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262772 WHITE - CITV CLERK �1��' /�� PINK - FINANCE CO11I1C11 � � B�UERY=�yDnEPAOR�TMENT GITY OF SAINT PALTL File - NO. � C ci Resolution � � Presented By � Referred To Committee: Date N Out of Committee By Date w a � F�EREAS, The Legislature of the State of Minnesota passed a law under `M Chapter No. 338 during the 1g73 Session which in paxt requires the City to seek bids for insurance coverages which upon renewal indicate an increase of 20°fo or more premium and WHF�tEAS, the requested renewal premium for the Saint Paul Fire and Marine Insurance Company policy No. CE 0920 covering Long Term Disability indicates an increase of 100°fo; now, therefore be it RESOLVID, that the Council of the City of Saint Pau1 upon the recommenda- tion of the Health and Welfaxe Insurance Advisory Committee that William E. Peter, Purchasing Agent of the City of Saint Paul, is hereby authorized and directed to request bids or proposals for Long Term Disability Insurance in accordance with the specifications, a copy of which is attached hereto and incorporated herein by reference, and in accordance and together with standaxd city form specifications used by the Purchasing Depaxtment. COUIVCILMEN Requested by Department of: Yeas �1�. Nays Konopatzki � In Favor Levine Meredith � Against BY ,� Roedler �ede.�ca Mme.President �7d�p[ �'t �EC � 4 !9� Form Ap v d by City Attorney Adopted by Council: Date Certified P� ed by C c 1 ry BY � By Approve Ma . Date Appro by M r r Submissio ouncil gy BY �ug��sH�e pEC 2 21� C 11 1 VF �t'1��in�.� pL'Y V 1J 2����►�2 H�ALTH A1V� WELFARE PROGIZAM ` SPECIF�Ca!1TI��v'S I� Gener�l prt;��isions The City of Sain� F'a.ul reque�ts th€�i: yo�a stizbmit a fozmal �roposal taith �e�p�ct to tiie Ci�y's e:npioyee ir.�ar�,:?c� pro�rw�,�. The City will evaluate a11 prcpos�ls received on the same oasis. Tf your p�oposal is �� receiv� considerat:�on, it �ust conform to the specif�cation� : herein outlined except where deviation is expressly perrnitted. The City reserves the rigY�� to reject any and a11 propos�ls. The City of Saint P�.ul and Independ�nt School ��strict No. 625 of the City �f Ss,int Paul �re desirous af receiving �, proposal proviair,� City employees e,nd In�'s.ependent School Distric�L No. 625 �ployees with group insuranc:e coveragE which �!ill provide long term disabilit5� insurance as set forth h�r�in.&.fter. Wiiere th� term "City" is used, it shall apply to the Indep�ndent School District No. 625 of the City of Saint Pau1 as well., �nd where reference is made to the Council of the City o° Saint Pa.ul, it shall a�p1.y also to Independent School District Na. 62; of �the City o� uaint Paul. �11 saies inaLeriai, applicatior_s, au�hori�atic,ns ior �ayroll deductions, evidence o�" insurability forms �nd :.*..ny caznnu:�icatior� �elating to any ch�nge in or amendment to coverages involved shall be subject to approva]. by the City. If' there ar� any terms, phrase�, or pravisions containEd in the proposed policy, a specimen of which shall be attac�ed, which may be cantr�dictory to the specifications prGVided herein,�the language of the sgecifications shall in all instances take precedense, assuming compliance with St�te and local law. Specimen copies of group master contractu to be issued to the City oP Saint 1'aul sha11 be furnished with the proposal. All successful bidders must provide a local claims office, said office to have the authority to adjust any and a11 claims submitted. The City of Saint Pa�al, in considerin� �he proposals submitted and in making an award of the proposal, shall take into consideration such factors as service capabilities, character, financial position, reputa.tion with respect to such carriers, and any othe� faczors which the Cit�r may` CIP.