HomeMy WebLinkAbout1995-06-27; City Council; 13226; AMENDMENT TO CONTRACT WITH NORTHWESTERN NATIONAL LIFE INSURANCE NWNL AND APPROVAL OF APPLICATION FOR GROUP VISION CARE WITH VISION SERVICES PLAN VSPE
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CUT~F CARLSBAD - AGEN~BILL 32 ’? G
AB # 13. aa6 TITLE: DEPT. MTG. 6-27-95 AMENDMENTTO THE CONTRACT WITH NORTHWESTERN NATIONAL ClTY p
DEPT. HR GROUP VISION CARE WITH VISION SERVICES PIAN (VSP) CITY h
RECOMMENDED ACTUON:
LIFE INSURANCE (NWNL) AND APPROVAL OF APPLICATION FOR
Adopt Resolution No. 95-189 amending the City’s contract with
Northwestern National Life Insurance (NWNL) and approval of application
for group vision care with Vision Services Plan (VSP).
ITEM EXPLANATION:
The City of Carlsbad has contracted with Northwestern National Life
Insurance (NWNL) to provide group medical, dental and vision coverage for
City employees. As a result of employee focus group meetings and labor
negotiations with the City’s fire and general employees, staff is
recommending several enhancements to the health insurance program
under Northwestern National Life. These benefit enhancements include:
1 ) dental insurance through NWNL for all employees currently enrolled
in Kaiser medical insurance;
enhanced vision coverage for fire and management employees
covered under Northwestern National Life; and
establishment of a wellness program for fire and management
employees covered under Northwestern National Life.
2)
3)
The above enhancements to the health insurance program are scheduled to
be implemented on July 1, 1995. An amendment to the City’s contract
with Northwestern National Life is required to add Kaiser enrollees to the
NWNL dental plan, to exclude vision care coverage under NWNL for fire and
management employees, and to establish a wellness benefit through NWNL
for fire and management employees. This amendment is attached as
Exhibit 2. Fire and management employees covered by NWNL medical
insurance will receive enhanced vision benefits from an outside firm
called Vision Services Plan, or VSP.
vision care required to establish this benefit.
Exhibit 3 is the application for group
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PAGE 2 OF AB# /3,22C4
FISCAL IMPACT:
The estimated costs associated with the enhancements to the health
insurance program are $91,000 per year. These costs will be funded from
the City’s Health Insurance reserve fund for the term outlined in the
Carlsbad Firefighters’ Association and the Carlsbad City Employees’
Association Memoranda of Understanding (through December 31, 1996 and
December 31, 1995, respectively.)
EXHIBITS:
1. Resolution No. 95-18?
2. Amendment to the City’s Contract with Northwestern National Life
3. Application for Group Vision Care with Vision Services Plan (VSP)
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EXHIBIT 1 0 e
RESOLUTION NO. 9 5 - 189
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
CARLSBAD, CALIFORNIA, AMENDING THE CONTRACT WITH
NORTHWESTERN NATIONAL LIFE INSURANCE (NWNL) AND
APPROVING THE APPLICATION FOR GROUP VISION CARE
WITH VISION SERVICES PLAN (VSP),
WHEREAS, the City of Carlsbad has considered the document
entitled “EXHIBIT 2 and finds it in the best interest of the City to
amend the City’s contract with Northwestern National Life (NWNL);
and
WHEREAS, the City of Carlsbad has considered the document
entitled “EXHIBIT 3” and finds it in the best interest of the City to
approve the application for group vision care with Vision Services
Plan (VSP); and
WHEREAS, complete and true copies of said documents are
attached hereto and made a part hereof;
NOW, THEREFORE, BE IT RESOLVED by the City Council of the
City of Carlsbad, California, as follows:
1. That the above recitations are true and correct.
2. That the Agreements referred to in the recitals above
are incorporated in this resolution by reference.
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3. That the amendment to the City’s contract with
Northwestern National Life (NWNL) will be adopted by the City of
Carlsbad effective July 1, 1995, as evidenced by the authorized
signature of the Human Resources Director on Exhibit 2.
