266297 WF11TE - CITY CLERK '+
PINK - FINANCE GITY OF SAINT PALTL Council �6 �9r�
CANARY - DEPARTMENT
E�_U E �-k`"��O R File N O.
� � �' o nci esolution
Presented By
Referred To Committee: Date
Out of Committee By Date
WF��,.S, The Legislature of the State of Minnesota passed a law
under Chapter Number 338 durin� the 1973 session which in part, requires the
City to seek bids for insurance coverages if the insurance eo�pany seeks an
increase in rate of 20� or more, and
WF�REAS, The Blue Cross-Blue �hield of Minnesota and Minnesota
Ind�nnity Incorporated, have indicated that their renewal rates for 1976
reflects an increase of approximately 31'� and
WHE�iEAS, a study was �ade to determine what provisions shonld be
incladed in the insurance specifications to make them attractive enough to
invite many bids for the covera�es without reducing any of the benefits, and
W�REAS, The Health and Welfare Insurance Advisory Com�ittee
approved the specifications attached hereto and made a part hereof now,
therefore be it
RESOI,�ED, that the Couneil of the City of Saint Paul hereby
a�thorize and direct William A. Peter, Purchasing Agent of the �ity oP Saint
- �Pett�3. to reqt�est bids for Hospital snd Medical Insurance in accorci�nce with
these specifications together with standard city form specifications used by
the Pcirchsaing Department.
COUIVCILMEIV Requested by Department of:
Yeas Nays
Christensen �
�� Hunt In Favor
Levine M1,
Rcedler �J Against BY
Sylvester
Tedesco
President E� Hozza
Adopted by C i : Date N� 4 �� For Approved ty E� ey
�
Cert' ' d Passe oun ' retar�f
By
Approve Mayor: D e � Approved May f r issio to nc'1
By By
Pus��sHF� N OV ! 51�75
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� �\ 'J �-`� �d� Q : Oct. 29, 1975
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7' O : ��in# Pa�� Cs�� ���n �i1
,
�� O �'� � C Ct f(t fi'1 l�'t�2� ��l FINANCE "
, chai�man, makes fihe tollovi;r�g
report on C. F. ❑ Ordinance
Q Resalution
�] Ofiher _.
�' tl�..E :
Please see attached resolution for transmittal, from
the City Council Finance Committee to the City
Council meeting of Tuesday, November 4, 1975.
. This resolution was acted on favorabl.y by the Finance
Committee with a unanimous vote for approval of iC.
It should be stricken from the list of Finance
Committee actions at this time. • '
C:�3' '?"il.�. 5�,�'�=,ti'I�� �';.C�J:� S�.t�"I P.�.'.;I�, .,'�'tii�;�S�:'A 5��0�
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CITY OF SAINT PAUL ��6�Q►'y
�l /
HEALTH ADID WII,FARE PROGRAM
SPECIFTCATIONS
I.
General Provisions
The City of Saint Paul and Independent School District No. 625 of the City
of Saint Paul hereby request formal proposa.ls to provide City employees and Inde-
pendent Schaol District No. 625 employees and their dependents with group insurance
which will provide covexage for hospitalization, surgical, in-hospital medical,
major-medical, diagnostic, X ray and la,boratory fi.rst-aid caxe. Where the term "City"
is used, it shall appl�v to the Independent School District No. 625 of the City of
Saint Paul as well, and where reference is made to the Council of the City of Saint
Pa,ul, it shall appl,y also to the Board of Education School District NQ. 625 of the
City of Saint Paul.
The City wi11 evalua.te a11 proposals received. on the same basis. I° your
proposal is to receive consideration, it must conform to the specifications herein
outlined except where deviation is expressly pesmi.tted.
zhe City reserves the right to reject ar�y and alI proposals.
A11 sales ma�erial, applications, authorizations for payroll deductions, evi-
dence of insurability forms and any other co�nunication relative to this insurance
shall be subject to approval by the City.
Zf there are any texms, phrases, or provisions contained in the propased go�.icy,
a speci.men of which shall be attached, which may be contradictory to the specifications
provided herein, the langua,ge of the specifications shall in al]. instances take pre-
cedence, assuming coz�pliance with State and local la.w. Speci.men copies of group mas-
ter contracts to be issued to the City of Saint Paul shall be fl�rnished with the pro-
posal.
The City will require a coordination of benefits provision in any agreement
resulting f�om the successflil proposal hereunder so as to coordinate with other group
insurance plans or Health Insurance for the A�ed Act, Plan A and Plan B, where eli-
gible. Eaployees or retirees without sufficient Social Security quarters to qualify
for f'ree Plan "A`t are not required to purchase Plan "A".
The City requires that all new employees be contacted personally within their
first sixty (60) days of employment and be given an apportunity to become completely
familiar with their group insura,nce progr2m and, if necessary, another personal contact
be made between the sixth and seventh month of employment, at which time the City will
ma.ke contribution towards the premivm.
It is further required that each employee be contacted by an annual service
call, reviewing their covera�es and offering assistance in a�y problems rel.a.ting to
their group insurance, Medicare, etc. This sesvice shall be avaa.lable at aLl reason-
able business hours to handle the day-to-da,y problems that arise.
,
� .
�es�9�
All successfl.il bidders must provide a local office, said office to have the
authority to adjust any and all claims submitted..
The City of Saint Paul, in considering the proposals sutunitted and in making
an award of the proposal, shall take into consideration such factors as the cost and
conversion options relating to the contracts, as well as the service capabilities,
chaxacter, financial position, reputation with respect to such carriers, and any
other factors which the City raay deem appropriate in arriving at an award to a paxtic-
ular carrier.
II.
