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HomeMy WebLinkAbout96-12 Resolution No. 96-12 RESOLUTION AUTHORIZING EXECUTION OF AN AGREEMENT WITH HMO ILLINOIS BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF ELGIN, ILLINOIS, that Richard B. Helwig, City Manager, and Dolonna Mecum, City Clerk, be and are hereby authorized and directed to execute an agreement on behalf of the City of Elgin with HMO Illinois for an employee health insurance program, a copy of which is attached hereto and made a part hereof by reference. s/ John Walters John Walters, Mayor Pro Tem Presented: January 24, 1996 Adopted: January 24 , 1996 Vote: Yeas 5 Nays 0 Attest: s/ Dolonna Mecum Dolonna Mecum, City Clerk „ _ . . 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"...'1 ,i.fra:.ti.=4-......*& z,z--i.i,..46-::.,,,ps„..,-:,,,, 4., ,---r,- --;., - ''.--i•-•' ..'-.t•=''''',, :"7-'k ,.,'". : i . . : ....4, ' : 't.:::: -'''..;:, ''' ,7.:'-.1-'"4.-.4:-.nc_-:- c",;:: :'• The u .`='*•-: ., =. person represents that he is authorized and responsible for purchasing coverage on behalf of . ,.. . . •.._-;,-i---. .,,..,•-,.,9.4., a :::' ti l! .. ;,;. the:,..,. :i.;. requested in this BE9efitprogrir Applice4jonp3PA),cincl c,n be 9100_0,.. ,,:,:- .:::''.4-.---:.,7k:••--,:-4,;;4 rilby .-:•,--,•..s.--.--:'-f---_-..,-...,,9 ::4 '..iji tliki',..ifi:,.;.",;, the ':: : - '.,:I.,,: •, adoutlined in the Proposal dottMtTrit Su- itted to the GrO -, the = =::`, ..'"-'':;.- .:• --:,t, shallat 1-.:',,,;•,8;",',.?:: :‘,_ -: --:-.; ?ii•-i:;,0-4: -4; - .''-'"-•-•,.-. f6-"-"' are specified below'jelewEdirariod the•ractual iiii.''--*'= ka-------,-.-- ,--,-.- ,z-,-. ::---:4,.,--.s'7. -IT'-Iticitiii..'. 0 -':-. tfie droop Polityliito whicfrthist3Pk be incorporied= '. .z... "='••4•;:i.:44,1-4'-.:"._-:_t. • . •z = ..t; iat., a acceptance byl-lealth Care Service Corporation,a Mutual''''''Reserve Corn pan y.KCSelln-.44_,.,'---- I:4 4',..„.'',•-4..----'-eve iii-. 1lCf 6eiiiiltit:ilieffil'OPOSit an' d the Group PolicY,thelikkfirOpS Of ttia kiliCY shalt Prevait'lt lift,- . :' •A`--,-(-,.-'-"--*-1`?-!.:`::_l',:t--- " -74•17,71... * ,..,k ",''. 471:'':',.1: Lnde -,..447,,this .; :--..' to acCeptinCe by HCSC. Upon k,..HCSC stidi iieiie,4ilitIO 'IbItilii4r,'"'••2`4.•':';-'4%=:-, r!''-.4:-i, '-''''G-.'''''';':-.i ilfi':r■:: '.-grieirT.'f :-. tiereby`'iiblirimMedgealtiat the Employee-Of -inalit-Iriikitivit eoiiiity—Mortt#4,--'-,- ::14'tt: • ,.' -- :: as am:. a z. -1SA)1 z•-••a=; z.