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03-50 Resolution No. 03-50 RESOLUTION ACCEPTING THE PROPOSAL OF UNICARE HMO FOR RENEWAL OF THE CITY OF ELGIN' S HMO MEDICAL INSURANCE PROGRAM AND AUTHORIZING THE EXECUTION OF DOCUMENTS RELATED THERETO BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF ELGIN, ILLINOIS, that the City of Elgin hereby accepts the proposal of Unicare HMO for the renewal of the City of Elgin' s HMO medical insurance program for the period of March 1 , 2003 through February 29, 2004 . BE IT FURTHER RESOLVED that Olufemi Folarin, Interim City Manager, be and is hereby authorized and directed to execute all documents necessary and incident to such proposal of Unicare HMO. s/ Ed Schock Ed Schack, Mayor Presented: February 26, 2003 Adopted: February 26, 2003 Omnibus Vote : Yeas : 6 Nays : 0 Attest : s/ Dolonna Mecum Dolonna Mecum, City Clerk Hrrl o UNICARE HEALTH PLANS OF THE MIDWEST, INC. Group Health Care Contract Contract Holder: City of Elgin Group Contract No.: GG-C27368 Contract Date: March 1,2003 Premium Due Dates: The Contract Date, and the first day of each month beginning with April 2003. Associated Companies: None UNICARE Health Plans of the Midwest,Inc.will arrange or provide the benefits described in Part I of the Certificate of Group Health Care Coverage, attached to and made a part of the Group Contract, subject to the Group Contract's terms. This promise is based on the Contract Holder's application and payment of the required premiums. All the provisions of the Certificate of Group Health Care Coverage, attached to and made a part of the Group Contract,apply to the Group Contract as if fully set forth in the Group Contract. The Group Contract takes effect on the Contract Date,if the initial premium has been paid and the Group Contract is duly attested below. It continues as long as the required premiums are paid,unless it ends as described in its General Rules. The Group Contract is delivered in and is governed by the laws of the State of Illinois. Secretary President 1000 COV 1001 C27368 1 • TABLE OF CONTENTS GENERAL RULES A. PARTIES 3 B. DEFINITIONS 3 C. INCLUDED EMPLOYERS 3 D. PAYMENT OF PREMIUMS-GRACE PERIOD 3 E. PREMIUM AMOUNTS 4 F. PREMIUM RATE CHANGES 4 G. MINIMUM CONTRIBUTION 4 H. MINIMUM PARTICIPATION 5 I. END OF THE GROUP CONTRACT 5 J. REINSTATEMENT 5 K. EMPLOYEE'S CERTIFICATE OR OTHER EVIDENCE OF COVERAGE 6 L. INFORMATION TO BE FURNISHED 6 M. THE CONTRACT-INCONTESTABILITY OF THE CONTRACT 7 N. NOTICES AND OTHER INFORMATION 7 O. RELATION AMONG PARTIES AFFECTED BY THE GROUP CONTRACT 8 P. CONFORMITY WITH LAW 8 SCHEDULE OF PREMIUM RATES 9 SCHEDULE OF COPAYMENTS 9 SCHEDULE OF PLANS 10 APPLICATION FOR GROUP HEALTH CARE COVERAGE 11 CERTIFICATES OF GROUP HEALTH CARE COVERAGE 1000 CTC 1100 2 General Rules A. PARTIES This Group Contract of Health Care Coverage("Group Contract")is entered into between the Contract Holder and UNICARE Health Plans of the Midwest,Inc. ("UNICARE®"),an Illinois corporation which is a separately incorporated and capitalized company owned by UNICARE Illinois Services, Inc., an Illinois corporation. Both are separately formed and capitalized subsidiaries of Wellpoint Health Networks Inc., a Delaware corporation, and are part of the Wellpoint Health Networks Inc. family of companies. ®is a Registered Mark of Wellpoint Health Networks Inc. B. DEFINITIONS The terms used in the Group Contract have the meanings set forth in the Group Contract and in the Certificate of Group Health Care Coverage(or other evidence of Coverage), attached to and made a part of the Group Contract. C. INCLUDED EMPLOYERS Included Employers under the Group Contract are the Contract Holder and its Associated Companies,if any. Associated Companies are employers who are the Contract Holder's subsidiaries or affiliates and are listed on the first page of the Group Contract. An Employee of more than one Included Employer will be considered an Employee of only one of those employers for the purpose of the Group Health Care Coverage. That Employee's service