Continuance and Cancellation
(1) Present City group insurance a�reements run for the calendar yeax, and
it is conteraplated tha.t an award of a contract pursuant to these Specif'S.cations will
be coordinated with present City agreements if continued. This contract is for the
initial term oP one year, beginning at midnight Central Standard Time, December 31,
1q75. Unless disconti.nued by the City, it shall be renewed automatically on the first
day of January, 1977, and each successive year thereafter during its continuance for
s�zccessive terms of one year each without evidence of insurability. The contract
shall be guaranteed renewable at the option of' the City arid noncance7lable by the in-
surer or carrier dtaring the contract year except for nonpayment by the City of pre-
miums when due and then on],y after a thirty-day �race period has expired.
(2} A�y requests for cost or premium adjustm�nts shall be made in writing to
the City prior to September lst to be considered for the next following yeaxly terms.
Such requests shall be addressed to the M�y�or and City Council and delivered to the
City Clerk.
�3) 2'his contract ma.y be cancelled by the City by thirty days' written notice
delivered to the insurer or carrier.
III.
Termi,nation oP Individual Insurance
(1) Insurance of the insured employee shall automatically terasinate at the
end of the contract month for which his premium was last paid and accepted by the
Company in the event:
(a) The group contract is lapsed or discontinued, or
(b) The required premivm payments cease to be made on the account of the in-
sured employee or on the date the i.nsured employee cancels or withdraws
his payroll deduction authorization, or
(c) The insured employee who is termi.nated from his employment with the em-
ployer may continue his hospital and medical coverages at his own expense
for six months or subsequent reemployment; or
(d) The insured. employee enters active duty in mi.litary or naval service, or
(e) The insured employee is temporarily laid off, �a,nted sick leave without
pay or granted a written leave of absence, provided, however, that in-
surance not terminated for other cause stated in (a) through (d) a'bove,
. : +4���r�.7 l
.. , may be continued for not exceeding twelve (12) months by payment of the
• . required premiums for such insurance directly to the administrator, on
or before their respective due dates.
(2) Insurance of the insured employee with respect to insured dependent(s)
shall automatically terminate at the end of the contract month for which his premiwn
was last paid and accepted by the company:
(a) In the event of the discontinuance of the group contract or failure to
malce any required. premium payment or contribution, or
(b) The insured employee who is terminated. f�om his employment with the em-
ployer may continue his hospital and medical coverages at his own expense
for six months or subsequent reemployment; or
(c) In the event the insured dependent becomes eligible for insurance under
the group contract as an insured employee, or
(d) In the e�vent the insured dependent no longer qualified under the eligible
dependent definition, or
(e) In the e�vent the insured employee receives compensation f�om the employer
for injuries arising out of employment, provided, however, that i.nsurance
not terminated for other cause may be continued for the period he re-
ceives compensation p�yments f�om the employer for temporary total or
temporary partial disability by payment of the required premiums for such
insurance directly to the administrator on or before theix respective
due dates.
IY.
Eli�ibility
(1) The Council of the City of Saint Paul sha11 have the sole authority for
determining eligibility for the employees, retirees and dependents insured herevnder
in a manner that precludes individual selection.
(2) Proposals shall authorize an op en solicitation period of 45 days froan
the date of the award of the bid wherein employees ma,y enroll themselves and their
dependents without evidence of insurability. In addition, proposals shall authorize
an open solicitation period at least once every year at a ti.me to be determined by
the City Council, when City ea�ployees shall be authorized to elect coverage hereunder
or change carriers, if desired, for themselves and dependents as it relates to the
basic covera.ge, without submitting evidence of insurability.
(3) Eligible employees who have been temporarily laid off work durin� said
open solicitation period or eligible employees who are on vacation or eligible em-
ployees who are on a leave of absence for a period oP one calendar year or less will
be provided. one calendar month after their return to work during which they may elect
coverage as above without e�vidence of insurability.
(4) A regular appointed employee who has become eligible for City Pay insur-
ance, if laid off his regular position and rehired on an emergency permit may be con-
tinued to be covered for City Pay insurance if he otherwise remains eligible.
(5) Each employee required to make a contribution toward the cost of his in-
surance hereunder Who does not appl,y for such insurance within one calendar mpnth
f�om the date of becoming eligible therefor or whose insurance terminates while re-
maining eligible, shall be required to Rirnish evidence oP insurability with respect
to himself, satisfactory and without expense to the company.
• = 26��9�
•� �' (6) Each employee who applies for insurance here�under with respect to his de-
' pendent(s), (i) more than one month after he first becomes eligible for such insur-
ance, or (ii) more than thirty days after the date he becomes eligible for insurance
with respect to himself without contribution on his part towaxd the cost thereof,
shall be eligible for such insurance upon flarnish3.ng evidence of insurability with
respect to such dependent(s) satisfactory and without expense to the company.
(7) The spouse of an employee or retiree �ho is employed elsewhere and is
insured. by her (his) employer's insurance carrier may within 30 days or her (his)
termination of eatployment apply for coverage under this contract without eviderice
of insurability. Evidence of termination of insurance f�om the other Group Carrier
must be flirnished.
(8) The effective date of the employee's insurance, including insurance with
respect to his dependent(s), who is requixed to furnish evidence of insurability shall
be the date of application of employee if such evidence of insurability is accepted.
Such coverage will be provided without charge for any initial partial a►onth.
(9) Zn the event of a transfer from one carrier to the other, the effective
date shall be the first day of the month following the date of application for trans-
fer.
(10) When transferring from the active or early retixee group to the regular
retixee group (over age 65); the spouse of the employee may be included. without evi-
dence of insurability.
V.
