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Unawarded Health Insurance Bids • Aick Fds QN_Brh Jr Littlne_C__ 1.30- u i (I ULuCULCULCI, &at COLEtrat (1) Jc Ltet ,S:LL ) 1)(10 Ct (LCLiyil(r't a(nuithrt crt6E.Arkattfou aid q\ tnur,\ Cuu., --tOk_Cuk POSTING of CITY OF OKEECHOBEE HEALTH AND LIFE INSURANCE BID FIN 02-32-06-01R Date and time of posting: 7-27-01 2:30 P.M. By: BC Three day period ends: 8-1-01 (&, 2:30 P M. By: NOTE: Failure to file a protest within the time prescribed in s. 120.53(5), Florida Statutes, shall constitute a waiver of proceedings under chapter 120, Florida Statutes. Offers from the vendors listed herein are the only offers received timely as of the above opening date and time. All other offers submitted in response to this solicitation, if any, are hereby rejected as late., TABULATION SHEET FOR INSURANCE PROPOSAL FIN 02-32-06-01 (RE-BID) Vendor/Policy Arthur J. Gallagher& Florida Health Care Sigma Group Insurance Company Plans Solutions Insurer Public Risk Management Same Same Blue Cross/Blue Shield Preferred Provider Option(PPO)High Deductible: Calendar Year$100.00 (3 per family aggregate) Per Admission $100.00 (Non PPC Hospital Only) Employee Only $356.23 No Bid No Bid No Bid Employee and Spouse $744.59 No Bid No Bid No Bid Employee and Child $694.32 No Bid No Bid No Bid Employee and Family $1,082.81 No Bid No Bid No Bid Preferred Provider Option(PPO)Low Deductible: Calendar Year$500.00 ( 3 per family-aggregate) Per Admission$500.00 (Non PPC Hospital Only) Employee Only $317.91 No Bid No Bid No Bid Employee and Spouse $658.42 No Bid No Bid No Bid Employee and Child $614.35 No Bid No Bid No Bid Employee and Family $954.97 No Bid No Bid No Bid Preferred Provider Option (PPO)Traditional Deductible: Calendar Year $300.00 Hospital $300.00 Employee Only No Bid No Bid No Bid $378.99 Employee and Spouse No Bid No Bid No B id $741.04 Employee and Child No Bid No Bid No Bid $668.09 Employee and Family No Bid No Bid No Bid $1,030.31 Health Maintenance Organization Option Blue Care (HMO) Employee Only $313.53 No Bid No Bid $250.35 Employee and Spouse $608.70 No Bid No Bid $516.06 Employee and Child $570.50 No Bid No Bid $457.93 Employee and Family $865.80 No Bid No Bid $723.64 .00% tegaotillEI\ 4151P,, .1500 tolvi ......................... CITY OF OKEECHOBEE - INVITATION TO BID HEALTHAN - INSURANCE Sealed PROPOSAL/BID(S) will be received by the City of Okeechobee, General Services Office, City Hall, 55 SE 3rd Avenue, Rm 101 , Okeechobee, FL 34974, (863) 763-3372 until 3:00 pm on Monday, July.. 201g0 at which time they will be publicly opened and read aloud. Any PROPOSAUBID(S) received after the time specified will not be accepted. Facsimile or e-mail PROPOSAUBID(S) will not be accepted. PROPOSAUBID(S) may not be revoked after PROPOSAL/BID opening. HEALTI-LAFE INSURANCE FIN 02-32-06-01 (Re-Bid) A complete set of this proposal/bid may be obtained from the Finance Department, Rm 102, during normal office hours, Mon-Fri, 8:00 am to 4:30 pm. The City of Okeechobee reserves the right to accept or reject any or all PROPOSAUBID(S), with or without cause, to waive any technical errors or informalities, or to accept the proposal/bid(s) deemed most advantageous to the City. Bill L. Veach, City Administrator City of Okeechobee, Florida • II 11111 P 41.11 M MME! 11411 .N1A11.1( POSTING of CITY OF OKEECHOBEE HEALTH AND LIFE INSURANCE BID FIN 02-32-06-01 Date and time of posting: 7-09-01 (&,4:00 P.M. By: LG Three day period ends: 7-11-01 (a, 4:00 P M. By: ALL BIDS WERE REJECTED. ITEM WILL BE RE-BID. NOTE: Failure to file a protest within the time prescribed in s. 120.53(5), Florida Statutes, shall constitute a waiver of proceedings under chapter 120, Florida Statutes. Offers from the vendors listed herein are the only offers received timely as of the above opening date and time. All other offers submitted in response to this solicitation, if any, are hereby rejected as late., ei" GROUP INSURANCE 46 ee#e4, ate. July 10, 2001 Ms Lola Parker City of Okeechobee 55 SE 3rd Ave Okeechobee FL 34972 Dear Ms Parker, Enclosed is the comparison of the City's present Blue Cross plan and a Dual Option renewal alternate. The Employer cost illustration assumes that the City pays 100% of single coverage and $70 per month toward the cost of dependent coverage. . If you have any questions, please call. Thank you. . r. I Scott A Harris 18230 RIVER OAKS DRIVE • JUPITER,FL 33458 • PHONE 561-747-5636 • FAX 561-747-3524 • 800-972-0963 el GROUP INSURANCE Ggildatiek44, GtiIC City of Okeechobee August 1, 2001 Group Health Insurance Blue Cross/ Blue Shield Renewal Comparison Benefits Care Manager A16 HMO Bluecare 4 PPO Plan 107 Present Dual Option Renewal Alternate HMO Lifetime Maximum Unlimited Unlimited NA Office Visit CoPay $ 5 $ 10 NA Hospital CoPay $ 0 $ 10 NA Emergency Room CoPay $ 25 $ 50 NA Prescription CoPays $5 generic/ $10 name $5 gen/ $15 pref/ $30 non pref NA Access to both plans all year? YES NO- insured selects HMO or PPO once a year Traditional/PPO Lifetime Maximum $ 1,000,000 NA $ 5,000,000 Calendar Year Deductible $ 300 NA $ 300 Hospital Deductible $ 300 NA $ 0 Co-Insurance 80 % NA 80 %par, 70 % non Out of Pocket Limit $ 2,000 + deds on covered charges NA $ 1,500 +ded on coy charges Prescription CoPays $5 generic/ $10 name NA $5 gen/ $15 pref/ $30 name Rates Present Renewal HMO PPO Employee Only (38) $ 230.10 $ 270.80 $ 250.35 $ 378.99 Employee/ Sp (8) 517.50 609.10 516.06 741.04 Employee/ Ch (9) 480.30 565.30 457.93 668.09 Family (4) 767.80 903.70 723.64 1,030.13 Annual Total (59) $ 243,338 $ 286,380 $ 247,891 $ 365,562 Total $ Change $ 43,042 $ 4,553 $ 122,224 Employer Cost $ 180,551 $ 209,366 $ 194,888 $ 285,965 Employer Cost$ Change $ 28,815 $ 14,337 $ 105,414 Employer Cost% Change 13.6 % 6.7 % 49.6 % 18230 RIVER OAKS DRIVE • JUPITER,FL 33458 • PHONE 561-747-5636 • FAX 561-747-3524 • 800-972-0963 :•. rf. $$$ •`'v`l'•r�:��$$':i:•,;:.;..4rS•. ''tiii{tii,�i"i�Y{:.:,..}:'.{}. :$$j:�?.•}: ."7), •+•.'•nv,/.,r':�%`� ,}\'}� ±: 'x\,}+}�;Fx4:$,:`rr�/rr.�' ..:,;?}}f.+;:�ik�k;:F: 1 CITY OF OKEECHOBEE - INVITATION TO BID HEALTH AND LIFE INSURANCE Sealed PROPOSAUBID(S) will be received by the City of Okeechobee, General Services Office, City Hall, 55 SE 3rd Avenue, Rm 101 , Okeechobee, FL 34974, (863) 763-3372 until 3:00 pm on Monday, July 23, 2001 at which time they will be publicly opened and read aloud. Any PROPOSAUBID(S) received after the time specified will not be accepted. Facsimile or e-mail PROPOSAUBID(S) will not be accepted. PROPOSAUBID(S) may not be revoked after PROPOSAUBID opening. HEALTH AND LIFE INSURANCE FIN 02-32-06-01 (Re-Bid) A complete set of this proposal/bid may be obtained from the Finance Department, Rm 102, during normal office hours, Mon-Fri, 8:00 am to 4:30 pm. The City of Okeechobee reserves the right to accept or reject any or all PROPOSAUBID(S), with or without cause, to waive any technical errors or informalities, or to accept the proposal/bid(s) deemed most advantageous to the City. Bill L. Veach, City Administrator City of Okeechobee, Florida • 'fiWk!<frlFFFF!//%�`�Ff/!f!F!!/fIFF!!f///ff1 ` "�.,,��•_:. r`rr.<:nufrrr lccu«carf :.lrf?b:7.�$•.'.e?2'dCH:iG£;Kc'.... :............. ,,..r ::x<;<rr<:.rrr..r ::rr fr ff!`rala::.rr:r.r....... -.�!•r.frs:?.r /f"{f:f•...:ffff q ...,r,. - uc- �a::r{{n,:�{{{n{{f;>}4c,:t; l .. ............:. ....'....... ...... .::�1 .........:r........ ::..,:.:::::::::::........ .......:w::::::.::::.. ...............::::::•::::.}}:}}}}:?^}}}::}}:?!::?..•:::.::is ii... :..i..:}j$�$$$:ii}'r}:;:;•: ... ......... .... ........:........ ............n.. ..................................,.......:•.................................. ......................... :::::::.}}v:::::::•::.iii>$};1.}}iii$$:ii$$'r::$;:;: (1,411. %ti•}}i;:r::::::x.•:4:::+ :::::::::.:v:.:, -.- r-r ..'F.lf:r;rrf r...rrA •r.••}}i:•iF:x:::. f...{- :•>:•}}i:::::iiii:•: -.-. ...- r - -- -.-... f -f...-. .....-.. :{:' :$/.•: .r .� xr.,ff..�ri:r.9f ff :.}'$z:H:�:furl r.•_a;ci:,,k/„wfir:,iriiiil;fGir::feo<ue m<.uiwic{e-�1r1�i�ir.'ocN#f�ucGJifctdfoc«ac.ufff:.:2G.:iffrrr rfi/,.:..,,",,...,� /:.....i�l.//..lfiL.✓ . ii Vic . / • facsimile TRANSMITTAL to: Independent Newspapers of Florida- Okeechobee News - Legal Ad Department fax#: 1877-354-2424 from: City Clerk's Office 763-3372 ext. 215 re: Legal Advertisement - Invitation to Bid Health Insurance date: May 17, 2002 pages: 2, including this sheet. Please publish the following advertisement as a Legal on FRIDAY, MAY 24, 2002 Proof of publication requested. Attached is our purchase requisition #11744: INVITATION TO BID HEALTH INSURANCE FIN 01-00-05-02 Sealed PROPOSAUBID(S) will be received by the City of Okeechobee, General Services Office, City Hall, 55 SE 3`d Avenue, Rm 101, Okeechobee, FL 34974, (863) 763-3372 until 3:00 pm on Friday, July 5, 2002 at which time they will be publicly opened and read aloud. Any PROPOSAUBID(S) received after the time specified will not be accepted. Facsimile or e-mail PROPOSAL/BID(S) will not be accepted. PROPOSAUBID(S) may not be revoked after PROPOSAL/BID opening. HEALTH INSURANCE FIN 01.00-02-02 A complete set of this proposal/bid may be obtained from the Finance Department, Rm 102, during normal office hours, Mon-Fri, 8:00 am to 4:30 pm. The City of Okeechobee reserves the right to accept or reject any or all PROPOSAUBID(S), with or without cause, to waive any technical errors or informalities, or to accept the proposal/bid(s) deemed most advantageous to the City. Bill L. Veach, City Administrator City of Okeechobee, Florida G\y.\OF pKF‹c14 ' 111!rk ; ,915*__ - City of Okeechobee May 17, 2002 The City of Okeechobee would appreciate your assistance in obtaining proposals for our Group health insurance . The ob- jectives of the proposals are : 1 . To compare the cost and benefits of our current plan with Plans that you represent . We would like to see if there would be any way of saving any material premium expense with comparable benefits . 2 . Not to place the City in any jeopardy of losing our present insurance plan or increasing our present rate with Blue Cross/ Blue Shield Insurance Co . 3 . Not to place in jeopardy any employee' s or dependent' s current coverage with Blue Cross/ Blue Shield Insurance Company, and to make sure that any Proposal that you might Submit would include absolutely no loss of any Benefit for any employee or their dependent due to a preexisting medical condition. 4 . That current and future retired employees and their dependents may stay on the plan. That current and future retired Elected Officials that may leave office and their dependents may stay on the plan. 5 . That the current and future retired City Attorney and their dependents are eligible and may stay on the plan. Enclosed are specifications of current insurance benefits, so that you may submit a proposal with no lesser of a benefit structure . The City will not entertain any proposals from insurance carriers who are not rated at least A+ or A++ by the A.M. Best Company. We would appreciate receiving your proposals on or before Friday July 5, 2002 at 3 : 00 P.M. . Sincerely Lola Parker Account supervisor 55 S.E.Third Avenue•Okeechobee,Florida 34974-2932•(863)763-3372•Fax: (863)763-1686 HEALTH INSURANCE PROPOSAL MAINLING LIST MAY 17, 2002 1. CHPA ATTN: MAJORIE SILBERMAN 4152 WEST BLUE HERON BLVD, SUITE 226 RIVIERA BEACH, FL 334 2. MURRAY INSURANCE SERV. INC. P.O. BOX 1417 OKEECHOBEE, FL 34973-1417 3. BERGER INSURANCE AGENCY 800 SOUTH PARROTT AVE OKEECHOBEE, FL. 34974 4. SCOTT HARRIS, GROUP INS. SOLUTIONS 18230 RIVER OAK DRIVE JUPITER, FL 33458 5. JOHN E. BURDESHAW INSURANCE 505 N.E. 4TH STREET OKEECHOBEE, FL. 34972 6. DEAKINS-LAWRENCE INS. INC. 2020 SOUTH PARROTT AVE OKEECHOBEE, FL. 34974 7. FARM BUREAU INS. 401 N.W. 4TH STREET OKEECHOBEE, FL 34972 8. DAVID HESTER INS. AGENCY 204 N.E. 3RD STREET OKEECHOBEE, FL. 34972 9. BRUCE HOMER INS. AGENCY 900 SOUTH PARROTT AVENUE OKEECHOBEE, FL 34974 10. LAKE OKEECHOBEE INSURANCE 407 SOUTH PARROTT AVENUE OKEECHOBEE, FL. 34974 11. PRITCHARDS & ASSOCIATES 3555 SOUTH 441 OKEECHOBEE, FL 34974 4'1 12. BILL LANE, FL HEALTH CHOICE PLAN 5300 WEST ATLANTIC AVENUE SUITE 302 DELRAY BEACH, FLORIDA 33484 13. MARC WEISS, ASSOCIATED FINANCIAL SERV. INC. 2699 STIRLING ROAD SUITE B 100 FT. LAUDERDALE, FL. 33312 14. AETNA HEALTH PLAN OF FLORIDA, INC. 4890 WEST KENNEDY BLVD SUITE 545 TAMPA, FL. 33609 15. CIGNA HEALTH CARE OF FL., INC. COMPLIANCE & CONTRACT DEV.-C-38 HARTFORD, CT. 06152-1038 SP( 16. FLORIDA HEALTH CARE PLAN, INC. °+ vest) P.O. BOX 9910 DAYTONA BEACH, FL. 32120 ( (e 17. BROWN & BROWN INSURANCE P.O. BOX 1229 - - TAMPA, FLORIDA 33601-1229 18. GARY LIVINGSTON SENIOR ACCOUNT MANAGER EOS/REVIEWCO 1240 MELISSA LANE DAVIE, FLORIDA 3325 19. ON TARGET SOLUTIONS ATTN: LYNN 182 COLLY WAY NORTH LAUDERDALE, FL 33068 20. TRUST INSURANCE GROUP 5439 SW 148 PLACE MIAMI, FL 33185-4029 21. ARTHUR J. GALLAGHER& CO. 1 BOCA PLACE SUITE 400E 2255 GLADES ROAD BOCA RATON, FLORIDA 33431-7379 222 Mark Sittig (mailed out 6-25-02) Membershiop Services Manager c/o Florida Lueage of Cities , Inc . P .O. Box 1757 Tallahassee , Florida 32302-1757 TABULATION SHEET EXHIBIT 3 for JUL 16 AGENDA Health Insurance Proposal FIN 01-00-05-02 Vendor/Policy Arthur J. Gallagher&Company Group Insurance Solutions Insurer Public Risk Management Blue Cross/Blue Shield Preferred Provider Option (PPO)High Employee Only $545.55 $394.16 Employee and Spouse $1,162.30 $852.67 Employee and Child $1,082.45 $725.67 Employee and Family $1,699.39 $1184.18 Preferred Provider Option(PPO) Low Employee Only $486.93 $367.89 Employee and Spouse $1,030.45 $795.88 Employee and Child $960.09 $672.27 Employee and Family _ $1,503.77 $1,100.26 Health Maintenance Organization Option Blue Care (HMO) Basic High Low Employee Only $485.80 $304.44 $297.09 Employee and Spouse $1,004.04 $658.00 $642.00 Employee and Child $936.95 $549.28 $536.45 Employee and Family $1,455.33 $902.80 $881.36 g;(1/6t/ i AetoiS 5439 SW 148`h Place MIAMI, FL. 33185-4029 Correspondents Lloyd's of London • Tel.:(305) 559-0545 • Fax:(305) 207-9684 August 11, 1997 ATTENTION: PURCHASING DEPARTMENT RE: CHANGE OF OUR ADDRESS IN YOUR BIDDER'S LIST Dear Sir/Madam : We are included in your Bidder's List to quote for INSURANCE COVERAGES (ALL TYPES). Kindly, update your records with our NEW ADDRESS AND TELEPHONE NUMBERS. TRUST INSURANCE GROUP 5439 SW 148 Place Miami, Fl. 33185-4029 Telephone: (305) 559-0545 Fax: (305) 207-9684 Please, send us confirmation of the receipt of this communication. Thank you very much. Kind regards, a(4) / CARLOS R. RAFFO President �II j II TABULATION SHEET for Health Insurance Proposal FIN 01-00-05-02 Vendor/Policy Arthur J. Gallagher& Company Group Insurance Solutions Insurer Public Risk Management Blue Cross/Blue Shield Preferred Provider Option (PPO) High Employee Only $545.55 $394.16 Employee and Spouse $1,162.30 $852.67 Employee and Child $1,082.45 $725.67 Employee and Family $1,699.39 $1184.18 Preferred Provider Option (PPO) Low Employee Only $486.93 $367.89 Employee and Spouse $1,030.45 $795.88 Employee and Child $960.09 $672.27 Employee and Family $1,503.77 $1,100.26 Health Maintenance Organization Option Blue Care (HMO) Basic High Low Employee Only $485.80 $304.44 $297.09 Employee and Spouse $1,004.04 $658.00 $642.00 Employee and Child $936.95 $549.28 $536.45 Employee and Family $1,455.33 $902.80 $881.36 POSTING of City of Okeechobee Health Insurance Bid FIN 01-00-05-02 Date and time of posting: 7-9-02 (a, 8:32 a.m. By: CA Three day period ends: 7-12-02 (a, 8:32 a.m. By: W.- Note: Failure to file a protest within the time prescribed in s. 120.53(5),Florida Statutes,shall constitute a waiver of proceedings under chapter 120,Florida Statutes. Offers from the vendors listed herein are the only offers received timely as of the above opening date and time. All other offers submitted in response to this solicitation,if any,are hereby rejected as late. BID TABULATION SHEET BID # , TITLE „ ITEM NO. & DESCRIPTION c TOTAL OFFER TERMS DELIVERY RECOMMEND AWARD • May 30 03 12:46p Scott Harris elBlue Cross ElueShield of Florida OM CM.* .4 OS Mold 41eallso 5/29/7003 JAMES KIRK CITY Or OKE ECHOBEE 55 SE 3RD AVE OKEECHOBEE, FL 34974 -2903 561- 747 -3524 P.2 770 Notihpoint Parkway, Suite 200 West Palm Brach, FL 33407 Anoiventary Date: 5/1/2003 Group Number: 90206 Product: B1ueCare NFQ LG Grp Plat► 4 wBlueCare Rs 5/15/30C Dear JAMES KIRK: Thank you fir being part of the one million plus Florida residents covered either by Blue Cross and Blue Shield of Florida, lac, or Health Options, Inc. We Iook forward to continuing to provide your business with quality health cans coverage. We have reviewed the futons that affect the cost of your group health benefits program. The new group rates noted op the enclosed documents ere subject to Florida Department of Insurance approval and our policyholders will not be billed for these proposed rates until the Florida Department of Insurance has issued approval. Employee Only Emnleygj(raiNaae EmPloyes/glildfran) F.neoloyes/Fam0v HMO 341.16 750.35 627.40 1030.79 The rates sasume that your group tree set qualify as a Small Group according to Section 627 .6699, Florida !tanned. In the event that your group hen 50 or fewer eligible employers, (employees who worst 25 hours or molt per week), please contact our office immediately. To continue group health benefits and to provide for smootb flow of claims proesadig for your eovcrsd employees and their covered dependetta without intertvptton, please (1) complete and age an Enrollment Summary; (2) provide a topy e4 your'most recent Employer's Quarterly Tax Report (UCT4] or IRS ton documentation appropriate to your bualam type. This may Include an IRS schedule C, 1120, 11105 aed K -1's, or 1065 and K -1's; then (3) return all of the above Information requested fa tilts notice by the 15th of the mend+ prior to your regt val date. sot return eh • ..1. aced bashes* • I 1.141: ntatlon rt J.2 anal s our cove { d as of your scheduled ar! tsr dais. , If you decide to change to another plan design instead of the one shown above, a new True Group Application must be aignod and returned 15 days prior to your anniversary date in order to assure a smooth transition. Under the Health Insurance Portability and Accountability Act (i:iIPAA) your group is required to hold an annual open enrollment, Your group's open enrollment period will begin 30 days prior to your anniversary date. Eligible employees and their eligible dependents who have satisfied their waiting period can now enroll for coverage. We would like to advise you that we can make available to you the following additional products: Dental Voluntary • Life, STD, LTD Short Term Disability Premium Conversion plan (Sec. 125) Ling Term Disability Flexible Spending Accounts (FSAs) Basic Life 4011( meek you for the opportunity to save you and your employees. We value your company's business and look forward to working with you in the future. Sincerely, Blue Croat Blue Shield of Plotida LINDA C LOWERS Account Repmeatativs Cc. GROUP INSURANCE SOLUTIONS INC - 0714 561- 747 -5636 561 - 147-3534 1'd 1Sd 013IHS 3f11H SSOhD 3f119 WtiOP :60 E0. 0E .ltil•JJI.GIua May 30 03 12:46p Scott Harris 561- 747 -3524 P.3 1;31tr+ u= 7that9hield - of Florida OP`s' ENROLLMENT SUMMARY • R ' i• COMPLIANCE (CTRF_CTC APpitOFR1ATR BMA 11 Our company employed 20 or more full and/or part -time employees* during the previous calendar year and is subject to federal COBRA. All full and part -time common law employees of en employer are considered in drtsrmining COBRA compliance. All full time ranployees are counted is one employee and each part-time employee is counted as a fraction of an employee. 0 Our company employed fewer than 20 full andtor part -time employees* eluting tbepreviou3 calendar year and is subject to the Florida Health Insurance Coverage Continuation Act ( °FHICCA "). All full and parr -time common law employees of an employer are considered in determining • COBRA compliance. All full time eTOployam are counted as ooe employee and each pats -lino employee is counted oa a fraction of an employe. "'For COBRA and FHICCA purposes, self- employed individuals, independent contractors and non - employee directors are not counted. SECONDA ' V , p MPLT N . . , AhIPRO ljou ars a s e employer plea: ❑Yea IIU No Our company employed 20 or more employees** eadt woridng day in 20 or more calendar weeks (does not have to be consecutive weeks) doting the currant or preceding calendar year. ryas are a Via employer, esadt4pls emptoysr or a seeki- ewrploysr plant: ❑ jies No Our company employed 100 or mare employees" on 50 percent or more elks business days du ring the preceding calendar year. f II ore a Araltiph employer or a idid:11- employer playa; Yee ❑ Ne Ali employer im ovr Grasp Health Plan (GHP) employed 20 or more etoployeuts ** for 20 or more consecutive weeks in either the current or preceding calendar year. ❑ Yes ❑ No M least one of the employers in our GHP employ d 20 or more employees ** for 20 or more consecutive weeks in either the current or preceding calendar year. ❑ Yes 0 No All employers in our GHP employed fewer than 20 employees *"' for 20 or more consecutive weeks in either the current or preceding calcmder year. * "Ion byeea" includes all full and/or part time a lo ma -_ It is important for the employer to have each employee who chooses not to participate, complete the refusal portion of the appltcatloa anal returns use rerusar Inrm as parr oz tine srnpaoyee-a moral. tame separate Dmeee or paper u ncerevatrlr 1. Group Name CITY OF OKEECHOBEE 2. Group Number 90206 3. Group Sales Rep/Agent LINDA C LOWERS (S14) 4. Effective Date 06/01!2003 • 5. . .lo Contribution Toward E . • .lo -es Premium must be at least 50% for 1 -50 75% for 5l+ 1. TOTAL EMPLOYEES ON PAYROLL I T A. otal Part Time mp1oyeeN B. Total New EmploysaM Sin Waiting Period) C Total EtmpIo se(s) Not Actively At Work l FA 2. TOTAL INELIGIBLE EMPLOYEES (A THROUGH C) S. TOTAL ELIGIBLE EMPLOYEES (l Minus 2) (DETERMINES GROUP SIZE & PRODUCT) D. T o t a l Employee. wfdr O t h e r C o v e r a g e t. 4-i, rY 4 f' , 'hr I v y v 5 1 H14-6t Ak id 4. TOTAL !LIG= FOR PARIIQPATIONL Minus D) ki E. Total Refusals F. Total Absentee ,,,..el 5. TOTAL ENROLLED �l IQ 6. EMPLOYEE PART1CPATION (3 divided by 4) (75% IS REQULRED) / -- el `L —, It is important for the employer to have each employee who chooses not to participate, complete the refusal portion of the appltcatloa anal returns use rerusar Inrm as parr oz tine srnpaoyee-a moral. tame separate Dmeee or paper u ncerevatrlr EMPLOYEE NAME REASON CODE i through El EMPLOYEE NAME REASON CODE (A through F2 fk- N'(s'c i< Jt- Nevi A•1e/ /� l 7 t 1 7423 541(Rsv 0x01) E 'c Title Data Ow does and ague Willa et Ronda, Inc anti Me1eh Orions, Inc. it IfgWordant Owlets oltA. olua Cross erne elut &lipid Aeeodeeen. lSd Q13IHS 3(118 SS02O 3(1-18 Wd0P:60 E0. 06 k W May 30 03 12:58p Scott Harris • 561- 747 -3524 p.2 In witness whereof, Companies and agent have caused this agreement to be executed by their duty authorized representatives as of the date set forth below, Slue Cross and Blue Shield of Florida, Inc. William W, Sharrett, Jr., Vice President, Sales and Sales Management Blue Cross and Blue Shield of Florida, Inc. Florida Ccnibined Life Insurance Company, Inc. By Randy Simmons, vice President Florida Combined Life Insurance, Inc. Health Options, Inc. ay: 44441444( William W. Sharrett, Jr.. Vice President, Sales and Sales Management Agent By; Name: Title: SC tja r✓e'j l�.9..D Sf 3J3 3 Data Appointed Representative(s) Date Printed Name(s) Apr Argeseht - owwr Representative Code(s) Rev. 09-27-02 E•d lSd O13IHS 3118 SS0213 3018 WEE:OI EO4 OE AdW - UCConfirmation Page 1 of 4 State of Florida Wartment of Revenue Unemployment Compensation - Click for HELP CITY OF OKEECHOBEE Employer's Quarterly Report (UCT -6) Confirmation Number is: 20030505160294 DATE: 5 /5/2003 TIME: 17:14:21 Please Print this Page for Your Records. Quarter Ending Due Date Penalty After Date Account Number March 31, 2003 April 01, 2003 April 30, 2003 9975445 1st Month Number 57 Tax Rate .0000 2nd Month Number 56 F.E.I. Number 596000393 3rd Month Number 57 SSN Last Name First MI Gross Wages 559-99-7222 ARNOLD C $ 6206.26 161 -34 -5424 BAUGH J $ 9806.03 083 -40 -2017 BERMUDEZ 0 M $ 11587.55 364-13-9564 BERRY A $ 5549.66 592 -78 -8971 BOURGAULT K D $ 8743.96 267 -53 -1499 BROCK R L $ 6206.23 266 -79 -0684 CALE R E $ 8015.16 263 -65 -8841 CARLTON W D $ 6117.53 263-39-0337 CHRISTOPHER N S $ 6073.73 265-33-7713 CONROY P $ 7496.78 262-33-3117 DAVIS D $ 11690.77 262 -04 -6299 DOUGLAS W $ 10553.03 266 -90 -7056 FISHER A $ 7665.06 t+�-- ^•din ,i. >>n i- a net /(r,ltimf7rlitva7wC7cym1 dak551/UCConfirmation.aspx 5/5/03 UCConfirmation Page 2 of 4 261-71-2388 FUSCO J J $ 8273.03 595-44-9443 GAMIOTEA S L $ 477.40 265-45-3882 GARCIA T $ 6073.73 266-49-0255 GOULD C R $ 6143.81 262 -79 -0213 HAGAN D $ 9477.35 266-74-1064 HANCOCK L S $ 1928.29 595-60-4604 HATHAWAY R C $ 7853.57 267-83-7662 HICKMAN W W $ 7589.75 589 -26 -4791 HILL C G $ 8177.82 263-75-6669 HILL W H $ 9290.99 264-37-8148 HODGES G $ 8692.21 592-88-9982 JONES C H $ 2612.41 267-60-9677 LAMB P C $ 7910.22 263-90-8529 LAN N I NG D L $ 1 124.44 265 -65 -3304 LOWE B 0 $ 8015.16 593-58-2157 MCCRARY P S $ 5054.52 266 -92 -1305 MERRY C $ 8924.50 592-60-6671 MOBLEY T M $ 6098.95 237 -19 -9844 PADGETT D B $ 6108.77 261 -23 -7816 PARKER L B $ 7944.67 224-17-1335 PETERSON R $ 10192.86 266-15-2149 RAULERSON J $ 10136.88 589 -40 -2468 REVELS A D $ 1111.71 262 -88 -1661 REYNOLDS D V $ 6073.73 325-50-3916 ROBARDS M J $ 5389.53 266 -57 -1052 ROBERTS M L $ 6073.73 420-66-4314 ROBERTSON D R $ 10051.99 289-68-0053 ROBERTSON P M $ 5924.67 hops: / /florida.uc. bswa.net/(pltjmfzpityszwgarn 1 dgk5 5 )/UCConfirmation.aspx 5/5/03 UCConfirmation Page 3 of 4 262-53-5824 RUS $ 0.00 262-81-0639 SANDERS G $ 8148.83 262.41.3828 SAUM W $ 8598.05 266.84.2401 SELF F $ 6108.76 594-18-7063 SHIREMAN M $ 8688.60 401-04-0798 SMITH H $ 10932.46 264-25-4162 SMITH J $ 9998.73 595-12-8911 SMITH Z J $ 8276.38 595 -36 -6738 STOKES B $ 7434.68 184-42-1354 TARNER T $ 9340.89 261-23-8310 TAYLOR B $ 8663.95 306-42-8369 TOMEY L K $ 11404.77 344-48-6873 VEACH B $ 14330.51 593-38-8367 VINSON K $ 2698.40 264-97-3321 WENDT D M $ 8523.33 267-61-3917 WILBUR D $ 9921.88 593-54-6092 WILKERSON P J $ 5793.72 265-49-1329 WILLIAMS L J $ 6206.64 400-84-9965 WILLIAMS V $ 7796.24 266-67-3354 ZEIGLER J $ 9774.07 • Total Gross Wages Paid This Quarter $451,079.33 • Wages Paid This Quarter in Excess of $7,000 per Employee This Year. The excess amount is based on reports filed with UC. Adjustment(s) will require contact with this agency. $0.00 • Taxable Wages for this Quarter $0.00 • Tax Due $0.00 • Penalty Due $0.00 5/5/03 https: // florida. uc.bswa.net /(pltjmfzpityszwggrnl dg(55)/UCConfiiniation.aspx UCConfirmation • Interest Due • Total Amount Due to Florida U.C. Fund (if less than $1.00 no payment necessary) • Payment you have authorized Please Print this Page for Your Records. File Another Report ' LogOut Maintained by Florida Department of Revenue Comments /Suggestions? SEND mail to: e- Services. @dor.state.fl.us Disclaimer, Privacy, and Conditions of Use Page 4 of 4 $0.00 $0.00 https: / /florida.uc.bswa. net /(pltjmfzpityszwggrn1 dgk55)/UCConfirmation.aspx 5/5/03 UCConfirmation Page 4 of 4 • Interest Due $0.00 • Total Amount Due to Florida U.C. Fund (if less than $1.00 no payment necessary) $0.00 • Payment you have authorized Please Print this Page for Your Records. File Another Report I LogOut Maintained by Florida Department of Revenue Comments /Suggestions? SEND mail to: e- Services @dor.state.fl.us Disclaimer, Privacy, and Conditions of Use https: // florida. uc.bswa.net /(pltjmfzpityszwggrn1 dgk55) /UCConfirmation.aspx 5/5/03 BrnzL Emq• Emp.1 spouse Emolcnild Family iA Heak-kh Insu.rcinck pp.eyturig __Today i s Y`nanda\4 Tiutie a aoa3 , 3prm �hx bid oR.enpng biwq klaJ ?au s and phase un abbfehdan ce.. Ov�e. Lp \a not VinSQn 34 ed. ..ate Bid 3o1Q.g5 7-71.31.4 to144 54 to X8,95 Centiry NQXrrVe., 6'04 InSuranca SotuhonS BCeS Z101 Prici. -_ Employee X 341. 4-co Emit yeelSpouse t 50 85 EmpIaVeephtld l�a"l. Employee ( rang • $ I030.-7q Cpl Narrtie FI o ola, l- eaqv.c o� C,cfiep Firs +1404 Ne1woYK, flOr PriCfb — StIXY eiSk2_ 4a4.Lkkl- S-3t0.-76/ gri.ao (s qe. ►q -iuV•L-o 1a59,1 a HEALTH INSURANCE PROPOSAL MAINLING LIST +e'i /_ , 200 1. CHPA ATTN: MAJORIE SILBERMAN 4152 WEST BLUE HERON BLVD, SUITE 226 RIVIERA BEACH, FL 334 2. MURRAY INSURANCE SERV. INC. P.O. BOX 1417 OKEECHOBEE, FL 34973 -1417 3. BERGER INSURANCE AGENCY 800 SOUTH PARROTT AVE OKEECHOBEE, FL. 34974 4. SCOTT HARRIS, GROUP INS. SOLUTIONS 18230 RIVER OAK DRIVE JUPITER, FL 33458 5. JOHN E. BURDESHAW INSURANCE 505 N.E. 4TH STREET OKEECHOBEE, FL. 34972 6. DEAKINS — LAWRENCE INS. INC. 2020 SOUTH PARROTT AVE OKEECHOBEE, FL. 34974 7. FARM BUREAU INS. 401 N.W. 4TH STREET OKEECHOBEE, FL 34972 8. DAVID HESTER INS. AGENCY 204 N.E. 3RD STREET OKEECHOBEE, FL. 34972 9. BRUCE HOMER INS. AGENCY 900 SOUTH PARROTT AVENUE OKEECHOBEE, FL 34974 10. LAKE OKEECHOBEE INSURANCE 407 SOUTH PARROTT AVENUE OKEECHOBEE, FL. 34974 11. PRITCHARDS & ASSOCIATES 3555 SOUTH 441 OKEECHOBEE, FL 34974 E/' D - O - 0y- 12. BILL LANE, FL HEALTH CHOICE PLAN 5300 WEST ATLANTIC AVENUE SUITE 302 DELRAY BEACH, FLORIDA 33484 13. MARC WEISS, ASSOCIATED FINANCIAL SERV. INC. 2699 STIRLING ROAD SUITE B 100 FT. LAUDERDALE, FL. 33312 14. AETNA HEALTH PLAN OF FLORIDA, INC. 4890 WEST KENNEDY BLVD SUITE 545 TAMPA, FL. 33609 15. CIGNA HEALTH CARE OF FL., INC. COMPLIANCE & CONTRACT DEV. -C -38 HARTFORD, CT. 06152 -1038 5Pr 16. FLORIDA HEALTH CARE PLAN, INC. d° v,,d P.O. BOX 9910 DAYTONA BEACH, FL. 32120 ()Kee 17. BROWN & BROWN INSURANCE P.O. BOX 1229 TAMPA, FLORIDA 33601 -1229 18. GARY LIVINGSTON SENIOR ACCOUNT MANAGER EOS/REVIEWCO 1240 MELISSA LANE DAVIE, FLORIDA 3325 19. ON TARGET SOLUTIONS ATTN: LYNN 182 COLLY WAY NORTH LAUDERDALE, FL 33068 20. TRUST INSURANCE GROUP 5439 SW 148 PLACE MIAMI, FL 33185 -4029 21. ARTHUR J. GALLAGHER & CO. 1 BOCA PLACE SUITE 400E 2255 GLADES ROAD BOCA RATON, FLORIDA 33431 -7379 22 Mark Sittig (mailed out 6- 25 -02) Membershiop Services Manager c/o Florida Lueage of Cities, Inc. P.O. Box 1757 Tallahassee, Florida 32302 -1757 3, JERRY CORZINE HILB, ROGAL AND HAMILTON COMPANY OF FORT MYERS 1614 COLONIAL BLVD FT. MYERS, FLORIDA 33907 BILLY NELSON 309 US 27 SOUTH LAKE PLACID, FL 33852 941 -939 -3813 HRH INS. FT. MYERS FaX 513 F01/01 JUL 36 '9E 15:38 Hilb, Royal and Hamilton Company of Fort Myers 1614 Colonial Boulevard Fort Myers, Florida 33907 To: General Services From: Jerry Corzine Phone* (941) 939 -1400 Fax* (941) 939 -3813 Company. Okeechobee Florida Fax: 941 763 -1686 Pages including cover sheet: 1 Date: 7/5/98 Re: Placement on BID LIST for all Insurance Coverages 0 Comments: Hilb , Rogal & Hamilton Co. is a National Insurance Broker with stock traded on the N.Y. Exchange We have several agencies in Florida and have access to very competitive Insurance Programs for Public Entities , Please place us on your bid list . J ' Corzine Vice President If anv problems Pr n the receipt of this fax. please caII. This fax iiis confidential information intended for the use of the •riduai or entity to which it is addressed. If you have received this in error lease notify us and des" fiis fax. Thank vou. FROM FAX- ON- DEMANG' MARKETING TO: 9,18637631686 New Medical Plan Now Available! $47.75 /month Covers Entire Family Save up to 80% ✓ Everyone `s Accepted (regardless of Medical History) ✓ Over 400,000 Providers Nationwide ✓ Doctors, Hospitals, Clinics, Chiropractors ✓ Prescription & Vision included ✓ Includes $2000 Accidental Injury ✓ Dental, Orthodontics Covered ✓ No Deductible ✓ Immediate Maternity coverage ✓ Available to Employer Groups For More Information and Immediate Activation Apply for your Card Today! 