with all other Included Employers will be treated as service with that one. On any date when an employer ceases to be an Included Employer,the Group Contract will be considered to end for Employees of that employer. This applies to all of those Employees except those who,on the next day,are still within the Covered Classes of the Group Contract as Employees of another Included Employer. The Contract Holder must let UNICARE know, in writing, when an employer listed as an Associated Company is no longer one of its subsidiaries or affiliates. D. PAYMENT OF PREMIUMS- GRACE PERIOD . Premiums are to be paid by the Contract Holder to UNICARE. Premium is due on each Premium Due Date stated on the first page of the Group Contract. The Contract Holder may pay each premium other than the first within 31 days of the Premium Due Date without being charged interest. Those days are known as the grace period. There is no grace period for payment of the first premium. The Contract Holder is liable to pay premiums to UNICARE for the time the Group Contract is in force. Premiums unpaid after the end of the grace period are subject to a late payment interest charge at an annual rate determined by UNICARE. In no event will that interest rate exceed the maximum allowed by law. Only a Covered Person for whom the premium is actually received by UNICARE shall be entitled to the benefits of this Group Contract and only for the month for which such payment is received. UNICARE may decide to accept a premium payment after 31 days grace period from the due date. Any such acceptance does not constitute a waiver of any terms of this Group Contract or the Certificate of Group Health Care Coverage made a part of the Group Contract. 1000 GR 1100 3 • E. PREMIUM AMOUNTS The premium due on each Premium Due Date is the sum of the premium charges for the coverage then provided. Those charges are determined from the premium rates then in effect and the Employees then covered. The following will apply if one or more premiums paid include premium charges for an Employee whose coverage has ended before the due date of that premium. Changes in the employee roster of Covered Persons may be submitted by Contract Holder no more than 60 days after the effective date of such changes. No such change shall be made retroactively regarding the termination of a Covered Person if benefits have been provided to the Covered Person during that period. F. PREMIUM RATE CHANGES The premium rates in effect on the Contract Date are shown in the Group Contract's Schedule of Premium Rates. UNICARE has the right to change premium rates effective as of any of these dates: 1. Any Premium Due Date. However,except for a premium rate change resulting from the events described in Paragraphs 2. or 3.below,a premium rate change under this Paragraph 1.will not take effect until the Group Contract has been in force for one year from the Contract Date. 2. Any date that an employer becomes,or ceases to be,an Included Employer. 3. Any date that the extent or nature of the risk under the Group Health Care Coverage is changed: a. by amendment of the Group Contract or Certificate of Group Health Care Coverage; or b. by reason of any provision of law or any governmental program or regulation,or c. by reason of a change in the demographic composition of the group. UNICARE will tell the Contract Holder when a change in the premium rates is made. UNICARE will provide notice of any such change in the premium rate to the Contract Holder not less than 31 days prior to the effective date of such revision. UNICARE may not make a change in premium rates which results in a Covered Person paying more than another similarly situated Covered Person of Contract Holder on the basis of any health-related factor. G. MINIMUM CONTRIBUTION The minimum contribution to be made by an Employer with regard to premiums due for its Covered Persons is 50%. 