HomeMy WebLinkAboutCity of Tamarac Resolution R-96-271Temp. Reso. #7613 1
November 18, 1996
CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R-96- o?%/
A RESOLUTION OF THE CITY COMMISSION OF
THE CITY OF TAMARAC, FLORIDA, AUTHORIZING
THE APPROPRIATE CITY OFFICIALS TO
EXECUTE AN AGREEMENT BETWEEN THE CITY
OF TAMARAC AND THE PRUDENTIAL FOR
GROUP DENTAL SERVICES FOR CITY OF
TAMARAC EMPLOYEES; PROVIDING FOR
CONFLICTS; PROVIDING FOR SEVERABILITY;
AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, Resolution No. R-96-198 approved The Prudential as the new dental provider
for City of Tamarac employees; and
WHEREAS, the City of Tamarac desires to enter into an Agreement with The Prudential to
provide Group Dental services to the City of Tamarac employees; and
WHEREAS, the City Attorney and the Risk Manager have reviewed the Agreement (A copy
of the Agreement is attached as Exhibit "A"); and
WHEREAS, the City Commission of the City of Tamarac, Florida deems it to be in the best
interest of the citizens and residents of the City of Tamarac that the City execute an agreement with
The Prudential for Group Dental Services for employees of the City of Tamarac.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF
TAMARAC, FLORIDA:
SECTION 1: The foregoing '"WHEREAS" clauses are hereby ratified and confirmed
as being true and correct and is hereby made a specific part of this Resolution.
SECTION 2: The appropriate City officials are hereby authorized to execute the
Agreement between the City of Tamarac, Florida, and The Prudential, for Group Dental Services
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1
Temp. Reso. #7613 2
November 18, 1996
for City of Tamarac employees.
SECTION 3: That all necessary budget transfers are hereby approved in order to
fund the City's portion from those applicable accounts associated with the savings in the benefits
program as approved by Resolution No. R-96-227.
SECTIOIt 4: All resolutions or parts of resolutions in conflict herewith are hereby
repealed to the extent of such conflict.
SECTION 5: If any clause, section, other part or application of this Resolution is
held by any court of competent jurisdiction to be unconstitutional or invalid, in part or application,
it shall not affect the validity of the remaining portions or applications of this Resolution.
SECTION 6: This Resolution shall become effective immediately upon its passage
and adoption.
PASSED, ADOPTED AND APPROVED this
ATTEST:
CAROL A. EVANS
CITY CLERK
I HEREBY CERTIFY that I
have approved this
R LUTION as to form.
MITCHELL S. KRAFT
CITY ATTORNEY
(c:\wpdata\reso7613\sms)
7 day of1996.
C7,1-',
LARRY M SHKIN
VICE MAYOR
RECORD OF COMMISSION VO" -
MAYOR 4
DIST 1'
DIST 4
DIST 3:
DIST 4: Gd • HOF.
74940-10/18/96-001
0 Application to
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The Prudential Insurance Company of America (Prudential)
For Group Contract No. G-74940
Applicant: THE CITY OF TAMARAC
Address: 7525 North West 88th Avenue
Tamarac, Florida 33321
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 Prudential.
It is agreed that this Application replaces any prior Application for the Group Contract.
THE CITY OF TAMARAC
II or Corporate Name of Applicant)
Dated at F r L} Wy 1 K �. �---� _ _
OvLOie) 4�(Signature and Title)
On .erenD&C 1/ 19-9L _ Witness
(To be signed by Resident
Agent where required by law)
83500
APP 1008
his %.op5i ! a . �, -:emu a ,) Th Company
11
(74940)
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ThePrudential
Group Insurance Contract
Contract Holder: THE CITY OF TAMARAC
Group Contract No.: G-74940
Prudential will provide or pay the benefits described in the Group Insurance Certificate(s) listed in the
4D Schedule of Plans of the Group Contract, subject to the Group Contract's terms. This promise is
based on the Contract Holders application and payment of the required premiums.