1 -866 -400 -7522 USA HEALTH BENEFITS If you have received this fax in error and 'or would like to have your number removed from our database , please call 832 -615 -1000 i U60\. am; CAze City of Okeechobee March 27, 2003 The City of Okeechobee requests your assistance in obtaining proposals for our group health insurance. The objectives of the proposals are as follows: 1. To compare the cost and benefits of our current plan with other plans that are represented by your company. Our goal is to reduce material premium expense and maintain comparable benefits. 2. To avoid jeopardizing our present coverage or increasing our current rate with Blue Cross /Blue Shield Insurance Co. 3. To avoid jeopardizing our employees' or dependents' current coverage with Blue Cross /Blue Shield Insurance Company. To make sure that any proposal that is submitted would include absolutely no Toss of benefit for City employees or their dependents due to a pre- existing medical condition. 4. That current and future retired employees and elected officials and their dependents may stay on the plan. 5. That the current and future City Attorney and their dependents are eligible and may stay on the plan. Enclosed are specifications of the City's current insurance benefits. We request that your proposal contain no lesser benefits than what the City currently has. The City will not consider proposals from insurance carriers who are not rated at least A+ or A ++ by the A.M. Best Company. We must receive proposals on or before Monday, June 2, 2003 by 3:00 P.M. Sincerel Lola Parker Account Supervisor 55 S.E. Third Avenue • Okeechobee, Florida 34974 -2903 • (863) 763 -3372 • Fax: (863) 763 -1686 City ofOkeechobce Blue Cross Blue Shield Rate Blue Care 111\10 Plan 111v10 Employee $ 297.09 Employee/ Spouse (142.00 Employee/ Ch 536.45 an►ily 881.36 Annual Total $ 288.3y3 City of Okeechobee blue Cross Blue Shield Benefit I IMO Benefits/ Plan 1,il'ctin►e Maximum 1'('1' ()V Co Pay Specialist OV Co Pay 1lospital Co Pay 1 ',n►ergency Room Co Pay Prescription Drug Co Pays Mail Order Prescriptions Blue Care I'I<► !IMO 5 Unlimited $ 10 It) 0 St) 5/1c/30 90 day's' 2 co p.► S Grorap !Vurnt4T- Group Name: Paid Period: Product: Monitoring Report by rasa nnnnr CITY OF OKEECHOBEE 200208 Through 200302 HMO Date: 03/26/2003 Contracts Capitation Hospital Year/Mo Single Emp/Sp EmpICh Family Total Members Premium PCP Specialty Total Inpatient Outpatient Total Hospital Physician Other Pharmacy Dental TotaIFFS Capitath 200208 0 0 0 0 0 0 60.00 6150.98 5719.44 $870.42 60.00 60.00 50.00 546.62 50.00 51,521.76 $0.00 52,438. 200209 48 10 7 1 66 93 524,154.21 - 5150.98 - 6553.58 - 5704.56 60.00 62249.55 52,249.55 5313.64 50.00 51,881.34 $0.00 53,739. 200210 48 9 9 1 87 100 524,775.23 5339.54 $1,246.20 51,585.74 519,099.25 53,785.11 522,884.36 66933.72 696681 56,395.75 50.00 638,766 200211 48 9 10 1 68 103 526,554.98 $320.90 5746.60 51,067.50 50.00 52,411.76 52,411.76 52,569.73 1102.12 $4,729.22 $0.00 510,880. 200212 47 9 9 1 66 98 525,690.00 $218.36 5703.50 5921.86 50.00 $338.12 1338.12 53,365.90 53,405.23 56,144.78 50.00 514,175. 200301 48 9 9 1 67 99 $26,044.82 5624.06 5412.10 51,036,16 50.00 511,608.23 511,608.23 54, 497.89 5680.96 56,020.63 50.00 523,843. 200302 47 9 9 1 66 98 525,450.64 5194.98 $701.90 $898.88 $12,321.97 58,807.82 521,129.79 511,255.03 51,176.46 $4,446.01 50.00 538,904, Total: 286 55 53 6 400 591 5152,669.88 51, 697.84 53, 976.16 55, 674.00 531,421.22 329,200.59 $60,621.81 $28,962.53 $6,331.58 531,139.49 50.00 5132,749 Average: 41 6 8 1 57 84 $21,809.98 3242.55 5568.02 5810.57 34, 488.75 51,171.51 58,860.26 34,140.36 5904.51 34,448.50 50.00 518,964 1 "Contracts and Members do not reflect retroactive additions and terminations. _`Experience Is reflective of both active and terminated members. Contracts monitoring rseport uy rata Group Number: 90206 Group Name: CITY OF OKEECHOBEE Paid Period: 200103 Through 200302 Product: NON -HMO Capitation Hospital Run Date. ag1?6/2003 Year/Mo Single Emp/Sp Emp/Ch Family Total Members Premium PCP Specialty Total Inpatient Outpatient Total Hospital Physklan Other Pharmacy Dental TotaIFFS � 200103 43 8 9 4 64 92 521,888.40 51,860.07 $0.00 51,860.07 53,513.54 $6,065.11 59,578.65 5977.05 $339.73 $5,915.97 50.00 518,671.4 200104 42 8 9 4 63 91 521,658.30 5732.24 50.00 5732.24 59,333.92 53,091.64 $12,425.56 $4,351.04 5836.89 55,049.17 50.00 $23,394.9 200105 42 8 9 4 63 91 521,198.10 51,751.92 50.00 51,751.92 51,888.69 $1,216.27 53,104.96 52,589.13 5264.68 $4,062.52 50.00 511,773.2 200106 42 8 10 3 63 89 520,968.00 5703.14 50.00 $703.14 55,155.08 $2,333.43 57,488.51 $2,987.91 5664.88 53,547.36 50.00 515,391.8 200107 42 8 10 3 63 89 520,105.50 $681.84 50.00 5681.84 51,113.65 53,938.65 55,052.30 54,956.38 $433.62 55,520.00 50.00 $16,644.1 200108 46 7 8 3 64 87 525,341.52 5695.97 50.00 $695.97 $2,423.78 33,871.53 56,295.31 53,923.60 80.00 $6,690.43 50.00 $17,605.3 200109 47 7 7 3 64 86 $23,659.50 5625.67 50.00 5625.67 $2,611.97 512,237.50 814,849.47 55,561.46 3379.08 55,909.48 50.00 $27,325.1 200110 47 7 7 3 64 86 $23,365.00 5646.76 50.00 8646.76 54,068.23 51,749.89 55,818.12 517,715.80 $1,340.74 34,931.48 $0.00 $30.452.5 200111 50 7 7 3 67 89 523,635.80 5667.85 $0.00 $667.85 50.00 $3,290.17 $3,290.17 57,167.61 55,984.47 85,489.89 50.00 $22,599.5 200112 50 7 6 2 65 84 323,002.90 3623.04 $0.00 5623.04 834,765.75 52,123.89 536,889.64 35,059.17 $2,128.97 $5,571.20 50.00 $50,272.0 200201 49 7 5 2 63 81 $22,623.78 8539.22 50.00 $539.22 $27,500.64 55,213.55 $32,714.19 514,643.36 55,215.40 59,890.62 30,00 $63,002.; 200202 50 7 6 2 65 84 523,002.90 5565.29 $0.00 5565.29 35,722.00 $5,115.10 510,837.10 35,983.02 84,700.82 510,014.14 50,00 $32,100.: 200203 49 7 6 2 64 83 522,437.60 $584.32 50.00 5584.32 58,500.00 51,565.64 $10,065.64 $6,365.57 55,542.84 56,331.29 50.00 528,889.E 200204 49 7 6 2 64 83 522,732.10 5584.32 50.00 3584.32 $3,241.15 $9,498.91 512,740.06 59,043.79 52,837.43 $6,843.76 50.00 $32,049.: 200205 50 7 6 2 65. 84 522,732.10 5590.96 50.00 3590.96 33,712.50 '-5212.30" " ' 83,924.80 56,221.12 $2,214.83 57,189.96 $0.00 820,141.1 200206 52 7 5 2 66 84 $23,273.70 5624.16 50.00 $624.16 - 513,101.14 52,221.10 - 510,880.04 54,850.59 8250.00 58,015.68 $0.00 $2,860.: 200207 52 7 6 2 67 86 $23,520.80 $604.24 50.00 5604.24 $13,912.98 53,464.49 $17,377.47 511,488.80 $285.70 56,330.12 50.00 $36,086.: 200208 50 7 6 2 65 84 523,273.70 50.00 50.00 50.00 $1,264.92 32,096.66 33,361.57 $7,550.33 5706.52 $6,183.75 $0.00 517,802.' 200209 0 0 0 0 0 0 50.00 $1,188.56 $0.00 51,188,56 $635.19 570.01 5705.20 82,414.00 5817.01 $4,365.44 $0.00 59,490.: 200210 0 0 0 0 0 0 $0.00 - 5451.52 50.00 - 3451.52 $0.00 51,125.72 $1,125.72 51,456.69 50.00 •559.30 30.00 52,071.! 200211 0 0 0 0 0 0 50.00 50.00 $0.00 $0.00 50.00 53,6888.63 53,688.63 $788.14 50.00 50.00 50.00 $4,476.' 200212 0 0 0 0 0 0 $0.00 $0.00 50.00 50.00 $3,075.21 $73.04 53,148.25 $452.52 33,263.83 $0.00 30.00 36,864.' 1 *Contracts and Members do not reflect retroactive additions and terminations. `Experience is reflective of both active and terminated members. 200302 0 0 0 0 0 0 $0.00 $0.00 $0.00 50.00 $0.00 $0.1.XJ $0.110 i[Se.w iv.w 4114.w wv.w Total: 852 131 128 48 1159 1553 $408,419.70 513,818-06 50.00 513,818.06 5119,338.06 574,263.22 $193,60128 5128,015.83 538,243.18 5117,792.96 50.00 5491,474; Average 36 5 5 2 48 65 517, 017.49 $675.75 50.00 $575.75 $4, 972.42 $3,094.30 58,066•72 56,33412 51,593.47 $4,900.04 $0.00 520,478.' 2 'Contracts and Members do not reflect retroactive additions and terminations. 'Experience is reflective of both active and terminated members. B1ueCross B1ueShield of Florida M M.dspordra Mows d ar Om tram and Blue BNeldAaaotlallon 0714 Includes any additional Insurance Coverages, where applicable (shown under "Other "). offered through Florida Combined Life Insurance Company, Inc. GROUP INVOICE Page: 3 Group: 90206001 Invoice: 137159 01 Dist: SBR Billed: 03/20/03 Due: 04/01/03 Pays To: 05/01/03 MSG COD INSURED ::.....::.:.::.;;;:.:. :;:::':. ,'!' NAA1E:'...:...:. i :, >::z:.::1N5URBA?; »:: NUMBER:, :',:...:...:::;NUMBER ,.. :;:;,:�MeLpYGR.: »« »: pkG COV. -;. ..HEALTH..; CLASS ::: ::O THER, ; 7: > :1'O'fAti`:.::.:`:;.'`::: ARNOLD CAROLYN N 01 06 536.45 .00 536.45 BAUGH JEFF D 5- 01 01 297.09 .00 297.09 BERMUDEZ OSCAR 16 j 01 01 297.09 .00 297.09 BERRY ADRIANA 01 06 536.45 .00 536.45 BOURGAULT KEITH D ..a ..a.,1._ .. y 01 07 642.00 .00 642.00 BROCK ROBIN 01 01 297.09 .00 297.09 CALF RUSSELL 4_°s 01 01 297.09 .00 297.09 CARLTON WAYNE 01 01 297.09 .00 297.09 CHANDLER NOEL A `., 01 01 297.09 .00 297.09 CHRISTOPHER NANCY S lI 01 01 297.09 .00 297.09 CONROY PHILLIP J 114.) 01 06 536.45 .00 536.45 COOK JOHN R 01 01 297.09 .00 297.09 DAVIS DENNIS W 11u 01 06 536.45 .00 536.45 DOUGLAS WILLIAM'L .'O 01 01 297.09 .00 297.09 FISHER ALFRED L ."3 01 07 642.00 .00 642.00 FUSCO JAMES. 01 06 536.45 .00 '536.45 GAMIOTEA STEPHANIE L y 01 06 536.45 .00 536.45 GARCIA TERISA y Y 01 01 297.09 .00 297.09 GOULD CLINT R 01 01 297.09 .00 297.09 HAGAN DONALD C 01 07 642.00 .00 642.00 HATHAWAY RYAN C 3 01 01 297.09 .00 297.09 HICKMAN WILLIAM 31 01 01 297.09 .00 297.09 HILL CHRISTOPHE G 3/ 01 06 536.45 .00 536.45 HILL WILLIAM H g5 01 01 297.09 .00 297.09 HODGES GLENN W 34.. 01 01 297.09 .00 297.09 JONES COURTNEY H .2, 01 01 297.09 .00 297.09 KIRK JAMES E (a i 01 01 297.09 .00 297.09 LAMB PALMER C (oC) 01 07 642.00 .00 642.00 LOWE BRYAN 0 ;27 01 01 297.09 .00 297.09 MARKHAM ROSCOE L MCCRARY PHILIP 57 - erm/A -k t-el 01 01 01 01 297.09 297.09 .00 .00 297.09 297.09 MERRY CHARLIE T 611.... 01 01 297.09 .00 297.09 MOBLEY TOMI M ;2y 01, 01 297.09 .00 297.09 PADGETT DANIEL B y/ 01, 01 297.09 .00 297.09 PARKER LOLA B a 01, 01 297.09 .00 297.09 PETERSON ROBERT C ti -a-- 01 01 297.09 .00 297.09 RAULERSON JOHN T hlir. 01 01 297.09 .00 297.09 REYNOLDS DONNA V y 01 01 297.09 .00 297.09 ROBARDS MARY J 54 01 02 881.36 .00 881.36 ROBERTS MARVIN L 3f. -_ 01 04 536.45 .00 536.45 ROBERTSON DONNIE R 53 01 01 297.09 .00 297.09 ROBERTSON PAULA M 1 3 01 01 297.09 .00 297.09 SANDERS GORDON L 3 Y 01 01 297.09 .00 297.09 SAUM WILLIAM J 4 01 01 297.09 .00 297.09 SELPH JOHN F 5 01 01 297.09 .00 297.09 SHIREMAN MARK A 3' 01 04 536.45 .00 536.45 SMITH HERBERT E 5/ .01 07 642.00 .00 642.00 SMITH JEROME z/7 01 01 297.09 .00 297.09 SMITH ZACK J 01 01 297.09 .00 297.09 STOKES BRYAN ,,2 :33 01 01 297.09 .00 297.09 TARNER THOMAS A 01 01 297.09 .00 297.09 TAYLOR BETTYE _-`',9-. 01 01 297.09 .00 297.09 TOMEY II LOUIS K 4, 6 01 07 642.00 .00 642.00 RG14- 03079 -06314 1 1 1 I) BlueCross BlueShield of Florida • M Indepondffll Llama' ol ihe Oka Cross and Blue Meld Aroclation 0714 Includes any additional Insurance Coverages, where applicable (shown under "Other "). offered through Florida Combined Life Insurance Company, Inc. c GROUP INVOICE Page: 4 Group: 90206001 Invoice: 13715901 Dist: SBR Billed: Due: 03/20/03 04/01/03 Pays To: 05/01/03 RG14-03079-06315 ?HR TOTAL VEACH BI LL L 4.2r 01 01 297.09 .00 297.09 - VINSON KATRINA B j-/ , . 01 01 297.09 .00 - 297.09 WATFORD DOWLING R 5") 01 01 297.09 .00 297.09 WENDT DAWN M :34. 01 01 297.09 .00 297.09 WILBUR DAVID G ii C 01 01 297.09 .00 297.09 WILKERSON PAMELA J _40 01 01 297.09 .00 297.09 WILLIAMS LYDIA J ii 01 01 297.09 .00 297.09 WILLIAMS VICTORIA i../ 01 01 297.09 .00 297.09 WILLIAMS JR DAVID C 1;1 01 07 642.00 .00 642.00 TOTAL ZEIGLER JOHN P Re uei e--) , 4,3h lse '7, DUE THIS PERIOD 41 ")--- i 7 01 07 . 642.00 24,214.46 .00 .00 642.00 24,214.46 NUMBER BILLED FOR THIS PERIOD 1-PERSON FAMILY 2-PERSON EMP-CHLDRN EMP-SPOUSE OTHER PKG 01 HEALTH MAINTENANCE ORG 45 1 0 9 8 0 TOTAL 45 1 0 9 8 0 *******3101*********** *MEMBER ADJUSTMENTS* **********X********* ADDITIONS: EFF DATE JONES COURTNEY H 030103 01 01 297.09 .00 297.09 *** NET MEMBER ADJUSTMENTS *** TOTAL: ADDITIONS 297.09 .00 297.09 CHANGES .00 .00 .00 DELETIONS .00 .00 .00 TOTAL GRP ADJUSTMENTS 297.09 .00 297.09 RG14-03079-06315 Blue Cross Blue Shield of Florida MWspordeallonwolft MusCnommandOmillOMMmidlon 0714 Includes any additional Insurance Coverages, where applicable (shown under "Other "). offered through Florida Combined Life Insurance Company, Inc. cor NUMHER GROUP INVOICE Page: 3 Group: 90206R01 Invoice: 13715900 Dist: SBR A--)e, 41/ rt. . pi» )1. Billed: 03/20/03 Due: 04/01/03 Pays To: 05/01/03 cov HEALTI CIAS CASTORINA NETTIE JUAREZ AMADO S MOBLEY LARRY TOTAL DUE THIS PERIOD NUMBER BILLED FOR THIS PKG 01 HEALTH MAINTENA 10TAL 5q PERIOD NCE ORG 1-PERSON FA 3 3 01 01 01 MIL 0 0 01 01 01 297.09 297.09 297.09 891.27 2-PERSON EM 0 0 (/2rM P-CHL .00 .00 .00 .00 DRN EMP- 0 0 (1:777/0 297.09 297.09 297.09 891.27 SPOUSE OTHER 0 0 0 0 RG14-03079-06318 511 KIRK, JAMES E. 511 CHANDLER, NOEL 511 WILLIAMS, JR. DAVID C. 511 MARKHAM, ROSCOE L. 511 WATFORD JR., DOWLING 2512 GAMIOTEA, STEPHANE L. 2512 HSP. AM BERRY, ADRIANA 2512 VINSON, KATRINA 512 512 VEACH, BILL BROCK, ROBIN 513 PARKER, LOLA B. 513 AM. IND. REYNOLDS, DONNA V. 513 AM. IND. WILLIAMS, LYDIA J. 519 HSP. AM ARNOLD, CAROLYN 519 VINSON, KATRINA 521 DAVIS, DENNIS W. 521 RAULERSON, JOHN T. 521 CALE, RUSSELL E. 521 HAGAN, DONALD C. 521 HILL CHRISTOPHER G. 521 HILL, WILLIAM H. 521 HICKMAN, WILLIAM 521 JONES, COURTNEY H. 521 HISP. AM LOWE, BRYAN O. 521 MERRY JR., CHARLIE 521 PETERSON. ROBERTC. 521 SAUM, WILLIAM J. 521 SHIREMAN, MARK 521 BLK/AM. SMITH, JEROME 521 TARNER, THOMAS A. 521 TAYLOR, BETTYE 521 WENDT, DAWN M. 521 WILBUR, DAVID G. 5� 521 WILLIAMS, VICTORIA L. 521 ZEIGLER, JOHN P. 521 HISP /AM GARCIA, TERISA G. 521 ROBARDS, MARY JO 521 LANNING, DONNA 522 MOBLEY, TOMI M. 522 ROBERTSON, PAULA M. 522 REVELS, ASHLEY 522 WILKERSON, PAMELA J. 522 TOMEY II, LOUIS K. 522 HANCOCK, LOUIS S. 522 BAUGH, JEFFREY D. 522 BOURGAULT, KEITH D. 522 CHRISTOPHER, NANCY S 522 CONROY, PHILLIP J. 522 HATHAWAY, RYAN 522 DOUGLAS, WILLIAM L. 522 HODGES, WILBUR GLEN 522 SANDERS, GORDON L. 522 SMITH, HERBERT E. 522 STOKES, BRYAN K. 522 FUSCO, JAMES J. 522 SMITH, ZACH J. 549 BERMUDEZ, OSCAR M. 541 ROBERTSON, DONNIE R. 541 LAMB, PALMER C. 541 FISHER, ALFRED L. 541 CARLTON, WAYNE D. 541 GOULD, CLINT 541 PADGETT, DANIEL B. 541 ROBERTS, MARVIN L. 541 SELPH, FLOYD JUNE 17, 2003 - REGULAR MEETING • PAGE 7 OF 9 AGENDA COUNCIL ACTION - DISCUSSION • VOTE IX. NEW BUSINESS CONTINUED. C. 2. c) Vote on motion. VOTE D. Consider Street and Alley Closing Application No. 69 submitted by Okeechobee County and a request to waive the application fees - City Clerk (Exhibit 4). Consider proposals and award a health insurance contract - City Administrator (Exhibit 5). KIRK - YEA CHANDLER • YEA MARKHAM - YEA WATFORD - YEA WILLIAMS • YEA MOTION CARRIED. Council Member Markham moved to direct the Ci Attorne to draft an ordinance to close the r • uested alleylstreets on Application No. 69 submitted by Board of County Commissioners, Okeechobee County, Florida, to reserve an easement for a water line on the right -of -way of Northwest 3rd Streetforthe Okeechobee Utility Authority, and to waive the Street!Alley closing fees; seconded by Chandler. Mr. John Moaner, President of the Contractors Association was present, and addressed the Council by stating that the intention was to build a very large community recreational facility, and hoped to seek the help of the City for contributions in the future. Council agreed that this was a community effort to build this recreational facility for the youth, and thanked everyone for joining their efforts to make this a reality. Council MemberWatford moved to award a loneyearrHealth Insurance Bid to Group Insurance Solutions (Blue Cross Blue Shield); seconded by Council Member Williams. Administrator Veach stated that the City received four bids, one from Scott Harris of Group Insurance Solutions, who currently is the health insurance provider for the City. The other was Florida League of Cities, who submitted three proposals. He explained the contents of the proposals, including co- payments for visits to your primary physician, emergency room, hospital stays, and prescriptions. He also compared prescription prices, and out of pocket expense. VOTE KIRK - YEA CHANDLER - YEA MARKHAM - YEA WATFORD - YEA WILLIAMS - YEA MOTION CARRIED. F MOM G TIME EXPIRE al& INT TUE EXPI.11 .0: IN 4 0 M04 r ATTMft -,ocqiESS tio if-ow- 3 CHPA ATTN: MAJORIE SILBERMAN 4152 WEST BLUE HERON BLVD, SUITE 22t, RIVIERA BEACH, F 1 ur plc 11:0Ti 766} AS AiiiMESSED, FORWARDING ORDER EXPIRED AETNA HEALTH PLAN OF FLORIDA, INC. 4890 WEST KENNEDY BLVD SUITE 545 TAMPA, FL. 33609 r kPIS4...,-646-,?:'z, 4. 5 •.5 i RECEIVED APR 0 8 2003 BELL LANE, FL HEALTH CHOICE PLAN 5300 WEST ATLANTIC AVENUE SUITE 302 DELRAY BEACH, FLORIDA 33484 JUN- 02-03 IN 02403 Pit FLORIDA LEAGUE FAX N(, 407347'181 P. ?' FLORIDA LEEJE Of CITIES, INC. 14 East COlon111 Drives 4 Pro Box 634065 4 ando, fl 3Z863N P110 (401, 425414/ SEE 3441244FAK(4414243113 4 wean: :1 ,uaossrtx X003FLCL9islativvkti iDay April OM tal{ahasoo.Lann County Ciuic Confer �DQ3FLCfinaualCo�fara ca host 14116,Z443 Wyndham palaea, Laka Quana Web To Lola Fax: 883 783-1636 From: Joni Rochester Dan; 6/2/2003 Re: Health quote Paper: 2 CC: O Urgent 0 For Review 0 Please Comment 0 Please Reply O Please Recycle Please sail (407) 42641142 if you have eny goestions or any problems receiving this fax. Confidentiality Notice: This fas and any flee transmitted with M am confidential and ere intended solely for the use of ths individual er entity 10 which hiey sn eddnepd. If the reader of this fee a not the intended raciplont, yen are hereby notified that tiny disseminated, ciatdbutton or envying of MN communication is steady prohibited, and that you have neelved tine fns end any eeeempanNng Mee In VIOL You should notlN Flotilla League of Cities rmmedlaNly by replying le Ihla he and destroyIng the Intennenon. Florida taken of Cities does net iooept responsibility for changes le faxes tMe eenur Wier they/ins. aeon sem. 1RnidaLag alGSGu [1, Oteadoke xs [- m-sr IZcg 11 am 1�Tel� orl'_c halmal JPO $414.41 $91:27 57a6.4d M.:59 ti 5337_P 1827 t6 $69,.19 11,1187: 5355695 .417,„36 56.4 54 $1,056.9: 599,94164 God Plm 87,33757 God Flan $6197.62 Gald Plr $129116 € tdI1 $111,199 14 SaTawa $6,694.97 Saws-Plan 56.29270 Siva Plea 51.146 73 Sdaz Ptan 576.776.60 DRAM PI= SF,1 ^6.90 Broom Ply 35,000 90 11.9na Plan $I,05E 95 Wane flan 5239,383 _66 S88 O5 _S7 582_771 .41 515„ 109_91 5218}389.71 580.328.80 $75,51 Z_36 313_784_ ?"7 3201,7121 _6c5 3'7-1_050_ :'8 569,6 1 0 _ "745 512_'70'7 _.47 S 11ver glary Silver Playa Silver plaza Salvo Plan Sroraze p1.9.aa r3ron>_e 1=.1a Broaaze Plan -w f3roxaxc_ Plan • An rarer alarm* . LU8e a.4, Oedurra nu ,aanptaue y eta tnpres Mop /,Kinea.r111.,,er■io. ^•Nrd.cnre SY. ie ent it mmlai4Jar eafi.el over ve 65 bd 5: PO NOV EO —Z7 —N f 18IGLICiL0t ON Xdd ❑ Administration/ Marketing ❑ Risk Control ❑ Underwriting Property & Casualty Health iVr Post Office Box 530065 125 East Colonial Drive Orlando, FL 32853 -0065 800 - 445 -6248 407 - 425 -9142 Suncom 344 -0725 Fax 407 - 425 -9378 Health Claims Post Office Box 538140 Orlando, FL 32853 -8140 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 ❑ Workers' Compensation Claims Post Office Box 538135 Orlando, FL 32853 -8135 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 ❑ Property & Liability Claims Post Office Box 538135 Orlando, FL 32853 -8135 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 FLORIDA LEAGUE OF CITIES, INC. PUBLIC RISK SERVICES May 30, 2003 City of Okeechobee Procurement Management Office 55 S.E. Third Avenue Okeechobee, FL 34974 -2903 Re: RFP - Group Health Insurance Dear Procurement Management Office: We appreciate the opportunity to provide you with this proposal of insurance for employee benefits. Medical coverage has been proposed on a Point of Service (POS) managed care basis through the Florida Municipal Insurance Trust, a non- profit, non - accessible, group - pooled program. The Trust also provides dental and short -term disability benefits and a prescription drug card plan. The Trust offers First Health to provide a statewide managed care network for its participants. These Comprehensive networks of doctors and hospitals are available in most regions. All rates quoted are guaranteed for sixty (60) days from the date of the proposal. The rates include costs of administration, reinsurance and estimated claims costs. Monthly, quarterly and annual loss reports are provided at no additional charge. We welcome the opportunity to further discuss our proposal and should you have any questions, please contact me at 1- 800 - 445 -6248. Sincerely, Chuck Wilde Marketing Representative CW /jr Enclosure Florida Municipal Insurance Trust ❑ Administration/ Marketing ❑ Risk Control ❑ Underwriting Property & Casualty Health id Post Office Box 530065 125 East Colonial Drive Orlando, FL 32853 -0065 800 - 445 -6248 407 - 425 -9142 Suncom 344 -0725 Fax 407 - 425 -9378 Health Claims Post Office Box 538140 Orlando, FL 32853 -8140 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 ❑ Workers' Compensation Claims Post Office Box 538135 Orlando, FL 32853 -8135 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 ❑ Property & Liability Claims Post Office Box 538135 Orlando, FL 32853 -8135 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 FLORIDA LEAGUE OF CITIES, INC. PUBLIC RISK SERVICES PROPOSAL OF INSURANCE FOR CITY OF OKEECHOBEE Effective Date: 10/01/2003 Provided by Florida Municipal Insurance Trust Administered by: The Florida League of Cities, Inc. PUBLIC RISK SERVICES P.O. Box 530065 Orlando, FL 32853 -0065 407 - 425 -9142 or Toll Free 1- 800 - 445 -6248 May 30, 2003 Florida Municipal Insurance Trust Florida League of Cities Treasure Island Medical/Rx First Health Network Contract Type Enrollment Current Rates United Health Care 7/1/02 - 6/30/03 Monthly Premium Annual Premium Single EE + Spouse EE + Child(ren) Family 87 8 2 15 $361.18 $774.73 $671.57 $1,096.12 $31,422.66 $6,197.84 $1,343.14 $16,441.80 $377,071.92 $74,374.08 $16,117.68 $197,301.60 .... „ Contract Type Enrollment Proposed PPO Rates (FLC) 7/1/03 - 09/30/04 Monthly Premium Annual Premium Single EE + Spouse EE + Child(ren) Family Single EE + Spouse EE + Child(ren) Family Single EE + Spouse EE + Child(ren) Family "r" ,;:,;„,-.;7".!,,FH :,.:,4- 87 8 2 15 87 8 2 15 87 8 2 15 1,,,rmat,40,1.2.,',Arig, '', $470.38 Gold Plan $1,006.64 Gold Plan $938.44 Gold Plan $1,474.70 Gold Plan $429.23 Silver Plan $918.56 Silver Plan $856.33 Silver Plan $1,345.67 Silver Plan $395.59 Bronze Plan $846.59 Bronze Plan $789.23 Bronze Plan $1,240.23 Bronze Plan ':'-'':-::r--.•,', ::--1.6.0:5,50:,''',,,:-.4i06.....1,', -..:' ..-:-F,. -- si944eAsitianiii' 7.46,:„.5 : Ilivinze Plan $40,923.40 Gold Plan $8,053.16 Gold Plan $1,876.89 Gold Plan $22,120.55 Gold Plan $37,342.60 Silver Plan $7,348.51 Silver Plan $1,712.66 Silver Plan $20,185.00 Silver Plan $34,416.58 Bronze Plan $6,772.70 Bronze Plan $1,578.46 Bronze Plan $18,603.39 Bronze Plan -:!' ,,:,‘ '‘10.4di ,:.,z, '`::::. 6X&77SilPisn ' ., : $64 71.4 Bronze Nan $491,080.75 Gold Plan $96,637.88 Gold Plan $22,522.63 Gold Plan $265,446.64 Gold Plan $448,111.18 Silver Plan $88,182.06 Silver Plan $20,551.90 Silver Plan $242,220.05 Silver Plan $412,998.91 Bronze Plan $81,272.46 Bronze Plan $18,941.53 Bronze Plan $223,240.62 Bronze Plan :: ::: 0,99*5.2tiSilliirP14it -; ::: , : ',$736;453.52,Brenze Nati **Medicare Supplement $266.98 . -... ' .,j .:...: ..-.:-::.' :: f':' .. . .,-::. 10.1*:n14P1kli Notes: All rates are subject to Large Claim Disclosure and acceptance by the League's stop loss insurance carrier. **Medicare Supplement is available for retirees over age 65 ***4% Commission included for Agent of Record k:Florida League of Cities\ New City\Treasure Island\Treasure Island rating.xls 5/30/2003 GROUP DFNTAI SCHEDULE OF BENEFITS FLORIDA MUNICIPAL INSURANCE TRUST GFNFRAL DFNTAL CARF BFNFFIT Lifetime Maximum Benefit - Unlimited Calendar Year Maximum Benefit - $1,000 per individual SUMMARY OF GFNFRAI CARF SFRVICF,S 1. Examinations and recall services, check -ups and cleaning of teeth 2. Palliative treatment 3. Endodontic treatment 4. Space maintainer 5. X -rays 6. Oral surgery 7. Periodontal treatment 8. Normal extraction of teeth 9. Silver and synthetic permanent fillings, crowns and jackets 10. Fixed bridges consisting of crowns or jackets 11. Dentures and removable bridges J�FDl1CTIRl F $50 per individual per calendar year. COINSURANCF Plan pays 80% of first $1,250 of eligible expenses per calendar year. DFNTAI RATFS (PFR MONTH) Employee Dental Dependent Dental Family Dental $28.91 S42 50 $71.41 ORTHODONTIC CARF BENFFIT Lifetime Maximum Benefit - $1,000 per individual. SUMMARY OF ORTHODONTIC CARF 1. Diagnostic procedures 2. Appliances for tooth guidance and control of harmful habits 3. Retention appliances 4. Comprehensive treatment with fixed and removable appliances for correction of malocclusion in permanent, primary and mixed dentition 5. Orthodontic treatment must be completed prior to attainment of age 19. LIFFTIMF DFDIJCTIRI P $50 per individual. COINSI IRANCF Plan pays 50% of first $2,000 of eligible expenses per individual in their lifetime. STAND Al ONF - (Without Health) Employee Dental Dependent Dental Family Dental $32.30 S47 60 $79.90 Dental coverage written in the Florida Municipal Insurance Trust is subject to a 25% participation of those employees quoted. * ** This summary was designed only to give you a brief description of benefits provided and does not include all of the provisions, limitations or exclusions in the policies. In an actual claim situation, the policy provisions, limitations, exclusions will apply. If this outline disagrees with the Plan Document in any way, the Plan Document will govern. FLORIDA MUNICIPAL INSURANCE TRUST DENTAL BENEFIT PLAN SUMMARY Reasonable and customary limits will apply to all covered eligible expenses. GFNFRAI DFNTAI CARF Calendar Year Maximum $1,000 Deductible $50 calendar year After the deductible has been met, unless otherwise stated, the following coinsurance will apply: This plan will pay 100% preventative services, not subject to the calendar year deductible, as follows: 1. Oral examinations 2. Dental X -rays (Bitewings twice per calendar year, Full Mouth or Panoramic once every 2 years) 3. Fluoride application (for dependents under age 15) 4. Prophylaxis This plan will pay 80% for basic dental services as follows: 1. Emergency treatment for pain 2. Space maintainers 3. Dental X -rays 4. Biopsies of oral tissue 5. Pulp vitality tests 6. Fillings 7. Extractions 8. Oral Surgery 9. Endodontics 10. Periodontics This plan will pay 50% for dental restorations and specialty services as follows: 1. Inlays, onlays 2. Crowns 3. Bridges, dentures ,SCHFIII II F OF ORTHODONTIC RFNFFIT (applies only to eligible dependents under age 19). Lifetime maximum (per person) Lifetime deductible $1,000 $50 per person Covered eligible expenses are payable after the deductible at 50 %. 1. Diagnostic procedures. 2. Appliances for tooth guidance and control of harmful habits. 3. Retention Appliances. 4. Comprehensive treatment with fixed and removable appliances for correction of malocclusion in permanent, primary and mixed dentition. These summaries are designed only to give you a brief description of the benefits provided and does not include all of the provisions, limitations or exclusions in the policies. In an actual claim situation, the policy provisions, limitations, exclusions will apply. If this outline disagrees with the Plan Document in any way, the Plan Document will govern. CLAIM ADMINISTRATOR. Florida League of Cities, Inc. Claims Center P.O. Box 538135 (407) 245 -0725 Orlando, FL 32853 -8135 (800) 756 -3042 GROUP VISION VISION SERVICE PLAN SCHEDULE OF BENEFITS DFDUCTIRI F A deductible amount of $10.00 is required for any service(s) rendered payable out of pocket by the eligible person to the panel doctor at the time of service. COVERED EXPENSES VISION EXAMINATION The primary purpose of the Vision Service Plan is to provide for professional vision examination and care. This examination comprises an analysis of the vision functions, including the prescription and supply of glasses where indicated. J FNSFS AND FRAMFS A. LENSES - The VSP Panel Doctor will order the proper lenses from a VSP approved laboratory. VSP provides any necessary lenses, including single vision, bifocal, trifocal or other more complex and expensive lenses, when necessary for the patients visual welfare. This assures the finest American - made lenses and quality workmanship. The doctor verifies the accuracy of the finished lenses. B. FRAMES - The patient is assisted in the selection of frames. VSP provides a wide selection of quality frames. Because of the cosmetic nature of frames and the rapidly changing styles, VSP has a limit on the cost of the frames provided under the program. The limit is designed to cover a majority of frames in current use. Patients who select frames that exceed the limit are required to pay the additional wholesale cost, plus a modest additional fee. C. MEDICALLY NECESSARY CONTACT LENSES - Contact lenses are allowed under the program in any of these instances provided prior approval is obtained from VSP by your doctor with documentation. 1) Following cataract surgery. 