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Home My WebLink AboutES05-336 - Amendment - Request - Standard Insurance Company - 2011-2012 Group Voluntary Life Insurance Contract - 10/01/2011 I $g l Records Ma-m-. 6gernentu., KENT FF Document W gSHINGTON CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: !$T- Dge� X4Lb A.RA*.- e, iy(f Vendor Number: 3-5�,� 7 zl JD Edwards Number Contract Number: t-SO5-- .93 �2 This is assigned by City Clerk's Office Project Name: Description: ❑ Interlocal Agreement ❑ Change Order Amendment ❑ Contract ❑ Other: --j-b C)NGptb4&� Vdi %i LLEnr, & 37R 4C7- Contract Effective Date: d -()I - I 1 Termination Date: 1A Contract Renewal Notice (Days): l`4 Number of days required notice for termination or renewal or amendment Contract Manager: Department: � � "ZeS Detail: (i.e. address, location, parcel number, tax id, etc.): Y S•Publ lc\PecordsManagement\Forms\ContractCover\adcc7832 1 11/08 1 k Request for Group Insurance Amendment Standard Insurance Company 900 SW Fifth Avenue Portland, OR 97204-1282 Employee Benefits Consultant: Garry Montag Employee Benefits Service Representative: Tiffany Reidinger Employee Benefits Sales and Service Office: Seattle Sales & Service Employer: City of Kent Group Number: 100394 I As an authorized representative ofthe Employer, I request that Standard Insurance Company ("The Standard')amend the above Employer's coverage under the Group Policy to make the following change(s) Remove EOI requirement for child coverage I request that the amendment become effective on October 1, 2011 1 understand that the amendment will not become effective unless approved and issued by The Standard. I request that the amendment be approved by The Standard subject to The Standard's &, usual underwriting requirements, including, if applicable, Evidence of Insurability or a Pre-existing Condition provision I understand that the amendment, if approved by The Standard, will be issued in the policy language customarily used by The Standard b A I understand that any increase in Insurance for a Member who is not Actively At Work all day on the Member's last regular work day before the scheduled effective date of the amendment will be deferred until the first day after the Member completes one full day of Active Work I request that the amendment, if approved and issued by The Standard, become effective by its terms without any further acceptance by the Employer, and that a copy of this Request for Group Insurance Amendment form be attached to and made a part of the amendment. r Sign Name: Title b11 GL X�W/U/J 'L'T7 tom' A thorized Representative f Print Name• y 4u_ V/f e l Date /d a 7—0 Standard Online Amendment Request 10/5/2011 3:40 PM Request for Group Insurance Amendment Standard Insurance Company 900 SW Fifth Avenue Portland, OR 97204-1282 Employee Benefits Consultant: Garry Montag Employee Benefits Service Representative: Tiffany Reidinger Employee Benefits Sales and Service Office: Seattle Sales & Service Employer: City of Kent Group Number: 100394 As an authorized representative ofthe Employer, I request that Standard Insurance Company ("The Standard")amend the above Employer's coverage under the Group Policy to make the following change(s) - Add family status language to contract I request that the amendment become effective on July 1, 2005. 1 understand that the amendment will not become effective unless approved and issued by The Standard. I request that the amendment be approved by The Standard subject to The Standard's usual underwriting requirements, including, if applicable, Evidence of Insurability or a Pre-existing Condition provision I understand that the amendment, if approved by The Standard, will be issued in the policy language customarily used by The Standard. I understand that any increase in Insurance for a Member who is not Actively At Work all day on the Member's last regular work day before the scheduled effective date of the amendment will be deferred until the first day after the Member completes one full day of Active Work I request that the amendment, if approved and issued by The Standard, become effective by its terms without any further acceptance by the Employer, and that a copy of this Request for Group Insurance Amendment form be attached to and made a part of the amendment Sign Name- Title- 1014XX_ 5+rG'I°` Au iorized'Reepksentative Print Name. 514Z V I f 4VA Date l d-a-7 Standard Online Amendment Request 10/5/2011 3:38 PM 1 r I TneStandard® I i Benefit and Cost Summary Proposal An Employee Benefits Proposal for: City of Kent ,i Presented By: E C r, R.L. Evans Company Inc. Standard Insurance Company i September 9, 2011 i ii Count on The Standard reputation Over the course of a century, Standard Insurance Company has earned a re p for personal service, financial strength and high quality Insurance products From our home office staff to the sales and service representatives in our local offices across the country, everyone at The Standard Is dedicated to helping you by providing creative and l effective solutions to meet your employee benefit needs l i Simple: Making it easy for you Whether you have two eligible employees or