1000 GR 1100 4 H. MINIMUM PARTICIPATION The minimum participation of Eligible Employees required to be enrolled as subscribers either in UNICARE under this Group Contract or in any product offered by UNICARE Health Insurance Company of the Midwest to Contract Holder is 75%. In the event that the minimum participation as set forth above falls below 75%,UNICARE may terminate this Group Contract upon 60 days prior written notice. I. END OF THE GROUP CONTRACT 1. The Group Contract may be terminated by UNICARE in the event of any of the following: A.. Failure by Contract Holder to pay premiums by the end of the grace period; B. An act or practice committed by Contract Holder that constitutes fraud, or a fraudulent omission or fraudulent misrepresentation in any materials required by UNICARE to be submitted under the Group Contract,with such fraud resulting in the rescission of coverage for the group or the individual committing the fraud at the option of UNICARE; C. Failure by Contract Holder to comply with participation and contribution requirements as set forth herein; D. Movement of Covered Persons outside the service area of UNICARE such that participation requirements are no longer met; E. Discontinuance by UNICARE of group health insurance coverage,with 90 days prior notice required to be provided to the Contract Holder; and F. Discontinuance of all health insurance coverage in the applicable group market by UNICARE. (2) On a premium due date,by the Contract Holder upon prior written notice delivered to UNICARE no fewer than 60 days prior to the termination date. In the event Contract Holder gives UNICARE fewer than 60 days prior written notice,the termination will become effective in UNICARE's sole discretion on a date agreed to by UNICARE upon payment by Contract Holder of all premiums required by UNICARE and/or this Group Contract. J. REINSTATEMENT A Group Contract which has been terminated for failure to pay premiums may be reinstated at the sole discretion of UNICARE. A Contract Holder whose Group Contract is reinstated by UNICARE under this provision shall be charged a$250.00 fee payable to UNICARE. A Contract Holder which is a small group as defined in the Illinois Health Insurance Portability and Accountability Act("Act")shall have a guaranteed availability of subsequent coverage upon provision of all requested information and subject to the provisions of the Act. 1000 GR 1100 5 K. EMPLOYEE'S CERTIFICATE OF GROUP HEALTH CARE COVERAGE OR OTHER EVIDENCE OF COVERAGE UNICARE will give the Contract Holder an individual certificate(or other evidence of coverage)to give each covered Employee. It will describe the Employee's coverage. Such individual certificate will be issued within 30 days from the later of(a)the effective date of the coverage or(b)the date UNICARE is provided completed notification of enrollment. Contract Holder hereby delegates to UNICARE the broadest possible discretion to interpret the terms of the Certificate of Group Health Care Coverage and the individual certificates given to each covered Employee and to decide whether benefits are payable thereunder. L. INFORMATION TO BE FURNISHED UNICARE will keep a record of the Covered Persons. It will contain the key facts about their coverage. The Contract Holder will provide UNICARE with all requested information,including but not limited to medical information,prior to and after the execution of the Group Contract. Further, at the times set by UNICARE,the Contract Holder will send the data required by UNICARE to perform their duties under the Group Contract,and to determine the premium rates. All records of the Contract Holder and of the Employer which bear on the Group Health Care Coverage shall be open to UNICARE for its inspection at any reasonable time. UNICARE will not have to perform any duty that depends on such data before it is received in a form that satisfies UNICARE. The Contract Holder may correct wrong data given to UNICARE,if UNICARE has not been harmed by acting on it. A person's coverage under the Group Health Care Coverage will not be made invalid by failure of the Contract Holder or the Employer,due to clerical error,to record or report