2) When visual acuity cannot be corrected to 20/70 in the better eye except by use of contact lenses. 3) Anisometropia of greater than 350 diopters and asthenopia or diplopia, with spectacles. 4) Keratoconus diagnosis where contact lenses is the treatment of choice. 5) Monocular aphakia and /or binocular aphakia where the doctor certifies medically necessary contact lenses are necessary for safety and rehabilitation to an occupational productive life. All five (5) categories of "medically necessary" contacts are subject to coordination of benefits with the medical insurance carriers. VSP will provide the contacts or glasses, but not both. D. COSMETIC CONTACT LENSES - When cosmetic contact lenses are selected, an indemnity allowance will be made in lieu of all other services. HOW OFTFN SFRVICFS ARF AVAII ARI F A. A VISION EXAMINATION - is available to each covered person every 12 months. B. LENSES - Are available every 12 months when required. C. FRAMES - Are available every 24 months. J IMITATIONS EXTRA COST - The plan is designed to cover visual needs rather than elective materials. If any of the following are selected and the VSP doctor does not receive prior authorization, there will be an extra charge: a) Oversized lenses b) A frame costing more than plan allowance c) Tinted or photochromic lenses (other than Pink 1 and 2) d) Coated lenses e) No -line bifocals (blended type) and progressive lenses f) Cosmetic Faceting g) Other cosmetic items. ITEMS NOT COVERED: a) Orthoptics or vision training b) Subnormal vision aids c) Aniseikonia lenses d) Two pair of glasses in lieu of bifocals e) Plano (non - prescription) lenses f) Cosmetic contact lenses. Replacement or repair of lost or broken lenses and frames, except at normal intervals. Medical or surgical treatment of the eyes. Services or materials provided as a result of any Workers' Compensation Law, or similar legislation, or obtained through or required by any government agency or program whether Federal, State or any subdivision thereof. Any eye examination required by an employer as a condition of employment, unless agreed upon in writing by VSP and included in the original contract. DI IAI CHOICF COVFRAGF Eligible persons not wishing to secure services from a Vision Service Plan Doctor may secure services from a non - participating doctor and submit bills for reimbursement. The amounts reimbursed are limited and may not cover the full charges. Fl IGIBILITY Each group electing vision care must maintain their vision care coverage for a minimum of one year from the time of inception. All employees and dependents who meet the eligibility requirements of their enrolled group are covered for vision care benefits. Neither employees nor dependents have the right to individually select vision care coverage. Requirements for participation are: a) 100% of all city employees, or b) 100% of all City employees carrying any coverages with FMIT. FRFMII JM RATFS Employee $ 5.74 Dependent $ 8.4:3 Family Total $14.17 ..1 THE FIRST HEALTH NETWORK Internet Provider Directory City of Okeechobee Current As Of: May 30, 2003 ?First Health. This Provider Directory is provided by First Health Group Corp. to present to you information on hospitals, physician and other providers who have agreed to provide their usual services to you at specially contracted rates of payment. All decisions about the type of care you receive are the responsibility of you and the physician whom you select. The quality and results of the care provided are the responsibility of the physician. Some health services may be provided by resident physicians under the supervision of the listed physicians. While First Health Group Corp. makes every effort to maintain accurate and up- to-date information, we cannot be responsible for any omissions or errors after publication. Please confirm provider participation prior to your visit. Okeechobee County Hospitals Okeechobee County Hospitals The First Health® Network Internet Provider Directory Current As Of: May 30, 2003 9First Health This Provider Directory is provided by First Health Group Corp. to present to you information on hospitals, physicians and other providers who have agreed to provide their usual services to you at specially contracted rates of payment All decisions about the type of care you receive are the responsibility of you and the physician whom you select. The quality and results of the care provided are the responsibility of the physician. Some health services may be provided by resident physicians under the supervision of the listed physicians. While First Health Group Corp. makes every effort to maintain accurate and up -to -date information, we cannot be responsible for any omissions or errors after publication. Please confirm provider participation prior to your visit. Okeechobee County Hospitals Directory Criteria Product: FIRST HEALTH HOSPITAL NETWORK Sorted By: City Counties Included: OKEECHOBEE States Included: FLORIDA The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited 2 Okeechobee County Hospitals OKEECHOBEE OKEECHOBEE HOSPITAL INC DBA RAULERSON HOSPITAL (863) 763-2151 1796 HIGHWAY 441 N OKEECHOBEE, FL 34973 THIS LIST IS SUBJECT TO CHANGE The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited. 3 Okeechobee County Facilities Okeechobee County Facilities The First Health® Network Internet Provider Directory Current As Of: May 30, 2003 QFirst Health. This Provider Directory is provided by First Health Group Corp. to present to you information on hospitals, physicians and other providers who have agreed to provide their usual services to you at specially contracted rates of payment. All decisions about the type of care you receive are the responsibility of you and the physician whom you select. The quality and results of the care provided are the responsibility of the physician. Some health services may be provided by resident physicians under the supervision of the listed physicians. While First Health Group Corp. makes every effort to maintain accurate and up -to -date information, we cannot be responsible for any omissions or errors after publication. Please confirm provider participation prior to your visit. 1 Okeechobee County Facilities Directory Criteria Product: FIRST HEALTH FACILITY CARE NETWORK Sorted By: City Counties Included: OKEECHOBEE States Included: FLORIDA The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited 2 Okeechobee County Facilities OKEECHOBEE LAB CORP FLORIDA (863) 357-7715 1008 N PARROTT AVE OKEECHOBEE, FL 34972 LAKE OKEECHOBEE REGIONAL CANCER CENTER (863) 763-7100 301 NE 19TH DR OKEECHOBEE, FL 34972 LOOKADOO SKYLINE LAB (863) 357-2666 1006 N PARROTT AVE OKEECHOBEE, FL 34972 MEDFOCUS FLORIDA (800) 398-8999 204 SE PARK ST OKEECHOBEE, FL 34972 MEDFOCUS FLORIDA (800) 398-8999 115 NE 3RD ST #A OKEECHOBEE, FL 34972 ONCOLOGY ASSOCIATES FL (863) 763-7100 301 NE 19TH DR OKEECHOBEE, FL 34972 OPEN MRI OF OKEECHOBEE (863) 824-6736 115 NE 3RD ST OKEECHOBEE, FL 34972 SURGERY CENTER OF OKEECHOBEE INC (863) 357-6220 1655 US HIGHWAY 441 OKEECHOBEE, FL 34972 THIS LIST IS SUBJECT TO CHANGE The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibiter. 3 Okeechobee County Physicians Okeechobee County Physicians The First Health® Network Internet Provider Directory Current As Of: May 30, 2003 9First Health® This Provider Directory is provided by First Health Group Corp. to present to you information on hospitals, physicians and other providers who have agreed to provide their usual services to you at specially contracted rates of payment. All decisions about the type of care you receive are the responsibility of you and the physician whom you select. The quality and results of the care provided are the responsibility of the physician. Some health services may be provided by resident physicians under the supervision of the listed physicians. While First Health Group Corp. makes every effort to maintain accurate and up -to -date information, we cannot be responsible for any omissions or errors after publication. Please confirm provider participation prior to your visit. 1 Okeechobee County Physicians Directory Criteria Product: FIRST HEALTH OUTPATIENT CARE NETWORK Sorted By: Specialty, City Counties Included: OKEECHOBEE States Included: FLORIDA The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited 2 Okeechobee County Physicians ANESTHESIOLOGY OKEECHOBEE MID FLORIDA ANESTHESIA ASSOCIATES (863) 763-7015 1655 US HIGHWAY 441 OKEECHOBEE, FL 34972 MID FLORIDA ANESTHESIA ASSOCIATES (863) 763-7015 1796 US HIGHWAY 441 OKEECHOBEE, FL 34972 MID FLORIDA ANESTHESIA ASSOCIATES (863) 763 -7015 300 NW 5TH ST #312 OKEECHOBEE, FL 34972 CARDIOVASCULAR DISEASE OKEECHOBEE ARAIN, SHAKOOR A (863) 467-9400 1600B SW 2ND AVE OKEECHOBEE, FL 34974 RIAZ, MOHAMMAD (863) 467-1156 204 NE I9TH DR OKEECHOBEE, FL 34972 CHIROPRACTIC MEDICINE OKEECHOBEE DOUGLAS, EDWARD W (863) 763-4320 916 NW PARK ST OKEECHOBEE, FL 34972 PLATT, KEVIN (863) 763 -2400 280 SW 32ND ST OKEECHOBEE, FL 34974 STEPHENS, PETER W (863) 763-0880 375 SW 32ND ST OKEECHOBEE, FL 34974 CRITICAL CARE MEDICINE OKEECHOBEE SHAKOOR, ARIF (863) 357-2300 265 NE 19TH DR OKEECHOBEE, FL 34972 DERMATOLOGY OKEECHOBEE SCHIFF, THEODORE A (863) 467 -6767 301 NE I9TH DR OKEECHOBEE, FL 34972 EAR NOSE & THROAT (OTOLARYNGOLOGY) OKEECHOBEE BEQUER, NAPOLEON C (863) 357-3333 212 NE 19TH DR OKEECHOBEE, FL 34972 EAR NOSE & THROAT (OTOLARYNGOLOGY) OKEECHOBEE BERGHASH, LESLIE R (863) 357-7791 1916 US HIGHWAY 441 OKEECHOBEE, FL 34972 EAR NOSE & THROAT (OTOLARYNGOLOGY) OKEECHOBEE LANZA, JOHN T (863) 357-7791 1916 US HIGHWAY 441 OKEECHOBEE, FL 34972 EMERGENCY MEDICINE OKEECHOBEE SCOTT, JOSEPH A (863) 763-2151 1796 US HIGHWAY 441 OKEECHOBEE, FL 34972 FAMILY PRACTICE OKEECHOBEE ARAGON, GLORIA R (863) 763-6496 1004 N PARROTT AVE OKEECHOBEE, FL 34972 HELLER, LELAND M (863) 467-8771 109 NE 19TH DR OKEECHOBEE, FL 34972 SWEDA, STANLEY H (863) 763 -1107 204 SE PARK ST OKEECHOBEE, FL 34972 GENERAL PRACTICE OKEECHOBEE CROUCH, JOHN C (863) 357-3600 115NE 3RD ST #C OKEECHOBEE, FL 34972 GENERAL VASCULAR SURGERY OKEECHOBEE KOTHALANKA, RAMA (863) 467 -5873 107 NE 19TH DR OKEECHOBEE, FL 34972 GERIATRIC MEDICINE OKEECHOBEE MAVROIDES, CHRISTOPHER J (863) 763-5666 1922 US HIGHWAY 441 OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE COLLINS, EVAN M (772) 219-1080 250 NE 2ND AVE OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE DELOACH, VICTOR E (863) 763-7481 308 NW 5TH AVE OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE GARCIA, TRINIDAD E (863) 763 -6427 GASTROENTEROLOGY 306 NE 19TH DR OKEECHOBEE, FL 34972 OKEECHOBEE CHANG, JOHN (863) 357-0888 235 NE 19TH DR OKEECHOBEE, FL 34972 HAAS, KENNETH F (863) 357-7447 1930 US HIGHWAY 441 OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE HUSAIN, SURAIYA (863) 763-8000 1300 N PARROTT AVE OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE THOMSON JR, ALTON (561) 219-1080 250 NE 2ND AVE OKEECHOBEE, FL 34972 HEAD & NECK SURGERY OKEECHOBEE BERGHASH, LESLIE R (863) 357-7791 1916 US HIGHWAY 441 OKEECHOBEE, FL 34972 LANZA, JOHN T (863) 357-7791 1916 US HIGHWAY 441 OKEECHOBEE, FL 34972 HEMATOLOGY OKEECHOBEE AKHTAR, VASEEM S (863) 467 -9000 1101 N PARROTT AVE OKEECHOBEE, FL 34972 INTERNAL MEDICINE OKEECHOBEE AHMED, IQBAL (863) 357-6030 202 NE 19TH DR OKEECHOBEE, FL 34972 AKHTAR, VASEEM S (863) 467-9000 1101 N PARROTT AVE OKEECHOBEE, FL 34972 ARAGON, CANDID() P (863) 763 -6496 1004 N PARROTT AVE OKEECHOBEE, FL 34972 ARAIN, SHAKOOR A (863) 467-9400 1600B SW 2ND AVE OKEECHOBEE, FL 34974 BERGER, JAY S (863) 467 -1117 1105 N PARROTT AVE OKEECHOBEE, FL 34972 CHAUDHARY, MUHAMMAD A (863) 763-1917 206 NE I9TH DR OKEECHOBEE, FL 34972 HAAS, KENNETH F (863) 357-7447 1930 US HIGHWAY 441 OKEECHOBEE, FL 34972 KHAN, SAEED A (863) 467-4788 1924 US HIGHWAY 441 OKEECHOBEE, FL 34972 KOTHALANKA, JANIKAMMA (863) 467 -5873 107 NE 19TH DR OKEECHOBEE, FL 34973 LADIA, FELIPE P (863) 763 -6431 210 NE 19TH DR OKEECHOBEE, FL 34972 LADIA, LILIA D (863) 763 -6431 210 NE 19TH DR OKEECHOBEE, FL 34972 MAVROIDES, CHRISTOPHER J (863) 763 -5666 1922 US HIGHWAY 441 OKEECHOBEE, FL 34972 MEHANNI, MAGED A (863) 763-3622 300 NW 5TH ST #300 OKEECHOBEE, FL 34972 NAEEM, TAHIR (863) 357-0104 1924 US HIGHWAY 441 OKEECHOBEE, FL 34972 RIAZ, 11.10HAMMAD (863) 467 -1156 204 NE I 9TH DR OKEECHOBEE, FL 34972 SHAKOOR, ARIF (863) 357-2300 265 NE I9TH DR OKEECHOBEE, FL 34972 MEDICAL ONCOLOGY OKEECHOBEE AKHTAR, VASEEM S (863) 467-9000 1101 N PARROTT AVE OKEECHOBEE, FL 34972 MULTISPECIALTY CLINIC OKEECHOBEE JUPITER HAND REHABILITATION CENTER INC (863) 357-4994 210 NE 3RD AVE OKEECHOBEE, FL 34972 MULTISPECIALTY FACILITY OKEECHOBEE ALLIANCE ANESTHESIA P A (863) 763-7015 300 NW 5TH ST #312 OKEECHOBEE, FL 34972 FLORIDA COMMUNITY HEALTH CENTERS INC (863) 763-1951 1100 N PARROTT AVE OKEECHOBEE, FL 34972 THIS LIST IS SUBJECT TO CHANGE The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited 3 Okeechobee County Physicians FLORIDA COMMUNITY HEALTH CENTERS INC (863) 763-7481 308 NW 5TH AVE OKEECHOBEE, FL 34972 NEUROLOGY OKEECHOBEE ALDANA, PETER R (863) 763 -5181 115 NE 3RD ST #C OKEECHOBEE, FL 34972 ALI, ABULFAZAL S (863) 357-2777 225 NE I9TH DR OKEECHOBEE, FL 34972 OBSTETRICS & GYNECOLOGY OKEECHOBEE COLLINS, EVAN M (772) 219-1080 250 NE 2ND AVE OKEECHOBEE, FL 34972 GONZALEZ, PABLO R (863) 763-7481 308 NW 5TH AVE OKEECHOBEE, FL 34972 THOMSON JR, ALTON (561) 219-1080 250 NE 2ND AVE OKEECHOBEE, FL 34972 OCCUPATIONAL THERAPY OKEECHOBEE DURAND, DONNA (863) 357-4994 210 NE 3RD AVE OKEECHOBEE, FL 34972 WILLETTE, MICHAEL (863) 357-4994 210 NE 3RD AVE OKEECHOBEE, FL 34972 OPHTHALMOLOGY OKEECHOBEE ESPIRITU, MIGUEL A (863) 467-0533 304 NE 19TH DR OKEECHOBEE, FL 34972 KELLY, KEVIN T (863) 467-4111 710 S PARROTT AVE OKEECHOBEE, FL 34974 KELLY, KEVIN T (863) 467-4111 8551 W SUNRISE BLVD OKEECHOBEE, FL 34974 ORTHOPEDIC SURGERY OKEECHOBEE SLUTSKY, BRADFORD A (863) 763 -8100 1920 US HIGHWAY 441 OKEECHOBEE, FL 34972 PAIN MANAGEMENT OKEECHOBEE MID FLORIDA ANESTHESIA ASSOCIATES (863) 763-7015 1655 US HIGHWAY 441 OKEECHOBEE, FL 34972 MID FLORIDA ANESTHESIA ASSOCIATES (863) 763-7015 1796 US HIGHWAY 441 OKEECHOBEE, FL 34972 MID FLORIDA ANESTHESIA ASSOCIATES (863) 763 -7015 300 NW 5TH ST #312 OKEECHOBEE, FL 34972 PATHOLOGY OKEECHOBEE HUSSAIN, MUSHTAQ (863) 467-7084 210 NW PARK ST #204 OKEECHOBEE, FL 34972 SCHIFF, THEODORE A (863) 467-6767 301 NE 19TH DR OKEECHOBEE, FL 34972 PEDIATRICS OKEECHOBEE ARAGON, GLORIA R (863) 763-6496 1004 N PARROTT AVE OKEECHOBEE, FL 34972 BROWN, FRED D (863) 763-1951 1100 N PARROTT AVE OKEECHOBEE, FL 34972 HUSSAIN, ANJUM P (863) 467-8398 255 NE I9TH DR OKEECHOBEE, FL 34972 ROBSHAW, CHRISTOPHER (863) 357-1117 1100 N PARROTT AVE OKEECHOBEE, FL 34972 PHYSICAL THERAPY OKEECHOBEE KIRTON, CHERYL L (863) 467-6669 332 SW 32ND ST OKEECHOBEE, FL 34974 NEW AMERICAN PHYSICAL THERAPY (863) 763-7773 1103 N PARROTT AVE OKEECHOBEE, FL 34972 NOORUDDIN, MUHAMMAD S (863) 763 -7733 1103 N PARROTT AVE OKEECHOBEE, FL 34972 PODIATRIC SURGERY OKEECHOBEE GARVIN, MICHAEL A (863) 357 -1166 105 NE 19TH DR OKEECHOBEE, FL 34972 PARRATTO, SCOTT F (863) 467-4311 1105 N PARROTT AVE OKEECHOBEE, FL 34972 PSYCHIATRY OKEECHOBEE ALI, ABULFAZAL S (863) 357-2777 225 NE 19TH DR OKEECHOBEE, FL 34972 PULMONARY DISEASE OKEECHOBEE MEHANNI, MAGED A (863) 763-3622 300 NW 5TH ST #300 OKEECHOBEE, FL 34972 SHAKOOR, ARIF (863) 357 -2300 265 NE 19TH DR OKEECHOBEE, FL 34972 RADIATION ONCOLOGY OKEECHOBEE HARTER, DAVID J (863) 467-9500 1115 N PARROTT AVE OKEECHOBEE, FL 34972 KRIMSLEY, ALAN S (863) 467-9500 1115 N PARROTT AVE OKEECHOBEE, FL 34972 KUMAR, RAMESH T (863) 467-9500 1115 N PARROTT AVE OKEECHOBEE, FL 34972 WOODY III, RONALD H (863) 467-9500 1115 N PARROTT AVE OKEECHOBEE, FL 34972 REHAB & OCCUPATIONAL MEDICINE CTR OKEECHOBEE JUPITER HAND REHABILITATION CENTER INC (863) 357-4994 210 NE 3RD AVE OKEECHOBEE, FL 34972 SURGERY OKEECHOBEE HUSAIN, MUZAFFAR (863) 763 -8000 1300 N PARROTT AVE OKEECHOBEE, FL 34972 KURTIN, ADAM D (772) 219 -4026 250 NE 2ND AVE OKEECHOBEE, FL 34972 SANTELICES, ARMANDO A (863) 467-8181 212 NE 19TH DR OKEECHOBEE, FL 34972 UROLOGY OKEECHOBEE PANGILINAN, TRISTAN H (863) 467-7666 200 NE I9TH DR OKEECHOBEE, FL 34972 SIGALOW, DAVID A (863) 763-0217 215 NE 19TH DR OKEECHOBEE, FL 34972 YOUNG, MARVIN J (863) 467-0909 245 NE I9TH DR OKEECHOBEE, FL 34972 WORK HARDENING CENTER OKEECHOBEE JUPITER HAND REHABILITATION CENTER INC (863) 357-4994 210 NE 3RD AVE OKEECHOBEE, FL 34972 THIS LIST IS SUBJECT TO CHANGE The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited 4 Dental Plan Florida Municipal Insurance Trust 1 Summary of Benefits Calendar Year Deductible Calendar Year Maximum Per Covered Participant $50 $1,000 Type A: Preventive Dental Services Oral examinations, dental x -rays, prophylaxis, and fluoride and sealant applications (for dependents under age 15) ♦ 100% of covered expenses, no deductible Type B: Basic Dental Services Emergency treatment for pain, space maintainers, dental x -rays, biopsies of oral tissue, pulp vitality tests, fillings, extractions, oral surgery, endodontics, periodontics ♦ 80% of covered expenses, after deductible Type C: Dental Restorations and Specialty Services Inlays, onlays, crowns, bridges, dentures ♦ 50% of covered expenses, after deductible Type D: Orthodontia Services Diagnostic procedures, comprehensive treatment, appliances ♦ 50% of covered expenses, after deductible ♦ $1,000 lifetime maximum per person ♦ $50 lifetime deductible per person ♦ Eligible dependents under age 19 only (This is intended as a Summary of Benefits and does not include all of the benefits, limitations, and exclusions of the plan. Complete terms of the plan are contained in the Master Plan of Benefits.) Florida Municipal Insurance Trust Certificate of Coverage This Dental Master Plan of Benefits ( "Plan ") sets forth your rights and obligations as a participant. It is important that you READ YOUR Plan FULLY and familiarize yourself with its terms and conditions. The Plan may require that the participant contribute to the required premiums. Information regarding the premium and any portion of the premium cost a participant must pay can be obtained from your employer. Florida Municipal Insurance Trust ( "Trust ") agrees with your employer to provide coverage for dental services, subject to the terms, conditions, exclusions and limitations of the plan. The plan is issued on the basis of the Participation Agreement of the employer and payment of the required plan charges. The employer's application is made a part of the contract. The Trust shall not be deemed or construed as an employer for any purpose with respect to the administration or provision of benefits under the employer's benefit plan. The Trust shall not be responsible for fulfilling any duties or obligations of an employer with respect to the employer's benefit plan. The Trust has sole and exclusive discretion in interpreting the benefits covered under the plan and the other terms, conditions, limitations and exclusions set out in the plan and in making factual determinations related to the plan and its benefits. The Trust may, from time to time, delegate discretionary authority to other persons or entities providing services in regard to the plan. The Trust reserves the right to change, interpret, modify, withdraw or add benefits or terminate the policy, in its sole discretion, without prior notice to or approval by participants. No person or entity has any authority to make any oral changes or amendments to the policy. Please show your plan identification card each time you request health care services. This is to ensure that the providers know that you are part of the plan; otherwise you may receive a bill for health care services. This plan shall take effect on the date specified and will be continued in force by the timely payment of the required plan charges when due, subject to termination of the plan as provided. All coverage under the plan shall begin at 12:01 a.m. and end at 12:00 midnight Eastern Time. IMPORTANT NOTICE REGARDING AMENDMENT AND TERMINATION The Policyholder expects and intends to continue the Plan indefinitely. However, the Policyholder reserves the right to amend or terminate the Plan at any time and for any reason. If the Plan is amended or terminated, you and other active employees may not receive benefits as described in other sections of this certificate. You may be entitled to receive difference benefits, or benefits under different conditions. However, it is possible that you will lose all benefit Coverage. This may happen at any time, if the Policyholder decides to terminate the Plan or your Coverage under the Plan. In no event will you become entitled to any vested rights under this Plan. Further, the provisions of this paragraph cannot be modified in any manner except by resolution of the Policyholder. SCHEDULE OF INSURANCE Calendar Year Deductible $ 50 per covered participant Calendar Year Maximum $1,000 per covered participant Deductible and Insured Percentages Type of Covered Expense Does the Deductible Apply? Insured Percentage Type A - Preventive Dental No 100% Services Type B - Basic Dental Services Yes 80% Type C - Dental Restorations and Yes 50% Specialty Services Type D - Orthodontia Services: Yes 50% Lifetime deductible - $50 Lifetime maximum - $1,000 Orthodontia Services apply to eligible Dependents under age 19 only Section Florida Municipal Insurance Trust Dental Master Plan of Benefits TABLE OF CONTENTS Heading Page I. DEFINITIONS 1 II. ELIGIBILITY AND ENROLLMENT ------------- --- - -4 III. DEDUCTIBLES AND MAXIMUMS 10 IV. COVERED DENTAL EXPENSES 10 V. EXCLUSIONS AND LIMITATIONS ------------------------------------- - - - -12 VI. COORDINATION OF BENEFITS - ----------- - - - -14 VII. CONDITIONS FOR RENDERING SERVICE--------- __-- _— __— ____— ____15 VIII. TIME OF PAYMENT, GRACE PERIOD - - -------------- - - - - -- ----- - - - -16 IX. EMPLOYER'S TERMINATION AND RENEWAL -- -16 X. PARTICIPANT'S TERMINATION OF COVERAGE— - - -- - ---- - - -17 XI. CONTINUATION OF COVERAGE - COBRA - -- - - - - -17 XII. GENERAL PROVISIONS 20 XIII. GRIEVANCE PROCEDURE - 22 XIV. SUBROGATION _ ___— _______________________ - -22 XV. NOTICE — ______ -23 Florida Municipal Insurance Trust Dental Master Plan of Benefits SECTION I — DEFINITIONS Accident means a non - occupational, unforeseeable, unintentional and unplanned event, other than the acute onset of a bodily disease or infirmity, resulting in a traumatic injury to a Participant while this Plan is in force. Injury or illness resulting from the acts of bending, stooping, lifting, stretching or standing is covered as a Sickness. Adopted Child means a child who, before attaining 18 years of age, has been lawfully adopted by the Employee under State Laws and the Employee has established a legal relationship with the child in which the State of Florida declares and recognizes the child to be legally the child of the Employee and the Employee's heir at law and legally entitled to all the rights and privileges and subject to all the obligations of a child born to such Employee in lawful wedlock. Annual Enrollment Period means a 30 -day period commencing on the date as specified by the Employer's Participation Agreement during which each Employee is given an opportunity to select coverage from among the alternatives offered under the Employer's health benefit program. Benefits shall mean the payment or reimbursement by the Plan of a portion of a Medical Expense incurred by a Participant. Calendar Year means a period of twelve (12) consecutive months commencing on January 1 and ending on December 31 of a given year. For participants enrolling during a Calendar Year, the "Calendar Year" begins on the Effective Date of the Participant's enrollment and ends on December 31 of the same year. Calendar Year Deductible means the amount stated in the Schedule of Benefits the Participant is required to pay to a Provider for Benefits in each Calendar Year before the Trust will pay for Benefits provided under the Plan in the same Calendar Year. COBRA means the federal continuation of Coverage requirements of the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended, also known as s. 4980B of the Internal Revenue Code of 1986. Coverage(s) or Covered Services or Covered Expenses means the services and supplies specifically outlined in Sec. VI of this Plan and not otherwise excluded under this Plan, when Medically Necessary and rendered within the scope of the license of an appropriately licensed Provider, for which payment will be made by the Trust to, or on behalf of, a Participant. Dentist means a person licensed as such by the State of Florida when providing dental services within the scope of the person's license and in accordance with State Laws. Dental Services means those dental services for which benefits are provided under this Plan as set forth in Section IV. Dependent means the legal, married spouse of an Employee and /or the eligible legal, unmarried (never married) Dependent children, as hereinafter described, who continue(s) to meet this Plan's applicable eligibility requirements and who is actually "Unless otherwise stated in the Schedule of Benefits trey. 08021 Page 1 Florida Municipal Insurance Trust Dental Master Plan of Benefits covered under this Plan. The Employee's child is a Dependent child if the child meets all of the following conditions: (1) the child is a natural child, step - child, Adopted Child, Foster Child or a child who has been placed in the court - ordered temporary or other legal custody of the Employee, and (2) the child is in the custody of and financially dependent upon the Employee. Condition (2) is waived if the Employee is required to provide Coverage to the child due to court order or divorce decree. A newborn child of a Dependent child having Dependent coverage is entitled to the same benefits as the Dependent child; provided, however, a Dependent child shall not be entitled to maternity benefits under this Plan, and with respect to a newborn child of a Dependent child, Coverage under the Plan for the newborn child shall terminate 18 months after the birth of the newborn child. A Dependent child shall cease to be a Participant at the end of the Calendar Year in which such child reaches the age of 19; provided, however, that if such child is dependent upon the Employee for support, and is living in the household of the Employee or is enrolled in and attending an accredited school, college, or university, Coverage will continue until the end of the Calendar Year in which the child reaches the age of 25, or upon the marriage of such child, whichever event shall first occur. A Dependent child, regardless of age, shall continue to be covered under this Plan while the child is and continues to be (1) incapable of self- sustaining employment by reason of a mental or physical disability that was diagnosed while the Dependent child was covered under this Plan; and (2) chiefly dependent upon the Employee for support and maintenance. Upon attaining the eligibility limiting age, it is the Participant's sole responsibility to establish that a child meets the applicable requirements for continued eligibility. The burden is on the Participant to establish such Dependent meets or continues to meet the applicable requirements for continued eligibility. The Trust may, at any time, require reasonably reliable and acceptable documentation that a child meets and continues to meet such requirements. Upon request by the Trust, the Participant must provide a sworn and properly executed affidavit, which states the Dependent, continues to meet the applicable requirements for eligibility. A Dependent's continued eligibility does not modify any eligibility requirements other than the limiting age requirement. Continued eligibility shall terminate on the last day of the month in which the child does not meet the requirements of continued eligibility. Dependent also may include individuals on short term sick or disability leave, FMLA Leave, USERRA Leave or occupational /vocational (Workers' Compensation) leave (for non occupational illness or injuries only) and who otherwise meet the requirements of this definition. Effective Date means, with respect to this entire Plan, and to Participants properly enrolled when this Plan first becomes effective, 12:01 a.m. on the date specified on the Participation Agreement; and, with respect to a Participant who is subsequently enrolled in this Plan, 12:01 a.m. on the date on which Coverage will commence for the Participant under the terms of this Plan. Employee means an officer or employee of the Employer or any class or classes of such employees, regularly working twenty -five (25) or more hours a week, who is eligible "Unless otherwise stated in the Schedule of Benefits treu.08021 Page 2 Florida Municipal Insurance Trust Dental Master Plan of Benefits for Coverage hereunder, who has been so designated by the Employer and who holds a valid Social Security Number. Employee also includes the elected or appointed officials of the Employer, employees who have retired and are receiving retirement benefits pursuant to a retirement plan lawfully established and maintained by the Employer and employees who are eligible for Medicare, but who nonetheless continue to satisfy the first sentence of this definition. Employee also may include individuals on short term sick or disability leave, FMLA Leave, USERRA Leave or occupational /vocational (Workers' Compensation) leave (for non occupational illness or injuries only) and who otherwise meet the requirements of this definition. Employer means each and every county, municipality, school board, special taxing district or local governmental unit established within, and pursuant to the laws of, the State of Florida and which becomes a party to this Trust by executing a Participation Agreement, and who has agreed to be bound by all the terms and provisions of the Trust Agreement, the Participation Agreement, this Plan and the rules and regulations adopted by the Trustees in the administration of the Trust. Initial Enrollment Period means the 30 -day period of time immediately following the initial dates an Employee or Dependent is first eligible to become a Participant under the terms of this Plan. Late Enrollee means a Participant who enrolls in the Plan at any time other than the Initial Enrollment Period or the Special Enrollment Period. Lifetime Maximum means the maximum liability of the Trust for Benefits provided under this Plan to each Participant covered