4. That the application for group vision care, dated June 2
1995, will be adopted by the City of Carlsbad effective July 1, 199
as evidenced by the authorized signature of the Human Resources
Director on Exhibit 3.
PASSED, APPROVED, AND ADOPTED at a regular meeting of the
Carlsbad City Council held on the 27th day of JUNE 9
1995, by the following vote, to wit:
AYES:
NOES: None
ABSENT: None
Council Members Lewis, Nygaard, Kulchin, Finnila, Hall
ATTEST:
ALETHA L. RAUTENKRANZ, City $lerk
(SEAL)
LII1LIJ.UJ.I L a 0
Route No.
Home Ofice use ( 1 To: Northwestem Nai ional Life Insurance Company
Box 20 - Minneapolis, Minnesota 55440
Request for Amendment of Group Plan(s)
Please be complete and speci$c in your request.
Group Plan Name CITY OF CARLSBAD
Group Plan Number(s) AS0 24438-4
Effective Date for Amendment(s) 07/01/1995
(if possible, the effective date should be the first day of a plan month)
Request is hereby made to Northwestern National Life Insurance Company for the following
revision(s) to the Group Plan(s) indicated above:
Terminate vision benefits with "L for all claim accounts (except claim account 3 General
resulting in an AS0 fee reduction of $.25 per employee per month for those terminated clair
accounts.
Add dental benefits for employees enrolled under the Kaiser plan (claim account 10). AS0 fee
will be $4.25 per dental only employee per month.
Add an annual $250 per family wellness benefit for all claim accounts (except claim account :
Generalj to be administered through the Reimbursement Account Administration Department ii
Minneapolis, MN.
(If additional space is needed, please use reverse side)
Dated 3 I
39279
-ILIA----- d L-
VISION SERVICE PLAN
APPLICATION FOR GROUP VlSIGN CARE PLAN
Virion Service Plan
P 0. Box 997 100
Sacramento, California 95899.9980
(800) 852-7600
Altn: SaIes Department
All applicable questions must be
completed accurately and in detail to avoid unnecesary
coricspondence and delay Additionally, applications inust be received
thirty (30) dayr in adkance to ensure the plan is impleinented by the effective date
1/05 V\I’ -4
0 VISION SERVICE PLAN e
APPLICATION FOR GROUP VISION CARE PLAN
___-____-__-_-_-__--_---------~"----------------_-_- GROUP ENFORbfA'rION __________________________________I____
I. Full lcgal 113111c of proposed group CITY OF CARLSBAJI
~~ .__. .-....- ... (As it is to itppcar on Policy) Addrcss 1200 Carlsbad Village Drive
San Diego County- _-._. ~- ~ City State ZlP-..-----
__- __._ ~_._ .... ......
Carlsbad CA . 92008
___ - 'I'clcpIiorie ( 51-)434-2852 * Fax#( 619 ) 720-1875
i'rincipai Contact Julie Clark Title Human Resources Manager
'I'clcphonc ( 619 ) 434-2853 v ) 7'0-1875
-.
Title-Human Resources Ass is t i
Human Resources Assii
2. who stioiild we C~II with Paymcnt uestions? Debbie 'campo .-
-..______
-~ ...- ___.__ Titlc 3. Who should wc I o 'fy for. Fligibilit questions? ... Debbie Ocampo
'I'cicptionc ( 6'4 ) 434-2853 Fax # ( 6192O-1875 .--..~.
How would you like your Eligibility contact to be notified of eligibility rejections?
&Fax Or LTelephone -Mail
Is hcre sonieone ti I than your Principal contact who will be responsible for the overall administration of thc plan (Hencfits Adiiiiiiii
N;inie- 8)s. Title ...
(if different from above)
lj'tnidriple Uetrejits Adriiiriistrators exist at other locations, please attach separate piece ofpaper, with tiuine(s). ridtit.c.c.c(c,s). plww. ./;I
4.
______ __-.__.
Direct dial phone Fax ## (.---..-) -.
5. Do you know your Standard Industry Code? Division and Major Group what is tile Nature of your Business? government agency ___.___ ._..._ ......
~_._.