No Lapse of Benefits
(1) The successful bidder hereunder shaLl automaticaLly assume all areas of
risk in such a manner that no person sha11 be denied or afPorded benefits and�or cov-
erages sole�y by reason of a change of insurers. In the event of any questionable
cla.i.ms under this clause, the stxccessflal bidder shall pay the claim subject to the
right of negotiation and subrogation of previous coverage holder.
(2) bcrployees who axe eligible for covera,ge, and at the time this contract
beaomes effective are on leave of absence, sick leave wi.thout pay, lay off, suspen-
sion, sabbatical leave or resigned with rights of restoration sha11 upon their return
to their position in the regular employment of the City, be covered along with their
dependents without evidence of i.nsurability.
VI.
Administrator
(1) The Administrator (current�y the Minnesota Mutual Life Insurance Company)
sha11. keep a11 the records of a11 those insured under the plan, bi71 the City monthly
for premiiuns due, including all employee-paid premi.ums, on an itemi.zed state�ment
showing a11 departments, divisions, na�nes of employees and coverages provided, collect
the premiums and disburse them to the other carriers. Said Administrator sha11 be
reimbursed for these services at a rate of .005°� of the premiums plus 92¢ for each
insured employee per month by the company awarded the contract hereunder. The cost
of this service may be included in your bid quotations.
� . . ����9�
' • (2) The administrator shall provide a brochvre for each employee covered.
hereunder, a sample of which may be obtained at the Personnel Office, Room 265
Court House.
(3) The City of Saint Paul shall provide nota,tion of all necessary changes.
VII.
Certificates for Insured. Persons
(1) The company will issue to the poLicyholder for delivery to each insured
person indivi.dual certificates setting forth a statement as to the insurance protec-
tion to which the insured person is entitled and to whom i.ndemnities provided by the
policies are payable.
VIII.
Clerical Error
(1) Clerical error upon the part of the policyholder or insurer shall not
prejudice the insurance of any insured person, nor shall such error continue the in-
surance of any insured person beyond the da.te it would otherwise terminate under the
terms of this policy except for error.
IX.
Reti.red. or Terminated. �ployees
(1) Present City Health and Welfare coverages provide that terminated eraploy-
ees and other employees not otherwise eligible to contznue their present Health and
Welfare coverages shall be given the right to convert their coverages vnder the City
insurance program without e�vi.dence of good heal.th to an i.ndividual policy of policies.
Bidders shall submit schedules sho�rS.ng present conversion rates and benefits for em-
ployees and�or dependents.
(2} The spouse of an employee who died of job rela.ted cause sha11 canta.nue
to be eligible for City p�y hospital-medical coverage for herself (hi.mself) and her
(his) dependents, the same as active employees.
(3) 7'he spouse of an employee in the Police or Fire Fighter Bargaining Unit,
active or retired, who dies, sha11 continue to be eligible for City pay hospital-
med.ical coverage for herself (himself) and her (his) dependents the same as active
employees.
The spouse in (2) and (3) above shall continue to be eligible
until:
(a) remaacriage
(b) e�mployment where group insurance is ava.ila,ble.
(�+) Retired employees and dependents will have the same hospital and medical
coverages afforded active employees.
�5) Early retixees and their dependents, as defined by resolution o.f the
City Council, shall be automatically enrolled in the regular retirees' program on the
first of the month in which they attain age 65.
�� .� �ss�s7
Xr.
Exhibits
All bids received must substantially comp�y with the basic covera.ges now
afforded the City as reflected. in the attached exhibits.
The following Exhibits are provided to refl.ect the p�esent covera,ge held by
the City and statistical data of relevant information to assist fn the preparation of
the bids.
The exhibits enumerated below are hereby incorporated by reference into the
City•s Health and Welfare Specifications and ma,d.e a paxt thereof.
Exhibit A - Current benefit level.
Exhibit B - Insurance Certificates.
ESshibit C - Letters of intent.
Exhibit D - Premium Structure.
Exhibit E - Census Data.
Exhibit F - Premiums Paid and Losses Pa.id.
NOTE: Exhibit "B" Insurance Certificates are available at the
Personnel Office Room 265 Court House if needed.
City of Saint Paul �,�6�9�
Health and Welfaxe Specifications
october 1, 1g75
Exhibit A (benefit level)
Group A
Hospital:
Room ana. Board Ma�cimum (365 days) Semi-priva,te (1)
Miscellaneous chaxges (inpatient) Unl�snited (2)
Miscellaneous plus room charges (outpatient) Unli.mited (3)
Maternity Same as illness (�+)
Non-acute care Same as illness
Group B
Surgical Maac�?n+� (excluding OB) $200.00 plus 8(�0
excess (5)
Anesthesiologist 25°� of surgical
allowance plus SO°�
Obstetrical Procedures $30.00 to $125.00
In-hospital medical (365 days) $6•�
excess to Major-Medical
Diagnestic lab and X-ray
(calendar year-unsched) $140•�4
excess to Major-Medical
Supplemental Accident
(including injuries to natural teeth) $25.00 plus 80°�O
of excess
Ma�jor Medical:
Calendar year deductible (single
and fami.ly maxianim} $50.00
Reimbursement rate $�io
Ma�cimum benefit $25,��•�
Restoration clause up to $25,��•04
(1) Private room maximum is that hospital's average multi-bed charge
(2) Available only while a room and board charge is allowed
(3) For medical emer�ency, accident and surgical expenses
(�+) Iamiediate at carriers inception of risk
(5) 20� co-insurance not eligible for major medical, see attached schedul.e.
Dependents are:
1. Spouse, unless legally separated
2. Disabled children
3. Unmaxried. children to age 19, except to age 25, if student.
1�TE The employees may also choose, as a health maintenance option, Group Health
Plan, Incorporated or Ramsey Health Plan instead of the coverage protrided by
the low bidder hereof.