under this Plan, during the entire period such Participant is covered under this Plan. Lifetime Maximum may refer to the maximum amount stated in the Schedule of Benefits or to the maximum amount specified in specific Benefits provided under Section VI of this Plan. New Employee means an Employee who has never been previously employed by the Employer prior to the Effective Date of this Plan and who is employed by the Employer on or after the Effective Date of this Plan, or an Employee who was employed by the Employer prior to the Effective Date of this Plan and was ineligible to participate in the Employer's prior plan because the Employee had not completed the period of continuous employment and hours requirement with the Employer as set forth in such plan, if any, to qualify to participate in such plan. Participant means and includes the Employee and any Dependent of the Employee who is actually enrolled and covered under this Plan. Participant also means and includes those Employees and their Dependents that qualify for continuation of coverage under COBRA. Plan means this Medical Master Plan of Benefits, the Dental Master Plan of Benefits, the Employer's Participation Agreement, the Employer's Schedule of Benefits, the Agreement and Declaration of Trust creating the Trust, the rules, regulations and resolutions adopted by the Trust, the Employer's Group Application, the Employee's Enrollment Forms, any Endorsements in effect, the identification cards issued to Employees and Dependents indicating they are Participants, any arrangement between "Unless otherwise stated in the Schedule of Benefits (rev. 08023 Page 3 Florida Municipal Insurance Trust Dental Master Plan of Benefits the Trust and a network of health care providers, and any other agreement between the Trust and the Employer by virtue of which the Employer and its eligible Employees and their Dependents participate in the Trust and this Plan. Provider means a person or facility defined herein when providing Benefits within the scope of the person or facility's license and in accordance with State Laws. Reasonable Fee means the maximum benefit allowance the Trust will pay for Benefits provided to a Participant. Benefit allowances will be determined solely by the Trust. The basis for the benefit allowance will be the relative value studies and schedules utilized and evaluated by the Trust. The benefit allowances utilized by the Trust are determined by studies of charges for similar benefits within a common geographical area, including pre- negotiated payment amounts, diagnostic related groupings, relative value scales, and /or the usual and customary charges for providing the medical service or supply. These studies are used to develop benefit value schedules, which are updated on a routine basis. Any charges above the amount determined to be a Reasonable Fee shall be the responsibility of the Participant. Single Procedure means a dental procedure to which a separate procedure number is assigned by the Trust. Special Enrollment Period means the 30 -day period of time specified in this Plan when an Employee and /or Dependent may be eligible to enroll in this Plan outside of the Initial Enrollment Period and the Annual Enrollment Period. State Laws means the laws of the State of Florida and all rules, regulations, ordinances and directives promulgated there under. Treatment Plan means a written report showing the recommended treatment of any dental disease, defect or injury for a Participant prepared by a Dentist as a result of any examination made by such Dentist while Coverage under this Plan is in effect for the Participant. Trust means the Florida Municipal Insurance Trust, its Trustees and individuals or organizations designated by the Trustees to act on behalf of the Trust. Waiting Period means the period specified in the Participation Agreement that must pass before an Employee or Dependent is eligible to become a Participant under the terms of this Plan, less any Applicable Credit that must be given if the Participant has satisfied a similar Waiting Period provision under a prior health insurance plan that was replaced by this Plan. SECTION II — ELIGIBILITY AND ENROLLMENT Commencement of Coverage - Subject to any Waiting Period set forth under this Plan and to any other condition of commencement expressed in this Plan, coverage hereunder shall commence as follows: "Unless otherwise stated in the Schedule of Benefits tree. 08021 Page 4 Florida Municipal Insurance Trust Dental Master Plan of Benefits (1) In the event an Employer had no group dental insurance plan covering its Employees and their Dependents in effect immediately prior to the Effective Date of this Plan, all Employees of such Employer on the Effective Date, and their eligible Dependents shall be eligible to participate in this Plan. Coverage shall commence as of the Effective Date of the Plan without proof of insurability provided the Trust receives a properly and accurately completed and executed enrollment form and any required medical statement application during the Initial Enrollment Period. If application is not received on or before the expiration of the Initial Enrollment Period, any application for coverage by an Employee, or the Employee's eligible Dependents, will be accepted only during an Annual Open Enrollment Period or a Special Enrollment Period. (2) In the event an Employee, or the Employee's eligible Dependents, were validly covered under a group dental insurance plan issued to the Employer and in effect immediately prior to the Effective Date of this Plan and such plan is discontinued and replaced with this Plan, all such Employees and eligible Dependents actually covered under such prior plan shall be eligible to participate in this Plan, without interruption of coverage and without proof of insurability, unless such Employee or Dependent is entitled to any extension of benefits in accordance with S. 627.667, F.S., under the terms of the prior plan, and provided the Trust receives a properly and accurately completed and executed enrollment form, and any required medical statement application, during the Initial Enrollment Period. In the event such Employee or Dependent is entitled to an extension of benefits in accordance with s. 627.667, F.S., under the terms of the prior plan, such Employee or Dependent shall be entitled to participate in this Plan without interruption of coverage and without proof of insurability provided the Trust receives an accurately completed and executed enrollment form, and any required medical statement application, during the Initial Enrollment Period; however, the level of benefits under this Plan shall be no more than the applicable level of benefits under this Plan, reduced by any benefits payable under the prior plan. Upon request, the Employer, Employee and /or Dependent shall provide the Trust all information as is reasonably necessary, including specific coverage or claim information from the prior plan, for the Trust to coordinate the level of benefits payable under this Plan and under the prior plan, for the Trust to verify the level of benefits provided under the prior plan, and for the Trust to determine each Employee and Dependent who was validly covered under the prior plan immediately prior to the Effective Date of this Plan. If application is not received on or before the expiration of the Initial Enrollment Period, any application for Coverage by an Employee, or the Employee's eligible Dependents, will be accepted only during an Annual Enrollment Period or a Special Enrollment Period. Eligibility - Employees and eligible Dependents shall be eligible for Coverage on or after the Effective Date of this Plan if: (1) They fall within the classification set forth in the Employer's Participation Agreement; and "Unless otherwise stated in the Schedule of Benefits frev. 08021 Page 5 Florida Municipal Insurance Trust Dental Master Plan of Benefits (2) They have completed the period of continuous employment with the Employer as set forth in such classification. An Employee shall not be eligible as a Dependent under the same Employer group except when both spouses are eligible Employees and desire dependent child(ren) coverage. In that case, one Employee may cover the spouse and children as Dependents for health Benefits and the spouse may be covered as a single Employee for other employee coverage(s). Enrollment - Employees and Dependents may enroll for Coverage under the Plan by completing and submitting to the Employer an accurately completed and executed enrollment form provided by the Trust, as specified below: (1) Initial Enrollment Period - within 30 days of satisfaction of the Plan Waiting Period. (a) New Employees, and their Dependents shall be eligible to participate in this Plan without proof of insurability subject to the exclusions contained herein for Totally Disabled individuals. Participation in the Plan shall commence on the first of the month following satisfaction of the eligibility requirements set forth above. If the enrollment form is not received on or before the expiration of the Initial Enrollment Period set forth above, any application for Coverage by a new Employee or their Dependents will be governed by the provisions set forth in Paragraph (4) of this section. (b) Except as otherwise provided in Commencement of Coverage Paragraph (2), in the event an Employee or Dependent is hospital confined, on sick /short term disability leave or Family Medical Leave as defined by the Family Medical Leave Act of 1993 (FMLA) when Coverage would otherwise begin, Coverage will commence the billing date of the month following the employee or dependent's return to good health when able to perform the normal activities of a well person of the same age and sex. This subsection does not apply to a newborn child of an employee covered for dependent coverage at the time of birth. (c) In the event an Employee's Coverage terminates due to termination of employment and such Employee returns to full -time employment within ninety (90) days, such Employee's Coverage may be reinstated without completing the period of continuous employment set forth in the Employer's Participation Agreement, provided an enrollment form is received by the Trust within thirty (30) days of the Employee's return to employment. If the enrollment form is received more than thirty (30) days after the Employee's return to employment, any application for Coverage will be governed by the provisions set forth in Paragraph (4) of this section. "Unless otherwise stated in the Schedule of Benefits (rev. 08021 Page 6 Florida Municipal Insurance Trust Dental Master Plan of Benefits (d) In the event an Employee was covered under this Plan through another employer within thirty (30) days prior to beginning employment with this Employer, such Employee will not be required to complete the period of continuous employment set forth in the Employer's Participation Agreement, provided an enrollment form is received by the Trust within thirty (30) days of beginning employment with this Employer. Required contributions must be paid at the new Employer's rates from the prior billing date for reinstatement of continuous Coverage. If the enrollment form is received more than thirty (30) days after the Employee's return to employment, any application for Coverage will be governed by the provisions set forth in Paragraph (4) of this section. (2) Open Enrollment /Re- enrollment Period - within 30 days after the Employer's Plan's policy renewal anniversary as specified in the Employer's Participation Agreement, or as agreed to in writing by the Trust and the Employer. All Plan Participant's must re- enroll by submitting a newly signed completed enrollment application. Eligible Employees can enroll in the Plan or terminate Coverage during the Open Enrollment Period. If application is received 30 days or more following the Plan's policy renewal anniversary, any application for coverage by an Employee or Dependents will be governed by the provisions set forth in Paragraph (4) of this section except in the case of re- enrollment. Failure to re- enroll in the Plan will result in suspended claim payment until a signed completed enrollment application is received by the Trust. Special Enrollment Period - within 30 days of certain events or loss of coverage as outlined below: (3) (a) Employees and /or Dependents may utilize the Special Enrollment Period if: 1) covered under another health benefit plan as an employee or dependent, or COBRA continuation of coverage at the time of initial eligibility to enroll for Coverage under this Plan; and 2) when offered Coverage under this Plan at the time of initial eligibility, stated, in writing, that coverage under another health plan was the reason for declining enrollment; and 3) demonstrated that loss of coverage under an individual or group health benefit plan occurred as a result of legal separation, divorce, death, termination of employment, reduction in the number of hours of employment, or the coverage was terminated as a result of the termination of employer contributions toward such coverage; and 4) the required showing regarding loss of coverage and an enrollment application is received by the Trust within thirty (30) days after the termination of coverage under another health benefit plan. "Unless otherwise stated in the Schedule of Benefits [rev. 0802) Page 7 Florida Municipal Insurance Trust Dental Master Plan of Benefits (b) A newly eligible Dependent acquiring such newly eligible status as a result of marriage, birth, adoption or placement for adoption, legal guardianship or court order, may utilize the Special Enrollment Period without proof of insurability, provided the Trust has received an accurately completed and executed enrollment form, within thirty (30) days of the event. Eligible dependents may only be enrolled if the eligible dependent is a Dependent of an Employee who is already participating in the Plan. If the Employee fails to apply within the thirty (30) day period specified herein, any application for Coverage will be governed by Paragraph (4) of this Section. 1) In the event of marriage, the Effective Date of Coverage for such Dependent shall be the first day of the month following receipt of notification by the Trust. 2) In the event of a newborn, Coverage for such Dependent will take effect on the date of birth. The Participant must provide a written enrollment form to the Trust to notify the Trust of the birth of the child within a notice period of thirty (30) days after the birth. If timely notice is received by the Trust, the Trust will not charge an additional premium for coverage of the newborn child for the duration of the notice period. If timely notice is not received by the Trust, the Trust may charge an additional premium from the date of birth. If notice is given within 60 days of the birth of the child, the Trust may not deny coverage of the child due to the failure of the Participant to timely notify the Trust of the birth of the child. Following this 60 -day period wherein no enrollment form is received by the Trust, the Participant may only establish coverage for such newborn Dependent(s) by utilizing the Annual Open Enrollment Period. Coverage for a newborn child of a Covered Dependent terminates under the Plan eighteen months after the birth of the newborn child. 3) In the event of an adoption of a newborn child, if a written application to adopt a newborn child has been entered into by the Employee prior to the birth of the child, such child shall be subject to the conditions and entitled to the benefits and services provided in this Plan applicable to newborn children provided the child is ultimately adopted pursuant to Ch. 63, F.S. As a condition of Coverage, the written agreement shall accompany the Employee's supplemental application for Coverage for such Dependent child. In the case of an adopted newborn child, Coverage begins at the moment of birth if a written agreement to adopt the child has been entered into by the Participant prior to the birth of the child. As a condition of continued Coverage, the Employee shall immediately provide the Trust with a certified copy of the judgment of adoption upon its entry and the Employee shall, upon request, provide to the "`Unless otherwise stated In the Schedule of Benefits (ree. 08021 Page 8 Florida Municipal Insurance Trust Dental Master Plan of Benefits Trust, under oath, such information as is reasonably necessary to keep the Trust apprised of the status of the adoption proceeding. See subsection 5 hereunder for further relevant information. 4) In the event of an adoption or placement for adoption (other than newborn), legal guardianship or court order, the Effective Date of Coverage shall be from the date of the child's placement in the Employee's residence or date specified by court order. The Participant must provide a written enrollment to the Trust to notify the Trust of the placement or adoption of the chilled within a notice period of thirty (30) days after the adoption or placement for adoption. If timely notice is received by the Trust, the Trust will not charge an additional premium for coverage of the child for the duration of the notice period. If timely notice is not received by the Trust, the Trust may charge an additional premium from the date of placement or adoption. As a condition of Coverage, the Employee shall provide the Trust with a certified copy of the judgment of adoption, guardianship of court order. See subjection 5 hereunder for further relevant information. 5) In order to be covered under the Plan, the adopting Participant must provide the Trust with written notice of the birth (in the case of a newborn adoptee) or placement of the adopted Dependent, including an enrollment form, within thirty (30) days of the birth or placement. If timely notice is received by the Trust, the Trust may not charge an additional premium for coverage of the newborn of adopted child for the duration of the notice period. If timely notice is not received by the Trust, the Trust may charge an additional premium from the date of birth or placement. If notice is given within 60 days of the birth or placement of the child, the Trust may not deny coverage of the child due to the failure of the Participant to timely notify the Trust of the birth or placement of the child. However, in no event will adopted Dependent Coverage continue beyond sixty (60) days after birth (in the case of a newborn adoptee) or placement, without receipt of application and enrollment form by the Trust. Following this 60 -day period wherein no enrollment form is received by the Trust, the Participant may only establish Coverage for such newborn Dependent(s) by utilizing the Annual Open Enrollment Period. It is the responsibility of the Participant to provide the Trust appropriate written documentation demonstrating the child is an Adopted Child, including proof of final adoption, a Foster Child, or a child placed in the court - ordered temporary or other custody of the Participant. It is the further responsibility of the Participant to notify the Trust if an Adopted Child is not ultimately lawfully placed in the Participant's residence, if and when the Foster Child is no longer in the care of the Participant, or if and when a child is no "Unless otherwise stated in the Schedule of Benefits trey. 08021 Page 9 Florida Municipal Insurance Trust Dental Master Plan of Benefits longer in the court - ordered temporary or other custody of the Participant. The child's Coverage under the Plan will terminate at the end of the month in which the Trust is notified the adoption could not be legally completed, the Participant's status as a Foster Parent is terminated, or the Participant's court- ordered temporary or other custody of the child is terminated. (c) An individual who loses coverage as a result of failure to pay premiums on a timely basis, or the discontinuance of any contributions toward the dental Coverage plan by the employer or for cause does not have the right to Special Enrollment under this Plan. Voluntary termination of Coverage does not constitute a loss of eligibility for coverage or loss of coverage entitling an Employee or Dependent to utilize the Special Enrollment Period. In the event a participant drops coverage, he /she and eligible dependents may not re- enroll in the dental plan until the end of thirteen (13) months. SECTION III — DEDUCTIBLES AND MAXIMUMS The Calendar Year Deductible is waived for all Type A- Preventive Dental Services. Only one Calendar Year Deductible applies if both Type B -Basic Dental Services and Type C- Dental Restorations and Specialty Services expenses are incurred. Such deductible amounts shall be satisfied on the basis of the first Covered Services rendered and by application of the Reasonable Fee for such services. Type D- Orthodontia Services is limited to a $50 lifetime deductible. The maximum benefit payable for all Type D- Orthodontia Services expenses to a Participant rendered during that Participant's lifetime shall not exceed $1,000. The maximum benefit payable for all (Type A- Preventive Dental Services, Type B -Basic Dental Services, Type C- Dental Restorations and Specialty Services, and Type D- Orthodontia Services) expenses rendered to a Participant during any one calendar year shall not exceed $1,000. SECTION IV - COVERED DENTAL EXPENSES Subject to the limitations, exclusions and other terms and conditions of this Plan, Benefits to the extent hereinafter set forth shall be provided for Basic Dental and Orthodontia Services set forth below when rendered by a Dentist. In the event a Participant shall incur expenses for Covered Dental Services on or after his /her effective date of Coverage hereunder, Benefits will be provided as follows for such expenses (except for any amount in excess of a reasonable fee): "Unless otherwise stated in the Schedule o1 Benefits Ireu. 08021 Page 10 Florida Municipal Insurance Trust Dental Master Plan of Benefits Type A - Preventive Dental Services Preventive Dental Services expenses are payable at 100% of the Reasonable Fee. No deductible need be met for these services. Preventive Dental Services are defined as: (1) (2) (3) Oral examinations - limited to two (2) visits every Calendar Year. Prophylaxis - limited to two (2) visits every Calendar Year. X-rays - a) Bite Wing - limited to two (2) visits per Calendar Year. b) Panoramic or Full Mouth - limited to one (1) every 24 months. More than 14 intraoral periapical x -rays are deemed a full mouth x -ray. Fluoride and sealant applications - limited to two (2) visits every Calendar Year. This benefit applies to Dependents under age 15 only. Type B - Basic Dental Services Basic Dental Services expenses are payable at 80% of the Reasonable Fee, after the Calendar Year Deductible has been met. Basic Dental Services are defined as: (1) Palliative treatment - temporary treatment of pain. (2) Endodontic treatment - including root canals. (3) Space maintainers - This benefit applies to Dependents under age 15 only. (4) X -rays - other than full mouth, panoramic, or bite wing. (5) Silver and synthetic permanent fillings - except when used in conjunction with straightening teeth. (6) Oral Surgery. (7) Periodontal treatment. (8) Normal extraction of teeth. Type C - Dental Restorations and Specialty Services Dental Restorations and Specialty Services expenses are payable at 50% of the Reasonable Fee, after the Calendar Year Deductible has been met. Dental Restorations and Specialty Services are defined as: (1) Crowns and jackets - except when used in conjunction with straightening teeth. (2) Gold fillings, crowns, onlays or inlays - will be paid at the recommended allowance (reasonable fee) for a similar porcelain, silver or alloy filling crown, onlay or inlay. (3) Fixed bridges - consisting of crowns or jackets and the artificial teeth. (4) Dentures and removable bridges - including adjustments and repairs. "Unless otherwise stated in the Schedule of Benefits free. 08021 Page 11 Florida Municipal Insurance Trust Dental Master Plan of Benefits Type D — Orthodontia Services (applies only to Dependent children under age 19) Orthodontia Services expenses are payable at 50% of the Reasonable Fee, after the Orthodontia Lifetime Deductible has been met. Benefits are only paid for services at the time they are rendered. In no event will the total Benefit be payable in one sum at the start of treatment. Orthodontia Services are defined as: (1) Diagnostic procedures. (2) Appliances for tooth guidance and control of harmful habits. (3) Retention appliances. (4) Comprehensive treatment — with fixed and removable appliances for correction of malocclusion in permanent, primary and mixed dentition. Pre - Treatment Estimate If Covered Expenses for a course of treatment are expected to be more than $300, a Treatment Plan must be submitted to the Trust before treatment begins. If the Trust determines that alternate procedures, services or courses of treatment can be performed to correct a dental condition, payment will be considered for the least costly procedure that will produce a professionally satisfactory result. SECTION V — EXCLUSIONS AND LIMITATIONS No Benefits shall be provided under this Plan on account of: (1) Services, care or treatment received from a dental or medical department maintained by or on the behalf of an Employer, a mutual benefit association, labor union, trustee or similar person or group. (2) Services, care or treatment with respect to congenital malformations or primarily for cosmetic or esthetics purposes. (3) Services, care or treatment furnished or available to a Participant in whole in part under the laws of the United States, or any state, or political subdivision thereof, or for which the Participant would have no legal obligation to pay in the absence of this or any similar Coverage. (4) Services, care or treatment to the extent Coverage is available to the Participant under any other Dental Care Plan. (5) Services, care or treatment not specifically listed under Section IV. (6) Expenses incurred for procedures, appliances or restorations necessary to increase vertical dimension or restore occlusion or for purposes of splinting. (7) Expenses incurred for the replacement of any prosthetic appliance or fixed bridge within five (5) years following the date of the last replacement of such appliance, crown or bridge. "Unless otherwise stated in the Schedule of Benefits free. 08021 Page 12 Florida Municipal Insurance Trust Dental Master Plan of Benefits (8) (9) Expenses incurred for lost or stolen appliance. Expenses incurred for initial placement of any prosthetic appliance or fixed bridge unless such placement is necessitated by the extraction of one or more natural teeth while covered under this Plan. Any such appliance or fixed bridge must include the replacement of the extracted tooth or teeth. (10) Expenses for the replacement of denture or bridgework or temporary appliance unless one or more natural teeth were extracted after Coverage began, and /or the appliance is at least five (5) years old and cannot be made serviceable. (11) Expenses incurred for any procedure begun before Coverage was in effect. (12) Services rendered or supplies furnished after the date the Participant ceases to be covered hereunder; or for any prosthetic dental appliances finally installed or delivered more than thirty (30) days after the participant's Coverage terminates. (13) Expenses by a Dentist for broken appointments or for completion of Dental Claim Forms. (14) Any services, care or treatment that do not meet the standards set by the American Dental Association or which are not reasonably necessary or customarily used for dental care. (15) Preventive Services performed more than twice in a Calendar Year period or for fluoride application(s) and sealants performed on Participants over the age of 15. (16) Charges made by a Dentist or dental hygienist who normally lives in the Participants home or is a member of the Participant's immediate family. (17) Services, care or treatment for which Coverage is available to the Participant, in whole or part, under any Workers' Compensation Law or similar legislation, whether or not the Participant claims compensation or receives benefits there under and whether or not any recovery is had by the Participant against a third party for damages resulting from a condition, disease, ailment or accidental injury necessitating such Services. (18) Dental care resulting from any injury sustained as a result of war, declared or undeclared, or any action of war or any resistance to armed invasion or aggression or international police action. (19) Dental care resulting from any injury which is self - inflicted or not caused by an Accident. (20) Dental care resulting from participation in the commission of a felony. (21) Services for the replacement of teeth using implant procedures or any services on such implants. "Unless otherwise stated in the Schedule of Benefits [rev. 0802] Page 13 Florida Municipal Insurance Trust Dental Master Plan of Benefits SECTION VI — COORDINATION OF BENEFITS The purpose of dental care coverage is to help meet actual expenses. In line with that purpose, this Plan contains a non - profit provision coordinating it with other plans, including group plans under which a Participant is covered, so that the total Benefits available will not exceed 100% of the allowable expenses. Primary Coverage — A plan without a coordination of benefits provision is always the primary plan. If all potentially applicable plans have this provision: (1) the plan covering the person as an employee rather than as a dependent is primary; (2) the plan covering the person as an active employee or as a dependent of an active employee rather than Medicare is primary; if a dependent child is covered under both parents' plans, the plan for the parent with the earliest birth date in the Calendar Year is primary; (4) if a dependent child is covered under both parents' plans, and both parents have the same birthday, the plan which has covered the parent for a longer period of time is primary. However, if a plan subject to the foregoing rule based on the birthday of the parents coordinates with an out -of -state plan which contains provisions under which the benefits cover a person as a dependent of a male are determined before those of a person