the person for the coverage. The Contract Holder will furnish UNICARE the employee and dependents eligibility requirements of the Employer's Health Benefits Plan that apply on the Contract Date of the Group Contract. Subject to UNICARE's approval,those requirements will apply to the Employee and Dependents Coverage under the Group Health Care Coverage. The Contract Holder will notify UNICARE of any change in the eligibility requirements of the Employer's Health Benefits Plan,but no such change will apply to the Employee or Dependents Coverage under the Group Health Care Coverage unless approved in advance by UNICARE. The Contract Holder will notify UNICARE of any event,including a change in eligibility,that causes termination of a Covered Person's coverage. Such notification will be made within 60 days of the effective date of the event. The liability of UNICARE to arrange or provide benefits for a person ceases when the person's coverage ends. If the Contract Holder fails to notify UNICARE as provided above,UNICARE will be entitled to reimbursement from the Contract Holder of the reasonable cash value of any benefits arranged or provided to any person after the person's coverage has ended. 1000 GR 1100 6 M. THE CONTRACT-INCONTESTABILITY OF THE CONTRACT The entire contract consists of: the pages that make up the Group Contract; the Certificates of Group Health Care Coverage(or other evidence of coverage)that are attached to and made a part of the Group Contract; the Contract Holder's application,a copy of which is attached to and made part of the Group Contract; any riders,endorsements or amendments to the Group Contract and Certificate of Group Health Care Coverage; and the individual applications,if any,of the persons covered. No statement of the Contract Holder will be used in any contest of the Coverage under the Group Contract. There will be no contest of the validity of the Group Contract,except for not paying premiums,after it has been in force for one year. The Group Contract may be amended,at any time,without the consent of the Covered Persons or of anyone else with a beneficial interest in it. This can be done through written request made by the Contract Holder and agreed to by UNICARE. UNICARE may also make amendments to the Group Contract,as provided in 2. and 3.below. UNICARE has the discretion contractually to modify the Group Contract at any time. Any such modification must be mutually agreed to by UNICARE and the Contract Holder. An amendment will not affect benefits for a service or supply furnished before the date of change. Only an officer of UNICARE has authority: to waive any conditions or restrictions of the Group Contract; or to extend the time in which a premium may be paid; or to make or change a contract; or to bind UNICARE by a promise or representation or by information given or received. No change in the Group Contract is valid unless the change is shown in one of the following ways: 1. It is shown in an endorsement on it signed by an officer of UNICARE. 2. In the case of a change in the Group Contract that has been automatically made to satisfy the requirements of any state or federal law that applies to the Group Contract,as provided in the Conformity with Law section,it is shown in an amendment to it that is signed by an officer of UNICARE. 3. In the case of a change required by UNICARE,it is shown in an amendment to it that: a. is signed by an officer of UNICARE; and b. is accepted by the Contract Holder as evidenced by payment of a premium becoming due under the Group Contract on or after the effective date of such change. 4. In the case of a written request by the Contract Holder for a change,it is shown in an amendment to it signed by the Contract Holder and by an officer of UNICARE. N. NOTICES AND OTHER INFORMATION Any notices,documents,or other information under the Group Contract may be sent by United States Mail, postage prepaid,addressed as follows: If to UNICARE: To its address shown on the first page of the Certificate of Group Health Care Coverage (or in any other evidence of coverage). If to a Covered Person: To the last address provided by the Covered Person on an enrollment or change of address form actually delivered to UNICARE. 