@TR appropriate in arriving at an award to a particular carrier. In the submission of the ro s�.l tc the Cit each carrier sha11 provide � � Y� a complete listing of the exclusions under e�.ch poliey, which sha.].1 be conUider�d by the City in making the award to the lowest qualifie3 Uidder. Any proposal which deviates from the specifications must be presented as an alterna�:e. Alternate propcsals will be �iven consideration provided they are specifically noted as alternates and that all deviations from the sp�cifications are also noted. These alternates must apply uniformly to all eligible persons o� the City and School District 625 gr�up. A+.a - . Co:�tinuance and Ct�ncell�.tion . . � (1) Present City group insurance agreements run �or the calendar ye�.r, and it is contemplated that an awa.rd of a contract pursuant to these speci.fications will be coordinated with present City �.creements if continued. This contract is for the initial term of one year, beginning at midnight Centr.al Standard Time, December 31, i973• L'nless discontinucd by �h° �ity it shall be renewed automatically on the first day of January, �975, and each successive year there�,fter during its continuance for suecessive terms oP one year each without evidence of insurability. The contract shtt].1 be guaranteed. re:�ewable at the option of the City and noncancellAt�le by the ir.surer or carrier during the contract year except for nonpa;�uent by the City of perrai�s when due and then only after a thirty-day grace period has expired. � (2) Any requests for cost or premium adjustments shall be m�de in writing t� the City prior t;o Septer.iber lst to be considered for �he nex� following yearly terms. Such requests shall be addr�ssed to the Mayor and City Council and delivered to the City Clerk. , , • . (3) This con�ract may be cancelled by the City by thirty days' �rri�ten �aotice delivered to the insurer or carrier. , � III. . Ter�nination of Individua:l Insurance (1) Insurance of the insured employee shall automatically terminate at the end of the contract month for which his premium was Zast paid and accepted by t�e Compan,� i.n tne event: (a) The group contract is lapsed or discontinued, or (b) The required premium payments cease to be made on the account of the insured employ�e or or. the date the insured employee cancels or withdra.ws his payroll deduction authorization, or � (c) The insured emp�oyee terminates his employment with the employ�r, or (d) The insured employee is retired or pensioned, or (e) The insured employee enters active duty in military or naval service, or (f) The insured employee is temporarily la�id o��, granted sick leave � without pay or granted a written leave of absence, provided, however, that insurance not terminated for other cause stated in (a) through , (e) above, may be cantinued for not exceeding twelve (12) months by payment of the required premiums for such insurance directly to the insurance company, on� or before their respective due dates. (2) A n Insured Person whose insurance hereunder ceases for any reason shall be eligible again to insure hereunder upon being reinstated to active employment by the Policyholder, provided the employee meets all other eligibility requirements herein stated, but an employee who applies (1) more than 30 days after the d,ate he becomes eligible, or (2) after the insurance ceases because oP failure to pay the required premium while•remaining eligible, shell be required to furnish evidence of insurability satisfactory and without expense, to the Company. -2- . . _ 1 ; N. � Eligibility ; (1) The Council of the City oP Saint Paul sha11 h�ve the sole t�uthority for determining eligibility for the employees insured hereunder in a manner that preclu�es individu�l selection. (2) The effective date of the employeets insurr�nce, who is required to furnish evidence of insurability, shall be the date of applicatian of employee if such evidence of insur�,bili�y is acce�?tec�. Such coverage wi.11 be provided without charge for any initial gartical month. V. Admini.str�.tor Th� Ninnesats. Nutual Life Insurance Co. is the Ad.