covered as a dependent of a female, and, if as a result, the plans do not agree on the order of benefits, the provisions of the other plan shall determine the order of benefits. if a dependent child is covered under both parents' plans, and the parents are divorced or separated, the primary plan will be determined in the following order: (3) (5) • First, the plan of the parent with custody of the child; • Second, the plan of the spouse of the parent with the custody of the child; and • Third, the plan of the parent not having custody of the child; unless the specific terms of a court decree state that one of the parents is responsible for the health care expenses of the child in which case the plan covering such parent is primary. A copy of the court decree must be furnished to the Trust; (6) The Plan covering an employee, or the employee's dependents, rather than a retiree, or the retiree's dependents, is primary; The Plan covering a person as an employee who has not retired, or as the employee's dependents, rather than the plan covering a person, or the person's dependents, as a retiree, is primary; (7) "Unless otherwise stated in the Schedule of Benefits (rev. 0802) Page 14 Florida Municipal Insurance Trust Dental Master Plan of Benefits (8) The Plan covering a person as an employee, or the employee's dependents, rather than a plan covering the person, or the person's dependents, under COBRA, shall be primary. If none of the above rules apply, the plan that covered an employee or dependent for a longer period of time is primary. Secondary Coverage — Services and Benefits under this Plan will be coordinated with, and this Plan is hereby deemed secondary to plans providing coverage for services, supplies or benefits furnished to a Participant or paid under any of the following plans of insurance coverage: (1) any plan, program or insurance policy providing dental benefits including, but not limited to, policies issued to any health maintenance organization or any entity to which such policies may legally be issued in the State of Florida for the purpose of insuring a group of individuals; (2) any plan, program or insurance policy and /or Personal Injury Protection automobile insurance as required and defined in the Florida Statutes or policy of No -Fault Insurance as defined by any other applicable state laws or provisions, which provide benefits or makes payments to or on behalf of a participant for hospital, medical and /or health care expenses; (3) any group contract issued to this Trust; (4) any dental coverage under a plan or law of any federal, state or local government or any political subdivision thereof, including but not limited to, coverage under Medicare and /or any other federal state or local government - sponsored program or programs, unless otherwise provided by law. A Participant shall have no right to benefits under this Plan if said participant elects to waive any entitlement to benefits provided under any plan described in this Section. The Participant shall provide, execute and deliver such information, instruments and papers, and do whatever else is necessary to secure the instruments and papers, and the Trust's rights under this paragraph. (5) SECTION VII - CONDITIONS FOR RENDERING SERVICE Benefits will not be paid for any one item of expense under more than one provision of the Plan. All related dental expenses will be part of the most comprehensive procedure and only the Benefit for such procedure will be payable. The Participant shall present proper identification issued by the Trust when applying for dental services covered under this Plan. The Plan does not confer upon the Trust any rights to select a Dentist for the Participant. The Participant shall be at liberty to elect his or her Dentist. Nothing contained herein shall interfere with the ordinary relationship between the Participant and the Dentist selected by "Unless otherwise stated in the Schedule of Benefits [rev. 08021 Page 15 Florida Municipal Insurance Trust Dental Master Plan of Benefits the Participant. Some Employers may elect to make special arrangements with specific Providers and /or Preferred Provider Networks. If an Employer makes such an arrangement, the arrangement must be submitted to the Trust and benefits under such an agreement will be paid on such terms and conditions as are agreed to in writing by the Employer and the Trust. The Trust does not undertake to furnish any Services, but merely to pay for Covered Services to the Participant to the extent herein specified. The Trust shall not, in any event, be liable for any negligence, misfeasance, nonfeasance, malfeasance, malpractice or any act of commission or omission on the part of any dental service Provider. SECTION VIII — TIME OF PAYMENT, GRACE PERIOD All contributions are due and payable on the first day of each month for which Coverage under this Plan is provided. If the Employer fails to pay the contributions to the Trust within twenty (20) days after they become due and payable, the Plan is automatically terminated effective the first day of the month in which such contributions were due and payable and no Participant shall thereafter be entitled to any further Benefits hereunder. In the event this Plan terminates for any reason, the Employer shall be liable for all contributions due and unpaid as of the date of termination in the event that claims were paid after the contributions became due and payable. The Trust must give an employer forty -five (45) days written notice of any change in the monthly rate of contribution or any changes in this Plan's terms or Benefits. SECTION IX — EMPLOYER'S TERMINATION AND RENEWAL Except as provided in Section VIII, this Plan may be terminated by either party hereto by giving not less than forty -five (45) days written notice of termination to the other. This Plan shall continue in force from month to month unless terminated pursuant to the foregoing provision. Except as hereafter provided, Coverage for all Employees and their Dependents covered under this Plan shall automatically terminate immediately on the earliest of the following dates: (1) On the date Coverage is terminated. (2) On the expiration date as provided in Section VIII, if the Employer fails to make the required contributions. All claims must be submitted no later than ninety (90) days after the date of termination of the policy in order to be eligible for payment. "Unless otherwise stated in the Schedule of Benefits frev. 08021 Page 16 Florida Municipal Insurance Trust Dental Master Plan of Benefits SECTION X — PARTICIPANT'S TERMINATION OF COVERAGE Unless a Participant qualifies for and elects continuation of Coverage pursuant to and in the manner provided in Section XI of the Plan: (1) Coverage for any Participant shall terminate automatically at the end of the month for which payment of the contributions specified herein shall have been made by the Employer for such Participant, in the event the Employer notifies the Trust that the Coverage of such Participant under this Plan is to be terminated. (2) Coverage of the spouse of an Employee shall automatically cease upon a legal separation of the spouse and Employee or termination of the marriage between the spouse and Employee. Coverage of the spouse and Dependents of an Employe shall automatically cease upon the death of the Employee. (4) Coverage of a Dependent child of an Employee shall automatically cease as provided under Section I - Dependent Definition. The Coverage of any Participant shall terminate automatically when the maximum Benefits for which such Participant is eligible have been paid. Coverage for any remaining family participants shall, unless otherwise terminated in accordance with provisions hereof, continue so long as payment of required contributions is timely made. (3) (5) SECTION XI — CONTINUATION OF COVERAGE - COBRA The Plan provides an election for continuation of Coverage to qualified beneficiaries who would otherwise lose Coverage under the Plan as a result of a qualifying event. A qualified beneficiary means the Dependent spouse or Dependent child of an Employee who is a Participant in the Plan on the day before the qualifying event. In the case of termination (other than for gross misconduct), the term also includes the Employee. One exception to this rule is when a child is born to (or placed for adoption with) an Employee during the COBRA continuation period. These children will receive all rights of a qualified beneficiary throughout the COBRA continuation period. A qualifying event means the occurrence of any of the following events, which would result in the loss of Coverage to: (1) Employee: (a) Termination of employment for any reasons other than gross misconduct. (b) Reduction of work hours. "Unless otherwise stated In the Schedule of Benefits (rev. 08021 Pagel] Florida Municipal Insurance Trust Dental Master Plan of Benefits (2) (3) Continuation requirements. is as follows: (1) (2) (3) Spouse: (a) Termination of Employee's employment. (b) Reduction of Employee's work hours. (c) Death of Employee. (d) Divorce or legal separation from Employee. (e) Employee becomes enrolled in Medicare. (f) A covered Dependent child ceases to be a Dependent under the Plan. Dependent: (a) Termination of Employee's employment. (b) Reduction of Employee's work hours. (c) Death of Employee. (d) Divorce or legal separation from Employee. (e) Employee becomes enrolled in Medicare. (f) Dependent child ceases to be an eligible Dependent as defined by the Plan. of Coverage is conditioned upon satisfaction of the following notice The notice requirement relating to election Coverage by qualified beneficiaries In the event of an Employee's death, termination of employment or Medicare eligibility, the Employer shall notify the Trust within sixty (60) days of such event. Upon receipt of notice, the Trust shall, within fourteen (14) days, notify the qualified beneficiary of his /her right to elect continuation Coverage under the Plan. In the event of divorce, legal separation or a Dependent child ceasing to qualify as a Dependent under the Plan, the Employee or the qualified beneficiary is required to notify the Trust within sixty (60) days of such qualifying event. Upon receipt of notice, the Trust shall, within fourteen (14) days, notify the qualified beneficiary of his /her right to elect continuation of Coverage under the Plan. Notice hereunder to Employees or qualified beneficiaries shall be by First Class Mail to their last known address; notice to the Trust shall be by First Class Mail to the Board of Trustees of the Florida Municipal Insurance Trust. A qualified beneficiary's election of continuation of Coverage must be made within sixty (60) days following notice of continuation rights being provided to the qualified beneficiary. If the qualifying event is termination, the covered Employee's election of continuation Coverage shall be deemed to include an election of continuation of Coverage on behalf of any other qualified beneficiary who would lose Coverage under the Plan by reason of the termination. If any other qualifying event occurs, the election of continuation of Coverage by the spouse shall be deemed to include an election of continuation Coverage on behalf of any other qualified beneficiary who would lose Coverage under the Plan by reason of the qualifying event. "Unless otherwise stated In the Schedule of Benefits trey. 08021 Page 18 Florida Municipal Insurance Trust Dental Master Plan of Benefits The cost of Coverage to the qualified beneficiary shall be 102% of the cost of providing Coverage for such period to a similarly situated Participant under the Plan to whom a qualifying event has not occurred. In the event the qualifying event entitling the qualified beneficiary to continuation of Coverage is the covered beneficiary's disability as defined by the Social Security Act, the cost of Coverage to the qualified beneficiary for any month after the 18th month of continuation Coverage following the date of termination shall be 150% of the cost of providing Coverage for such period to a similarly situated Participant under the Plan to whom the qualifying event has not occurred. The cost of Coverage shall be paid directly to the Employer in monthly installments. In the event of a covered Employee's termination, the period of continuation of Coverage is: (1) Up to eighteen (18) months from the date of said termination for such Employee and the Employee's qualified beneficiaries. (2) Up to thirty -six (36) months from the date of Employee's death, divorce, or legal separation for such Employee's covered surviving spouse, divorced spouse, legally separated spouse and such Employee's covered Dependents. (3) Up to thirty -six (36) months from the date a covered Dependent child ceases to be covered as a Dependent under the Plan. (4) Up to thirty -six (36) months from the date the covered Employee becomes entitled to Medicare benefits for the Employee's covered spouse and Dependents. Up to twenty -nine (29) months from the date of such termination for such Employee and such Employee's qualified beneficiaries, if it is determined, under Title II or XVI of the Social Security Act, the covered Employee was disabled on the date of termination. The Employee must notify the Trust of said determination within sixty (60) days of said determination and within eighteen (18) months of the date of termination. In the event another qualifying event occurs during the eighteen (18) months following the date of the Employee's termination, the period of continuation of Coverage is up to thirty -six (36) months from the date of termination for such Employee and his qualified beneficiaries. (5) A qualified beneficiary's continuation of Coverage shall cease on the earliest of the following: (1) The maximum Coverage period date allowed for the qualifying event. (2) The date on which the Employer ceases to provide any group health plan to all Employees; (3) As provided in Section VIII, if the qualified beneficiary fails to pay contributions within thirty (30) days after they become due; (4) The date the qualified beneficiary becomes covered under another group health plan (as an employee or otherwise) with similar coverage, which does not contain any exclusions or limitations for pre- existing conditions, and if there is any pre- existing condition exclusion or limitation, coverage shall terminate on the date such limitation or exclusion ends; The date the qualified beneficiary becomes entitled to Medicare benefits; (5) "Unless otherwise stated in the Schedule of Benefits trey. 08021 Page 19 Florida Municipal Insurance Trust Dental Master Plan of Benefits (6) If the coverage period is twenty -nine (29) months and the Employee ceases to be totally disabled, on the first day of the month within the Coverage period that begins more than eighteen (18) months after the date of termination and is more than thirty (30) days after the date on which the Employee ceased to be totally disabled under Title II or XVI of the Social Security Act. Notwithstanding the above, in no event shall said Coverage extend beyond the twenty -nine (29) month Coverage period. If COBRA is elected and the eighteen (18) or thirty -six (36) months maximum time frame is exhausted, the qualified beneficiary may be eligible for Coverage under an individual plan (through an insurer of their choice) on a guaranteed issue basis without any pre- existing condition limitations. In the event the Plan offers a conversion privilege, the qualified beneficiary shall be entitled to said conversion privilege provided the qualified beneficiary applies for such conversion plan during the last 180 days of the period of continuation Coverage. Coordination of Benefits with other plans for COBRA recipients will follow current National Association of Insurance Commissioners (NAIC) recommendations. SECTION XII — GENERAL PROVISIONS The Trust will issue to the Employer for delivery to each participating Employee covered hereunder, a Schedule of Benefits, a copy of this Plan and appropriate identification cards, which the Employee or eligible covered Dependents can present to a Dentist in claiming Benefits due under this Plan. It shall be the Employer's responsibility to disseminate to the Employee the Schedule of Benefits, a copy of this Plan and appropriate identification cards. The Employee's Benefits are non - assignable prior to a claim. If any amendment to this Plan shall materially affect any Benefits, the amendment, a new Schedule of Benefits and an updated copy of this Plan shall be delivered to the participating Employer to be distributed to Employees. The Trustees shall provide benefits that are designed to meet the needs of the Participants and that are based on actuarial soundness. The Plan may be modified or discontinued by the Trustees at any time. Notices of modification or discontinuance shall be mailed to the employer's last known address at least forty -five (45) days prior to the effective date of such modification or discontinuance. All statements made by Employers or the Employees of such Employers shall be deemed representations and not warranties and no statement made for the purpose of effecting Coverage shall void such Coverage or reduce Benefits unless contained in a written instrument signed by the Employer or Employee of such Employer, a copy of which has been furnished to such Employer or Employee as the case may be. No reduction in Benefits shall be made by reason of change in the occupation of any Employee while in the employ of the Employer or by reason of the Employee's doing any act or thing pertaining to any other occupation. No representative has authority to change this Plan or waive any of its provisions. No change in this Plan shall be valid unless approved by the Board of Trustees. "Unless otherwise stated in the Schedule of Benefits trey. 08021 Page 20 Florida Municipal Insurance Trust Dental Master Plan of Benefits Written proof of claim for services must be furnished to the Trust within 365 days after the date of such services. Benefits provided in this Plan would be payable to the Dentist rendering service under this Plan or to the Participant upon receipt, by the Trust, of paid bills in acceptable form. No action at law or in equity shall be brought to recover under this Plan prior to the expiration of sixty (60) days written notice to the Trust. No such action shall be brought after the expiration of the specified statute of limitations on such action. Such notice to the Trust shall be sufficient if given to: The Florida Municipal Insurance Trust Attention: Health Department 125 E. Colonial Drive Orlando, Florida 32801 An Employee applying for Coverage under this Plan for himself /herself or eligible Dependents and the Participant and /or each Dependent of the Participant agrees that, as a condition of payment of Benefits, Services and supplies, any Provider that has made or may hereafter make a diagnosis, render service, attendance or treatment of or to a Participant, may furnish and is authorized to furnish to the Trust at any time upon its request, a report containing all information and records or copies of records pertaining to diagnosis, attendance, service or treatment. The applicant or Participant and /or each Dependent of the applicant or Participant agree as a condition of payment of Benefits or services, to execute such medical authorization as may be required by the Trust. The Trust shall not be responsible for the payment of any expense for services or supplies not covered by this Plan or any amounts in excess of the maximum Benefits allowed by this Plan. Eligible new Participants may be added to the Plan in accordance with the terms and conditions of the Plan. No otherwise eligible Employee or Dependent of a participating Employer shall be refused Coverage or be charged an unfairly discriminatory rate for participation solely because such Employee or Dependent is mentally or physically handicapped; provided, however, nothing in this Plan shall be construed to require the Trust to provide Coverage against a handicap which the Participant sustained on or before the Participant's effective date of Coverage. In the event Coverage under this Plan is conditioned upon a certain event or condition, or conditioned upon the continuation of a certain event or condition, the burden is on the Participant to establish the existence of such event or condition or the continuation of such event or condition. To the extent of any conflict, the express words and language in this Plan will prevail over any oral or written communications to or by the Trust concerning the terms and conditions expressed in this Plan and such communications are hereby deemed to be modified to reflect the terms and conditions in this Plan in the event such conflict arises. The burden is on the applicant or Participant to make complete and accurate representations to the Trust concerning questions of eligibility, Coverage and services or Benefits under this Plan. "Unless otherwise stated in the Schedule of Benefits (rev. 08021 Page 21 Florida Municipal Insurance Trust Dental Master Plan of Benefits SECTION XIII — GRIEVANCE PROCEDURE There are situations when Participants have questions about their Coverage or are dissatisfied with Plan services. Such inquiries and complaints will be handled in a timely manner. In the event that a claim is denied and the Participant disagrees with the denial, a re- determination may be requested in writing detailing the reasons for the disagreement. This request must be received within sixty (60) days of the initial claim denial. The Plan will respond with a written decision, within sixty (60) days from receipt of the request. SECTION XIV — SUBROGATION If any payments are made to or on behalf of a Participant and such payments arise as a result of an injury, illness or other condition for which the Participant has, or may have, or asserts any claim or right of recovery (including, without limitation, claims for pain and suffering, loss of consortium, consequential, punitive, exemplary or other damages) against a third party or parties, then any benefits advanced by the Trust for such medical expenses shall be made on the condition and with the agreement and understanding that the Participant shall reimburse the Trust to the extent of (but not exceeding) any amount or amounts recovered by or on behalf of the Participant (including the Participant's estate) from any third party by way of settlement or in satisfaction of any judgment relating to said claim. The Trust shall maintain a hen on any such recovery and be entitled to reimbursement in full in accordance with this Section irrespective of whether the Participant has been fully compensated for all or any of said claims. The Trust shall be entitled to such reimbursement from first dollar recovery amounts received by the Participant. As security for the Trust's rights to such reimbursements the Trust shall be subrogated to all claims, demands, actions or rights of recovery of the Participant against any third party or parties (or their insurers) to the extent of any and all benefits advanced by the Trust; and any Participant that takes any action prejudicing or otherwise impairing the subrogation rights of the Trust shall be liable to the Trust for any losses to the Trust caused by such action. Any action prejudicing or otherwise impairing the subrogation rights of the Trust made by the Participant shall also terminate the Trust's obligation to advance benefits to or on behalf of the Participant. The Trust shall withhold payments of claims made under this Plan, to the extent that the Trust has reason to believe that said claims arise as a result of any act of a third party, until the Participant or the Participant's legal representative executes a subrogation agreement. The subrogation rights of the Trust, as set forth in this Section, also apply to payments made by the Participant's own auto insurance (with the exception of payment for property damage). For purposes of this Section and any subrogation agreement executed pursuant hereto, the term Participant shall include the heirs, guardians, executors or other representatives of the Participant. For purposes of this Section and any subrogation agreement executed pursuant hereto, the spouses, children and other Dependents as Participants under the Plan are third party "Unless otherwise stated in the Schedule of Benefits [rev. 08021 Page 22 Florida Municipal Insurance Trust Dental Master Plan of Benefits beneficiaries under the Plan and therefore subject to the same duties and obligations as Employees who are Participants under the Plan. If the Participant is a minor, any amount recovered by or on behalf of such minor- Participant shall be subject to this provision, to the fullest extent permissible under State Law. The Trust shall have no obligation to share the cost of, or pay any part of, the Participant's attorney fees and costs incurred in obtaining any recovery against the third party. The Trust retains the right, at its sole discretion, to sue third parties on behalf of the Participant should the Participant not commence lawsuit within a reasonable period of time. The Trust reserves the right to make changes to this provision, as necessary, provided appropriate advance notice is given to the Participant. SECTION XV — NOTICE Notice to an Employer given under the Plan shall be sufficient if given to the Employer when addressed to its office location stated in the Participation Agreement. Notice to the Trust, except as otherwise herein expressly provided, shall be sufficient if given to: The Florida Municipal Insurance Trust Attention: Health Department 125 E. Colonial Drive Orlando, Florida 32801 "Unless otherwise stated in the Schedule of Benefits freu.08021 Page 23 I Florida Municipal Insurance Trust Major Plan Benefit Calendar Year Deductible: Individual Family Maximum Out of Pocket: Individual Family Lifetime Maximum In Network 0 0 $2,000 $4,000 $1,000,000 Out of Network $500 $1,500 $3,000 $6,000 $1,000,000 ♦ Inpatient Services ♦ Outpatient Services ♦ Emergency Room Services • Preventative Care • Routine Services • Well Child Care • Specialty Care • OB /GYN Care • Allergy Injections • Surgical Expense • Maternity Care Hospital Services $100.00 Co -Pay per Day for days 1 -5, then 70 % of covered expenses $100.00 Co -Pay, then 70% of covered expenses $100.00 Co -Pay, then 100% of covered expenses Physician Services $30.00 Co -Pay ** $30.00 Co -Pay ** $30.00 Co -Pay ** $30.00 Co -Pay ** $30.00 Co -Pay ** $30.00 Co -Pay ** 70% $30.00 Co -Pay, 1St Visit, then 100% $500.00 Co -Pay, then 50% of reasonable charges after deductible $100.00 Co -Pay, then 50% of reasonable charges after deductible $100.00 Co -Pay, then 100% of reasonable charges Not Covered 50% of reasonable charges 50% of reasonable charges 50% of reasonable charges 50% of reasonable charges 50% of reasonable charges 50% of reasonable charges 50% of reasonable charges * *Co -Pay applies to office visit charge only - all other In Network in office services paid at 70% MBF FLC -MS09B REV 10/01 Florida Municipal Insurance Trust i Other Health Care Services ♦ Prescription Drugs (Express Scripts)) In Network 10.00 Generic 20.00 Preferred Brand 35.00 Non Preferred Brand ♦ Mental & Nervous Disorder • Inpatient Services (30 days per calendar year maximum) • Outpatient Services $1,000 calendar year maximum ♦ Alcohol and Drug Dependency • Individual Visit $2,000 lifetime maximum $35.00 per visit maximum (44 outpatient visits lifetime maximum) ♦ Hospice Care (6 month maximum care) $6,000 lifetime maximum ♦ Home Health Care $1,000 calendar year maximum ♦ Physical Therapy $2,000 calendar year maximum ♦ Skilled Nursing Facility (60 days per year maximum) ♦ Chiropractic Services ♦ Routine X -Rays, Lab Tests, Diagnostic Services $100.00 Co -Pay, then 70% $30.00 Co -Pay, then 100% $30.00 Co -Pay then 70% Out of Network Wholesale Price, less 13 %, less In Network Co -Pay $500.00 Co -Pay, then 50% of reasonable charges 50% of reasonable charges $50.00 per visit maximum 50% of reasonable charges 70% 50% of reasonable charges 70% 50% of reasonable charges 70% 50% of reasonable charges 70% 50% of reasonable charges $30.00 Co -Pay, then 70% 50% of reasonable charges $40.00 per visit maximum 70% 50% of reasonable charges All surgical procedures over $500.00 must be pre- authorized. Failure to obtain a pre- authorization will result in a denial of benefits. All emergency and non - emergency hospital stays must be pre- certified. Failure to obtain pre - certification will result in a 20% penalty. All Out of Network Benefits are covered at 50% of reasonable and customary charges, after the calendar year deductible has been met. All deductibles do not apply toward the annual maximum out of pocket expenses. Co -Pays do not apply to the annual maximum out of pocket expenses. The hospital Co -Pay for Out of Network confinement due to an emergency does not apply. All charges exceeding reasonable charges are patient responsibility. (This is intended as a Summary of Benefits and does not include all of the benefits, limitations, and exclusions of the plan. Complete terms of the plan are contained in the Master Plan of Benefits.) MBF FLC -MS09B REV 10/01 Florida Municipal Insurance Trust I Major Plan Benefit Calendar Year Deductible: Individual Family Maximum Out of Pocket: Individual Family Lifetime Maximum In Network 0 0 $1,500 $3,000 $1,000,000 Out of Network $500 $1,500 $2,500 $5,000 $1,000,000 • Inpatient Services • Outpatient • Emergency Room Services • Preventative Care • Routine Services • Well Child Care • Specialty Care • OB /GYN Care • Allergy Injections • Surgical Expense • Maternity Care Hospital Services $250.00 Co -Pay, then 80% of covered expenses $100.00 Co -Pay, then 80% of covered expenses $100.00 Co -Pay, then 100% of covered expenses Physician Services $25.00 Co -Pay ** $25.00 Co -Pay ** $25.00 Co -Pay ** $25.00 Co -Pay ** $25.00 Co -Pay ** $25.00 Co -Pay ** 80% $25.00 Co -Pay, 1st Visit, then 100% $500.00 Co -Pay, then 60% of reasonable charges after deductible $100.00 Co -Pay, then 60% of reasonable charges after deductible $100.00 Co -Pay, then 100% of reasonable charges Not Covered 60% of reasonable charges 60% of reasonable charges 60% of reasonable charges 60% of reasonable charges 60% of reasonable charges 60% of reasonable charges 60% of reasonable charges * *Co -Pay