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HomeMy WebLinkAboutContract 47336 c ,. Stop Loss Insurance Renewal Offer V®ya Employee Benefits Prepared for: City of Fort Worth Effective Date January 1, 2016 Policy Number 68412-1 Excess Risk Insurance is issued by ReliaStar Life Insurance Company, a member of the Voya® family of companies. Rr—TI tEMEN`r I INVESTMr:NTS I INSURANCE I�m���f fry��p�EA ���� rro�� ���� 11/17/2015 Renewal offer presented to: City of Fort Worth c/o Arthur J. Gallagher & Co. 221 W. 6th Street, Suite 1980 Austin, TX 78701 Renewal effective date 01/01/2016 Policy number 68412-1 Dear Justin, Thank you for your continued business with Voya Employee Benefits. We are pleased to offer the enclosed renewal for the above client and effective date. Voya Employee Benefits, a division of ReliaStar Life Insurance Company, is dedicated to providing innovative products, competitive pricing and exceptional customer service. Our broad product portfolio is designed to meet a wide range of employer and employee needs. Our client services model puts local sales and account managers at the forefront of the customer service experience. If we can assist with any additional products, please contact me at your earliest convenience. We welcome the opportunity to renew this business with you. Thank you again for your continued business with Voya Employee Benefits. Sincerely, Clifton Browning CC: Jessica Ayala Executive Regional Manager Account Executive RPTIREMENT i 1NVr-.STMr-NTS i INSURAwc a VNANCtAL rj� Stop Loss Insurance Renewal Offer City of Fort Worth 684121 Estimated Annual Cost Stop Loss Insurance Coverages Individual Excess Risk Insurance Current Renewal Plan Effective Date 01/01/2015 01/01/2016 Coverages Medical, RX Medical, RX Individual Deductible $1,000,000 $1,000,000 Policy Year Maximum Unlimited Unlimited Paid in 12 months and Paid in 12 months and Contract Period incurred January 1, 2014 incurred January 1, 2014 or after or after Benefit Percentage 100% 100% Quoted rates include commissions of 0.00% 0.00% Enroll Counts Rates Composite 6,997 $4.57 $4.35 Estimated Annual Cost $383,715 $365,243 Change From Current _5% If not preliminary, please check acceptance box: RF-TIEEMENT I INVESTMENTS I INSURANCE �U � FINANCIAL r Assumptions: Renewal As-Of Date: 11/17/2015 Renewal Offer Good Through: 12/21/2015 Situs State TX Claim Administrator UHC Network UHC Choice Plus Retirees Covered Yes Yes Are retirees age 65 and over covered? Yes Yes Waived Actively-at-Work Yes Yes Endorsements: Plan Mirroring Coordination The individual stop loss renewal is based upon the current leveraged trend factors, market conditions, plan designs and current demographic factors. The aggregate renewal is based upon the experience of the group and current trend. Any plan changes may affect this renewal and need to be disclosed prior to the renewal acceptance. Authiz,ecOSignature Date City g Susan Alanis � C Assistant Ci Manager Print Name ; Title "p a �® "" �" ® 4 C � 1 a w mmy T yd APPROVED AS TO FORM AND LEGALITY: City of Fort Worth EEM�.0 REQUIRED 68412-1 " 01/01/2016 AT Excess Risk Insurance is underwritten by ReliaStar Life Insurance Company. Policy form RL-SL-POL-2013 (may vary by state). CITY sEc REVARY J {J o"`°"Ir ) x AM R ETIREMPNT I INVESTMrNTS I INSURANCE N�CI',a AL