All of the provisions of the Group Insurance Certificate(s), 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 it is duly attested under the Group Contract
Schedule. It continues as long as the required premiums are paid, unless it ends as described in its
General Rules. Dividends are apportioned each year.
The Group Contract is delivered in and is governed by the laws of the Governing Jurisdiction.
Ll
Secretary
�r
Chairman of the Board
83500
COV 1004
(1-5)(74940)
i Group Contract Schedule
Contract Date: October 1, 1996
Contract Anniversaries: October 1 of each year, beginning in 1997.
Premium Due Dates: The Contract Date, and the first day of the month beginning with November,
1996.
Governing Jurisdiction: State of Florida
Associated Companies: Employers who are the Contract Holder's subsidiaries or affiliates, and are
reported in writing to Prudential for inclusion under the Group Contract.
Minimum Participation Number: 25
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 in the Group Contract Schedule.
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 Contract. 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 a plan of benefits of the Group
Contract as Employees of another Included Employer. The plans of benefits for Covered Classes are
listed in the Group Contract's Schedule of Plans.
The Contract Holder must let Prudential know, in writing, when an employer listed as an Associated
Company is no longer one of its subsidiaries or affiliates under common control.
Table of Contents (as of the Contract Date): The Group Contract includes these forms with an
83500 prefix: COV 1004(1-5)(74940), GCS 1028(74940), SPR 1001(74940), GR 1019(1-28), MOD
1001(74940), SCH 1001(74940). APP 1008(74940)
Attest:
83500
GCS 1028
K
(74940)
•
Schedule of Premium Rates
Group Contract No.: G-74940
Classes of Employees to which this Schedule applies:
All classes
Applicable Coverages Monthly Rate Per Employee
All Coverages The premium rates in effect on the Contract Date are those
determined by Prudential. Those rates will be shown on the
billing notice(s) sent to the Contract Holder (subject to any
subsequent corrections).
83500
SPR 1001
1
(74940)
40 General Rules
A. PAYMENT OF PREMIUMS - GRACE PERIOD.
Premiums are to be paid by the Contract Holder to Prudential. Each may be paid at a Prudential
office or to one of its authorized agents. One is due on each Premium Due Date stated in the Group
Contract Schedule. 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.
The Contract Holder is liable to pay premiums to Prudential for the time the Group Contract is in force.
B. PREMIUM AMOUNTS.
The premium due on each Premium Due Date is the sum of the premium charges for the insurance
under the Coverages. Those charges are determined from the premium rates then in effect and the
Employees then insured.
The following will apply if one or more premiums paid include premium charges for an Employee
whose insurance has ended before the due date of that premium. Prudential will not have to refund
more than the amount of the premium charges for such Employee that were included in the premiums
paid for the two month period immediately before the date Prudential receives written notice from the
Contract Holder that the Employee's insurance has ended.
Premiums may be determined in another way. But it must produce about the same amounts and be
is agreed to by the Contract Holder and Prudential.
C. PREMIUM RATE CHANGES.
The premium rates in effect on the Contract Date are shown in the Group Contract's Schedule of
Premium Rates. Prudential has the right to change premium rates:
(1) As of any Premium Due Date, upon 45 days advance notice; and
(2) As of any date that an employer becomes, or ceases to be, an Included Employer; and
(3) For a Coverage, as of any date that the extent or nature of the risk under that Coverage is
changed: (a) by amendment of the Group Contract; or (b) by reason of any provision of law or
any governmental program or regulation; or (c) by termination of, or any change in, benefits not in
that Coverage but considered in determining the premium rates for that Coverage.
But, unless the Schedule of Premium Rates or an amendment states otherwise, (1) above will not be
used to change premium rates for an insurance or any part that has separate rates before the first
Contract Anniversary.
Prudential will tell the Contract Holder when a change in the premium rates is made.