1000 GR 1100 7 If to the Contract Holder: To the last address of the Contract Holder on record with UNICARE. O. RELATION AMONG PARTIES AFFECTED BY THE GROUP CONTRACT The relationship between UNICARE and any Hospital is that of an independent contractor. No Hospital is an agent or employee of UNICARE,nor is UNICARE or any employee of UNICARE any employee or agent of any Hospital. Each Hospital will maintain the hospital-patient relationship with Covered Persons under the Group Contract and is solely responsible to Covered Persons for Hospital supplies and services. The relationship between UNICARE and any Participating Health Care Providers is that of an independent contractor. No Participating Health Care Provider is an agent or employee of UNICARE,nor is UNICARE or any employee of UNICARE an employee or agent of a Participating Health Care Provider. Each Participating Health Care Provider will maintain the provider-patient relationship with the Covered Persons under the Group Contract and is solely responsible to Covered Persons for supplies and services furnished to Covered Persons. Neither the Contract Holder nor any Covered Persons under the Group Contract is the agent or representative of UNICARE. Neither the Contract Holder nor any Covered Person under the Group Contract will be liable for any acts or omissions: (a)of UNICARE, its agents or employees; or(b)of any Hospital or other health care provider with which UNICARE,its agents or employees make arrangements for furnishing supplies and services to Covered Persons. Employer has delegated to UNICARE the broadest possible discretion to interpret the terms of the Certificate of Group Health Care Coverage and to determine which benefits under the terms of the Certificate the Employee and his/her eligible dependents are entitled to receive. P. CONFORMITY WITH LAW If the provisions of the Group Contract do not conform to the requirements of any state or federal law that applies to the Group Contract,the Group Contract is automatically changed to conform with UNICARE's interpretation of the requirements of that law or regulation consistent with the Illinois Department of Insurance. 1000 GR 1100 8 SCHEDULE OF PREMIUM RATES GG-C27368 Classes of Employees to which this Schedule applies: All classes Monthly Rate Per Employee UNICARE HEALTH PLANS OF THE MIDWEST,INC. Single Family Group Health Care Coverage $208.47 $573.29 The rates shown above for Employee Coverage will no longer apply to an Employee's Employee Coverage when the Employee is or could be covered under Medicare and Federal law does not require that Medicare take other group health care benefits into account when determining Medicare's benefits. Also,the rates shown above for Dependents Coverage will no longer apply to an Employee's Dependents Coverage when the Employee has a Qualified Dependent spouse who is or could be covered under Medicare and Federal law does not require that Medicare take other group health care benefits into account when determining Medicare's benefits. SCHEDULE OF COPAYMENTS Classes of Employees to which this Schedule applies All classes Certain Eligible Services and Supplies are subject to a Copayment. Copayments are the sole responsibility of the Covered Person. Copayments and the services and supplies to which they apply are described below. 1. Emergency Room Visits-Subject to Emergency Room Visit Copayments: $25.00 Eligible Supplies and non-professional Services furnished by a Hospital for medical care during a visit to the Hospital's emergency room are subject to an Emergency Room Visit Copayment that must be paid for each visit. 