thousands, we put all our strengths to work to help you create a cost-effective benefits package—for you and for them. Find the benefits you want and need.We offer understandable, comprehensive products configured to meet your needs. You'll find a full range of disability, life, dental and vision Insurance, Individual and voluntary Insurance products, and retirement plans. Comprehensive contract pricing and no surprises. We strive to offer the best value, going beyond the formulas, using a long-term pricing philosophy. Dedicated contacts—no outsourced call centers. Our experienced employees deliver strong, empathetic and personalized service.We pride ourselves on our expert claims- handling, accurate, fair and prompt payments, and clear, accessible appeals process. Account support tailored for you.You'll enjoy customized administration, implementation and enrollment services And you'll benefit from Insightful reporting, Industry benchmarking and program recommendations. .I Local: Supporting you where you do business We have over 40 offices across the nation to serve our customers Our representatives I� are committed to their communities and have an Insider's understanding of local needs. � Dependable: A track record you can trust • More than 100 years of history and five decades of employee benefits experience More than 27,100 group insurance policies In force with over$1.8 billion In force premium' Recognized as a top 10 provider of group Long Term, Short Term Disability and Life insurance based on in force premlum2 Over 91%of our business is employee benefits, letting us focus on what our customers really need Our first group insurance customer is still with us—after 58 years a Figures are as of June 30,2009 and are based on internal data developed by Standard Insurance Company Reinsurance assumed is excluded Certain statistics are unaudited 2 2008 U S Group Disability Market Survey,JHA and U S Group Life Sales and In Force 2008 Annual Results, LIMRA International These findings used combined data for StanCorp Financial Group's insurance subsidiaries,Standard Insurance Company and The Standard Life Insurance Company of New York City of Kent 9 Additional Life Plan 1 Covered Members An elected Mayor currently in office or a regular full-time or part-time employee of the Employer working 21 hours per week A regular employee of the Employer working in a job share position working 20 hours per week Plan Benefit Formula Increments of$10,000 Maximum Benefit The lesser of$300,000 or 6 X Annual Earnings Minimum Benefit $10,000 To 65% at age 70; To 45% at age 75; Age Based Benefit To 30% at age 80, Reduction To 20%at age 85, To 15% at age 90; To 10% at age 95 Guarantee Issue $50,000 j Employer Contribution 0% d Cost Members Age Rate: Per$1,000 All Enrolled 25 <=29 0.086 23 30-34 0.091 41 35-39 0.119 67 40-44 0.194 43 45-49 0.340 47 50-54 0 524 31 55-59 0.897 20 60-64 1 070 4 65-69 2.056 1 0 70-74 3.701 0 75-79 5.545 " 0 80-99 10 246 Total • Volume and premium include Spouse Dependents Life. • The policyholder will be notified of renewal rates 60 days prior to the renewal effective date. i. Features • Waiver Of Premium is included: no termination at any age. Plan Notes Standard Insurance Company Benefit and Cost Summary Proposal 1195426 1 i� I 3 s City of Kent MEDEX®Travel Assist is included, offering plan participants access to appropriate medical care and t other emergency services when traveling at least 100 miles from home or internationally MEDEX Travel Assist offers a full range of professional 24-hour medical, legal and travel assistance services. • An Accelerated Benefit of up to 75%of Life and Supplemental Insurance is included • To assist you with your compliance obligations under Washington law, domestic partner language is available upon request. • Proof of good health is required for employees who are eligible under the current plan but are not enrolled. • Proof of good health is required for employees who enroll more than 31 days after eligibility. • Proof of good health is required for elective increases. s Conditions • Additional Life may be purchased only with Basic Life • This is not our customary age reduction schedule As an employer, you are responsible for determining that the schedule you have requested complies with the ADEA. We assume that you have made that determination. ;l T I� l I i i� Standard Insurance Company j Benefit and Cost Summary Proposal 1195426 2 City of Kent Spouse Dependents Life Plan 1 Covered Members An elected Mayor currently in office or a regular full-time or part-time employee of the Employer working 21 hours per week A regular employee of the Employer working in a lob share position working 20 hours per week Plan 6 Benefit Formula Increments of$10,000 Maximum Benefit $300,000 Minimum Benefit $10,000 ` o " To 65/o at age 70; � To 45% at age 75; " Age Based Benefit To 30% at age 80; Reduction To 20%at age 85, To 15% at age 90; To 10% at age 95 Guarantee Issue $10,000 Employer Contribution 0% • Spouse age based on Member's age. {, 1 Cost Monthly Members Age Rate: Per$1,000 X Volume = premium All Eligible <=29 0 086 30-34 0 091 35-39 0119 40-44 0194 45-49 0.340 50-54 0.524 55-59 0.897 60-64 1 070 65-69 2.056 70-74 3 701 75+ 5 545 80-99 10 246 Total • Volume and Premium under Additional Life. r • The policyholder will be notified of renewal rates 60 days prior to the renewal effective date. Features • Insurance continues without premium for 5 months after the death of the insured employee. f Standard Insurance Company Benefit and Cost Summary Proposal 1195426 3 s - l City of Kent Plan Notes 3 • The Right to Convert is included. „ Proof of good health is required for spouses who are eligible but not enrolled under the current plan. j • Proof of good health is required for spouses enrolling more than 31 days after eligibility • Proof of good health is required for elective increases. 