83500
GR 1019 (1-28)
4
re - 6-12 _� I
•
D. DIVIDENDS.
Prudential will determine the share, if any, of its divisible surplus allocable to the Group Contract as of
each Contract Anniversary, if the Group Contract stays in force by the payment of all premiums to that
date. The share will be credited to the Group Contract as a dividend as of that date.
Each dividend will be paid to the Contract Holder in cash unless the Contract Holder asks that it be
applied toward the premium then due.
Prudential's sole liability as to any dividend is as set forth above.
Non-profit Clause: This applies if the aggregate dividends under the Group Contract and any other
group contract(s) of the Contract Holder exceed the aggregate payments toward their cost made from
the Employer's own funds. The Contract Holder will see that an amount equal to the excess is applied
for the benefit of insured persons.
E. END OF THE GROUP CONTRACT OR OF AN INSURANCE.
During or at End of Grace Period - Failure to Pay Premiums: If any premium is not paid by the
end of its grace period, the Group Contract will end when the grace period ends. The Contract Holder
may request in writing that the Group Contract be ended at the end of the period for which premiums
have been paid or at any time during the grace period. Then the Group Contract will end on the
requested date, but in no event will it end before the date Prudential receives the written request from
the Contract Holder. The Contract Holder is liable to pay premiums to. Prudential for the time the
Group Contract is in force.
On a Premium Due Date - Failure to Maintain Insuring Conditions: On any Premium Due Date,
Prudential may end the part of the Group Contract for Contributory or Nan -contributory Insurance
under a Coverage if one or more of the following conditions then exists for that part. But notice of its
intent to do so must be given to the Contract Holder at least 45 days in advance.
Contributory Insurance: The insured Employees are:
(1) less than the Minimum Participation Number; or
(2) less than 75% of the Employees who are eligible to request the insurance; or
(3) contributing at a rate higher than the maximum, if any, stated in the Group Contract for the
insurance.
Non-contributory Insurance: The insured Employees are:
(1) less than the Minimum Participation Number; or
(2) contributing for the insurance.
The Minimum Participation Number is shown in the Group Contract Schedule.
On a Contract Anniversary: Prudential may end the Group Contract on any Contract Anniversary.
But notice of its intent to do so must be given to the Contract Holder at least 45 days in advance.
83500
GR 1019
(1-28)
A
F. AGE ADJUSTMENT.
If an age is used to determine the premium charge for an Employee's insurance and the age is found
to be in error, the premium charge for that insurance will then be adjusted to reflect the correct age. If
this adjustment results in a change in the amount of premium, any difference between the premium
paid and the premium required on the basis of the correct age will be paid as follows:
(1) If the adjustment results in an increased premium, the difference will be paid by the Contract
Holder when notified by Prudential.
(2) If the adjustment results in a decreased premium, the difference will be refunded by Prudential.
If the change in age affects the amount of the Employee's insurance under any Coverage, such
amount will be changed on the basis of the correct age. Any premium adjustment will take this into
account.
G. EMPLOYEE'S CERTIFICATE.
Prudential will give the Contract Holder an individual certificate to give each insured Employee. It will
describe the Employee's coverage under the Group Contract. It will include (1) to whom Prudential
pays benefits, (2) any protection and rights when the insurance ends, and (3) claim rights and
requirements.
H. RECORDS - INFORMATION TO BE FURNISHED.
Either the Contract Holder or Prudential, as they agree, will keep a record of the insured Employees.
It will contain the key facts about their insurance.
At the times set by Prudential, the Contract Holder will send the data required by Prudential to perform
its 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 insurance must be open to Prudential for its inspection
at any reasonable time.
Prudential will not have to perform any duty that depends on such data before it is received in a form
that satisfies Prudential. The Contract Holder may correct wrong data given to Prudential, if
Prudential has not been harmed by acting on it. An Employee's insurance under a Coverage will not
be made invalid by failure of the Contract Holder or the Employer, due to clerical error, to record or
report the Employee for that insurance.
