispensing fee per prescription Retail_Brand=$2.25, Retail Generic=$2.50, Mail Brand=$1.00, Mail Generic $1.00 d. Transaction/service fee per prescription $.59 e. Please describe pharmacy rebates, drug utilization reporting and other pharmacy services provided. Rebates are available to the plan. Numerous types of reporting are • available online or upon request. The available reports include but are not limited to drug utilization, top drugs dispensed, mail vs. retail utilization and claims summary. 55 r~ U • DEVIATIONS FROM MODEL PROGRAM EMI is recommending the following changes to the current PPO plan design. EMI feels that these changes would maximize steerage into the network and overall reduce claims experience. The stop loss terms are based upon the current plan design. If the Village is interested in pursing these changes, data will be sent to the stop loss carver for review. A reduction in claims will reduce the terms (factors and/or- rates) under the stop loss contract. In addition, in order to maximize the discounts under the Dimension "Plus" program, a 20% coinsurance differential must be in place between in and out of network services. PPO Current Coinsurance: In-Network 80% Out of Network 70% PPO Proposed Coinsurance: In-Network 80% Out of Network 60% Deductible: In-Network Single $200 In-Network Family $600 Out of Network Single $200 Out of Network Family $600 Deductible: In-Network Single $200 In-Network Family $600 Out of Network Single $400 °---- Out of Network Family $1200 56 STOP-LOSS INSURANCE PROPOSAL FORMS PROPOSER'S GENERAL INFORMATION Name of Insurer: Pacific Life Insurance Com~any FEIN/SS#: 95-1079000 (TINS Address: P O Box 2890 ~ Newport Beach, CA 92658-9010 Primary Contact: Rick Dawson ~Re~ional Sales Director) or Marianne Koenig (Stop Loss Sales Coordinator) Telephone Numbers Daytime/After Hours: Rick~800) 578-5666, Marianne (800L800-7661 x2124 Email: rdawson(~pacificlife.com Agent/Broker Firm: (if other than TPA) AgentBroker Account Representative: N/A Telephone Numbers Daytime/After Hours:N/A Email: N/A Fax: N/A • 58 • ~~ ~_~ MINIMUM QUALIFICATIONS Provide your current financial rating from each of the following firms. If not applicable, please indicate by "N/A." Rating Firm A.M. Best Moody's Standard & Poor's Weiss Ratings, Inc. Ratin A++ (Superior) Aa3 (Excellent.) Very Stron~l N/A GENERAL INFORMATION 1. When a specific cap is reached, indicate (check) when the Village will receive reimbursement: Monthly End of Calendar Year End of Contract/Plan Year Other (explain) Within 5 davs of receipt of a complete reimbursement request. 2. Does the specific stop-loss insurance cover all organ transplants included in their current coverage? Yes_ No~_ If No, please explain: Our Quote covers transplants as defined in the Plan Document. 3. Does the aggregate stop-loss insurance cover all organ transplants included in their current coverage? Yes_ No__ If No, please explain: Our Ouote covers transplants as defined in the Plan Document. 4. Does the aggregate stop-loss insurance have a maximum reimbursement limitation (cap)? Yes_ No_ If Yes, indicate that dollar limit: $1,000.000 5. Is an intermediary or MGU utilized in connection with this proposal? If so, please provide details including contact name, telephone numbers and address. N/A 59 PLAN COST INFORMATION 1. Are rates sub~ect to Chan eat final underwriting? Yes No_ J g If Yes, specify conditions: quoted Rates and Factors are subject to final Pacific Life Disclosure. 