E�nployees , retirees�� and their dependents, upon attaining age 65, must secure
Medicare "B" at their own expense to receive full contractual benefits.
� . _ bchibit C page 2.
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/�;, :`• ,'�(\ E;��;� �� ri;E'i,i � ! ;, ,• i'�`�ic 2344NicolletAve. « Minneapolis,Minnesota5i404
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, 3535 Biue Cross Road x SL Paul,hlinnesota 5511 1
t' .i,�_,.t._! Telephone:4�6-4000
October 15, 1 G71
?�'�r. John Devlit7
Civil Ser�-ice Bureau
265 City Hall
St. Paul, Min.ne sota 5 51 U 2
Re: Citv of 5t. Yaul Employees Group Insurance
Dear Mr. Devlin:
�n answer to your quesf.-�on about survivin� spouses of retirec? (orer 65)
Gi�r eniployees, please be advised that it is not the intent of Blue Cross-
��iII to tern�inate the Supplenzer�tai to Medicare Benefit of a depender.*
spouse merely because of the death of t-.he el.igibie rntired employee.
Specifically, this nzear.s that death would not be a reason for termination
of coverage under paragraph D of the section entitled Termina;�on of
Supplenlental to D�lcdicare Benefi;; fcopy attached).
T trust this i�formation z��iil be helpful,
Sincere�}',
_ . _ _
�: _����;���_ _:_���
l�-
D. E. F'latt
'�_�.,
Actu�rial Research Division
DEP:ih .
� � Exhibit c p�����'
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i�S•arch 23, 197I
TVIr. John Devlin
Ci�-i] Service itareau
�7ttT pr �t. PcZLli
2d� Citt� Hal1
Si. "r'aial. �•linneso'a
I�.c�: ;�fII Group 'vor,occ�i�;ati:�r.��.l Accic?er.t ar.d
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L f i�_'.' '�: C .._i. \i'�. s-.'l :i?! —L Fi .'.l i i .'l c 1 1�' 2'E'C ,, . (: 1 '
j' . _ . C![:l- . ,. ...�t.:� 1:
. :i. ,..!T . a ;?�'�. i} ! ):_ c:�7.i .."�I' ,}'. I:l�l:: ��C? �.1:��:C;�;C' �<
�,C�`. .E.. 1.,'� .. li:2il? ._ic' 111�1"1'- •.:1']i . �
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.CiC1Uc11'inl ��C.'SF'(iI'Ci, r1'_:'1SiU?'
l�;:,i�:1�7
GF; OUP HEAf.TH PLAN , INC. Exhibit C page 5.
.� 1.5U0 Ccmo Avenue
Sai�st Raul, P,�lir�nesota 5510A
Februar�.� i5, ].971 �����►�y
,r
.�.r, John C. �evlin
tiealtf. and �el�are ConT,itte�
Saint Paui Civil Service Bureau
265 (:i_t}� i3all
Saint Pa.ul.. Minnesota 551G2
Dear i�ir. Devlir.: �
GrOtl?� Healtn Flan heren;� a�re�� to adopt � uni.FOrr; policy in tl�e �it.� o`
C�11i1C p2i11 �ro�ip t�ldt iS S=.?fi1�.:�Y' t!_? �'i�E POZIC;' 2I7 triE �tatG OF ;'�?P.:C�Ct.£:
group for e:�ployees ���i�o transfer their cover�ne betw�en hE;alth carrie�r•s
a4 tcr a Tr��;nancy has begun. It is our ti�derstandin� the po:tic��� z� �:
f ollo;;•s:
In t`�e event an em�lo}�ee transfers c��verage -r� one h4�altl�
car�iel- te the other after conceptior has accvrre�, the.
cari-ier '� co:�eraRe c.-':;ic'� t-:as in effe.ct on the date of ccncel�-
ticn s.Lall provide ,.�e�nar.cv benefits tc, the e�tent tii�it c��ou?c:
have been availa�;;1e �:ad the r.rensfer not cccurred .
,,•d'� lvE, F1t�3SF �11VE SCi^t COIif12^':c'3�1C`R Or t�1G agreer-�er.t idl' �`i;�" i 7.i.c.5.
.�uc'rf as a copy a= t�i�> letter ::r.a; Elue Crc�� .
Si.icerel v,
�,.._ �.;
;� ....�__.__:� �,�/�71„�
y° ,�ii��'�d1.!::��/'�'Y!�3' o.
� �
�`'uuT'1.Ce �. 'F`ir�c1�
Ge�eral *1�ana��t=�i:
�IJr1:ef
cc : James Q. regnier, �7ice �resident
Saies �a �ublic Relat:io�:= i?�vision
Tiinnesota I�:ospit�:i Scr;�ice �ssociatien
�
� .�thibit C page 6.
. . .- , . - � � .
irv � u � �, N�c � corn �=anii �_ s
..�.a.�...,.,,,,y ,
�
� �, �
Servma you a;ound L`�e �vorld. .t.,-0und fhe[lo[h � ���r �
3�5 1^tASNIr�G70N ST.. ST. PAUI, h71NN 55102 A}�T1I LSf in7�
rfr. 3ahn G. �cvlin
F�ealth �, Welfare Cor,rmittee
Givil Service Bureau
265 C�.ty HaIZ
St. Favi, Mir.nesota 55102
Policy No. CF� 920
Cit;• of St. PaFal
Daa� Jo?�r.;
The intent �f the S±, �'auZ Fire ar:� P:3T1Tk� Insuran�e CArP::ny is;
S*er.il.izatian surgic��l procedures i7clu�ir�g vasectoMies anc;
tubular li.g�tic�r.s rerforn:ed sole:y upon the nec'ical. or
�sqchiatric �:.:�r.asi� �i a ohE�sician indicatin� suc� iti
neeessary for the wE11 �eir.€ of ihe Irtsure� Person, ar.
spouse, either physica? r.r �ie*�ta2, �ai12 be payable,
:.t�is �nt-.a�t �.s s�bject to 2pgrov�l of the Insur�r.c:e Boar�' �rcJ ti;ill becoc�e
effectivE ir;.rr;n�iatAly folla�:ing such approval.