I. THE CONTRACT - INCONTESTABILITY OF THE CONTRACT.
The entire Group Contract consists of: (1) the Group Insurance Certificate(s) listed in the Schedule of
Plans, a copy of which is attached to the Group Contract; (2) all modifications and endorsements to
such Group Insurance Certificates which are attached to and made a part of the Group Contract by
amendment to the Group Contract; (3) the forms shown in the Table of Contents as of the Contract
Date; (4) the Contract Holder's application, a copy of which is attached to the Group Contract; (5) any
endorsements or amendments to the Group Contract; and (6) the individual applications, if any, of the
persons insured. No statement of the Contract Holder shall be used in any contest of the insurance
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.
83500
GR 1019
6
(1-28)
The Group Contract may be amended, at any time, without the consent of the insured Employees 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 Prudential. But an amendment will not affect a claim incurred
before the date of change.
Only an officer of Prudential 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 Prudential by a promise or representation or by information given or received. A Prudential
agent is not an officer.
No change in the Group Contract is valid unless shown in:
(1) an endorsement on it signed by an officer of Prudential; or
(2) an amendment to it signed by the Contract Holder and by an officer of Prudential.
But a change in the Group Contract may be made in an amendment to it that is signed only by an
officer of Prudential if:
(a) The amendment reflects a change in the Group Contract that has been automatically made to
satisfy the requirements of any state or federal law or regulation that applies to the Group
Contract, as provided in the Conformity With Law section. This change is known as a Statutory
Amendment.
(b) The amendment reflects a change in group insurance benefits where (i) the benefits are for
services and supplies provided through Prudential Health Care Providers; and (ii) the change
applies to all group insurance contracts which include these benefits. This change is known as a
Managed Health Care Amendment. When the Group Contract is so amended, payment by the
Contract Holder of the next premium due under the Group Contract will constitute acceptance of
the Managed Health Care Amendment.
(c) The amendment reflects a change in Prudential's administration of its group insurance benefits
and is intended to apply to all group insurance contracts which are affected by the change. This
change is known as a Portfolio Amendment. Prudential will give the Contract Holder written
notice of its intent to make a Portfolio Amendment in the Group Contract at least 31 days in
advance of the effective date of the Amendment. When the Group Contract is so amended,
payment by the Contract Holder of the next premium due under the Group Contract will constitute
acceptance of the Portfolio Amendment, unless the Contract Holder has rejected the
Amendment, in writing, prior to its effective date.
J. IDENTIFICATION CARDS.
Any identification cards (called ID Cards below) issued by Prudential in connection with insurance
under the health care expense coverages, if any, of the Group Contract are for identification only and
remain the property of Prudential. Possession of an ID Card does not convey any rights to benefits
under the Group Contract. If any Covered Person permits another person to use the Covered
Person's ID Card, Prudential may invalidate that Covered Person's ID Card.
K. RELATION AMONG PARTIES AFFECTED BY THE GROUP CONTRACT.
The relationship between Prudential and any Hospital is that of an independent contractor. No
Hospital is an agent or employee of Prudential, nor is Prudential or any employee of Prudential an
employee or agent of any Hospital. Each Hospital will maintain the hospital -patient relationship with
83500
GR 1019
(1-28)
7
I- �6_?-)i
•
Covered Persons under the Group Contract and is solely responsible to Covered Persons for Hospital
supplies and services.
The relationship between Prudential and any Prudential Health Care Provider is that of an
independent contractor. No Prudential Health Care Provider is an agent or employee of Prudential,
nor is Prudential or any employee of Prudential an employee or agent of a Prudential Health Care
Provider. Each Prudential 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 Person under the Group Contract is the agent or
representative of Prudential. Neither the Contract Holder nor any Covered Person under the Group
Contract will be liable for any acts or omissions: (a) of Prudential, its agent or employees; or (b) of
any Hospital or other health care provider with which Prudential, its agents or employees make
arrangements for furnishing supplies and services to Covered Persons.