�ninistrator who keeps all tlze records of a.11 those insured under tl�e plan, bi11 thP City r�onthly Por premiurns due, including a11. emg�loyee-paid premiums, on �.n iter.iized statezne�t showing al.l departments, bux•e�us, names of esnployees and covera��s provided, collect �he premiunis and disburse them to the other c�.rriers. Sa�id Administrator is reimbursed for these services on a percenta,ge basis of premiurns disbursed �o the carriers, VI. Certificates Por Ins�ired Persons (1) The comp�,ny will issue to the policyhalder for delivery to each insured p:�rson individual certificates setting forth a statement a,s to the insurance protectian to which the insured per�on is entitled and to whom indemnities provided by the policies are paytcble. VII. Clerical Error (1) Clerical error up�n the part of the policyholder or insurer shall not prejudice the insurance of any insured person, nor sha11 such error continue the insurance of any insured person beyond the date it would otherwise terminate under the terms of this policy except for error. VIII. No Lapse of Benefits The successful bidder hereunder shall automatica.11y assume all areas of risk in such a manner that no person shall be denied or afforded benefits and�or coverages solely by reason of a change of insurers. In the event of any questionable claims under this clause, the successfu.l bidder shall pay the claim subject to the right ofz�egotiation and subroga.tion of previous coverage holder. -3- J There are currently 1582 employees insured under the long term disabilitv contracte It should be noted however that since the Fublic �nployees Retirement Association increased their benefits in Ju1y of J_973s many af these contracts have been redezced or canceled because of the 60� limit an employee is allowed to collect on his salary. Attached please find (a) Experience. January 1, 1971 to December 31, 1971 (b} Experience. January 1, 19'72 to December 31, 1972 ; (c) Experience. January 1, 1973 to August l, 1973 (d) Specimen of gresent insurance (e) Quotation for bidder i:o complete. (f) Retentior. exhibit for bidder to complete. / -4- __..._ .... ._.�..Y�,.:� ���.,.,..,�.,__.-_ a . .� " � TH E �'�'. ���L COMPANI ES ,. x.;.,�.�a:�,�R. ,T ,��_ . , ,:. ; . , . . ,. , F,,� � , . . �i-, , .:.�y. � .. S�rrinp you eround the world...�round ths cloek 385 WASHIN6TON ST.,ST. PAUL MINN. 55102 D�Cem�r 6� 1973 Mr. John Devlin . Civil Service Office 265 city Hau st. Paul, r+�.nn. 55102 Re: CEO 920 City of St. Paul • . Long-Term Disability Dear Mr. Devlin: Per your request, enclosed is the Experience for the period of Janu�ry 1� 1971 to January 1, 1972. _ Premiums $u7,722.88 Clasms Pd 54,6�3.26 Incurred Claims 151,163.00 Retention 28,959•83 Loss 117,0�+3.21 Sincerely, . � � 0��� ; Richard E. Opitz Health Special Risk Supervising Underwriter ST. PAUL FIRE & MARI11� INSURANCE COMPANY mam St. Paul Fire and Marine Insurance Company, St. Paul Mercury Insurance Company,The St. Paul Insurance Company �ti .. .. . � 2��� '� ,: � �. CITY OF ST. PAUL CEO 920 . r LO�G TERl�7 DISABILITY � � January 1, 1972 to December 31, 1972 � � ! ` Premiums Written $109,571.80 � € t E { � Paid Losses Outstanding - IBNR $ 86,614.02 Reserves (12/3I/72) Outstanding - IBNR $299,720.96 Reserves (12/31/71) �215,369.06 Total Incurred Claims $170,966.92 Expenses Commission $ 10,957.18 Claims Adjustment , $ 4,054.16 Administration $ 6,464.74 Tax $ 2,191.43 Profit $ 3,287.15 $ 26,954.15 Total Loss and Expense $197,921.58 Policy Year Loss $ 88,349.78 ' �R'h�. �� `i-4.