�z::ccre.I y,
S1. P�4UL i'IF�� I�iD r�.ARltd^ INSIIRE�Pi+LE C(}tiL�.yIvY
�` - �--- � i' �--
; . ., �� --`�.
Fr.ec: ;,. Ker�t, Sup�rvisar
EiCc'����; �>p�C1Q1 �i S�
c,;L
TFfE ,rai'. P'E+,UL IFdSURAMCE CJMPANIES ST. PALt FIRE AND MARINE INSURANCF COMPAt•JY
�T. P�UL PAERCURY INSURANCE COMf'AP�Y . WESTEF3h LiFE !NSUFANCE CON' PANY
� ' Exhiblt ll oage 1,
•' ESchfbit D Premium Structure
cf6���
Ctu�rent Cavera,ges (bchibit A)
ACTIYE II�IFLOyEES
Hospital
E�nployee Dep�ndents Famf.],y
1975 14�.58 35.�2 _50.00
1974 15.35 37.32_ 52.67
1973 �.73 33.21 45,9�+
1972 11.�+2 29.81 �1.23
Med.ical
1�5 7.7$ 16.36 24.14
l�� 7.23 15.19 22.�+2
i�2 6.90 1�+.63 21.53
6.55 13.95 20.50
EARLY RETIREES (City Pay)
Same coverage and rates as active �mployees.
EARLY RETgtEES (Re�iree Pay)
Option I - Same coverage asid rates as active e�ap].,oyees�
Option II
Hospital Benefits Medical BeneFlts
80�20 - 70 Day Plau $200.00 Surgical Schednle.
$ 6.00 Per DBQr In Hospital Doctor Visits.
� 25.00 Accideat fYrst a3d.
$100.00 Diagnostic x-ray and Zabo�atory
Hospita�.-Medic8l Combined Premi�s
H�ployee Depeneient �'amily
1�5 16.83 23.39 40.22
1�� 17•� 23.37 �1.37
1�3 14.5�+ 21.09 35.63
1972 13.00 17,pg ��p3
1WOTE: There are no Option II contracts in force at this time.
` Exhibit 11 pa�e G.
��s���
REGULAR RETIREES
E�ployee Dep�ndent Family
Hospital
1�5 9.�7 6.1�+ 15.61
1g7� 9.98 6.�7 �6.�+5
1�3 7.� 6.28 1�+.1�+
1972 6.80 6.48 13.28
Medical
1975 4.32 3.81 8.13
�97�+ �+.02 3.53 7.55
1�3 3•91 3.72 7.63
1972 3.68 3.52 7.20
NOTE: Effectave January 1, 19?5, retirees had same contract be�nefits as active
employees, coordinated. with Medicare.
- ' ����97
.�,�y o� s�. P� - ��/.�-
EXHIBIT -E- Page 1.
�r'^';T�IRUT`)RY L1F� _ HEALrH COVERAGES
AGF �!0. FMP. �MP. 'lE�'. ncp , �3�(J� HLU� GRP. GRP. . RAM. R�1M.
- -__ I^;S . t_ I�F LiFF Li �� LI�'F , SIhG _ FAM SIIdG- �A�? S[NG FA+�1 '
rJ�t. 9'�T �JO. A��!T
19 1 , 1
1 �? 4 3
?_0 � . 1 1 2
21 6 1 1Q i 3 4 1 1
�i l� 3 3 ? 4 B l 2 1 I
73 3? b 65 3 3 15 3 13 5 ?
24 �r0 B �4 7 2 t 19 6 14 6 4 1
.7. 5 5? 15 169 11 ?q 3? 14 •!6 8 b 1
25 F6 ?1 319 l � �5 36 20 ?5 14 2 1
27 �tl 34 394. 32 89 51 32 25 i5 4 1
2R 102 41 ��5 42 . 114 b! 49 • 3�r 23 b 2
?9 58 25 37� ?7_ � 1 Z8 23 ?b 15 7_ 1
30 47 20 227 2T !�3 31 29 12 b 3
31 �5 z?_ 277 Z3 56 34 29 19 11 3 2
32 5� 25 433 ?� 64 41 34 1t 8 3 3
33 f�0 ?? 371 32 ?8 49 41 9 b 2 2
34 54 31 445 3�+ 7�i 3B 31 13 i�J 3 1
35 F3 �5 4?_'� ?+ nt 33 28 18 lb 1
35 49 24 � 4^3 31 77_ 42 35 6 b 1 1
37 4-� 21 ?45 2 ? b9 35 29 12 9 1 1
?�i 58 31 3�? �4 a0 44 32 11 11 ? . 2
?9 �? 2? 2^4 29 7� 31 29 b 5
4� 5� 27 4?^v 41 - �^ 3Q 3Z 8 9 3 2
�t1 54 73 ?_'4 3 ? 9� 45 35 7 5 ? I
4Z 67 41 474 54 1 Z�� 50 4T i4 13 � 3 3
43 ? 1 4^ 4� T b3 I >2 56 50 11 9 4 3
f4 77 �+3 � 75 !�2 1 5a 64 55 12 10 1
45 7, 3� 3'14 5� 131 60 5� 11 5 2
4F ?2 41 424 59 ] 4R 63 54 7 6 1 1
47 104 7� h7.. 8 �� 208 3B 74 13 13 3 1
4E 113 54 572 94 �? 1 9T 87. 12 11 3 2 '
49 �?� 5� 52b 73 184 74 66 10 10 2 2
50 116 7� 557 �3 14' 102 87 12 10 . 2 1
51 �3 47 �335 5 � 139 h9 57 13 12 1 1
52 9� 50 �SO 54 1 ?_ 3 69 51 9 7 2 2
� 3 �� 57 37� E�7 1 �2 74 58 1 b i2
54 36 4� 35� 54 144 75 5?.. LO T
55 83 4? 314 5i 132 70 48 13 11
5F :i2 47 19? 54 11 b 56 49 5 3 1
57 �8 4Z ?Z3 53 i7_7 72 5b 6 4
5u 78 4?_ 2R^S 4'� 107 72 60 5 3 i 1
59 63 3� 85 " 42 �b �8 43 3 3 Z
+5�� ,73 30 97 �+l 90 70 47 3 . 1
61 55 22 95 2� 59 49 35 7 5
62 4B ?3 77 27 48 49 24 3 2
63 38 8 3� t '� 21 3b 20 2 2
b4 34 1 ? 32 T7 35 32 ?4 2 1
65 2 2 2
75 1 1
2820 1440 L3063 1765 4173 Z?_ ,?. 5 1T35 467 349 82 40
I � c,f ���� .��. � - F�� ���,��'�
� � � EXHIBIT -E- Fa�e 2.
