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HomeMy WebLinkAboutBenefit Administrative/HR/Excess Loss Insurance SCHEDULE OF EXCESS LOSS INSURANCE (Hereinafter referred to as "the Schedule") POLICYHOLDER: City of Carmel ADDRESS: One Civic Square, Carmel, IN 46032 ADMINISTRATOR: Benefit Administrative Systems, LLC ADDRESS: 17475 Jovanna Drive Suite 1 B, Homewood, IL 60430 ALL AMOUNTS AND NUMBERS SHOWN IN THIS SCHEDULE APPLY ONLY TO THE POLICY YEAR IN EFFECT. A NEW SCHEDULE WILL BE ISSUED FOR EACH NEW POLICY YEAR. A. [X] AGGREGATE EXCESS LOSS INSURANCE: 1. BENEFITS COVERED: X Medical _ Dental Weekly Income Vision X _ Prescription Drug Card Other: 2. BENEFIT PERIOD: Eligible Expenses Incurred from 01/01/2012 through 12/31/2013; and Eligible Expenses Paid from 01/01/2013 through 12/31/2013. If this Policy terminates prior to the Expiration Date, no Aggregate Excess Loss Benefits will be payable and premium paid will not be refundable. 3. MINIMUM AGGREGATE ATTACHMENT POINT: $12,919.865 4. AGGREGATE LOSS LIMIT(per Covered Person): $150,000 5. AGGREGATE BENEFIT PERCENTAGE: 100%, however, eligible expenses incurred by the Employer for retirees age 65 and older will be reimbursed under the Policy as secondary to Medicare. 6. MAXIMUM AGGREGATE BENEFIT (WHILE COVERED, AND WHILE THIS POLICY IS IN FORCE): $1,000,000 7. RUN-IN/RUN-OUT LIMIT: $N/A 8. MONTHLY AGGREGATE FACTOR(S)/ENROLLMENT: FACTORS: COVERED UNITS/ENROLLMENT: Single: $837.24 Single: 153 Family: $2,200.83 Family: 431 Composite:$N/A Composite: 584 9. AGGREGATE PREMIUM ([N/A] Annual/X Per Employee Per Month): $8.70 10. MINIMUM AGGREGATE PREMIUM ([N/A] Annual /[N/A] Monthly): $N/A 11. PREMIUM PAYMENT MODE: Monthly SL2004 i 12-17-12 B. [X] SPECIFIC/INDIVIDUAL EXCESS LOSS INSURANCE: 1. BENEFITS COVERED: X Medical X Prescription Drug Card 2. BENEFIT PERIOD: Eligible Expenses Incurred from 01/01/2012 through 12/31/2013; and Eligible Expenses Paid from 01/01/2013 throughl2/31/2013. If this Policy terminates prior to the Expiration Date, the Benefit Period will not extend past the date of termination. In addition, the deductible per Covered Person will apply as if the Policy were in force for the entire Policy Year. 3. DEDUCTIBLE(PER COVERED PERSON): $150,000 Except for the following: a. N/A : $ N/A 4. SPECIFIC BENEFIT PERCENTAGE: 100%, however, eligible expenses incurred by the Employer for retirees age 65 and older will be reimbursed under the Policy as secondary to Medicare. 5. SPECIFIC BENEFIT LIMIT (PER LIFETIME, PER COVERED PERSON) WHILE THIS POLICY IS IN FORCE: No Lifetime Maximum. 6. RUN-IN/RUN-OUT LIMIT: a N/A : $ N/A 7. MONTHLY SPECIFIC PREMIUM RATE/ENROLLMENT: RATE: COVERED UNITS/ENROLLMENT: Single: $43.85 Single: 153 Family: $119.89 Family: 431 Composite: $N/A Composite: 584 8. MINIMUM SPECIFIC PREMIUM ([N/A] Annual /[N/A] Monthly): N/A SL2004 ii 12-17-12 • [X] WAIVER OF ACTIVELY AT WORK ELECTED [X] ADVANCED FUNDING ELECTED [X] RETIREE EXPENSES INCLUDED Limited to: Refer to Paragraph A, item 5 and Paragraph B, item 4 of Schedule of Excess Loss. OPTIONAL RIDERS ELECTED: [N/A] Aggregating Specific Rider [N/A] Monthly Cumulative Accommodation For Aggregate Excess Loss Rider [N/A] Aggregate Excess Loss Terminal Liability Rider [N/A] Specific Excess Loss Terminal Liability Rider NOTES: Sagamore and PHCS is the PPO(s) network of choice. LCM & UR will be handled by Medical Cost Mangement. AGREED: City of Carmel Policyholder/You Signature: Sr Sr` *k..-•/ Name (please print): Title: Date: • SL2004 iii 12-17-12 CITY OF CARMEL, INDIANA By and through its Board of Public Works and Safety Jame Brainard, Pres'I'ng Officer Date ���� Mary n Burke, Board Member Date 0-/&�� 3 Lori Wa .•n, Board Member Date ATTEST: Diana Cordray('I • MC, Clerk-Treasurer Date 1