2. Please provide a complete copy of the underwriting contingencies. Refer to the Quotation Conti~encies page of the attached Quotation Proposal. SPE IFIC 4ND AGGREGATE STOP DOSS PRICING $50,000 Specific with $1,000,000 Aggregate: Benefits to be covered: Medical Only (no RX or Dental) Current Dual Option Plan Design (EPO/PPO) $50,000 Specific 24/12 Specific Stop-Loss Aggregate Stop-Loss Limit of Liability Per Covered Unit $1,950,000 $1,000,000 Reimbursement Factor 100% 100% Monthly Premium Per Covered Unit Covered Units Employee/Dependent Basis Employee 178 $64.52 Dependent 84 $68.72 Composite ~ $5.54 Monthly Aggregate Factor Covered Units Employee/Dependent Basis N/A N/A Composite $592.27 Monthly Transplant Rider Rate N/A Aggregate Advance Factor N/A Maximum Claims Liability N/A Expected Claims N/A. Are agent broker commissions included in your fees or rates? Yes ___No Please state the amount of commissions as a percentage of premiums. _10_% of Both (i.e., aggregate, specific or both). NOTE: Individual Lifetime Maximum is $2,000,000 60 iS ~ Uc, i'irii.: 1 r , ~E'L •OP LOSS QUOTATION PLAN SPONSOR: Village of North Palm Beach TPA: Employers Mutual, Inc. NATURE OF BUSINESS: Municipality PROPOSED EFFECTIVE DATE: July 1, 2004 PLAN LIFETIME MAXIMUM: $2,000,000.00 COMMISSIONS: 10.0% SPECIFIC STOP LOSS COVERAGES INCLUDE: - Medical ASSUMED LIVES EE: 176 DEP: 84 OPTION ~ - DEDUCTIBLE: $50,000 SPECIFIC STOP LOSS ACCUMULATION PERIOD: Incurred in 24/Paid in 12 MONTHLY RATES: EE $64.52 AGGREGATE STOP LOSS ACCUMULATION PERIOD: Incurred in 24/Paid in 12 AGGREGATE DED: 25% TEL t•.li_t : G49-c::l ~- =„P;.4 #~~ FJG~I S F'HGE : ~ -~ ~~ I~A~I FIB LII= ~ B.ANNll(TYCOMPANY Stop Loss Products Underwritten by Pacific Life Insurance Company STATE: FL SIC CODE: 9111 AGREEMENT PERIOD: July 1, 2004 through June 30, 2005 MONTHLY ACCOMMODATION: No AGGREGATE REIMBURSEMENT MAXIMUM: $1,000,000.00 AGGREGATE STOP LOSS COVERAGES INCLUDE: Medical ASSUMED LIVES EE: 176 DEP: 84 MONTHLY ANNUAL DEP :COST-.. COST $68.72 ,~" $17,128.00 $205,536.00 ~._- MONTHLY ATTACHMENT AGGREGATE ~ ~ ' f,~. C ~ FACTORS ANNUAL RATE MONTHLY ANNUAL ' ~ COMPOSITE DEDUCTIBLE COMPOSITE COST COST $592.27 $1,250.874.24 $5.54 $975.04 $11,700.4& OPTION Z - DEDUCTIBLE: $65,000 SPECIFIC STOP LOSS , ACCUMULATION PERIOD: Incurred in 24/Paid in 12 MONTHLY ANNUAL MONTHLY RATES: EE DEP COST COST $48.07 $53.52 $12.956.00 $155,472.00 AGGREGATE STOP LOSS ACCUMULATION PERIOD: Incured in 24/Paid in 12 AGGREGATE DED: 25% MONTHLY ATTACHMENT AGGREGATE FACTORS ANNUAL RATE MONTHLY ANNUAL COMPOSITE DEDUCTIBLE COMPOSITE COST COST $622.20 $1,314,276.48 $5.54 $975.04 $11,700.48 PLEASE SEE NEXT PAGE FOR MORE OPTIONS • 51 ~',: flr=, LIAR 1?, 2E1Er4 STOP LOSS QUOTAT{®N CONTINUE® TEL N0~ y49-E1~-_;8E4 #,~E1Erb4:~ F'AGE~ ~~~ PACIFIC LIFE 8~ ANNUITY COMPANY Stop Loss Products Underwritten by Pacific Life Insurance Company ~PTION 3 - DEDUCTIBLE: $75,000 SPECIFIC STOP LOSS ACCUMULATION PERIOD: Incurred in 24/Paid in 12 MONTHLY ANNUAL MONTHLY RATES: EE DEP COST COST $41.83 $46.59 $11,275.64 $135,307.68 AGGREGATE STOP LOSS ACCUMULATION PERIOD: Incurred in 24/Paid in 12 AGGREGATE DED: 25°rb MONTHLY ATTACHMENT AGGREGATE FACTORS ANNUAL RATE MONTHLY ANNUAL COMPOSITE DEDUCTIBLE COMPOSITE COST COST $633.16 $1.337,276.16 $5.54 $975.04 $11,700.48 PLEASE SEE NEST PAGE FOR ALL QUOTATION CONTINGENCIES • "~] a ~,r,-~- - ~~ _.