�ONTRI ?UT�kY � tfF . HEAI.TH COYERAGES
��,E r�n. �MP. E�.�P� �')�'�. nFp . RIUE BLUE GRP. GRP. R4M. RAM.
1NS . L IFE LIF� LIFF Lr�� . SI��G FAM SING F4M SING FAM
�10. �MT �J�. AMT
Ol 1 � �
lg � 4 1 1
19 1 3 • 8 1 5
20 12 � 9 3
?1 24 1 3 1B 1 5 1 1
? � �9 1 3 15 2 12 1 1
Za 37 4 ?� ? 4 18 3 13 1 6 1
2cf 4S 2 10 ? 6 LS 1 22 2 3 2
25 4� � ?5 3 9 24 5 18 4
� 26 4� 5 37 2 f± 7g 9 14 3 4
27 33 2 l0 � 5 i2 16 i � 13 �4 2 i
?_8 3� 4 3b 6 lg 26 b lE? 2
?9 ?4 5 105 4 1 ?. 16 4 7 3
3� 2Z Z 10 4 11 13 2 T 2 1
31 1� ? 35 5 14 13 3 6 �
3z 22 4 ?! 5 11 l7 3 5 1
33 l4 5 43 3 7 lI 3 3
�4 1 � 4 �� � 1 5 13 3 3 1 1 � 1
35 14 5 4b 7 15 11 7 3 2
36 lf3 3 ?1 4 12 15 3 2
37 23 7 4b 4 il 16 4 5 4
3� i5 t 5 ? 4 lf� 3 3 1 1
3� l8 7 F2 ' ?_ 3 12 2 3
4J ll 4 55 6 16 10 3 1 1
41. 1 ? 2 30 7 l� 13 3 5 3 . I
4? 17 4 46 4 10 14 5 3
43 ?7 ?� 7 5 13 14 . 4 5 1
44 � 1 6 24 11 2� 2� 4 T Z
�+5 4� 5 g5 11 2g 28 5 9 3 Z 1
46 ' ? 5 40 . lZ 34 18 b 7 5 � 2
47 36 5 2Z 1 't 33 27 4 8 5
46 3h 13 1�6 9 21 �0 13 3 1. 2 1
44 '-�4 15 82 15 38 2T 10 16 3
50 3n 8 20 14 35 3Z 7 5 1
'S1 5E� 1 ? 64 1b 36 43 12 9 4 1
52 30 7 ? 7 n 1R 24 6 5 t
5� 44 10 5Q 11 ?2 40 8 2
54 4Z 9 34 17 34 29 4 11 3 1 1
5� 57 1 ? 46 16 �6 51 11 3 1
56 50 9 33 14 20 43 . 9 6 1
57 45 11 32 12 Z 4 37 � 5 2
58 5� 9 26 ZO 43 44 9 5 1 1 1
5� 35 9 34 13 23 32 7 2
50 52 7 13 13 ?9 47 11 2 2
61 43 7 13 1:5 36 3 7 7 � 5
b2 35 � 27 � 19 33 4 Z
53 2� 4 7 5 9 24 4
64 ?_8 3 8 ? ' 15 26 T 1 .
65 1 1
1458 254 1578 3S4 805 1081 Z28 294 72 33 9
. f ��� o�' Fd� - ,��.� � �ss�9`�
. , EXHIBIT -E- Page 3.