�i:p',,. . . INSUi+ANCF COMf'AN�t S ' . . \ S�r rnp� •rounE Ine vo•i0. .•roun0�n�[N�� 6269 ficv.5-G2 Prinled in U.S.A. _.. .. ..._., ..__�.._.._._.�_...-......_ _..-.•�-*�..�•- .. ,,..._,..�.�.ti�,.. —,: � � C O M P A N I E S . ' ��„—�---.�-_,�.ot-T"� Serving yuu around fhe world...around lhe clock � ` � 385 WASHINGI'ON ST., ST. PAUL. MINN. 55102 October 9, 1973 Mr. John Devlin Civil Service Office Court House St. Paul, Minnesota 55102 ' Dear Mr. Devlin: , Per your telephone request, shoran lielow is the Experience for the period of January 1, 1973 through July 319 1973: City Of St. Pau1; Long Term Disability Policy Term: January l, 1973 to August 1, 1973 Premiums $65, 144.88 Paid Losses 26,b08.50 _ Incurred Losses 49,655.83 Retention 16,026.65 Loss 27, 146. 10 / P •? �(���/��� S.,�S���l-G2j�_'. r �- Sincerely, `� � ���� c�' �G���'� Richard E. Opitz Health Special Risk Supervising Underwriter St. Paul Fire S� Marine Insurance Co. ' bj t St. Paul Fire and Marine Insurance Company, St. Paui Mercury Insurance Company, The St. Paul Insurance Company �.� _�_. � � t djll.7Yf i�Ti T } ��..i' �._ ri N�l 9 Y t�'�f�t���� 8 ..�51 Y 1 5 • I{I�.�Il.S�.:S 5 L 1 L'L S � S . _ t t.i'.L ','.i':L S i i::i i . .'��t 1 i S t,','7 7..1„S,��i 1 I�� ` �dr�. .�. . .��:. �.���. .��. o���.����.���.�;. . �. _ ' ry .��wM���.li ,�.�. . .�n. .�. . .'�� .��.��. .�::. ,�.�.,�.::.. . . .�.���. .,. �:, ' - . . . ., ' . .�� • . . .�..�.i�. ..,.. •�i�.. . • . .... . . .:�:�;�. • .�� . u �. .• :� . .�.�. r� • •�. _ "� � ST. PAUL FIRE AND MARINE INSURANCE COMPANY �y = �;�° St. Paul Minnesota 55102 ���A� --° !'� , ,. ,� 1�,: � �� (A Capital Stock Company, Herein Called the Company) £� = THE ST.PAUL - #;;t;� COMPANIE$ EMPLOYEE ° '``�"` � CERTIFICATE OF INSURANCE €"'"i Master Policy Number __- _::€,,. -- �,::- d.,�,..,o..,o...,....,,.....,o...,..<„�. CEO 920 = 3,: Schedule of Benefits :��� ;:;_,; __ ���f{,,: :,,,; :;,:t;;, :iiT;;e ,,: Insured Person � \� � Certificate Number �, ;;:,,: � �.,� � :;;x,;: ��€� Policyhol��, �.� Effective Date �F ' ' < City of St. Paul = _ _� --_ �`�' � � SHORT TERM TOTAL DISABILITY LONG TERM TOTAL DISABILITY __ _ :;,; _ ��=_:;;4 :--: 3 �{ ly Benefit Elimination Periods Monthly Benefit s - �"�� - �,� $ Days Accident Days Sickness $ :,;t,�. :;,€i;;: ' s ACCIDENTAL DEATH, DISMEMBERMENT AND LOSS OF SIGHT �'''��!' °°�;; .,:�,,. ��; Beneficiary I Principal Sum �_ � � .::_ _ '�;;.� As on file with Administrator of Plan i $ '"�'" :�: ����: .;� _ __ ��� ,.;.n, niuniuxtY�, . .ii ....r';+ ...;,: ......': . .;: . .'- . r':� r r , . v.:,t r : r iiz s ri r r t t'': t ri s s':�i 7.c.: This certifies that the person to whom this Certificate is issued (herein called the Insured Person), is insured under and subject to all the provisions, conditions, limitations and exclusions of the Master Policy from 12:01 A.M., Standard Time, at the address of the Policyholder, on the Effective Date stated in the Schedule of Benefits,for loss resulting from(1)acci- dental bodily injuries occurring to any Insured Person which are the direct and independent cause of the loss (herein called such injuries), or(2) sickness or disease contracted by the Insured Person(herein called such sickness)subject to the provisions, conditions and exclusions of the Master Policy. The provisions of the Master Policy principally effecting this insurance are described in this Certificate. All benefits described herein are subject in every respect to the Master