~~- t.l;~c, .y- -i~nJq TEL I`IU~ `~+4'~+-E1'~-~rE4 #cJl~l64~ F'HGE~ 4;'~ QUOTATION CONTINGENCIES PACIFIC LIFE 8~ ANNUITY COMPANY Stop Loss Products Underwritten by Pacific Life Insurance Company • The rates, factors, and terms in this proposal are conditional upon receipt of the following: 1. a. Complete proposal will be presented to Plan Sponsor. b. The Pacific Life Disclosure Statement completed in full, signed by the Plan Sponsor, and submitted within the time frame noted on fhe form. c. Receipt of updated medical status, case management notes (if available), date of onset, treatment received, and current course of treatment, at the time of disclosure, for shock claimants #1, #3, #5, and #ti. d. Report of any claims in house (pended/held/preprocessed/etc.) but not yet paid as of the disclosure date. e. Receipt of updated aggregate experience through the end of May 2004 on carrier/TPA letterhead. Please provide the prior plan year aggregate on letterhead also. f. An explanation for the fluctuation in monthly paid claims. Why are the reported, gross paid claims for August 2003 so low and March 2003 a negative number'? g. Receipt of current and/or renewal Specific and Aggregate rates or premium. h. Verification of the current number of Fire/Police/Sheriff department enrollees. i. Receipt of prior plan year Schedule of Benefits. j. Receipt of current eligibility provisions as defined in the Plar. Document. 2. Managed Care Vendor(s): a. Dimensions Network b. Beechstreet 3. Utilization Review Vendor(s): a. EMI 4. TPA will advise Pacific Life Insurance Company of any material changes in the information used to develop the proposal that could impact quoted rates and/or attachment factors. 5. Coverage will not become effective until acceptance is confirmed in writing by Pacific Life. 6. Com~~ersion option available at a cost of $1.t7C per employee per month. Due to state requirements, the com~ersior, option is not available in Oregon. 7. This Stop Loss Quotation covers entity named above. No affiliates/subsidiaries or other related entities are covered. 8. Quote Assumes: a. The number of Fire/Police/Sheriff Department employees is less than 50% of the total enrollees. b. The current Plan of Benefits which includes retiree coverage. c. There is no coverage under the Plan for part-time, seasonal, temporary, contracted employees or independent agents. The quote also assumes there is no coverage for the Board of Directors, unless they meet the definition of a full-time employee. d. Lives on the effective date will not differ by more than 10% from the quoted lives, or we reserve the right to re-evaluate our offer. The minimum annual aggregate deductible will be calculated using the greater of lives quoted or the lives on the effective date. f. Overall group participation in the Employee Benefit Plan is at least 50%. g. HMO penetration does not exceed 50%. h. COBRA content does not exceed 5%. i. Employer is contributing at least 50% of the employee cost. j. A minimum of 75% of the covered lives are enrolled in a PPO. k. Aggregate Reimbursement Maximum: $1,000,000.00 If this prospec± does not meet these minimum