CO'VTRt �iUTJ�Y ,I. IFF hE�1lTH CflVERAGES
AGE �1�. Er�P. EM� . �FP. nF� , RLUE BIUE GRP. GRP, RAM. RAM,
I�.S . LIFE LIFE �.IF� LIF� , SING �AM SIlVG FAM SIN6 FAM
N�� ,aMT N7. A�+T
22 1 �
?3 ? 1 45 2 2 7 2
24 9 2. 3C 1 ? 5 2 4
?_ 5 1 � � 1�95 3 , ° 11 3 6 3 I �
2� 45 ? t J57 I �.? ?9 21 9 22 14 2
27 31 14 297 7 t9 lk b i7 LO
2B 5q 2� 54fi 11 33 Z2 iZ 3T. Z1
29 �3 2Q 461 11 2.9 LO 9 23 14
�0 47 2'+ 476 1?_ 34 18 11 26 lb
31 . 39 27 5h1 1� 49 23 19 15 13
32 48 35 �65 � 2.0 52 23 19 25 lb
�3 �4 25 E�46 17 4?_ 21 17 12 8 1 ' 1
34 4� 30 573 23 6?_ �3 15 lb 15
3 � ?_7 70 471 13 ?9 15 10 12 10
3b 41 ?_8 654 21 54 25 lb 16 14
��7 41 35 �29 ?9 78 ?2 2� 19 16
3�3 44 3 t fi?3 2E� +50 2g 21 i 3 9
39 4? 37 �42 3 _7 �i3 29 2T 13 t2
40 3?_ 31 6�3 2� b2 21 19 1 � 10
41 31 ZS 5�1 2� �� 17 15 14 11
42 37 31 S78 3� 65 �2 20 15 13
43 38 35 659 30 7?_ 23 ?0 15 14
44 �+4 45 9G2 37 '?6 2g 27 15 14 1 1
45 �7 3? 5t8 3� 53 22 15 14 12 L 1
4b 41 36 ?20 ?_ 4 67 29 2.7 � 11 9 . I
47 3^ 2R b91 25 63 24 23 5 5 1 1
4R �� 2� 4�7 Z4 58 24 2i b 6
49 �6 31 5?Z 2� fir3 30 24 6 2
5U ?7 3? 5�� 2g 58 29 25 8 7
� 1 37 40 596 3� �2 24 22 12 10 1 1
52 26 ?6 447 22 57 16 16 10 8
53 ?6 3� 41Z ?7 5$ Z8 25 g �
54 20 Z2 40J 19 42 14 12 5 5
55 ?_b ?_4 ?34 19 41 yp 1�5 b 5
56 16 16 246 11 ?_5 11 7 4 2 1 1
57 i3 11 105 11 23 T 6 6 4
58 11 10 1�+R 14 �4 6 5 5 5
5� 13 9 a7 � 17 10 7 3 2
b0 13 9 �8 '� 1? 1 ? 12 1 i
6i 14 8 �6 � 13 10 9 4 _ 3
h2 20 9 96 � 2� 19 13 1
63 11 4 45 3 5 q � i
b4 9 3 15 ? 6 q 4
65 2 2 Z5 2 2 � 2
66 3 7 ? L � 2 3 1
67 1 1 .
75 Z 1 i� 1
1274 964 18852 75?_ 1 �i3 i 794 61'� 4T4 349 10 6
,
. �c�6�9►�
(3oari[ o t ���`�'t — Fi��"�' EXHIBIT -E- Pa e 4.
�
Cf?�!TRI�?l.1TnRY L IFE . HEALTN COVERAGES
AGE �l�l . F'�p. �M�'. �FP. n��. P.�UE BIUE rRp. GRP. RA!r!. R4M.
irlS . IIFF IIFF LdF� I. IfF , SING FAM SING FAM SING FdM
N[�. �MT �d0. � 4��T
01 1 , . 1 1
?1 3 � 3
2 � . 7 3 1 4 1
Z3 27 4 54 1 3 9 18 2
?4 44 19 23 3 2 I
7_5 70 6 . 54 ? E, 3 2 3 37 3 1
26 94 � 55 ? 6 43 4 41 5
? 7 ?Z 7 5� b 16 50 8 39 12 2 1
?. 8 97 9 107 5 14 51 7 44 T
?9 5� 10 I�5 3 7 44 7 20 7
30 4b 6 96 3 7, 2� 4 1T 3 '
31 49 4 118 5 13 ?9 5 18 5
32 44 1 0 �3 1 �J ?4 27 4 lb 8
3� 51 1 � 1 �6 11 � 1 37 12 14 b
3�+ � �� 7 1°4 3 7 1T 3 8 5 �
35 �� 1 ,� 155 6 14 21 5 7 1
3� ?5 9 1�?_ 7 1Q 15 4 7 3 1 1
37 47 14 ?14 � 23 28 3 16 4 .
3A 44 13 Z2Z 9 ?4 ?g 8 15 7
39 33 1!� Z29 13 33 18 5 14 9 1 �
40 ?5 9 1.37 .5 16 13 4 11 6
4t �(l 7 �6 6 18 ?1 2 7 6
42 'S 9 110 5 13 29 7 5 1
43 �3 14 176 Zl 3i ZQ 5 12 5 '
44 Z6 4 ?1 7 15 2� 5 b 2
45 ?R 10 83 1� ?5 21 4 6 2
46 �2 16 1R� Q 24 �4 5 7 4 �
4? 31 13 159 T L5 19 4 S 3 1
kg ?� . 12 145 11 � 20 26 6 3 Z .
4� ZJ 7 47 . 7 17 13 3 b 2
50 35 9 121 14 27 2T 6 b 4 1
51 21 11 i20 h 10 i5 4 6 2
57 i � 5 �5 9 18 � i4 4 4 2
53 2_9 i 1 13� 12 27 ?0 5 9 2
54 25 7 111 5 16 2L 3 2 1 1 1
55 ?4 15 1 ?�.7 8 16 23 5 5
5b 2b 16 165 11 17 22 3 4 3
57 2? 7 56 6 15 26 3 6 i
�g 17 6 �4 5 8 14 4 3 1
59 ZE3 13 . 94 5 13 25 3 2 1 1
60 24 li 40 �3 2?_ Z4 6
b1 24 10 54 b 15 ? 1 2 3
b2 ?_0 8 35 6 18 . 19 3 1 �
63 27 11 64 b 13 26 2 �
64 12 4 20 ? 6 11 3 1
65 11 B 3� 5 11 9 2 2 1
�z5 7 2 5 T
67 4 2 3 1 1 4 1
75 2 1 i 1
1557 404 4536 ��0 h95 I0�2 188 489 14t 14 4
. , s � s ..A m m m ro o � � ' •
' i ny �e�+ ,�vy � n n � m w n � �
� • Cy p N O 1� • .