2. Certain Physician's Outpatient Visits for Mental,Psychoneurotic and Personality Disorders: $20.00 Eligible Services and Supplies furnished by a Physician for medical care of a person's mental, psychoneurotic and personality disorders(other than during a Hospital Inpatient Stay, in connection with convulsive therapy or during a visit to a Hospital's emergency room) are subject to an Outpatient Mental,Psychoneurotic and Personality Disorders Copayment that must be paid for each visit. If treatment is rendered on a group basis, this copayment will not apply. 3. Prescription Drugs—Subject to Prescription Drug Copayment Each Prescription Unit of Eligible Prescription Drugs listed in the Fomulary is subject to a Copayment of $5.00 for a preferred Generic Drug and a Copayment of $10.00 for a preferred Brand Name Drug. Each Prescription Unit of Eligible Prescription Drugs not listed in the Formulary is subject to a non-preferred Prescription Drug Copayment of $25.00, or the cost of the Eligible Prescription Drug,whichever is less. 1000 SCP 1100 C27368 9 SCHEDULE OF PLANS Effective Date: March 1,2003 Group Contract No.: GG-C27368 This Schedule of Plans sets forth the Plan of Benefits that applies to each Covered Class under the Group Contract listed below as of the Effective Date. The Plan of Benefits for a Covered Class is determined by: 1.the Certificates of Group Health Care Coverage(or other evidence of Coverage)that apply to the Covered Class, and 2. any modification to those Certificates,provided the modification is included in an amendment to the Group Contract. A copy of each Certificate(or other evidence of coverage)and any modification to it is attached to the Group Contract and made a part of it. Covered Class: As designated by the Employer and subject to UNICARE approval. Plan of Benefits that Applies to this Covered Class: The benefits described in the UNICARE Certificate of Group Health Care Coverage as forms in the UNICARE Member Certificate bearing the code HMO Cert UHP0005280. And includes the following forms: Rider Nos.41, 58,211,218, 342, 373, 381,400,20207. 1000 SCP 1100 C27368 10 Application to UNICARE HEALTH PLANS OF THE MIDWEST,INC. For Group Contract No. GG-C27368 Applicant: City of Elgin Address: 150 Dexter Court,Elgin,IL 60120 The Group Contract is approved and its terms are accepted. This Application is made in duplicate. One is attached to the Group Contract. The other is to be returned to UNICARE. It is agreed that this Application replaces any prior Application for the Group Contract. CITY OF ELGIN f� ark or Corporate Name of Applicant) `, Dated at �" 4-t By ark _ N • Jk1r' Z • Signa l e and Tit e) On 3/400.3 Witness I 4 . • (To be signed by Resident Agent where required by law) THIS COPY IS TO BE RETURNED TO UNICARE HEALTH PLANS OF THE MIDWEST,INC. 1000 APP 1100 C27368 12 ,,,{ O F„. a yy., \�� Agenda Item No. . , City of Elgin rob, , „ E tii February 7, 2003 L . 0 "' 1 ! G ;,, TO: Mayor and Members of t he City Council I ti FROM: Olufemi Folarin, Interim City Manager FINANCIALLY STABLE CITYGOVERNMENT EFFICIENT SERVICES. AND QUALITY INFRASTRUCTURE SUBJECT: Stop Loss Insurance/Life Insurance Carrier PURPOSE The purpose of this memorandum is to provide the Mayor and members of the City Council with information to consider approval of Trust Mark Insurance Company as the Stop Loss provider and Jefferson Pilot Insurance Company as the Life Insurance provider for the City of Elgin. BACKGROUND rThe City currently utilizes the services of Mutual of Omaha Insurance to . provide Stop Loss coverage on the medical PPO plan and Life Insurance coverage for varied employee groups . Our contract with Mutual of Omaha expires 2/28/03 and, in keeping with past practice, Mutual of Omaha has informed the City what the proposed 2003 rates would be. A comparison of their quotes follows: 2002 2003 % Increase Specific $46 . 13 $80 . 73 75% Aggregate 3 . 07 5 . 03 63% Life Insurance $0 . 17/0 . 04 $0 .20/0 . 04 17%/0% After reviewing Mutual of Omaha' s quotes, we shopped the insurance market and found a much better Stop Loss rate with Trust Mark and a no-increase Life Insurance rate with Jefferson Pilot Insurance Company. Their respective quotes are as follows : Trust Mark Jefferson Pilot Specific $55. 36 Life 0 . 