assumptions, please contact us immediately. • ,. - ' lie CONFIDENTIALITY CLAUSE: The parties acknov/ledge that in preparing this proposal, either party may have access to and receive from the other party non puo personally identifiable financial and/or health information (NPI), as defined in federal and state taw. The parties agree to maintain fhe confidentiality of such NPi and shall not use, disclose, furnish or make accessible such NPI to anyone ether than authorized employees and agents of tha( party. 63 ~ = : i_~" I~tAF.' 17 . 2k~U4 TEL NCt ~ 94y-X15-~8E4 #~t7t~64~ PAGE ~ ~ -' • STOP LOSS PROPOSAL PLAN DOCUMENT STANDARDS All Pacific Life quotations assume that similar or more restrictive provisions will be in the PLAN DOCUMENT. Claim Submission: Provision stating written proof of claim must be submitted within 12 months of date of service or less. COBRA: Should be consistent with Federal notification requirements. Coordination of Benefits: Should identify any Plan with which the Plan Sponsor's Plan will coordinate and state the order of benefit determination. Definition of an Eligible Employee: Must be working in a full-time capacity for not less than 20 hours per week. Definition of ar. Eligible Dependent: Includes only legal spouse and unmarried children under age 19, extension for full-time students up to age 25. Definitions: Plan Document should at least clearly define: Medical Necessity, Total Disability, Usual & Customary, Physician, Nurse, Hospital, Open Enrollment, Actively-at-Work and Leave of Absence. Exclusions: Plan Document should, at a minimum, exclude charges related to the following: Work related Injuries/Illness; Act of War, Cosmetic Surgery, Government Provided Services, Experimental/Investigative Procedures, Excess of Usual & Customary, not Medically Necessary and not Legally Obligated to Pay. Extension of Eligibility Provision: Should state the maximum period of extended coverage for each cause, as an approved Leave of Absence or Medical Disability Leave. Late Enrollment: Should be consistent with Federal requirements. Mental Heaith Benefits: Should be consistent vvith Federal requirements. Third Party Recovery: Provision stating the Plan's right to recover monies payable when a third party liability is established. An acceptable Plan Document, with signature page and ERISA requirements where applicable, forms a part of the Stop Loss Agreement (SL-1 ). The exact wording for these minimum standards should be made by the Plan Sponsor; but the substance of the provisions must comply with the general description above. NOTE: As a matter of company policy, Pacific Life will not accept Plan Documents with AIDS limitations or restrictions. • 64 Carrier. Enrollment # Single # Family Specific Deductible Contract Basis 24/12 Specific Rates Single Family Annual Premium Aggregate Coverage Contract Basis 24/12 Aggregate Factors Single Family Aggregate Maximum Claims Annual Expected Claims Aggregate Rate (Composite) Annual Aggregate Premium Total Reinsurance Premium Total Premium & Claims Liability Conversion Annual Cost EMI Administration Fee Etvll/Dimensions Network Mana Total Annual Admin Fees Total Annual Fixed Costs Total Annual Maxiumum Costs Total Annual Expected Costs • Current Safeco Medical Only 92 64 $50,000.00 VILLAGE OF NORTH PALM JULY 1, 2004 RENEWAL Renewal Excess Risk RE Sun Life NBR Pacific Life RMTS Safeco OBE Moulton Medical Only Medical Only Medical Only Medical Only Medical Only Medical Only Medical Only 92 92 92 92 92 92 92 84 84 84 84 84 84 84 $50,000.00 $50,000.00 $50,000.00 $50,000.00 $50,000.00 $50,000.00 $50,000.00 PPO $66.88/EPO $56.85 PPO $87; 96/EPO $74.77 $69. 