applies to office visit charge only - all other In Network in office services paid at 80% MBF FLC -MSO9S REV 10/01 1 Florida Municipal Insurance Trust Other Health Care Services ♦ Prescription Drugs (Express Scripts) In Network Out of Network $10.00 Generic Wholesale Price, less 13 %, $20.00 Preferred Brand less In Network Co -Pay $35.00 Non Preferred Brand ♦ Mental & Nervous Disorder • Inpatient Services (30 days per calendar year maximum) • Outpatient Services $1,000 calendar year maximum ♦ Alcohol and Drug Dependency • Individual Visit $2,000 lifetime maximum $35.00 per visit maximum (44 outpatient visits lifetime maximum) ♦ Hospice Care (6 month maximum care) $6,000 lifetime maximum ♦ Home Health Care $1,000 calendar year maximum ♦ Physical Therapy $2,000 calendar year maximum ♦ Skilled Nursing Facility (60 days per year maximum) ♦ Chiropractic Services ♦ Routine X -Rays, Lab Tests, Diagnostic Services $100.00 Co -Pay, then 80% $25.00 Co -Pay, then 100% $25.00 Co -Pay then 80% $500.00 Co -Pay, then 60% of reasonable charges 60% of reasonable charges $50.00 per visit maximum 60% of reasonable charges 80% 60% of reasonable charges 80% 60% of reasonable charges 80% 60% of reasonable charges 80% 60% of reasonable charges $25.00 Co -Pay, 60% of reasonable charges then 80% $40.00 per visit maximum 80% 60% of covered charges All surgical procedures over $500.00 must be pre- authorized. Failure to obtain a pre- authorization will result in a denial of benefits. All emergency and non - emergency hospital stays must be pre- certified. Failure to obtain pre - certification will result in a 20% penalty. All Out of Network Benefits are covered at 60% of reasonable and customary charges, after the calendar year deductible has been met. All deductibles do not apply toward the annual maximum out of pocket expenses. Co -Pays do not apply to the annual maximum out of pocket expenses. The hospital Co -Pay for Out of Network confinement due to an emergency does not apply. All charges exceeding reasonable charges are patient responsibility. (This is intended as a Summary of Benefits and does not include all of the benefits, limitations, and exclusions of the plan. Complete terms of the plan are contained in the Master Plan of Benefits.) MBF FLC -MSO9S REV 10/01 1 Florida Municipal Insurance Trust Major Plan Benefit Calendar Year Deductible: Individual Family Maximum Out of Pocket: Individual Family Lifetime Maximum In Network 0 0 $1,000 $2,000 $1,000,000 Out of Network $300 $900 $2,000 $4,000 $1,000,000 ♦ Inpatient Services ♦ Outpatient Services ♦ Emergency Room Services • Preventative Care • Routine Services • Well Child Care • Specialty Care • OB /GYN Care • Allergy Injections • Surgical Expense • Maternity Care Hospital Services $100.00 Co -Pay, then 90% of covered expenses $100.00 Co -Pay, then 90% of covered expenses $100.00 Co -Pay, then 100% of covered expenses Physician Services $20.00 Co -Pay ** $20.00 Co -Pay ** $20.00 Co -Pay ** $20.00 Co -Pay ** $20.00 Co -Pay ** $20.00 Co -Pay ** 90% $20.00 Co -Pay, 1St Visit, then 100% $500.00 Co -Pay, then 70% of reasonable charges after deductible $100.00 Co -Pay, then 70% of reasonable charges after deductible $100.00 Co -Pay, then 100% of reasonable charges Not Covered 70% of reasonable charges 70% of reasonable charges 70% of reasonable charges 70% of reasonable charges 70% of reasonable charges 70% of reasonable charges 70% of reasonable charges * *Co -Pay applies to office visit charge only - all other In Network in office services paid at 90% MBF FLC -MS090 REV 10 /01 1 Florida Municipal Insurance Trust Other Health Care Services • Prescription Drugs (Express Scripts) In Network $10.00 Generic $20.00 Preferred Brand $35.00 Non Preferred Brand • Mental & Nervous Disorder • Inpatient Services (30 days per calendar year maximum) • Outpatient Services $1,000 calendar year maximum • Alcohol and Drug Dependency • Individual Visit $2,000 lifetime maximum $35.00 per visit maximum (44 outpatient visits lifetime maximum) • Hospice Care (6 month maximum care) $6,000 lifetime maximum • Home Health Care $1,000 calendar year maximum • Physical Therapy $2,000 calendar year maximum • Skilled Nursing Facility (60 days per year maximum) $100.00 Co -Pay, then 90% $20.00 Co -Pay, then 100% $20.00 Co -Pay then 90% Out of Network Wholesale Price, less 13 %, Tess In Network Co -Pay $500.00 Co -Pay, then 70% of reasonable charges 70% of reasonable charges $50.00 per visit maximum 70% of reasonable charges 90% 70% of reasonable charges 90% 70% of reasonable charges 90% 70% of reasonable charges 90% 70% of reasonable charges • Chiropractic Services $20.00 Co -Pay, 70% of reasonable charges then 90% $40.00 per visit maximum • Routine X -Rays, Lab Tests, 90% 70% of reasonable charges Diagnostic Services All surgical procedures over $500.00 must be pre- authorized. Failure to obtain a pre- authorization will result in a denial of benefits. All emergency and non - emergency hospital stays must be pre - certified. Failure to obtain pre - certification will result in a 20% penalty. All Out of Network Benefits are covered at 70% of reasonable and customary charges, after the calendar year deductible has been met. All deductibles do not apply toward the annual maximum out of pocket expenses. Co -Pays do not apply to the annual maximum out of pocket expenses. The hospital Co -Pay for Out of Network confinement due to an emergency does not apply. All charges exceeding reasonable charges are patient responsibility. (This is intended as a Summary of Benefits and does not include all of the benefits, limitations, and exclusions of the plan. Complete terms of the plan are contained in the Master Plan of Benefits.) MBF FLC -MS09G REV 10/01 Florida Municipal Insurance Trust Master Plan Document This Medical Master Plan of Benefits ( "Plan ") sets forth your rights and obligations as a participant. It is important that you READ YOUR Plan FULLY and familiarize yourself with its terms and conditions. The Plan may require that the participant contribute to the required premiums. Information regarding the premium and any portion of the premium cost a participant must pay can be obtained from your employer. Florida Municipal Insurance Trust ( "Trust ") agrees with your employer to provide coverage for medical services, subject to the terms, conditions, exclusions and limitations of the plan. The plan is issued on the basis of the Participation Agreement of the employer and payment of the required plan charges. The employer's application is made a part of the contract. The Trust shall not be deemed or construed as an employer for any purpose with respect to the administration or provision of benefits under the employer's benefit plan. The Trust shall not be responsible for fulfilling any duties or obligations of an employer with respect to the employer's benefit plan. The Trust has sole and exclusive discretion in interpreting the benefits covered under the plan and the other terms, conditions, limitations and exclusions set out in the plan and in making factual determinations related to the plan and its benefits. The Trust may, from time to time, delegate discretionary authority to other persons or entities providing services in regard to the plan. The Trust reserves the right to change, interpret, modify, withdraw or add benefits or terminate the policy, in its sole discretion, without prior notice to or approval by participants. No person or entity has any authority to make any oral changes or amendments to the policy. Please show your plan identification card each time you request health care services. This is to ensure that the providers know that you are part of the plan; otherwise you may receive a bill for health care services. This plan shall take effect on the date specified and will be continued in force by the timely payment of the required plan charges when due, subject to termination of the plan as provided. All coverage under the plan shall begin at 12:01 a.m. and end at 12:00 midnight Eastern Time. Florida Municipal Insurance Trust Medical Master Plan of Benefits TABLE OF CONTENTS Section Heading I. DEFINITIONS Pa_e 1 II. DEDUCTIBLES 13 III. LIFETIME MAXIMUM AND RESTORATION OF BENEFITS 13 IV. MAXIMUM EXPENSE TO PARTICIPANTS 13 V. ELIGIBILITY AND ENROLLMENT 14 VI. COVERED SERVICES 20 VII. HOSPITAL BILL SELF -AUDIT 37 VIII. EXCLUSIONS AND LIMITATIONS 37 IX. COORDINATION OF BENEFITS 43 X. PRE- EXISTING CONDITIONS LIMITATIONS 48 XI. TIME OF PAYMENT, GRACE PERIOD 49 XII. CONDITIONS FOR RENDERING SERVICE 49 XIII. EMPLOYER'S TERMINATION AND RENEWAL 49 XIV. PARTICIPANT'S TERMINATION OF COVERAGE 50 XV. CONTINUATION OF COVERAGE - COBRA 52 XVI. PRESCRIPTION DRUGS 55 XVII. GENERAL PROVISIONS 56 XVIII. PAYMENT OF BENEFITS, ASSIGNMENT 58 XIX. GRIEVANCE PROCEDURES 58 XX. SUBROGATION 58 XXI. NOTICE 59 Florida Municipal Insurance Trust Medical Master Plan of Benefits SECTION I — DEFINITIONS Accident means a non - occupational, unforeseeable, unintentional and unplanned event, other than the acute onset of a bodily disease or infirmity, resulting in a traumatic injury to a Participant while this Plan is in force. Injury or illness resulting from the acts of bending, stooping, lifting, stretching or standing is covered as a Sickness. Acquired Immune Deficiency Syndrome or (AIDS) means the human immunodeficiency virus identified as the causative agent of acquired immune deficiency syndrome, the syndrome itself, an acquired immune deficiency syndrome - related complex, or a Sickness or medical condition derived from the human immune deficiency virus or AIDS. Adopted Child means a child who, before attaining 18 years of age, has been lawfully adopted by the Employee under State Laws and the Employee has established a legal relationship with the child in which the State of Florida declares and recognizes the child to be legally the child of the Employee and the Employee's heir at law and legally entitled to all the rights and privileges and subject to all the obligations of a child born to such Employee in lawful wedlock. Advanced Registered Nurse Practitioner means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when providing services within the scope of the person's license and in accordance with State Laws. Ambulatory Surgical Center means a facility, other than a facility that is part of a Hospital or Birth Center, licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust, the primary purpose of which is to provide elective surgical care in which the Participant is admitted to and discharged from the facility within the same working day and is not permitted to stay overnight. Annual Open Enrollment Period means a 30 -day period commencing on the date as specified by the Employer's Participation Agreement during which each Employee is given an opportunity to select coverage from among the alternatives offered under the Employer's health benefit program. Benefits shall mean the payment or reimbursement by the Plan of a portion of a Medical Expense incurred by a Participant. Billing Date represents the first of the month. Birth Center means any facility, institution, or place, other than an Ambulatory Surgical Center or a Hospital, licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust at which births are planned to occur away from the mother's usual residence following a normal, uncomplicated, low -risk pregnancy. Board - Certified Endocrinologist means a Physician who has received formal recognition as a specialist in endocrinology from the specialty board of the American Board of Medical Specialties or from another recognizing agency approved by the Board of Medicine. Board of Medicine means the board established under s. 458.307, F.S. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 1 Florida Municipal Insurance Trust Medical Master Plan of Benefits Bone Marrow Transplant means human blood precursor cells administered to a Participant to restore normal hematological and immunological functions following ablative therapy with curative intent. Human blood precursor cells may be obtained from the Participant in an autologous transplant or from a medically acceptable related or unrelated donor, and may be derived from bone marrow, circulating blood, or a combination of bone marrow and circulating blood. If chemotherapy is an integral part of the treatment involving bone marrow transplantation, the term "bone marrow transplant" includes both the transplantation and the chemotherapy. Breast Reconstructive Surgery means surgery to reestablish symmetry between two breasts. Calendar Year means a period of twelve (12) consecutive months commencing on January 1 and ending on December 31 of a given year. For a Participant enrolling during a Calendar Year, the "Calendar Year" begins on the Effective Date of the Participant's enrollment and ends on December 31 of the same year. Calendar Year Deductible means the amount stated in the Schedule of Benefits the Participant is required to pay to a Provider for Benefits in each Calendar Year before the Trust will pay for Benefits provided under the Plan in the same Calendar Year. Cast means a solid mold used to immobilize fractures, dislocations, and other severe injuries. Certified Diabetes Educator means a person properly certified as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust to supervise diabetes outpatient self- management training and educational services when performing said services within the scope of the person's license and in accordance with State Laws. Certified Nurse Midwife means a person who is licensed as an Advanced Registered Nurse Practitioner by the appropriate governmental or regulatory authority as reasonably determined by the Trust and who is certified to practice midwifery by the American College of Nurse Midwives when practicing midwifery within the scope of the person's license and in accordance with State Laws. Child Health Supervision Services means the following Physician- delivered or Physician - supervised services provided to a Dependent child from moment of birth to 16 years of age: a history, physical examinations, developmental assessments, anticipatory guidance, oral and /or injectable immunizations, and laboratory tests normally performed for a well child. Clinical Social Worker means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when providing clinical social services within the scope of the person's license and in accordance with State Laws. Condition means an Accident or a Sickness. COBRA means the federal continuation of coverage requirements of the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended, also known as s. 4980B of the Internal Revenue Code of 1986. Co- Insurance means the charge set forth in the Schedule of Benefits the Participant is * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 2 Florida Municipal Insurance Trust Medical Master Plan of Benefits required to pay for Benefits provided under the Plan. Co- Insurance is usually expressed as a percentage rather than as a dollar amount and constitutes a sharing of the Reasonable Fees for Benefits between the Trust and the Participant. After the Participant's Deductible requirement is met, the Trust will pay the percentage of the Reasonable Fees for Benefits set forth in the Schedule of Benefits. Co- Payment means the charge set forth in the Schedule of Benefits the Participant is required to pay for Benefits at the time of service. The Co- Payment is usually expressed as a dollar amount rather than as a percentage and is paid directly to the Provider at the time of service. Contract means this agreement between the Trust and the Employer by virtue of which the Employer and its eligible Employees and their Dependents become Participants; the Participation Agreement of the employer; the Agreement and Declaration of Trust creating the Health Benefit Trust; the rules, regulations and resolutions adopted by the Board of Trustees; the attached endorsements and riders, if any; the individual applications of the Employees; and the identification cards issued to Employees indicating their participation in the coverage provided hereunder. Coverage(s) or Covered Services or Covered Expenses means the services and supplies specifically outlined in Sec. VI of this Plan and not otherwise excluded under this Plan, when Medically Necessary and rendered within the scope of the license of an appropriately licensed Provider, for which payment will be made by the Trust to, or on behalf of, a Participant. Creditable Coverage means the period of time a Participant is covered under any of the following: 1. A group health plan; 2. Health insurance coverage; 3. Part A and Part B of Title XVIII of the Social Security Act (Medicare); 4. Title XIX of the Social Security Act (Medicaid, other than coverage consisting solely of benefits under Sec. 1928 of the program for distribution of pediatric vaccines); 5. Ch. 55 of Title X, United States Code (medical and dental care for members and certain former members of the uniformed services and their dependents); 6. A medical care program of the Indian Health Service or of a tribal organization; 7. The Florida Comprehensive Health Association or another similar state health benefit risk pool; 8. A health plan offered under Ch. 89 of Title V, United States Code; 9. A public health plan; and 10. A health benefit under Sec. 5(e) of the Peace Corps Act (22 U.S.C.s. 2504(e)). Dependent means the legal, married spouse of an Employee and /or the eligible legal, unmarried (never married) Dependent children, as hereinafter described, who * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 3 Florida Municipal Insurance Trust Medical Master Plan of Benefits continues to meet this Plan's applicable eligibility requirements and who is actually covered under this Plan. The Employee's child is a Dependent child if the child meets all of the following conditions: (1) the child is a natural child, step - child, Adopted Child, Foster Child or a child who has been placed in the court - ordered temporary or other legal custody of the Employee, and (2) the child is in the custody of and financially dependent upon the Employee. Condition (2) is waived if the Employee is required to provide coverage to the child due to court order or divorce decree. A newborn child of a Dependent child having Dependent coverage is entitled to the same benefits as the Dependent child; provided, however, a Dependent child shall not be entitled to maternity benefits under this Plan, and with respect to a newborn child of a Dependent child, coverage under the Plan for the newborn child shall terminate 18 months after the birth of the newborn child. A Dependent child shall cease to be a Participant at the end of the Calendar Year in which such child reaches the age of 19; provided, however, that if such child is dependent upon the Employee for support, and is living in the household of the Employee or is enrolled in and attending an accredited school, college, or university, coverage will continue until the end of the Calendar Year in which the child reaches the age of 25, or upon the marriage of such child, whichever event shall first occur. A Dependent child, regardless of age, shall continue to be covered under this Plan while the child is and continues to be (1) incapable of self- sustaining employment by reason of a mental or physical disability that was diagnosed while the Dependent child was covered under this Plan; and (2) chiefly dependent upon the Employee for support and maintenance. Upon attaining the eligibility limiting age, it is the Participant's sole responsibility to establish that a child meets the applicable requirements for continued eligibility. The burden is on the Participant to establish such Dependent meets or continues to meet the applicable requirements for continued eligibility. The Trust may, at any time, require reasonably reliable and acceptable documentation that a child meets and continues to meet such requirements. Upon request by the Trust, the Participant must provide a sworn and properly executed affidavit, which states the Dependent, continues to meet the applicable requirements for eligibility. A Dependent's continued eligibility does not modify any eligibility requirements other than the limiting age requirement. Continued eligibility shall terminate on the last day of the month in which the child does not meet the requirements of continued eligibility. Dependent also may include individuals on short term sick or disability leave, FMLA Leave, USERRA Leave or occupational /vocational (Workers' Compensation) leave (for non occupational illness or injuries only) and who otherwise meet the requirements of this definition. Dietitian means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust to engage in dietetics and nutrition practices or nutritional counseling when performing said services within the scope of the person's license and in accordance with State Laws. Durable Medical Equipment means medical equipment designated for repeated use and which is Medically Necessary to improve the functioning of a malformed body member, or to prevent further deterioration of the Participant's medical condition. Effective Date means, with respect to this entire Plan, and to Participants properly enrolled * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 4 Florida Municipal Insurance Trust Medical Master Plan of Benefits when this Plan first becomes effective, 12:01 a.m. on the date specified on the Participation Agreement; and, with respect to a Participant who is subsequently enrolled in this Plan, 12:01 a.m. on the date on which coverage will commence for the Participant under the terms of this Plan. Emergency means a Condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain or other acute symptoms, such that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to the Participant's health, including a pregnant Participant or her fetus; serious impairment to bodily functions; or serious dysfunction of a bodily organ or part. With respect to a pregnant Participant, Emergency also means there is inadequate time to effect safe transfer to another Hospital prior to delivery, a transfer may pose a threat to the health and safety of the pregnant Participant or her fetus, or there is evidence of the onset and persistence of uterine contractions or rupture of the membranes. Any purported Emergency Condition is subject to determination as such based on the average, reasonable person facing the same or substantially similar acute medical symptoms. Employee means an officer or employee of the Employer or any class or classes of such employees, regularly working twenty -five (25) or more hours a week, who is eligible for Coverage hereunder, who has been so designated by the Employer and who holds a valid Social Security Number. Employee also includes the elected or appointed officials of the Employer, employees who have retired and are receiving retirement benefits pursuant to a retirement plan lawfully established and maintained by the Employer and employees who are eligible for Medicare, but who nonetheless continue to satisfy the first sentence of this definition. Employee also may include individuals on short term sick or disability leave, FMLA Leave, USERRA Leave or occupational /vocational (Workers' Compensation) leave (for non occupational illness or injuries only) and who otherwise meet the requirements of this definition. Employer means each and every county, municipality, school board, special taxing district or local governmental unit established within, and pursuant to the laws of, the State of Florida and which becomes a party to this Trust by executing a Participation Agreement, and who has agreed to be bound by all the terms and provisions of the Trust Agreement, the Participation Agreement, this Plan and the rules and regulations adopted by the Trustees in the administration of the Trust. Experimental or Investigational means any evaluation, treatment, therapy, or device which involves the application, administration, or use of procedures, techniques, equipment, supplies, products, remedies, vaccines, biological products, drugs, pharmaceuticals, or chemical compounds if, as determined solely by the Trust. a. such evaluation, treatment, therapy, or device is not the standard treatment, therapy, or device utilized by practicing Physicians in treating other patients with the same or similar Condition; b. such evaluation, treatment, therapy, or device is provided pursuant to a written protocol which describes as among its objectives determinations of safety, efficacy, or efficacy in comparison to the standard evaluation, treatment, therapy or device; c. such evaluation, treatment, therapy or device has not been proven safe and effective * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 5 Florida Municipal Insurance Trust Medical Master Plan of Benefits for treatment of the Condition in question, as evidenced in the most recently published medical literature in the United States, Canada, or Great Britain, using generally accepted scientific, medical or public health methodologies or statistical practices; d. there is no consensus among practicing Physicians that the treatment, therapy, or device is safe and effective for the Condition in question; or e. it has not been approved as a safe, effective and usual treatment method for the specific Condition by the appropriate federal regulatory agency, including, but not limited to, the U.S. Food and Drug Administration (FDA) and the Health Care Financing Administration (HCFA). Facility means an establishment that can include a Hospital or Ambulatory Surgical Center where Covered Services are provided. Foster Child means a child who, before attaining 18 years of age, is recognized as such by the appropriate state authority and is lawfully placed in the Employee's residence and care by the Florida Department of Children and Family Services. Foster Parent means the Participant who is legal required to maintain the care and custody of a Foster Child. Fraud is the intentional deception or misrepresentation that an individual knows to be false or does not believe to be true and makes, knowing that the deception could result in some unauthorized benefit to himself /herself or some other person. Under the broad definition of fraud are violations including the offering or acceptance of kickbacks, waiver of deductible, coinsurance and co- payments. Genetic Information means information about genes, gene products and inherited characteristics that may derive from the Participant or a family member of the Participant. It includes information regarding carrier status and information derived from laboratory tests that identify mutations in specific genes or chromosomes, physical medical examinations, family histories and direct analysis of genes or chromosomes. High -Risk Participants means estrogen- deficient Participants who are at clinical risk for osteoporosis, Participants who have vertebral abnormalities, Participants who are receiving long -term glucocorticoid (steroid) therapy, Participants who have primary hyperparathyroidism, and Participants who have a family history of osteoporosis. Home Health Agency means any public agency or private organization licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust to provide Home Health Services. Home Health Aide means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust who, within the scope of the person's license and in accordance with State Laws, provides hands -on personal care, performs simple procedures as an extension of therapy or nursing services, assists in ambulation or exercises, or assists in administering medications. Home Health Services means the following services and supplies furnished to a Participant * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 6 Florida Municipal Insurance Trust Medical Master Plan of Benefits by a Home Health Agency in a place of residence used as the Participant's home including: 1) part -time or intermittent nursing care provided by a Registered Nurse or a Licensed Practical Nurse; 2) physical therapy provided by a Physical Therapist, subject to the limitations provided in Section VI, occupational therapy provided by an Occupational Therapist, respiratory care services by a Respiratory Therapist or a Respiratory Care Practitioner, or speech therapy provided by a Speech Therapist, when related to a cleft lip or cleft palate Condition; 3) services of a Home Health Aide; 4) dietetics and nutrition practice and nutrition counseling; 5) medical supplies, restricted to drugs and biologicals prescribed by a Physician. Home Health Services do not include homemaker services, domestic maid services, sitter services, companion services, or services and supplies rendered by an employee or operator of an adult congregate living facility, an adult foster home, an adult daycare center, a nursing home facility, or similar facilities. Hospice Care means care, meeting the standards established by the National Hospice Association, given to a terminally ill Participant by or under arrangements with a Hospice Care Agency. Hospice Care Agency means an organization, licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust, which: (1) (2) (3) (4) (5) has twenty -four (24) hour Hospice Care available; and provides skilled nursing_ services, medical social services, psychological and dietary counseling; and provides Physician services, services of a Physical Therapist, services of a part - time Home Health Aide and Inpatient care; and keeps medical records; and has a full -time administrator. Hospital means an establishment licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust that offers services more intensive than those required for room, board, personal services, and general nursing care, that offers facilities and beds for use beyond 24 hours by a Participant requiring diagnosis, treatment, or care for illness, injury, deformity, infirmity, abnormality, disease, or pregnancy, and that regularly makes available at least clinical laboratory services, diagnostic X -ray services, and treatment facilities for surgery or obstetrical care, or other definitive medical treatment of similar extent. The term Hospital does not include an Ambulatory Surgical Center, a Skilled Nursing Facility, a Birth Center, a facility for the diagnosis, care, and treatment of Mental and Nervous Disorders or Substance Abuse, a convalescent, rest or nursing home, or a facility which primarily provides custodial, educational, or rehabilitative care. Hospital Per Admission Co- Payment means the amount stated in the Schedule of Benefits the Participant is required to pay upon admission as an Inpatient to a Hospital. Initial Enrollment Period means the 30 -day period of time immediately following the initial dates an Employee or Dependent is first eligible to become a Participant under the terms of this Plan. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Pagel Florida Municipal Insurance Trust Medical Master Plan of Benefits Inpatient means a patient who has been admitted upon order of a Physician as a bed patient for treatment in a Hospital and who has been charged for room and board. Late Enrollee means a Participant who enrolls in the Plan at any time other than the Initial Enrollment Period or the Special Enrollment Period. Lifetime Maximum means the maximum liability of the Trust for Benefits provided under this Plan to each Participant covered under this Plan, during the entire period such Participant is covered under this Plan. Lifetime Maximum may refer to the maximum amount stated in the Schedule of Benefits or to the maximum amount specified in specific Benefits provided under Section VI of this Plan. Marriage and Family Therapist means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when providing therapy services within the scope of the person's license and in accordance with State Laws. Massage Therapist means a person properly licensed to administer massages, pursuant to Chapter 480 of the Florida Statutes, or other states' applicable law. Mastectomy means the removal of all or part of a breast for Medically Necessary reasons. Medically Necessary means treatment, care, services, or supplies that are consistent with the diagnosis and treatment of the Participant, that comply with acceptable medical standards, that are widely accepted by the Provider's peer group as efficacious and reasonably safe based upon scientific evidence, that are universally accepted in clinical use such that omission raises questions regarding the accuracy of the diagnosis or the appropriateness of the treatment, that are not primarily for the convenience of the Participant, the Participant's family, the Physician, or other health care Provider, that are not experimental or investigational, that are not for cosmetic purposes, and that are the most appropriate level of treatment, care, services, or supplies which can be safely provided the Participant. When applied to Inpatient care, it means the care cannot be safely provided on an Outpatient basis. Care that has not received federal approval by the appropriate federal regulatory agency, including without limitation, the United States Food and Drug Administration (FDA) and the Health Care Financing Administration (HCFA) as a safe, effective and usual treatment for the specific Condition will not be considered Medically Necessary. Mental and Nervous Disorder means a disorder set forth in the diagnostic categories of the most recently published edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, regardless of the underlying cause or effect of the disorder. Examples include attention - deficit hyperactivity, anorexia nervosa, bulimia, bipolar effective disorder, autism, mental retardation, and Tourette's disorder. Mental Health Counselor means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when providing counseling services within the scope of the person's license and in accordance with State Laws. Midwife means a person, other than a Physician or a Certified Nurse Midwife, licensed as such by the appropriate governmental or regulatory authority as reasonably * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 8 Florida Municipal Insurance Trust Medical Master Plan of Benefits determined by the Trust when practicing midwifery within the scope of the person's license and in accordance with State Laws. New Employee means an Employee who has never been previously employed by the Employer prior to the Effective Date of this Plan and who is employed by the Employer on or after the Effective Date of this Plan, or an Employee who was employed by the Employer prior to the Effective Date of this Plan and was ineligible to participate in the Employer's prior plan because the Employee had not completed the period of continuous employment and hours requirement with the Employer as set forth in such plan, if any, to qualify to participate in such plan. Occupational Therapist means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when practicing occupational therapy within the scope of the person's license and in accordance with State Laws. Orthotic Device means a rigid or semi -rigid device needed to support a weak or deformed body member or to restrict or eliminate body movement. Outpatient means a patient who has not been admitted to a Hospital as an Inpatient and who has not been charged for room and board. Outpatient Services Co- Payment means the amount stated in the Schedule of Benefits the Participant is required to pay upon receipt of any services received as an Outpatient. Partial Hospitalization Services means treatment in which the Participant receives at least 7 hours of institutional care during a portion of a 24 -hour period and returns home or leaves the treatment facility during any period in which treatment is not scheduled. A Hospital shall not be considered a "home." Partial Hospitalization Services shall include care rendered under the direction of a Physician for a Mental or Nervous Disorder. For each fourteen (14) hour period of Partial Hospitalization Services received for a Mental or Nervous Disorder, the Participant's available Mental and Nervous Disorder Benefit for the extant Calendar Year shall be reduced by one (1) day. Participant means and includes the Employee and any Dependent of the Employee who is actually enrolled and covered under this Plan. Participant also means and includes those Employees and their Dependents that qualify for continuation of coverage under COBRA. Participating Network Transplant Center of Excellence, or In Network means, in regard to any Tissue or Organ Transplant Benefit supply or service, a licensed healthcare facility that has entered in to a participation agreement at fee arrangements as established with the participating network approved by the Trust to provide transplant - related health services to the Trust. Physical Therapist means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when practicing physical therapy within the scope of the person's license and in accordance with State Laws. Physician means a doctor of medicine (M.D.) or a doctor of osteopath (D.O.), licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust to practice medicine and perform surgery. Doctors of dental surgery **Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 9 Florida Municipal Insurance Trust Medical Master Plan of Benefits (D.D.S.), doctors of dental medicine (D.M.D.), doctors of podiatry (D.P.M.), doctors of chiropractic (D.C.), and doctors of optometry (O.D.), when practicing within the scope of their licenses, are deemed to be Physicians. Plan means this Medical Master Plan of Benefits, the Dental Master Plan of Benefits, the Employer's Participation Agreement, the Employer's Schedule of Benefits, the Agreement and Declaration of Trust creating the Trust, the rules, regulations and resolutions adopted by the Trust, the Employer's Group Application, the Employee's Enrollment Forms, any Endorsements in effect, the identification cards issued to Employees and Dependents indicating they are Participants, any arrangement between the Trust and a network of health care providers, and any other agreement between the Trust and the Employer by virtue of which the Employer and its eligible Employees and their Dependents participate in the Trust and this Plan. Pre - Authorization means the process of notifying FMIT of any impending non - inpatient requests for treatment services or supplies to assess for coverage and medical necessity. All Inpatient hospitalizations, Alternate Level of Care, Skilled Nursing Facilities, Outpatient Surgery performed either in a Hospital or a Physician's office, all MRI, CT scans, Cardiac Stress Tests, Diagnostic Sleep Disorder Studies, Durable Medical Equipment over $500, allergy testing and injectable medications (except insulin) must be Pre - Authorized by the Managed Care Department of the Trust. Failure to obtain a Pre - Authorization will result in a complete denial of Benefits for the subject services. No authorizations for treatment or services after the treatment or services have been rendered (Post- Authorization) will be permitted, where the Participant was required to obtain Pre - Authorization, except at the absolute discretion of the Trust. To avoid any forfeiture of Benefits, all questions pertaining to whether Pre - Authorization for certain treatment or services is required should be directed to the Trust's Customer Service Department at 1 (800) 756 -3042. Services requiring Pre - Authorization are subject to change at any time at the sole discretion of the Trust. Pre - Certification means the process of notifying FMIT of any impending elective and /or scheduled admission to a hospital or alternate level of care in order for FMIT to assess for coverage and medical necessity. Pre - Certification notice to FMIT also includes providing notice to FMIT of all Emergency services within 48 hours of receipt of service. Pre - Existing Condition means any condition, regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the 6 -month period ending on the first day of a Participant's Waiting Period for Participants who enroll during the Initial Enrollment Period or within the 6 -month period ending on the Participant's Effective Date for Participants who enroll during the Special Enrollment Period or the Annual Enrollment Period. Pre - Existing Condition excludes a Participant's pregnancy, generic information about the Participant in the absence of a diagnosis of a Condition, routine follow -up care for breast cancer after the Participant was determined to be free of breast cancer, or a Condition arising from domestic violence committed against the Participant. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 10 Florida Municipal Insurance Trust Medical Master Plan of Benefits Preventative Care means services and supplies ordered and /or provided by or under the direction of a Physician for which there is no medical diagnosis or for which the Physician does not seek to diagnose, treat, or cure a Sickness or injury. Prosthetic Device means a device, which replaces all or part of a body part or an internal body organ or replaces all or part of the functions of a permanently inoperative or malfunctioning body part or body organ. Provider means a person or facility defined herein when providing Benefits within the scope of the person or facility's license and in accordance with State Laws. Psychologist means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when practicing psychology within the scope of the person's license and in accordance with State Laws. Reasonable Fee means the maximum benefit allowance the Trust will consider for Benefits provided to a Participant. Benefit allowances will be determined solely by the Trust. The basis for the benefit allowance will be the relative value studies and schedules utilized and evaluated by the Trust. The benefit allowances utilized by the Trust are determined by studies of charges for similar benefits within a common geographical area, including pre- negotiated payment amounts, diagnostic related groupings, relative value scales, and /or the usual and customary charges for providing the medical service or supply. These studies are used to develop benefit value schedules, which are updated on a routine basis. Any charges above the amount determined to be a Reasonable Fee shall be the responsibility of the Participant. Registered Nurse or Licensed Practical Nurse means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when engaged in the practice of nursing within the scope of the person's license and in accordance with State Laws. Rehabilitative Services means health care service designed or provided to restore functional defects. Respiratory Care Practitioner means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when delivering respiratory care services within the scope of the person's license and in accordance with State Laws. Respiratory Therapist means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when practicing respiratory therapy within the scope of the person's license and in accordance with State Laws. Routine Care means services and supplies ordered and /or provided by or under the direction of a Physician for the purpose of the diagnosis, treatment, or cure of a Sickness or injury. Schedule of Benefits means the Benefits provided to the Participant based on the Plan selected by the Employer (i.e. POS Gold, Silver, Bronze, or Indemnity). It encompasses the network of Providers offered to the Group, (i.e. First Health). Each network of Providers is subject to an established fee schedule for all Providers within a * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 11 Florida Municipal Insurance Trust Medical Master Plan of Benefits particular network. Out -of- network and Indemnity fee schedules are based upon Medicare usual and customary fee allowances for various services. Second Surgical Opinion means the second opinion contained in a written statement on the necessity for the performance of a covered surgical operation given by a board - certified specialist who, by the nature of the Physician's specialty, qualifies the Physician to provide the surgical opinion being proposed and who is not associated with the Physician initially recommending the surgical operation. Sickness means a disease, illness, infirmity, injury, bodily disorder, bodily dysfunction (including a Mental or Nervous Disorder), or pregnancy of a Participant occurring while this Plan is in force. Skilled Nursing Facility means a facility licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust, which provides 24 hour nursing care for a Participant whose Condition does not warrant hospitalization. The facility can operate independently or as part of a Hospital. Special Enrollment Period means the 30 -day period of time specified in this Plan where an Employee and /or Dependent may be eligible to enroll in this Plan outside of the Initial Enrollment Period and the Annual Enrollment Period. Speech Therapist means a person licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust when practicing speech therapy within the scope of the person's license and in accordance with State Laws. Splint means an appliance used for fixation, union or protection of an injured part of the body. State Laws means the laws of the State of Florida and all rules, regulations, ordinances and directives promulgated there under. Substance Abuse means a Participant chronically and habitually uses alcoholic beverages to the extent that it injures the Participant's health, to the extent it substantially interferes with the Participant's social or economic functioning, or to the extent the Participant has lost the power of self - control with respect to the use of such beverages, or means a Participant is dependent upon, or by reason of repeated use is in imminent danger of becoming chemically dependent upon, or addicted to, any legal or illegal substance controlled under Ch. 893, F.S. Total Disability means a medically determinable physical or mental impairment that renders a Participant so incapacitated as to be unable to engage in any gainful occupation within the range of his /her normal ability, taking into consideration the Participant's education, training and work experience. Truss means a device worn to hold a hernia in place. Trust means the Florida Municipal Insurance Trust, its Trustees and individuals or organizations designated by the Trustees to act on behalf of the Trust. Waiting Period means the period specified in the Participation Agreement that must pass before an Employee or Dependent is eligible to become a Participant under the terms of this Plan, less any Applicable Credit that must be given if the Participant has * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 12 Florida Municipal Insurance Trust Medical Master Plan of Benefits satisfied a similar Waiting Period provision under a prior health insurance plan that was replaced by this Plan. SECTION II — DEDUCTIBLES Individual Deductible – In any Calendar Year the Participant incurs expenses for Covered Services on or after the Participant's Effective Date, such expenses shall be subject to the Calendar Year Deductible set forth in the Schedule of Benefits. Family Deductible – In any Calendar Year, all Participants within a family shall be subject to the maximum accumulative Calendar Year Deductible set forth in the Schedule of Benefits. Deductible Credit from Employer's Prior Coverage – In the event a Participant has incurred and paid Covered Expenses during the 90 days preceding the initial Effective Date of this Plan under any other group health insurance plan issued to the Employer which was in effect immediately prior to the Participant's coverage under this Plan, then, upon receipt of written evidence submitted in manner satisfactory to the Plan, the amount of such Covered Expenses actually incurred and applied toward the deductible provisions of the Participant's other group health insurance plan shall be credited toward the Participant's Calendar Year Deductible under this Plan in the Calendar Year of the Participant's initial Effective Date. SECTION III — LIFETIME MAXIMUM AND RESTORATION OF BENEFITS Each Participant is entitled to the Benefits specified in Section VI of this Plan when incurred while the Plan is in force and when the Benefits are necessary and consistent with the Condition for which the Participant is being treated. Subject to the provisions of this Section, the Lifetime Maximum for each Participant during the entire period such Participant is covered under this Plan shall be the amount specified in the Schedule of Benefits. (1) If, during any one Calendar Year, more than $1,000 in Benefits have become payable on behalf of a Participant, said Participant shall automatically be entitled to $1,000 in restored Benefits commencing with the next Calendar Year, regardless of whether the Lifetime Maximum in the Schedule of Benefits has been reached. Subsection (1) of this Section does not pertain to the specific Lifetime Maximums of limited Benefits specified in Section VI of this Plan. SECTION IV — MAXIMUM EXPENSE TO PARTICIPANTS When the Covered Expenses of a Participant reach the amount specified in the Schedule of Benefits, subject to the co- insurance requirements stated in the Schedule of Benefits, all further Covered Expenses for that Calendar Year will be considered at 100% of the actual Reasonable Fees, up to the Lifetime Maximum stated in the Schedule of Benefits. "Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 13 Florida Municipal Insurance Trust Medical Master Plan of Benefits SECTION V — ELIGIBILITY AND ENROLLMENT Commencement of Coverage - Subject to any Waiting Period set forth under this Plan and to any other condition of commencement expressed in this Plan, coverage hereunder shall commence as follows: (1) In the event an Employer had no group health insurance plan covering its Employees and their Dependents in effect immediately prior to the Effective Date of this Plan, all Employees of such Employer on the Effective Date, and their eligible Dependents shall be eligible to participate in this Plan. Coverage shall commence as of the Effective Date of the Plan without proof of insurability provided the Trust receives a properly and accurately completed and executed enrollment form and any required medical statement application during the Initial Enrollment Period. If application is not received on or before the expiration of the Initial Enrollment Period, any application for coverage by an Employee, or the Employee's eligible Dependents, will be accepted only during an Annual Open Enrollment Period or a Special Enrollment Period. (2) In the event an Employee, or the Employee's eligible Dependents, were validly covered under a group health insurance plan issued to the Employer and in effect immediately prior to the Effective Date of this Plan and such plan is discontinued and replaced with this Plan, all such Employees and eligible Dependents actually covered under such prior plan shall be eligible to participate in this Plan, without interruption of coverage and without proof of insurability, unless such Employee or Dependent is entitled to any extension of benefits in accordance with S. 627.667, F.S., under the terms of the prior plan, and provided the Trust receives a properly and accurately completed and executed enrollment form, and any required medical statement application, during the Initial Enrollment Period. In the event such Employee or Dependent is entitled to an extension of benefits in accordance with S. 627.667, F.S., under the terms of the prior plan, such Employee or Dependent shall be entitled to participate in this Plan without interruption of coverage and without proof of insurability provided the Trust receives an accurately completed and executed enrollment form, and any required medical statement application, during the Initial Enrollment Period; however, the level of benefits under this Plan shall be no more than the applicable level of benefits under this Plan reduced by any benefits payable under the prior plan. Upon request, the Employer, Employee and /or Dependent shall provide the Trust all information as is reasonably necessary, including specific coverage or claim information from the prior plan, for the Trust to coordinate the level of benefits payable under this Plan and under the prior plan, for the Trust to verify the level of benefits provided under the prior plan, and for the Trust to determine each Employee and Dependent who was validly covered under the prior plan immediately prior to the Effective Date of this Plan. If application is not received on or before the expiration of the Initial Enrollment Period, any application for coverage by an Employee, or the Employee's eligible Dependents, will be accepted only during an Annual Enrollment Period or a Special Enrollment Period. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 14 Florida Municipal Insurance Trust Medical Master Plan of Benefits (3) In the event an Employee was validly covered under a group health insurance plan issued to the Employer and in effect immediately prior to the Effective Date of this Plan and such plan is discontinued and replaced with this Plan, the Employee's eligible Dependents not covered under the previous plan may utilize the medical statement application process contained in Paragraph (4) of this section and have Coverage commence accordingly, in lieu of the Open Enrollment Period. Eligibility - Employees and eligible Dependents shall be eligible for coverage on or after the Effective Date of this Plan if: (1) They fall within the classification set forth in the Employer's Participation Agreement; and (2) They have completed the period of continuous employment with the Employer as set forth in such classification. An Employee shall not be eligible as a Dependent under the same Employer group except when both spouses are eligible Employees and desire dependent child(ren) coverage. In that case, one Employee may cover the spouse and children as Dependents for health Benefits and the spouse may be covered as a single Employee for other employee coverage(s). Enrollment - Employees and Dependents may enroll for Coverage under the Plan by completing and submitting to the Employer an accurately completed and executed enrollment form provided by the Trust, as specified below: (1) Initial Enrollment Period - within 30 days of satisfaction of the Plan Waiting Period. (a) New Employees, and their Dependents shall be eligible to participate in this Plan without proof of insurability subject to the exclusions contained herein for Totally Disabled individuals. Participation in the Plan shall commence on the first of the month following satisfaction of the eligibility requirements set forth above. If the enrollment form is not received on or before the expiration of the Initial Enrollment Period set forth above, any application for Coverage by a new Employee or their Dependents will be governed by the provisions set forth in Paragraph (4) of this section. (b) Except as otherwise provided in Commencement of Coverage Paragraph (2), in the event an Employee or Dependent is hospital confined, on sick /short term disability leave or Family Medical Leave as defined by the Family Medical Leave Act of 1993 (FMLA) when Coverage would otherwise begin, Coverage will commence the billing date of the month following the employee or dependent's return to good health when able to perform the normal activities of a well person of the same age and sex. Any period of delayed commencement contained herein is subject to a reduction based on the amount of any prior Creditable Coverage. This subsection does not apply to a newborn child of an employee covered for dependent coverage at the time of birth. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 15 Florida Municipal Insurance Trust Medical Master Plan of Benefits (c) In the event an Employee's Coverage terminates due to termination of employment and such Employee returns to full -time employment within ninety (90) days, such Employee's Coverage may be reinstated without completing the period of continuous employment set forth in the Employer's Participation Agreement, provided an enrollment form is received by the Trust within thirty (30) days of the Employee's return to employment. If the enrollment form is received more than thirty (30) days after the Employee's return to employment, any application for Coverage will be governed by the provisions set forth in Paragraph (4) of this section. (d) In the event an Employee was covered under this Plan through another employer within thirty (30) days prior to beginning employment with this Employer, such Employee will not be required to complete the period of continuous employment set forth in the Employer's Participation Agreement, provided an enrollment form is received by the Trust within thirty (30) days of beginning employment with this Employer. Required contributions must be paid at the new Employer's rates from the prior billing date for reinstatement of continuous Coverage. If the enrollment form is received more than thirty (30) days after the Employee's return to employment, any application for Coverage will be governed by the provisions set forth in Paragraph (4) of this section. (e) Pre - Existing Condition limitations will apply to the Initial Enrollment Period, as outlined in Section X. (2) Open Enrollment /Re- enrollment Period - within 30 days after the Employer's Plan's policy renewal anniversary as specified in the Employer's Participation Agreement, or as agreed to in writing by the Trust and the Employer. All Plan Participant's must re- enroll by submitting a newly signed completed enrollment application. Eligible Employees can enroll in the Plan or terminate Coverage during the Open Enrollment Period. Pre - Existing Condition limitations will apply to the Open Enrollment Period, as outlined in Section X. If application is received 30 days or more following the Plan's policy renewal anniversary, any application for coverage by an Employee or Dependents will be governed by the provisions set forth in Paragraph (4) of this section except in the case of re- enrollment. Failure to re- enroll in the Plan will result in suspended claim payment until a signed completed enrollment application is received by the Trust. (3) Special Enrollment Period - within 30 days of certain events or loss of coverage as outlined below: (a) Employees and /or Dependents may utilize the Special Enrollment Period if: 1) covered under another health benefit plan as an employee or dependent, or COBRA continuation of coverage at the time of initial eligibility to enroll for Coverage under this Plan; and * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 16 Florida Municipal Insurance Trust Medical Master Plan of Benefits 2) when offered Coverage under this Plan at the time of initial eligibility stated, in writing, that coverage under another health plan was the reason for declining enrollment; and 3) demonstrated that loss of coverage under an individual or group health benefit plan occurred as a result of legal separation, divorce, death, termination of employment, reduction in the number of hours of employment, or the coverage was terminated as a result of the termination of employer contributions toward such coverage; and 4) the required showing regarding loss of coverage and an enrollment application is received by the Trust within thirty (30) days after the termination of coverage under another health benefit plan. (b) A newly eligible Dependent, acquiring such newly eligible status as a result of marriage, birth, adoption or placement for adoption, legal guardianship or court order, may utilize the Special Enrollment Period without proof of insurability, provided the Trust has received an accurately completed and executed enrollment form, within thirty (30) days of the event. Eligible dependents may only be enrolled if the eligible dependent is a Dependent of an Employee who is already participating in the Plan. If the Employee fails to apply within the thirty (30) day period specified herein, any application for Coverage will be governed by Paragraph (4) of this Section. 1) In the event of marriage, the Effective Date of coverage for such Dependent shall be the first day of the month following receipt of notification by the Trust. 