- certain requirements for employee welfare 6enefit plans.As defined in Section 3 a.04-•-r,,.-4Y-' ,.,..--, '' '-''''-'-' -' EAra •'-'-'- r- . 4------ -" berisAt plan" dude:5 pl ---' iiO4-"----- -;thit-blaiestabliailitlit ,.,,* .- . . : :,),, ern e in any an program c m= - ,,- ----. •.:4,, -:,.. lfki. :6..,..: X',..t. z ,e:yer or by =j Otago organization,or by bcith,to' e e ,--: that:dual plan fund&prOgtani- :4t.It' v.i.;-.,-,-......-';';:_-•-•:-- vs,.. f. .4;::•i•-, . . . 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'-'75',',..:.,.4:-...Z''' "'Salee- ; :*----".-7'7:'' '.,:ie.; .,*.'414.-',-/.', ■"' -' -10-f '..,...•-b4.-4--,, , ''.:44'...4-,:-.,..-• ,rff. -, -• . or Authorized Purdiseersi-V4,V%----',-;:'',Iiirc-,''• I- : 41, r71745-:"--F-1'',1"J'RI-. -.-Zr ' '..- ...'n n' .."n .••,lz,7, ,:- 4.,- -•.%, c..----t,:-49.,,,,,--,,---...,,r-,..4.4.-Z-V--,-,-,- '•,,‘,54.k:,-27.,,":‘, 88.k:••:......---•:••.:-.:;-:- ' 708-586-07 , -.•..;!it,-;+f-4.6"--lk,f.-0,•-. -..:•• -r•f-'•13'...-,,z57;1-.=;: -i• City 14anagetc:, Tlde._. ,-: ;"-:. kf'21.- ?,....-.,.:.f.',',.. 44 t ,.i.... :,...t..`""..".."., .N.a.-Z"'Vt= ':,44,",•;',"..,:,t.. R 0 ber • c fdtke & Associates -• -.---,.• - r, •' : - • ,-:;.•••• fix-4.fcrk;-:•*.-- 1•:'.. •-'•-.;"... . ,-.§-_---,*- ,-,:z7:k- '•••,-- • .,.,.-J,.;',v -- - .s -,,,,4„,... Producer Repreeentalte4rAirtr..:.,r, ,r.,..%,;;:f.,,..k-A;;: ,..,-..2,•,•-4,.:-,, ,..,,,,,.. . Dem ,_,,..:,:,-,,,.-.,,..,-... ,:-1._ r.. ..„, -.-.;„4,-.,-,---.„-, • -._ ,,,,,,,-:-',„, . . , :-.'-' 1750 Old a f Day Roac1;,-:,:,':', .-.- -'' Gt., /7\r/-c-- 14- i' .c- 'ClaLi. . • .. Producer FIrrekl,V.11- - '': 1.: -'-a' Witness : ..,-! '- ..!-?-'-17,1;1,4..-•f_.1. in col nshi re, It 600694,4,-,•,--- •.•-•;• , , . , -.. •„... . $ Producer •• ,,,,--;.'%,*--,,x,,,, :-.;,,,,,,,,..v., , .: „ ,, , '4-. --r:4-7-f. '...-.vttt .4,71?-:-%:,'. ;,'..'""t,"' . '`"V,.0,,,,.0.". , .•,.._... .',, , ' •. • '• ,' '.' Teucl.D.,N0:;,,,,,,-iC,---, „ • ' " - !••' ,Solo,3 2-14 - - .., ,.., r:..,:......i..,...r. ,_ .-•--'.. .*--.._-• --. 2.;',4.,;,.,.,o.:.i':;.., , . Underwriting ,Only 1 • '' ' - : :: , - , ...:1,,,•.,,i! - • • , -.,._•,:. ' Date BPA approved by Underwriting ,„ 2-4' "-,..„ ;.. . ,,. . -, , Signature of Underwriter approving - • -,-'-&;-.5-,4-.:-- - -• • s•••*. .a...'-,-.1-,.•,-:. ..-• . - ., • . . . „ • -: _ Certificate Booklets. ‘'• ''' . 0 Individual Mail .• -, ‘ ..'„itk,r4; , - - . • . . . , 0 Ship to: z,. , .• . Attn: No.: Mail Policy to: 0 Group 0 District GA-16-1.1 HCSC Page 3