Policy which alone constitutes the agreement under which payments are made. PART I SHaRT TERM TOTAL DISABILITY When such injuries or such sickness results in continuous Total Disability of the Insured Person and requires him to be under the professional care and attendance of a Doctor, the Company will pay the Short Term Total Disability Monthly Benefit stated in the Schedule of Benefits, commencing immediately after the applicable Elimination Period stated in such Schedule of Benefits, but for not more than 6 consecutive months on account of any one accident or sickness, except that for total disability caused by any one period of pregnancy, such Monthly Benefit shall not be payable for more than 11� months. Provided always that such Monthly Benefit shall not be paid for more than 6 months,during any period of 12 months, for Total Disability caused by such sickness of the Insured Person after attaining age 60. ' PART II LONG TERM TOTAL DISABILITY When such injuries or such sickness results in continuous Total Disability of the Insured Person and requires him to be under the professional care and attendance of a Doctor, the Company will pay the Long Term Total Disability Monthly Benefit stated in the Schedule of Benefits, commencing immediately after an Elimination Period of 180 days,but not more than up to the Insured Person's 65th birthday. Such Monthly Benefit will be reduced, subject to a minimum Monthly Benefit of $50, by any amount paid or payable under Workmen's Compensation, the Disability provisions of the Social Security Act (both Primar5 and Family),Railroad Retirement Act or any Veteran's Administration Disability Provision, Public Employees Retirement Association, and any other governmental retirement plan, but only to the extent that these benefits plus the Monthly Benefit under this Part II N exceed the allowable Maximum Benefit by Annual Salary at the time of claim in accordance v��ith the Salary Qualification � Schedule. � aWhen such injuries or such sickness result in "i'otal Disability for which indemnity is payable under this Part II,the Com- pany will waive any premiums which become due for such Part II insurance within said period of Total Disability, subject r� to the Termination of Individual Insurance provision, excluding section"(b)"referring to payment of premium. Following � such period of Total Disability during which the Company has waived Part II premiums, the payment of premiums shall g be resumed as they become due. � — CONTINUED — This Cerfificate replaces and supersedes a�y Certificate of similar insurance heretofore issued fo fhe employee by St. Paul Fire and Marine Insurance Company. REINSTATEMENT OF INDIVIDUAL INSURANCE An Insured Person whose insurance hereunder ceases for any reason shall be eligible again to insure hereunder upon being reinstated to active employment by the Policyholder, provided the employee meets all other eligibility requirements herein stated, but an employee who applies (1) more than 30 days after the date he becomes eligible, or (2) after the insurance ceases because of failure to pay the required premium while remaining eligible, shall be required to furnish evidence of insurability satisfactory and without expense, to the Company. POLICY PROVISIONS Notice of Claim: Written notice of claim must be given to the Company within 30 days after the occurrence or com- mencement of any loss covered by the Master Policy,or as soon thereafter as.is reasonably possible.Notice given by or on behalf of the Insured Person or the beneficiary to the Company at its Home Office in the City of St. Paul, Minnesota, or to any Branch Office of the Company, or to any authorized agent of the Company, with information