L. CONFORMITY WITH LAW.
If the provisions of the Group Contract do not conform to the requirements of any state or federal law
or regulation that applies to the Group Contract, the Group Contract is automatically changed to
conform with Prudential's interpretation of the requirements of that law or regulation.
83500
GR 1019 (1-28)
8
�e_9(-ter--1
i
•
Modification of the Group Contract
The Group Contract is modified to include the following section:
END OF EMPLOYMENT
An Employee's employment ends when the Employee is no longer actively at work on a full-time basis
for the Employer. But, for insurance purposes, the Contract Holder may consider the Employee as
still employed and in the Covered Classes for the insurance during certain types of absences from full-
time work. The Contract Holder decides which Employees with those types of absences are to be
considered as still employed, and for how long. In doing this, the Contract Holder must not
discriminate among persons in like situations.
An Employee may be considered as still employed up to any time limit for the Employee's type of
absence. When so considered, the Employee's insurance under a Coverage will be continued only
while the Employee is paying contributions for it at the time and in the amounts, if any, required by the
Contract Holder (whether or not that insurance would otherwise be Non-contributory Insurance). But it
will not be continued after it would end for a reason other than end of employment. The types of
absences and the time limits are shown below, subject to any exceptions.
TYPES OF ABSENCES AND TIME LIMITS:
For absence due to part-time employment or retirement, there is no time limit.
For absence due to disability:
Under health care expense Coverages, if any, the time limit is the end of the 29th contract month
following the contract month in which the absence from full-time work starts.
Under any other Coverages there is no time limit.
For absence due to temporary layoff the time limit is the end of the contract month following the
contract month in which the absence from full-time work starts.
For absence due to leave of absence, there is no time limit.
L�:t•14;ktral 114
Dental Expense Coverage
Retirement is not an eligible type of absence.
83500
MOD 1001
(74940)
�CC-'12-7I
6 Schedule of Plans
Effective Date: October 1, 1996
Group Contract No.: G-74940
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 Group Insurance Certificates that apply to the Covered Class; and (2) any
modification to those Certificates, provided the modification is listed below or included in an
amendment to the Group Contract. A copy of each Certificate and any modification to it are attached
to the Group Contract and made a part of it.
Covered Class:
All Employees included in the Covered Classes of the Group Insurance Certificate described
below.
Plan of Benefits that Applies to this Covered Class:
The Coverage(s) described in the Group Insurance Certificate:
(a) Prepared for Group Contract No. G-74940;
(b) With the Program Date of October 1, 1996;
• (c) Bearing the codes "FL-PPDMO; Code 1" and 74940; Ed. 10/96; Doc. #1LTO0001; Rev. #1 "
•
83500
SCH 1001 (74940)
10
'`) I 74940-10/18/96-001
•
C�
Ll
Application to
The Prudential Insurance Company of America (Prudential)
For Group Contract No. G-74940
Applicant: THE CITY OF TAMARAC
Address: 7525 North West 88th Avenue
Tamarac, Florida 33321
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 Prudential.
It is agreed that this Application replaces any prior Application for the Group Contract.
Dated at
THE CITY OF TAMARAC
(Full or Corporate Name of Applicant)
By
(Signature and Title)
On , 19 Witness
(To be signed by Resident
Agent where required by law)
83500
APP 1008
This COPY i R faro&& For Your Files
11
(74940)
74940-10/18/96-001
•
•
0
Application to
The Prudential Insurance Company of America (Prudential)
For Group Contract No. G-74940
Applicant: THE CITY OF TAMARAC
Address: 7525 North West 88th Avenue
Tamarac, Florida 33321
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 Prudential.
It is agreed that this Application replaces any prior Application for the Group Contract.
Dated at
On
83500
APP 1008
THE CITY OF TAMARAC
(Full or Corporate Name of Applicant)
By
(Signature and Title)
19 Witness
(To be signed by Resident
Agent where required by law)
This copy 7 h_ :�� -: E Company
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11
(74940)