1t • Waiver Of Premium and Accelerated Benefits are not included. Conditions I� • Member must be enrolled in AL to enroll in the Spouse Life plan. • Spouse Life can't exceed 100%of member's enrolled benefit for AL 13 1 I i f J� F II 4 I it .l 1� 1, i I i l i i 'I d { j i F Standard Insurance Company Benefit and Cost Summary Proposal 1195426 4 City of Kent i j Child Dependents Life Plan 1 Covered Members An elected Mayor currently in office or a regular full-time or part-time employee of the Employer working 21 hours per week A regular employee of the Employer working in a job share position working 20 hours per week I t Plan & Cost • Option 1 Flat$2,000 at$0 40 per Member • Option 2 Flat$5,000 at$1 00 per Member i • Option 3. Flat$10,000 at$2.00 per Member r, Features • Insurance continues without premium for 5 months after the death of the insured employee. j i Plan Notes • The Right to Convert is included. E Conditions • Member must be enrolled in AL to enroll in the Child Life plan. • Child Life can't exceed 100% of member's enrolled benefit for AL. • Dependents coverage includes unmarried children) from live birth through age 20, or through age 24 if the child is a full-time registered student. 1 fC I� Iw f (z j�I' Standard Insurance Company Benefit and Cost Summary Proposal 1195426 5 City of Kent Producer Compensation Disclosure We recognize the valuable role of Insurance advisors, consultants and brokers ("producers") in helping their clients design an employee benefits program, and we support reasonable and fair compensation for these services Producers may be eligible to receive compensation from The Standard Any questions regarding the compensation connected with this proposal should be directed to the producer. Please visit our website at www.standard.com/compensation/eb/to view our normal commission scales If this proposal is quoted with a non-standard scale or override it is noted below. An override if noted is compensation paid in addition to or in lieu of commissions Please consult with your producer for details. Non-standard commission scale: N/A Override N/A Unless participation is declined by the producer or client, contingent compensation is additional compensation that may also be paid and is contingent on the satisfaction of one or more minimum requirements, such as a specified amount of new premium volume or persistency in connection with the producer's block of business For information about our customary producer rewards program visit 13 www.standard.com/compensation/eb/ Some producers may have a contingent compensation arrangement that differs from our customary program Please consult with your producer for additional details Additionally, fees for administrative, marketing or consulting services may apply. If applicable, fees are noted below. Fees: N/A 3 I I I' Standard Insurance Company Benefit and Cost Summary Proposal 1195426 6 City of Kent f f 'o 3 � 6 I � I I We appreciate the opportunity to provide you with this benefit and cost summary proposal from The ; Standard This document outlines certain important features of the group insurance coverages available. This is not a contract or an offer to contract for such coverages Detailed information about other important features of the coverage proposed is available on request.Just ask your broker/consultant or Standard representative A completed application must be submitted before a group can be considered for coverage. Insurance will i be effective after the application is accepted by The Standard If approved, we will issue a contract containing our customary language It will not duplicate existing policy language, if any The group contract will contain provisions and defined terms not described in this Benefit and cost summary proposal The group contract will control if there are discrepancies between it and this proposal. E The proposed premium rate and plan design for each coverage are based on the underwriting data received by The Standard Final premium rates and plan provisions will be determined by The Standard on the basis of- applicable state laws, policyholder contributions. confirmation of occupations, the actual composition of the group of persons who will become insured, and our current underwriting rules and practices 1 , This benefit and cost summary proposal expires on December 8, 2011, unless replaced or withdrawn by j a The Standard. Standard Insurance Company Benefit and Cost Summary Proposal 1195426 7