82 $114. 30 $138.17 $121.76 $64.52 80.47 PPO $151.43/EPO $128.72 PPO $199.17/EPO $169.30 $164. 42 $239. 19 $313.10 $307.90 $133.24 214.49 ,. ' '.w::tq,.^, ' _::x.._ ~ .. _ .~ $219,798.00 $289 086.96` $242,816. 64 $367,290. 72 $468,144.48 $444,786.24 % $205 536.00 ; $305,044.80 PPO $494.96/EPO $569.21 PPO $663.12/EPO $677.66 $536. 64 $414. 64 $658.70 $406.31 $592.27 $629.81 PPO $494.96/EPO $569.21 PPO $663.12/EPO $677.66 $536. 64 $867. 69 $658.70 $938.27 $592.27 $629.81 $1,075,649.52 $1,406,441.76 $1,133,383. 68 $1,332,394. 08 $1,391,174.40 $1,394,342.40 $1,250,874.24 $1,330,158.72 $860,519.62 $1,125,153.41 $906,706. 94 $1,065,915. 26 $1,112,939.52 $1,115,473.92 $1,000,699.39 $1,064,126.98 $13.53 $5. 97 $7. 15 $8.52 $7.58 y»~$s:5~1 2,000 Lump $28,575.36 28,575.36 $12,608 .64 $15,100. 80 $17,994.24 $16,008.96 $.11,700.48 ,! $12,000.00 $248,373.36 $317,662.32 $255,425 .28 $382,391. 52 $486,138.72 $460,795.20 $217,236.48 $317,044.80 $1,324,022.88 $1,724,104.08 $1,388,808 .96 $1,714,785. 60 $1,877,313.12 $1,855,137.60 $1,468,110.72 $1,647,203.52 $0.55 $0.50 $0 .75 $0. 75 $0.75 $0.75 ,_-$0:75-a< $0.75 $1,161.60 $1`,056.00 `: $1,584 .00 $1,584 .00 $1,584.00 $1,584.00 ~1,,584.Q0;°"" $1,584.00 $13.50 $14.00 $14 .00 $14 .00 $14.00 $14.00 $14.00 $14.00 $2.T5 $4.25 $4 .25 $4 .25 $4.25 $4.25 $4.25 $4.25 $34,320.C10 $38,544.00 $38,544 .00 $38,544 .00 .$38,544.00 $38,544.00 $38,544.00 $38,544.00 $283,854.96 $357,262.32 $295,553 .28 $422,519 .52 $526,266.72 $500,923.20 $257,364.48 $357,172.80 $1,359,504.48 $1,763,704_08 c ~$1,428,936 .96 $1,754,913 .60 $1,917,441.12 $1,895,265.60 $1,5 8.72" ~'~ $1,687,331.52 $1,144,374.58 $1,482,415.73 $1,202,260 .22 $1,488,434 .78 $1,639,206.24 $1,616,397.12 _-. ;~$1,258,063.87~ $1,421,299.78 .. _. ~., ,.~, VILLAGE OF NORTH PALM JULY 1, 2004 RENEWAL Carrier Safeco Excess Risk RE Sun Life NBR Pacific Life RMTS DBE Moulton Medical Only Medical Only Medical Only Medical Only Medical Only Medic:310n1y Medical Only Enrollment # Single 92 92 92 92 92 92 92 # Family 84 84 84 84 84 84 84 Specific Deductible $65,000.00 $65,000.00 $65,000.00 $65,000.00 $65,000.00 $65,000.00 $65,000.00 Contract Basis 24/12 Specific Rates Single PPO $68.86/EPO $58.53 $56.13 $89.17 $118.64 $103.70 $48.07 65.16 Family PPO $155.92/EPO $132.53 $135.19 $191.90 $273.86 $262.25 $101.59 173.56 Annual Premium $226,309.92 $198,239.04 $291,878.88 $407,029.44 $378,832.80 $15,472.00 $246,885.12 Aggregate Coverage Contract Basis 24/12 Aggregate Factors Single PPO $686.66/EPO $701.73 $557.75 $427.08 $685.38 $419.01 $622.29 645.56 Family PPO $686.66/EPO $701.73 $557.75 $893.72 $685.38 $967.59 $622.29 645.56 Aggregate Maximum Claims $1,456,374.48. $1,177,968.00 $1,372,366.08 $1,447,522.56 $1,437,917.76. $1,314,276.48 $1,363,422.72 Annual Expected Claims $1,165,099.58 $942,374.40 $1,097,892.86 $1,158,018.05 $1,150,334.21 $1,051,421.18 $1,090,738.18 Aggregate Rate (Composite) $15.83 $5.97 $7.15 $8.52 $7.58 $5.54 $13,500 Lump Sum Annual Aggregate Premium $33,432.96 $12,608.64 $15,100.80 $17,994.24 $16,008.96 $11,700.48 $13,500.00 Total Reinsurance Premium $259,742.88 $210,847.68 $306,979.68 $425,023.68 $394,841.76 $167,172.48 $260,385.12 Total Premium 8 Claims Liability $1,716,117.36 $1,388,815.68 $1,679,345.76 $1,872,546.24 $1,832,759.52 $1,481,448.96 $1,623,807.84 Conversion $0.50 $0.75 $0.75 $0.75 $0.75 $0.75 $0.75 Annual Cost $1,056.00 $1,584.00 $1,584.00 $1,584.00 $1,584.00 81,584.00 $1,584.00 EMI Administration Fee $14.00 $14.00 $14.00 $14.00 $14.00 $14.00 $14.00 EMI/Dimensions Network Management Fee $4.75 $4.75 $4.75 $4.75 . $4.75 $4.75 $4.75 Total Annual Admin Fees $39,600.00 $39,600.00 $39,600.00 $39,600.00 $39,600.00 $39,600.00 $39,600.00 Total Annual Fixed Costs $300,398.88 $252,031.68 $348,163.68 $466,207.68 $436,025.76 $208,356.48 $301,569.12 Total Annual Maxiumum Costs $1,756,773.36 $1,429,999.68 $'1,720,529.76 $1,913,730.24 $1,873,943.52 $1,522,632.96 $1,664,991.84 Total Annual Expected Costs $1,465,498.46 $1,194,406.08 $'1,446,05Ei.54 $1,624,225.73 $1,58E'i,359.97 $1,2.°i9,777.66 $1,392,307.30 • • Carrier Enrollment # Single # Family Specific Deductible Contract Basis 24112 Specific Rates Single Family Annual Premium Aggregate Coverage Contract Basis 24/12 Aggregate Factors Single Family Aggregate Maximum Claims Annual Expected Claims Aggregate Rate (Composite) Annual Aggregate Premium Total Reinsurance Premium Total Premium & Claims Liability Conversion Annual Cost .EMI Administration Fee EMI/Dimensions Network Management Fee Total Annual Admin Fees Total Annual Fixed Costs Total Annual Maxiumum Costs Total Annual Expected Costs 1 Safeco Medical Only 92 84 $75,000.00 PPO $59.06/EPO $50.20 PPO $133.72lEPO $113.66 $194,092.32 PPO $698.757EP0 $714.09 PPO $698.75lEPO $714.09 $1,482,018.72 $1,185,614.98 $17.18 $36,284.16 $230,376.48 $1,712, 395.20 $0.50 $1,056.00 $14.00 $4.25 $38,544.00 $269,976.48 $1,751,995.20 $1,455,591.46 VILLAGE OF NORTH PALM JULY 1, 2004 RENEWAL Excess Risk RE Sun Lite NBR Pacific Life OBE Moulton Medical Only Medical Only Medical Only Medical Only Medical Only 92 92 92 92 92 84 84 84 84 84 $75,000.00 $75,000.00 $75,000.00 $75,000.00 $75,000.00 $46.76 $77.75 $97.53 $78.95 $41.83 $114.41 $169.73 $237:73 $199.66 $88.42 $166,948.32 $256,923.84 $347,304.96 $288,418.08 $135,307.68 RMTS Medical Only 92 84 $75,000.00 $54.17 $144.16 $205,116.96 $572.57 $439.89 $711.42 $435.94 :5633.18 $658.47 $572.57 $920.53 $711.42 $1,006.68 $633.18 $658.47 $1,209,267.84 $1,413,532.80 $1,502,519.04 $1,496,011.20 $1,337,276.16 $1,390,688.64 $967,414.27 $1,130,826.24 $1,202,015.23 $1,196,808.96 $1,069,820.93 $1,112,550.91 $5.97 $7.15 $8.52 $7.58 $5.54 $15,000 Lump Sum $12,608.64 $15,100.80 $17,994.24 $16,008.96 $1'1,700.48 $15,000.00 $179,556.96 $272,024.64 $365,299.20 $304,427.04 $14',008.16 $220,116.96 $1,388,824.80 $1,685,557.44 $1,867,818.24 $1,800,438.24 $1,48~t,284.32 $1,610,805.60 $0.75 $0.75 $0.75 $0.75 $0.75 $0.75 $1,584.00 $1,584.00 $1,584.00 $1.584.00 $1,584.00 $1,584.00 $14.00 $14.00 $14.00 $14.00 $14.00 $14.00 $4.25 $4.25 $4.25 $4.25 $4.25 $4.25 $38,544.00 $38,544.00 $38,544.00 $38,544.00 $38,544.00 $38,544.00 $219,684.96 $312,152.64 $405,427.20 $344,555.04 $187,136.16 $260,244.96 $1,428,952.80 $1,725,685.44 $1,907,946.24 $1,840,566.24 $1,524,412.32 $1,650,933.60 $1,187,099.23 $1,442,978.88 $1,607,442.43 $1,541,364.00 $1,2`6,957.09 $1,372,795.87 t'~