6. Nmes of Subsidiary or Affiliated Companies or Divisions who use another name and will be covered by this plan:
NAME CITYETATE NA'HJRf! (If.. 1st
__-- ~ __.__ ~.- -..- ~
___.~~ ________._ .. - N 7A
____._~
7. Billing address: FiridOrganization City Of Carlsbad ___ ......
-~ Address: 1200 Carlsbad Village Drive
City: 92008 Zip: CA State: Carlsbad
--. 619 720-1 8 75 tion one( 619 ) 434-2852 Fax # (-1 Will scparate billings be required? Yes X No (ifyes, please atrach or indicate in 3% nmws c~fc/n.s.\ijic~tiriorr.c.. loc~titio~r (i
iticliidin<q coiitrty , telephone arid fax niirnber, and conract)
II' Atliiiinislrntivc Sci.vicc 1'rogr:iiii. do claims billings xitl adniinistrntivc fcc billings go to s;iiiic p'crson? .......
.vii/)/ily i'i)ti/iii'/ ir)iil /i//c,, iii/tlrc,.s.v, tc*l(~l~lroric~. Ji1.v #/i,r. erir.11 /~/Jc c$hiIlirig)
YCS NO (//'/),I. 11
8. If'rape reporting: Contact N/A Title
Firm -.
Adtlrcss ~__ ..... - ... City State Zip Phone ( )
Fax # ( )
9. Deliver brochures to: x Group's Benefit Administrator ~ Third Party Administrator ~ Bro kcr/Con s ti I tn I
__ Other - lf~norc /litin one locntion, please attach a separate piece of paper with names, addresses and nutiiber of brochrrres r-eqiiiretl ut errcA I(
trdrlirior~cil fie coiild he require(1,fi)r rnultiple locations.
IO. Eligibility rulcs for covcrcd cinployccs (my exclusions must be based upon conditions pertaining to eniploynicnt)
( x) Full tinic cniployccs (who uwrk :i[ Icnst
( ) 011icr (:lcscril>c iii c!c!~:il)
30 __ hours per week)
____ _____.______.___ ~ .._______._.. ._. ............... ~___ ______.._.._. ......
1/93 - YS!'
' 1 I. Waiting period: New employees will b rn ,ible on the first day of the calendar month follow @ . date of hire -G4mpkt.s
O%LW*UifflUWCfC44k-4*yWR(r
( ) Other (describe in dctail)
12. 'l'otal nuiiilxr of a11 covered employees
13. I)cpeiidciil.;: I )cpciitlcnts, if eligible. are the covcred employee's spouse and unmarried dependent children who have not attaincd tlici
___.._ 19th bii.lhday (also includes an unmarried child if incapable of self-support because of physical or inental incapacity that coi prior to reaching the above age), or their
14. 'l'lic 'l'liird I'ni-ty Adiiaiii.<trator (it'applicnblc):
140
24th birthday, if attending school full-time.
I :i rm NIA
Atldrcss
city_.-- State Zip -
I'llollc ( ) Fax # (L.-.-..)
co I1 t act Title
_____---_-____----_--_-------------------------------- POLICY DETALLS--------------------------------------------
IS. 1:reiluency 01 Scrvicc - Slandard Plan: A ( 12/24/24) x B (12/12/24) . C (12/12/12)
~- Oilicr (Ilxaiii-months; Lenses-months; Frames-months) or __ Exam Only (every-months)
Exam/$ Materials I)ctluctible: $ 25 * 00
IO. (;roup has purchased Extended Benefits: __ Yes
Total deductible (applies to exam and materials) or Split $
XNo. If yes; -Covered Contact Lenses - Second Pair of Glasses - Vision Therapy -Primary Eyecare - Safcty Eyccarc
I;requciicy of Service: Exam-months; Lenses-months; Frames-months - Deductible !$
17. fOR INSURHI PROGRAMS:
First month's premium remittance calculation:
Employee Only or Composite x$ =$
TOT/
KEMITIA NC ## EES RATE
~wo- or Time-ratc Basis E only 50 x$ 8.69 - - $-___-....-- 434.50
= $1,394.46-
$p.------ x$ -
E+l 29 x $ 13.26 = $ 384.54
Family 61 x $ 22.86 -
TOTAL = $ 2,213.50
I 8. I~'0R Al)h~~lNISl'I<A77 VI:' .I'ERVlCE PROGRAMS:
,~[~iiiiiii~~i.~iti~~. I:cc: I:ixctl lw- N/A or Pcrccnt of clnims __.____.. .-._....__.. .
