CNA Continental Casualty CoContinental Casualty Company
CNA Plaza
Chicago, Illinois 60685
A Stock Company
AMENDMENT RIDER #1
FOIM
In consideration of the payment of the premium for the policy to which this rider is attached, it is hereby
understood and agreed that the Premium Rate as stated in Policy Provision DI-3AA, "How is Premium
Calculated?", is amended in part to read as follows:
HOW IS PREMIUM CALCULATED?
Premium is calculated by multiplying the total insured Monthly Earnings by *. Do not include Monthly Earnings
for any individual in excess of $8,333.33 per Month in the premium calculation.
Insured Employee's Attained Age as of the
latest of (1) Policy Effective Date, (2)
individual Effective Date, ~3) Most Recent
Birthday
Rate Applied to Monthly Eamings
24 or younger
25-29
30-34
35-39
40-44
45`49
50-54
55-59
60-64
65-69
7O or older
Accepted By:
Title:
Date:
,24%
.31%
.41%
.65%
.98%
1.45%
2.02%
2.75%
2.49%
1.52%
1.25%
In all other respects this policy shall remain the same.
This rider takes effect on November '1, 2000 12:01 A.M., Standard Time, at the address of the Holder; it expires
concurrently with the policy to which it is attached and is subject to all the definitions, conditions and provisions of the
policy not inconsistent herewith.
Attached to and made part of Policy No. SR-83q06383 to City of Carmel by the CONTINENTAL CASUALTY COMPANY,
General Office, Chicago Illinois, but the same shall not be binding upon the Company unless countersigned by its duly
authorized agent.
Chairman of the Board
SecretaF'~~'''''
Countersigned by
SRR-15288 Licensed Resident Agent
CITY OF CARMEL, 1NDIANA
by and through its Board of Public
Works and Safety
BY:
Date:
~alkcr, Mem(~'d~l'/'~'~rr
Date: ~/~
Diana Cordray Clerk-~
'
Human Resources
Memo
To= Board of Public Works and Safety
From: Barbara Lamb, Director of Human Resources
CC: Clerk-Treasurer Diana Cordray
Date: 10103100
Re: Long-Term Disability Premium Rates
I am submitting an amendment to the City's long-term disability (LTD) insurance policy as an add-on
item for the October 4 agenda.
We have reached the end of our initial two-year agreement with CNA, and, as expected, they are
adjusting our premium rates to reflect our claims experience and their increasing costs. The
amendment pertains to rates only; all other terms and conditions of the policy remain the same.
All employees enrolled in the plan will be individually notified of the new rates prior to the November 1
effective date. As this is an optional plan, employees may elect to continue their participation or not.
· Page 1