sufficient to identify the Insured Person shall be deemed notice to the Company. Claim Forms: The Company, upon receipt of notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss. If such forms are not furnished within 15 days after the giving of such notice,the claimant shail be deemed to have complied with the requirements of the Master Policy as to proof of loss upon submitting, within the time fixed in the Master Policy for filing proofs of loss,written proof covering the occurrence,the character and the extent of the loss for which claim is made. Proofs of Loss: Written proof of loss must be furnished to the Company at its said office in case of claim#or loss for which the Master Policy provides any periodic payment contingent upon continuing loss within 90 days after the termination of the period for which the Company is liable and in case of claim for any other loss within 90 days after the date of such loss. Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one year from the time proof is otherwise required. Time Payment of Claims: Indemnities payable under the Master Policy for any loss other than loss for which the Master Policy provides any periodic payment will be paid immediately upon receipt of due written proof of such loss. Subject to due written proof of loss, all accrued indemnities for loss for which the Master Policy provides periodic payment will be paid monthly and any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof. Payment of Claims: Indemnity for loss of life wi11. be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to the estate of the Insured Person. Any other accrued indemnities unpaid at the Insured Person's death may, at the option of the Company, be paid either to such bene- ficiary to such estate. All other indemnities will be payable to the Insured Person. Change of Beneficiary; Assignment: The right to change of beneficiary is reserved to the Insured Person and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of the Master Policy or to any change of beneficiary or beneficiaries, or to any other changes in the Master Policy. No change of beneficiary or assignment of interest under the Master Policy shall be binding upon the Company unless and until the original or duplicate thereof is received at the Home Office of the Company, which does not assume any responsibility for the validity thereof. Physical Examination and Autopsy: The Com�any at its own expense shall have the right and opportunity to examine the person of the Insured Person when and so often as it may reasonably require during the pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law. Legal Actions: No action at law or in equity shall be brought to recover on the Master Policy prior to the expiration of 60 days after written proof of loss has been furnished in accordance with the requirements of the Master Policy. No such action shall be brought after the expiration of 3 years after the time written proof of loss is required to be furnished. Not in Lieu of Workmen's Compensation: The Master Policy is not iti lieu of, and does not affect any requirement for coverage by, Workmen's Compensation Insurance. , �anQ- �a. (�na,�.c.,� Prerident. SALARY QUALIFICATION SCHEDULE Annual Salary Maximum Monthly Benefit Annual Salary Maximum Monthly Benefit 1. $ 4,000 - $ 5,000 $ 200 9. $12,001 - $13,000 $ 650 2. 5,001 - 6,000 ?50 10. 13,001 - 14,000 700 3. 6,001 - 7,000 350 11. 14,001 - 15,000 750 4. 7,001 - 8,000 -400 12. 15,001 - 16,000 800 5. 8,001 - 9,000 �50 13. 16,001 - 17,000 850 6. 9,001 - 10,000 i00 14. 17,001 - 18,000 900 7. 10,001 - 11,000 550 15. 18,001 - 19,000 950 8. 11,001 - 12,000 600 16. 19,001 - 20,000 1,000 , � . . f,��,c T�.r,;�i DzSASx��r��z� Ii�SUFJ':r,c�: � _ _ ,��'j,��,� . - � ; �' � __. _. �.l fi:?