' C'� 6 M N ►+ t+ h+ rw�. ~ N ('*'1 �
. !� 4 A 1p r7-• O� ~� a
� W ?fe f0 ►+ r r r+ `� � K
� � m a� �c �o .o •° .�i .-o °
O v V V V V �/Ol �O O�
, � O ,+ pCp p VI A W N •. �W
b 7 N r
Ma' r ►! Y1 C N N N : �+ '
. W lLl \7 W fp N (J O OD V Cf .
v �+O. lA � �O OD ��O W
� 1 N� �O � T N N C�
G. N '! �r�i� V m W N W N O
, . � � � OD �O N W V [f N
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' � 7 W O O O O O 9
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A N "' 1 W ta W N M
V W 1� h+ OD N�
a . ' .. '
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pp in �o v o ao oNi ra+� Wr tnp y
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' Questionnai:e ����(]�
J
1. Wi.11 you operate otir hospital a.nd medical plan on a Direct C�.a�sa Hr�,n,ndgi.ng syst�an
with no Ssint Paul invo].vement in individua.l claim proc�ssing? Please fttirxaish
forms and instructions which �mployees would use.
�. '�IYiat is the 14cation �P your c�.aim affice wh3.ch will pracess aur ha�pita.3. a;nc3
me^dical cla3.m�?
3. If claim affia� is not 1oca7_, �rhat ldcal office will hav°e the aut�aarity to
sPt�le d�sputed �r questionable c:laims?
k�. l�e De:'icits carried forward to be recoupeci from f�zture year's suxp?uses`? If
ndt, please explain how they will be fins.xiaed.
5. In the event �f contract ca.ncellation either �n or af'�° the anr��.versaa�yy da�e,
wil'? you reftiind th� entire eacc�ss, if any, or y�oux Tz�curred �laim (c�pen but
unrecorded) reserve over the actual eZaim.S paid aPter the c�n���l.atic�n date?
�lhile determining your #'inal liability after canc.el.l.ation (either c�n or o��`
�he anniversary date�, wi.11 ycsu make an adflitional R�t�ntian or servi�� charge?
If so, what woul.d be the approximate amount af tY�is charge?
�. �Til�. it be necessary for you to maintain any Prem�u� Sfab�.liza�tiaa� ar Cl�.im
Fluctuation Reserves if you ad.mi.nister aur hospit�,.l and m�d.ica7.. �rc��ram.? �f
, � R
� so, please adva.se (1) t�ze a,*nc�unt of reserve, (2) hoW you �ri1.1. establi�h��h�"� !
reserve, (3) the intex°est rate which you will cred3.t to t�e r�serve, a.nd (�)
whe�h�r and at what time this reserve wiLl be refl�nded to St. Faul in the even�
of �ontract cancell atian.
7. At the end of e�.ch contract year, will you prc�vide a co�plete accounting of
a17. pr�mium dollars paid t� you durin� the year i.n the fax� of Incurred C]L�,3ins
and Retex�tian? Will a11 Pa�d Premium for the year in exc�ss of Incurred Claa:m�
and R�tentic�n �+� re�`unded �c� St. Paul at the �:�me of �has acco�unting? If not,
please e�plain.
$. Kindly advise how yoar xetea�tion factors would be affect�d by a 10� i.ncr�ase
or decrease in either. , or both, paid premium ox incurred claims, assuming that
the p1�n of Genefits a;�� the numaer of insureds wi11 rema.in: constant.
. �� ����TZ��s 266�9'�
Active �ployee
Benefit Ilnployee Dependent Fam,il,�r
�r��pital � �� �
B�,sic and Major Medical$� $ ��
TOTAL �� � �
Ear7,y Retiree (Option II)
Bea�efit �.o ee Bependent �'�.zy
H��spital and Medical
Coanbined Pr�i�ams � �� �
Regular R�tirees (ovex° ap�e 65)
Beriefit Emplo�ee D�epen�ent Family
Hospital � � �
Basi.c and Ma�or
Medical �. � �
v � r
r .
RE`I'II3y'ICTti FR.�':IUtd EST7MATF,S ��",�,��
Pl�ase complete the following:
Gross Premiums $3 8C)O�OOti. $3,Et}c3;000. �3,800�Q(30.
(Hospital,Med�cal,Major Medical)
Incurred. Cla3ms Faid �,3,650,000. $3s65qa000. $3,650,000.
(Indica,�,e Actual Cl��s Paid)
It�ni.zec. Expenses
Co�nmi�sions
Cl.�,im Expense
Tax�s
Adm�rai strat�.on
Records and Billing
Other Expense
Campany Profit
Ineurred but unpaid Claim Reserve
Net Profit
All retention exhibits sha1Z be figured �.th •th� exr�,mple of "�racurred Claims and
Gross Pre�iums" inserted. above. All i�e�s no� �uaran�eed re�andable upon e�irations
of clai.m period should be entered in "O�Yse�r �x�ez�se".
Re�ention exhibits are for reference anl;{, contr�et wi�I be awarded an basis of ini-
tia.� cost.
�
,� . �����.7 /
R�PORT TO THE HONORABL� LAWRENCE D, COHEN, MaYOR
FROM: Thomas J. I�elley, City AdmiMistrato`�����
�
DATE; Oetober 15, 1975
REGARDING: Ccmncil xesolutioa seeking bids for e�ployee hospital ar►d
medical eovera�e.
S�URGE: Health and Ylelfare Insurarice /�driscxg Cc�mi.ttee
ACT�ON REQUESTED: Reco�end for Cotmcil passage.
ATTACHMENTS: 1. Said Reso]tition.
2. Specifications.