17 eft'. _Aggregate 4 . 47 AD-D 0 . 04 r Stop Loss Insurance/Life Insurance Carrier February 7, 2003 Page 2 Of all the quotes we received, Trust Mark and Jefferson Pilot were the most cost effective. Additionally, our HMO health plan has increased our 2003 rates by 10% and we have elected to remain with UNICARE HMO as their rates are in line with other HMO companies . The reasons for the rate increases are due to the fact that we incurred $3, 900, 000 in PPO/Drug claims in 2002 and our Stop-Loss premium payments have been $284, 788 over the last 11 months. Additionally, we have had seven (7) medical claims which have each exceeded $100, 000, which is the cut-in point for our Stop- Loss coverage. COMMUNITY GROUPS/INTERESTED PERSONS CONTACTED None. OLFINANCIAL IMPACT The expected annual premium for Stop Loss coverage from Trust Mark will total $383 , 391 . The expected annual premium for Life/AD-D coverage will total $51, 304 .72 . The expected annual claims for the HMO plan is $1, 396, 000 . There is a total of $1, 873, 500 budgeted in account numbers 635-0000-796. 50-01 ($384, 000) , 635-0000-796. 50-02 ($70, 000) , 630-0000-796 . 50-04 ($1, 419, 500) . Sufficient monies are available to fund these proposed contracts \INVLEGAL IMPACT None. ALTERNATIVES 1 . Approve the contract for services with Trust Mark and Jefferson Pilot . 2 . Reject the contract and stay with Mutual of Omaha. few Stop Loss Insurance/Life Insurance Carrier February 7, 2003 Page 3 RECOMMENDATION It is recommended that the City Council approve the contracts for Stop Loss and Life/AD-D Insurance with Trust Mark and Jefferson Pilot respectively and the HMO contract with UNICARE. Respectfully submitted, fltb aft, Olu -, i Pola 'n Inte i anager NAO/mh iork CITY OF ELGIN Life Competitive Bidding for Contract Year. 3-1-03 to 3-1-04 Volume: 20,361,136 M.O.H. * M.O.H. Carrier: Current Renewal A.U.L. Jeff. Pilot _ Prudential , HiMark MetLife Benefits: All benefits proposed are identic 1 to the current 'chedule Rate: _ Life $ 0.17 $ 0.20 $ 0.18 $ 0.17 $ 0.19 **No Quote **No Quote AD&D $ 0.04 $ 0.04 $ 0.04 $ 0.04 $ 0.04 Total: Life 3,461.39 4,072.23 3,665.00 3,461.3 3868.62 _ AD&D 814.00 814.00' 814.0 814.0 814.00 Monthly Combined: $ 4,275.39 $ 4,886.23 $ 4,479.00 $ 4,275.39 $ 4,682.62 Annual Combined: $ 51,304.72 $ 58,634.73 $ 53,748.05 $ 51,304.72 $ 56,191.39 *Two year rate guarantee **No quote due to high population of Police and Fire e�\ Vt -"") -r) ) - ; ° CITY OF ELGIN STOP LOSS RENEWAL ANALYSIS For Contract Year)=1-03 to 3-1-04 . F Census 534 Employees Mutual Mutual Ulico Carrier of Omaha of Omaha Trustmark lnion Labor Canada Monumental AIG Current Renewal Life Life AUL Hartford Life Life Specific Deductible $100,000 _ Monthly Specific Rate Composite $46.13 $80.73 $55.36 $59.52 $104.84 $73.45 $76.47 $96.96 $88.68 Monthly Aggregate Rate Composite $3.07 $5.03 $4.47 $5.43 $2.14 $3.48 $5.15 $3.27 $3.85 Combined Annual Premium $315,274 $549,549 $383,391 $416,199 $685,528 $492,967 $523,021 $642,274 $592,932 Attachment Point ' $4,667,179 $5,100,038 $4,987,185 5,054,190 $4,981,110 $5,394,839 $4,785,606-$4,887,225 $5,972,795 • $125,000 Monthly Specific Rate Composite 61.94 $38.47 $45.18 $84.55 $58.53 $63.50 $53.46 $68.54 Monthly Aggregate Rate Composite $5.03 $4.47 $5.43 $2.41 $3.48 $6.08 $4.09 $3.97 Combined Annual Premium $429,143 $275,160 $324,309 $557,240 $397,360 $445,869 $368,780 $464,644 ' Attachment Point $5,100,038 $4,987,185 $5,141,958 $5,383,818 $5,498,964 $4,863,125 $5,413,344 $6,182,238 " $150,000 Monthly Specific Rate Composite $49.83 $20.54 $36.57 $55.38 $46.73 $43.60 $32.00 $47.03 Monthly Aggregate Rate Composite $5.03 $4.47 $5.43 $2.41 $3.48 $7.02 $4.91 $4.10 Combined Annual Premium $351,542 $160,264 269,136 $370,318 $321,746 $324,373 $236,519 $327,641 Attachment Point $5,380,829 $5,290,916 5,194,018 $6,164,585 $5,572,990 $4,981,877 $5,742,497 $6,386,596 i AM Best Rating A A A+ A- A+ A+ A A+ A++ Contract Basis 36/12 48/12 15/12 15/12 15/12 15/12 15/12 15/12 15/12 , No Quotes: Sun Life Financial Safeco . National Risk Transfer