I)rct'untling ( Advaiice Payinent) Amount if Group is an Administrative Service Program
$- rfi (per covered employee - as quoted) x - -
(# ees)
IO. I<cqucstcd cl'lcctivc dntc (Effective date should not precede date of receipt of this application by the company)
This policy will become elfective on the 1st day of
complcted prior to this effective date:
July , 19 95 , provided that all of the following t
A.
R.
C.
Application has been received and accepted by Vision Service Plan.
VSP has becn furnished a list, tape or diskette of all employees showing name, social security number, and number of dcpc
if applicable.
A check for first month's premium [together with ASP advance payment (prefunding), if applicable] is included herewith;
payments are due on the 1st of each consecutive month.
20. 'l'his agrccnicnt will continue in force 24 months from the effective date.
I/9S - VSI'
I I, 5500 licpor~ Irit'ormation (if over IO ni ployees): Financial Year July 1 0, through June 30
5.500 will be wit to [lie pci-son named as Pi-incipal Contact. A copy of the report may also he sent to your Broker and /or yo~r Tliir
A 11 I i I I 11 is I f;i lor.
1'lc;Ix sclltl ;I c01,y to:
12. l'rior ctrvci-;iyc \villi VSP: Yes x No
It' Yes: Prior Group Name Was prior group coverage: HMO Plan Association Union Otl~er-
Other carrier:
2.3. '1'11~- p1;iii (\\ill ..- ._.__ will not x ) be ol'lcred undcr $ 125 of [lie Internal Revenue Code ;IS an optionol benefit.
2-1. 9 125: 1'~i~c~iitiiyc ol'~)reiiiiuins to be coii[i-ibuted by group
Olllcr-
Percentage of premiums to be contributed by cinployccs
______________-_____------------------------------------- ACREEMENT----------_--------_-------------_-----_----.
'l'lic iiniIcr\igiicd yroiip hcrclly applies [or vibion ci11-e coverage through Vision Service Plan.
11 i\ IIII~I~I~SIO~I~I [hiil:
;I. 'l'l~c grotip will cover all einployees specified tinder Item 12 and pay 100% of the cost (if $125: %of cos1).
1%. All I'iiiiii.~ ciiiployccb \vi11 be covered when they bccomc eligible.
C'. C'o\~ragc will tcriniiiatc lor ;in employee on the last day of the month in which his employment terminates.
I). R~~IIII~cI. pasi xrvicc lor grotips prcviously covered by VSP will carry over and remain in force.
,I9 95 June 'l'lii\ ;ipplic;i\ioii >igncLI this 20th day of
City of Carlsbad
& Ann Jensen Title: Human Resources ____ Direct< - _.
below is hereby designated Broker of Record by the above signed employer
________-_-____---__--------_-------------------------- BROKER/CONSULTANT--------------------------------_
1,'11.111 hiill1lc: ........... ___-.___. __
Atl~liC\h: ..... _......._ ______ .-
( 'I[),: ........... .~ sti1tc: Zip: Phone:( ). ___ ~
('ollllly: .... Fax#: ( )
c 'oiltact Nari~c:. -...-...... Title:
________
(1'Ic;isc I'rint)
Iii-ohci. /I>>i>I;iiit Nanic:
'l~ilxp;lyc1. 1.1). #:-
C'(iiiiiiii~\ioii ('hcchs l'ayablc to: Firin Name Contact Name Not Pai
'l'his appliciiiioii signed this day of 7 19--
I3y Siaic I .icciisd Agelit:--
l'1,I~~ASl~ I<NCI,OSl< A COPY OF AGENTBROKER LICENSE.
Title:
li'li . VSI'