_�.--i:17;1G' �Ci,�.Vi� G.".1�`.�Oj�C':.'.i cari,�g y�i�'r�C•v�i OX' L1^v2'£.' �l`.:t:ll�l�r �Tl .j'.�:C �'.�t.V QZ I Ste PatiZ a�cs 13 �t� ;,�!� are e?ar;�'.��e ta ar,piy �or tne f'cl�o,rir.� lon� ter� disabtlity pl�n. �;��wlcncc �s .rc•t;.;lir=�d of.��.11 eli�ible e:nployee� �h*ho enr��ll eVicept for :.�owi�s pf i.�su.^?�,ce 7c;� �i: �'�rce. :�`:ont.�i:�y bcnefi�a ca: bc purcl�a�ed in $50 units subject to a ua.�:�:v.:s o� �1G:. M�rid st.b�ect to thc follo�,�ir.,�, na::i�u;�s; . 1`x,nu^? ��'_^:v � Maxa..�:�ur.i 2•`.on�hlv �^nefit : ��,0�4 - ?�7,coa , � .� $35� �l��' � ��,35CC0 � $4C70 ,�`,.�5?00� - wi���� �. � ���� ��.�•�l - ;;::.03C�0 . . �5� � . ��lO�CC� -- �?�,C�O �SSQ � - .��.,00� - ;>>.2pc�o . � �6oa ,>�2�coi - ti��_3�cco . �650 . . � �13 s�oi -- �1�,c;GO �7U� � � . � . Y�.�:sco�. - Y�5,c�o 75Q , �?5�0��. - Y?b,aUo . �Bo� $16,coi �- .��7,c�o $85� . ��•t,co? - ��:;,c�o . ;�a _ ��8,c��i - ��l,,c�o �95� � . � .. �lJp��t � .yCV>CV'J ' � - .. . ��'�O`J . . . .� , .. . 1Y!OL'�.G3 f�.^..^'. £'��',T:�_O`J��.' D^ C11?�.b�E.' ICT 52.1.?.�T"y� b�I��f1J'i..^, fT'C� i'lOZ':�°T1�S �.`;�W��.'.::5^..t10:1� ��:� C3.l�c��J.�1.T•j� Aii JY�S�l'-:•�> Gi �:iC SOC:L�::1 S�CLLT:.'�i.j' :iC� �G��rl rJ:3.,::���f c,T�C� ic.."1�!f J� 1.^-1�_i O:t� Ret�re::._r,L Ac�; er �::�r Vetera.rs f?ry.:��.nistraiien Disabili�-y Pro•.�is�c�; n�bii.c �.�io:,rees ,,,� a 1��,C •t • J. �n-.. t_a :�'^.��"`� � 1+`�n r_. '��Z 1�� Retire:.,.,,V `:•)JOC1 C.�V1.C��, and any Ovlt�d t�O��.T� .. 1 V41 re:,i_ .i.,izv �1^::, ..i� :�. . :� � - jY:.nef��li 1�.r.:��C�'.w �..:.�,.� : ;•i l, � ,� 1�Y; ;�m ,r 1-• r�c�n � � - T. �..�.:n i� he ruci.�.Qez ny �._e o�..��G oz �r.,.�.. b�:�:.iit�, a� or payub�e �� t:�� e:;.c.� ±::a� tl:ese be:ef'��� plus nis ?•{o:a�l�].� �°i�ei:.t i:r��er zhi� ��lzn PXC43GC3. t'.7_S ^c.���..C;i c t)3.L' :`�'=-'::�.^.1:.� ��J:1�fll.;�f S::GI1L'I1� 1Ol' I11S �i�"'.;1•,.LwI. ac`Sl:l�ry ?11 �CCO�(��i.^.Cc�', k*.�..u'.'s �Che Sa?a���y �uali�ic^�io.� Sc�iedule, ho�rever' a r^..in::�a� I�i�ntiil.y Eeneiit of �50 �s �}zaran�f�e:� ra5-able. . . . '�^?�e bent f�.ts be�ir� o:� t::e 18Z�� d;y oi �ct31 c'3.sabil��� an1 are p�id u� -�o ��e 55 far sicl�:es� �;ti3 li�c:�LiW�� :in tiie cu�e o� l3CClt?£.':"iL. Fre��.u.;,� arr wa:�v;:d d:zr�:�� per.�.cd benef�ts are beir.� �aid. i°occturin� u:�subw:.ities sliall be dee�•�d u con�inuaiion o�' the priar di;^�o.��i�•;,� �u:�css• uc�::een �uch �cric�::. �a e:�ploycc hus perfo��:ed tne da��es � o� his rc�ulc:r a<.cupai;ion o:� A continuous oasis tor a� lcas� six �anths. 7.'o�t�l dis�bilit;,� r.�:ccr.:� the inab:i�.it�r of tui e.:.-�ployee to en��:ae in b�:sires� or occupat�.cn of any }-,i.�1a ror wiiic�� ttie emp].oyce is reas�nably fit�cc� by educai.ion� trainin�� or GXpGT�CIICC. ' _ . • QUOTATICN � MONTHLY B�NEFIT � - RATE PER MONTH � $ 100 to � 1,000. Rate for each $50. • benef it $ � . Cit;y��if'�aaint Faul, Minnesota : Hcsalth and Welfare SFecifications Retentions Exhibit First Second Third Year Year Year Gross Premiums Actual Claims Pa.id 50,000. 5d,000. 50,000. Gross Profit Itemizeci Erpenses Commissions Clai� E�:pense Taxes Administration Records and Billing Other E:.peuse Comgany Profit IncurrE�. but unp�.id Cl&im Reserv� � �... Net Profit All retention exhibits shall be figured wiLn the ex�.rnple of "Claims Pe��d" inserteci above. All items not gu�.ranteed refundable upon expir�,tions of claim period sho;xld be entered in "Other Expense". This policy shall b� experience ra�ed and the "Net Profit as shown above shall be returned to the policy holder either �.s a dividend or a retroactive reduction in preMium. There shall be no assessment or retroactive r�,te increase in the event of a net loss.