2) In the event of a newborn, Coverage for such Dependent will take effect upon receipt of an enrollment application for such newborn. If the enrollment application is received within thirty (30) days of the birth of the newborn, coverage will be considered effective from the newborn's date of birth. If an enrollment form is not received by the Trust during the initial 30 -day period, the Trust reserves the right to charge a premium for Coverage of such newborn Dependent during the initial thirty (30) day period following the birth, along with the ordinary premium that would apply to such newborn Dependent from the 31" day following the birth through the date of receipt of application and enrollment forms. However, in no event will newborn Dependent Coverage continue beyond sixty (60) days after the birth without receipt of application and enrollment forms by the Trust. Following this 60 -day period wherein no enrollment application is received by the Trust, the Participant must attempt to establish coverage for such newborn Dependent(s) by utilizing the Annual Open Enrollment Period explained in subsection (2) of the Enrollment section. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 17 Florida Municipal Insurance Trust Medical Master Plan of Benefits Coverage for a newborn child of a Covered Dependent terminates under the Plan eighteen months after the birth of the newborn child. 3) In the event of an adoption of a newborn child, if a written application to adopt a newborn child has been entered into by the Employee prior to the birth of the child, such child shall be subject to the conditions and entitled to the benefits and services provided in this Plan applicable to newborn children provided the child is ultimately adopted pursuant to Ch. 63, F.S. As a condition of Coverage, the written agreement shall accompany the Employee's supplemental application for Coverage for such Dependent child. In the case of an adopted newborn child, Coverage begins at the moment of birth if a written agreement to adopt the child has been entered into by the Participant prior to the birth of the child. As a condition of continued Coverage, the Employee shall immediately provide the Trust with a certified copy of the judgment of adoption upon its entry and the Employee shall, upon request, provide to the Trust, under oath, such information as is reasonably necessary to keep the Trust apprised of the status of the adoption proceeding. See subsection 5 hereunder for further relevant information. 4) In the event of an adoption or placement for adoption (other than newborn), legal guardianship or court order, the Effective Date of Coverage shall be from the date of the child's placement in the Employee's residence or date specified by court order. The Participant must provide a written enrollment to the Trust to notify the Trust of the placement or adoption of the child within a notice period of thirty (30) days after the adoption or placement for adoption. If timely notice is received by the Trust, the Trust will not charge an additional premium for coverage of the child for the duration of the notice period. If timely notice is not received by the Trust, the Trust may charge an additional premium from the date of placement or adoption. As a condition of Coverage, the Employee shall provide the Trust with a certified copy of the judgment of adoption, guardianship or court order. See subjection 5 hereunder for further relevant information. 5) In order to be covered under the Plan, the adopting Participant must provide the Trust with written notice of the birth (in the case of a newborn adoptee) or placement of the adopted Dependent, including an enrollment form, within thirty (30) days of the birth or placement. If timely notice is received by the Trust, the Trust may not charge an additional premium for coverage of the newborn or adopted child for the duration of the notice period. If timely notice is not received by the Trust, the Trust may charge an additional premium from the date of birth or placement. If notice is given within 60 days of the birth or placement of the child, the Trust may not deny coverage of the child due to the failure of the Participant to timely notify the Trust of the birth or placement of the child. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 18 Florida Municipal Insurance Trust Medical Master Plan of Benefits However, in no event will adopted Dependent Coverage continue beyond sixty (60) days after birth (in the case of a newborn adoptee) or placement, without receipt of application and enrollment form by the Trust. Following this 60 -day period wherein no enrollment form is received by the Trust, the Participant may only establish Coverage for such newborn Dependent(s) by utilizing the Annual Open Enrollment Period. It is the responsibility of the Participant to provide the Trust appropriate written documentation demonstrating the child is an Adopted Child, including proof of final adoption, a Foster Child, or a child placed in the court- ordered temporary or other custody of the Participant. It is the further responsibility of the Participant to notify the Trust if an Adopted Child is not ultimately lawfully placed in the Participant's residence, if and when the Foster Child is no longer in the care of the Participant, or if and when a child is no longer in the court - ordered temporary or other custody of the Participant. The child's Coverage under the Plan will terminate at the end of the month in which the Trust is notified the adoption could not be legally completed, the Participant's status as a Foster Parent is terminated, or the Participant's court - ordered temporary or other custody of the child is terminated. (c) An individual who loses coverage as a result of failure to pay premiums on a timely basis, or the discontinuance of any contributions toward the health Coverage plan by the employer or for cause does not have the right to Special Enrollment under this Plan. Voluntary termination of coverage does not constitute a loss of eligibility for coverage or loss of coverage entitling an Employee or Dependent to utilize the Special Enrollment Period. (d) Pre - Existing Condition limitations will apply to the Special Enrollment Period, as outlined in Section X, except in the case of newborn and adopted Dependents. (4) Medical Statement Application Enrollment - Those eligible Employees who refuse Coverage for themselves or their Dependents under this Plan, those Employees applying for Coverage, including Dependent Coverage, under this Plan subsequent to the Effective Date of the Participation Agreement of the Employer, or those Employees and Dependents who do not satisfy the Coverage provisions specified in Paragraphs (1), (2), and (3) of this Section may apply for Coverage at a later date by medical statement application. Such Employee, on behalf of himself /herself or his /her Dependents, shall provide the Trust with a completed medical statement application. The Trust will review all medical statement applications and provide the eligible Employee's Employer with a notice of acceptance or notice of rejection. If accepted, the Effective Date of Coverage for such applicant shall be the first day of the month following the receipt of notice of such acceptance. Pre - Existing Condition * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 19 Florida Municipal Insurance Trust Medical Master Plan of Benefits limitations will apply, as outlined in Section X. The Employer shall submit such form and any required medical statement application, as a prerequisite to the Coverage of such Employee(s) or Dependent(s) under this Plan. Certificates of Creditable Coverage, as specified in Section X, should be provided at the time an application for enrollment is made by the Employee and /or the Employee's Dependents. The Employer does not act as an agent of the Trust in the enrollment and withdrawal of its Employees and their Dependents. Notwithstanding, and in addition to, any other conditions expressed herein for Coverage or payment of Benefits and Covered Services, Coverage for each Employee and Dependent under this Plan shall commence no earlier than the first day of the month immediately following the date on which the Trust has actually received a properly and accurately completed and executed enrollment form and any required medical statement application. SECTION VI — COVERED SERVICES If the Employer and the Participant have satisfied the terms and conditions provided in this Plan for coverage and for the payment of Benefits, the Participant is entitled to the Benefits listed below when incurred while the Plan is in force and when Medically Necessary and consistent with the Participant's Condition. The Trust will base its reimbursements for benefits on Reasonable Fees for such Benefits, unless otherwise expressly provided herein, shall be subject to the Hospital Per Admission Deductible, the Calendar Year Deductible, the Co- Payment, and the Co- Insurance requirements shown on the Schedule of Benefits, and to the pre - existing exclusion section in this Plan. Unless otherwise expressly provided herein, Benefits shall be paid up to the Lifetime Maximum shown on the Schedule of Benefits or under the specific Benefit, or to the end of the Calendar Year, whichever first occurs. (A) Hospital Pre - Admission Certification — Except in the case of an Emergency, the attending Physician must receive certification from the Trust for all Inpatient admissions to a Hospital. Certification must be received no less than 7 days prior to a planned Inpatient admission. Emergency admissions must be certified within 48 hours following Emergency admission or no later than the first business day following admission, whichever is later. Pre - Admission Certification is not required for an admission for the birth of a child, provided the Hospital or Birth Center length of stay does not exceed 48 hours following a vaginal delivery or 96 hours following a cesarean delivery. Certification by the Trust must be received following a vaginal delivery or a cesarean delivery if the length of stay exceeds 48 hours or 96 hours, respectively. Additionally, if a newborn is required to remain hospitalized after the birth mother is discharged, the hospital must provide notice of such to FMIT's managed care nurses. Certifications made by the Trust are made only to determine the appropriateness of care and the appropriateness of setting for the care delivered to the Participant for purposes of payment for Benefits under this Plan. Failure to timely obtain certification will result in a 20% reduction in benefits paid under this Plan. Services requiring Pre - Admission Certification are subject to change at any time at the sole discretion of the Trust. The Trust will provide notification prior to any changes. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 20 Florida Municipal Insurance Trust Medical Master Man of Benefits (B) Inpatient Hospital Services — The Plan will base its reimbursements for benefits on Reasonable Fees for the following care, treatment, services and supplies when provided to the Participant as an Inpatient at the Hospital (1) Hospital room and board, not to exceed the average rate for a semi - private room. (2) Intensive care unit (including cardiac and neonatal care units), not to exceed three (3) times the average rate for a semi - private room. Progressive care unit, not to exceed one and one -half (11h) times the average rate of a semi - private room and only if incurred immediately following a confinement in an intensive care unit. (3) (4) Miscellaneous services and supplies, such as use of operating, recovery and emergency rooms, x -ray and other diagnostic procedures, laboratory tests, pathological services, intravenous solutions, medications and dressings. Transfusion services and supplies, including blood administration expenses, but excluding blood, blood plasma and /or blood derivatives unless otherwise specifically stated in this Plan. Oxygen therapy, diathermy and physiotherapy. Chemotherapy treatment, when such treatment is in connection with proven malignancies. Services of a Physical Therapist or Occupational Therapist (in connection with a covered Condition). Other Medically Necessary Services and Supplies (5) (6) (7) (8) (9) (C) Physician Services — The Plan will base its reimbursements for benefits on Reasonable Fees for the following Physician care, treatment, and services. (1) Surgical Services — wherever performed, limited to operative procedures for the treatment of a Condition. The surgical allowance includes post - operative treatment. (2) Surgical Assistant — provided the assistance is Medically Necessary, no intern, resident, or other staff Physician is available, and the condition of the Participant and the type of eligible surgery performed require such assistance. Consultations — which are Medically Necessary due to complications, complexity or different diagnosis. A consultation report must be part of the hospital medical records. (4) Professional Component Expenses — of radiology, pathology ultrasound, allergy testing and laboratory. Medically Necessary Visits — while the Participant is an Inpatient in a Hospital, while the Participant is in a Skilled Nursing Facility, while the Participant is in an Ambulatory Surgical Center or while the Participant is an Outpatient (e.g., office visits), but not including visits for post- operative treatment. (3) (5) * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 21 Florida Municipal Insurance Trust Medical Master Plan of Benefits (6) Medically Necessary Care and Treatment - rendered outside of the Hospital. Expenses for routine physical examinations are not covered, unless otherwise specifically stated in the Schedule of Benefits. Concurrent Physician Care - Provided the concurrent Physician care is provided by a Physician that actively participates in the care and treatment of the Participant, the Condition involves more than one body system or is so severe or complex that one Physician cannot provide the care and treatment unassisted, and the Physicians have different specialties or have different sub- specialties within the same specialty. (D) Other Medical Services - The Plan will base its reimbursements for benefits on Reasonable Fees for the following services and supplies. (1) Alternative Treatment Provision - The Trust may, in its sole discretion, modify some Plan provisions, if a Medically Necessary and a less costly alternative Course of Treatment is available. (7) (2) Ambulance Transportation Services and Supplies - from a Hospital which is unable to provide proper care and treatment to the nearest Hospital that can provide proper care and treatment, from a Hospital to the Participant's nearest home or to a Skilled Nursing Facility, or from the place where an Emergency occurs to the nearest Hospital that can provide proper care and treatment. Ambulance services by boat, airplane, or helicopter will be paid at the benefit amount allowable for ground transportation unless, in the judgment of the Trust, the pick -up point is inaccessible by ground vehicle, the speed in excess of ground vehicle speed is critical to the care and treatment of the Participant, or the travel distance in getting the Participant to the nearest Hospital that can provide proper care and treatment is too far for the medical safety of the Participant. Transportation services and supplies for a newborn child to and from the nearest available facility appropriately staffed and equipped to treat the newborn child's condition, when the necessity of such transportation is certified by the attending physician as necessary to protect the health and safety of the newborn child, shall be covered. In no event shall the benefits for transportation services and supplies under this Plan exceed the sum of $1,000 per incident, or exceed $3,000 per incident in the event of aircraft ambulance services. (3) Anesthesia - The administration of, including supplies and equipment charges, for regional, intravenous, inhalation, intraspinal and caudal anesthesia services when performed by a qualified anesthesiologist (which may be defined as a Physician or Certified Registered Nurse Anesthetist) in connection with a covered surgical service and not administered by the operating surgeon or surgical assistant. (4) Prosthetic, Orthotic and Other Devices - initial (under this Plan) appliances, crutches, braces, cardiac pacemakers, standard model wheelchairs, or other mechanical appliances Medically Necessary for the correction of conditions arising out of an Accident or Sickness, including a Prosthetic Device following "Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 22 Florida Municipal Insurance Trust Medical Master Plan of Benefits (5) a covered Mastectomy, and services to fit, adjust, and repair such devices, provided the devices and services are prescribed by a Physician and the devices and services do not, in whole or in part, serve as a comfort or convenience item. Pre - authorization must be obtained by the Trust for any devices and services the cost of which exceed $500. The Trust shall have the right to buy or rent such devices as it may elect. Splints, Casts, Trusses — which are medically necessary for the care and treatment of a covered condition. (6) Other Durable Medical Equipment Rental — required for temporary therapeutic use, provided the equipment is prescribed by a Physician and the equipment does not, in whole or in part, serve as a comfort or convenience item. Pre - Authorization must be obtained by the Trust for equipment the cost of which exceeds $500. The Plan will consider reasonable fees for rental, however, cannot exceed the purchase price for any Durable Medical Equipment. Initial Eye Glasses or Contact Lens — resulting only from cataract or glaucoma surgery (including those surgically implanted), subject to a limit of $150. Radiology, Anesthesiology, and Pathology Benefits — Where radiology, anesthesiology, or pathology services (RAP) are to be performed at a Facility, the Plan provides coverage at the in- network level of benefits, subject to the required in- network Co- Insurance, and without being subject to the Calendar Year Deductible, provided the Facility is within the relevant provider network approved by the Trust. However, the Plan will only pay the usual and customary fees for such RAP services, according to the CPT Code submitted. If the Facility is outside the relevant provider network approved by the Trust, the Plan will pay for radiology, anesthesiology, or pathology services at the out - of- network benefit level. (7) (8) (E) Multiple Surgical Procedures - Multiple Surgical Procedures performed by one or more qualified Physicians during the same operative session will be covered according to the following guidelines: (1) The lesser of the actual charges or the amount stated in the Schedule of Benefits will be allowed for the primary surgical procedure. (2) 50% of the lesser of the actual charge or the amount stated in the Schedule of Benefits will be allowed for other secondary Covered surgical procedures. Bilateral Surgical Procedures - Bilateral Surgical Procedures performed by one or more qualified Physicians during the same operative session will be covered according to the following guidelines: (F) (1) (2) The lesser of the actual charges or the amount stated in the Schedule of Benefits will be allowed for the primary surgical procedure. 50% of the lesser of the actual charges or the amount stated in the Schedule of Benefits will be allowed for the secondary Covered surgical procedure. Bilateral Surgical Procedures when preformed in combination with Multiple Surgical * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 23 Florida Municipal Insurance Trust Medical Master Plan of Benefits Procedures will be reimbursed according to the application of the reimbursement conventions enumerated in Section (E) above and the application of this Section (F)'s reimbursement conventions. (G) Assistant Surgeon - A Physician who actively assists the operating surgeon in rendering a Covered surgical service to a Participant. Benefits are payable only if an intern, resident, or Hospital staff member is not available. No Benefits are payable for surgical assistance rendered by an intern, resident, or Hospital staff member. Assistant surgeons will be reimbursed at the lesser of the assistant surgeon's charges or 20 percent of the covered reimbursement amount of the operating surgeon. (H) Clinical Claim Audits - Medical and surgical services rendered by a qualified Provider to a Participant in or out of a Hospital may be subject to a Clinical Claims Audit to determine appropriateness of the Provider's billing. Such claims will be audited for the following billing practices: (1) Upcoding: Upcoding is the term for the practice of billing the Plan using a billing code that provides a higher payment rate than the billing code intended for use with the item or service furnished to the Participant. Claims determined by the Plan to be upcoded shall be reassigned and reimbursed according to the appropriate billing code intended for use with the item or service provided. (2) Unbundling: is the practice of billing separately for services when a global billing code is provided and billing under the global billing code would result in a lower payment rate. Claims determined by the Plan to be unbundled shall be reassigned and reimbursed according to the appropriate billing code intended for use with the item or service provided. (I) Supplemental Accident Benefit - The expenses incurred for services or supplies to treat injuries resulting from an Accident will be paid, up to the maximum stated in the Schedule of Benefits, provided such expenses are incurred within ninety (90) days of the Accident. Such expenses shall be subject to the Hospital Per Admission Deductible, but shall not be subject to the Calendar Year Deductible, the Co- Insurance, or the Co- Payment requirements stated in the Schedule of Benefits. Expenses incurred in excess of the maximum stated in the Schedule of Benefits or incurred after the ninety (90) day period set forth above shall be subject to the Calendar Year Deductible, the Co- Payment and the Co- Insurance requirements stated in the Schedule of Benefits. (1) Supplemental Accident Dental Benefit - The expenses incurred for services and supplies to treat damage to natural (not artificial) teeth, not previously compromised by decay or periodontal disease, and to treat damage to immediate adjacent structures (e.g., periodontium) resulting from an Accident will be paid, provided such treatment is initiated within ninety (90) days of the Accident. An unexpected event while chewing food which causes traumatic injury to natural teeth is not an Accident. (K) Diagnostic X -ray, Laboratory and Pathological Services Benefit - The Plan will consider the Reasonable Fees for Outpatient Hospital and Physician services for diagnostic x -ray, laboratory and pathology services required for the treatment of a * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 24 Florida Municipal Insurance Trust Medical Master Plan of Benefits Sickness up to the amount specified in the Schedule of Benefits. (L) Ambulatory Surgical Center Benefit — The Plan will consider the Reasonable Fees for the following services and supplies when such services and supplies are provided at an Ambulatory Surgical Center: (1) Miscellaneous services and supplies, such as use of operating and recovery rooms, x -ray and other diagnostic procedures, laboratory tests, pathological services, intravenous solutions, medications and dressings. (2) Transfusion supplies and services, including blood administration expenses, but excluding blood, blood plasma and /or blood derivatives unless otherwise specifically stated in this Plan. Anesthesia services, including supplies, equipment and Physician charges for regional, intravenous, inhalation, intraspinal and caudal anesthesia services when performed in connection with surgical, obstetrical, electro- shock, or dental services covered under this Plan. (M) (N) (3) (4) Oxygen therapy, diathermy, and physiotherapy. (5) Chemotherapy treatment, when such treatment is in connection with proven malignancies. (6) Other Medically Necessary services or supplies. Chiropractic Services Benefit — The Plan will consider the Reasonable Fees for the services of a Doctor of Chiropractic (DC) when performing services within the scope of the doctor's license. Outpatient Therapeutic Services Benefit — The Plan will consider the Reasonable Fees for the following therapeutic services and supplies. (1) Physical therapy services provided by a Physician or a Physical Therapist, limited to 40 visits, up to a $2,000 per Calendar Year maximum; (2) Chemotherapy treatment for proven malignant diseases; (3) X -ray, cobalt, or other acceptable forms of radiation therapy for treatment of proven malignant diseases; (4) Allergy immunotherapy; and (5) Electroshock therapy services when performed by a Physician. (6) Occupational Therapy, which will result in significant clinical improvement in a patient's condition. Significant clinical improvement is solely determined by the Florida Municipal Insurance Trust, and must occur within 60 days from the date of the first treatment. A written treatment plan must be submitted for approval. The patient's participation in Occupational Therapy must relate to a current health condition, and have a reasonable chance for improvement. The Trust will not pay for vocational rehabilitation, maintenance, job training, or those services that fall under the Workers' Compensation benefit. This benefit * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 25 Florida Municipal Insurance Trust Medical Master Plan of Benefits (7) shall be limited up to $2,000 per Calendar Year maximum; Speech Therapy, which can result in a significant clinical improvement in a patient's condition. Significant clinical improvement is solely determined by the Florida Municipal Insurance Trust, and must occur within 60 days from the date of the first treatment. A written treatment plan must be submitted for approval. The patients participation in Speech Therapy must relate to a current health condition, and have a reasonable chance for improvement. This benefit shall be limited up to $2,000 per Calendar Year maximum. (0) Second Surgical Opinions - Second Surgical Opinions may be obtained from a Physician prior to surgery for the following surgical procedures: (1) Arthoplasty - plastic operation on a joint or the formation of an artificial joint when performed on the knee or hip; (2) Arthroscopy - internal examination performed by the use of a scope, when performed on the knee; (3) Cholecystectomy - removal of the gall bladder; (4) Coronary Bypass and Pacemaker Insertion; (5) Dilation and Curettage (D &C); (6) Hemorrhoidectomy - removal of a mass of swollen varicose veins in the rectal mucous membrane; (7) Hysterectomy - removal of the uterus by excision; (8) Laminectomy or Laminotomy - removal of or incision into a disk; (9) Prostatectomy - excision of the prostrate gland; (10) Subcutaneous Mastectomy - excision of cyst, tumor, or lesion of the breast; (11) Submucous resection /rhinoplasty - surgical correction of deviated septum, plastic surgery on the nose; (12) Tonsillectomy /adenoidectomy - removal of the tonsils and adenoids. (13) Bunionectomy - surgical removal of the bunion. (14) Cataract removal - removal of the opacity of the crystalline lens of the eye. The Second Surgical Opinion must be obtained from a Physician that specializes in the surgical procedure and who is not associated with the attending Physician. Services available under the Second Surgical Opinion Benefit are subject to change at any time at the sole discretion of the Trust. In addition, the Trust has the discretion to request a Second Surgical Opinion as part of their clinical review process for additional surgical procedures not included on the above list. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 26 Florida Municipal Insurance Trust Medical Master Plan of Benefits (P) (Q) Mental and Nervous Disorder Benefit - The Plan will consider the Reasonable Fees for services and supplies to treat a Mental and Nervous Disorder, subject to the following terms, conditions and limitations: (1) Inpatient benefits shall be limited to 30 days per Calendar Year. (2) Outpatient benefits shall be provided under the direction of a Physician, shall be limited to $1,000 per Calendar Year, and shall be limited to consultations with a Physician, a Psychologist, a Mental Health Counselor, a Marriage and Family Therapist, or a Clinical Social Worker. In no event shall the Reasonable Fees for Partial Hospitalization Services or a combination of Inpatient and Partial Hospitalization Services exceed the cost of 30 days of Inpatient benefits measured by the usual and customary daily cost of Inpatient hospitalization in the community in which the Partial Hospitalization Services are rendered. (3) Medicare Supplement Benefits - A Participant over the age of 65 who retires from the employ of the Employer while this Plan is in force is only eligible for the Medicare Supplement Benefits of this Plan. Medicare Supplement Benefits are limited to the following: (1) For initial Hospital expenses for confinement as a Hospital Inpatient, the Plan will pay the Part A Medicare deductible. (2) For Hospital expenses from the 61st day through 150th day as a Hospital Inpatient, the Plan will pay the amount of the daily Medicare coinsurance. (3) The Medicare Part B deductible is paid by the Plan at 100% per Calendar Year. (4) The Medicare Part B co- insurance is paid by the Plan for eligible reasonable fees incurred as determined by Medicare. Prescription Medicines - When ordered by a Physician, consistent with the treatment of a specific diagnosis, when dispensed by a licensed pharmacist, and when obtained through the mandatory prescription program provided in Section XVI of this Plan. Vitamins, minerals and over - the - counter medications are not eligible expenses. Expenses are subject to the individual Calendar Year Deductible, Co- Insurance and Co- Payment requirements set forth in the former Employer's Schedule of Benefits. Home Health Services performed by a Home Health Agency, subject to the terms, conditions, and limitations contained in Section VI (w) of this Plan. The Lifetime Maximum for all Medicare Supplement benefits is $1,000,000. (5) (6) (7) (R) Substance Abuse Benefit - As used in this Section, `substance abuse' means the use of alcoholic beverages or any psychoactive or mood altering substance in such a manner as to induce mental, emotional or physical problems and cause socially dysfunctional behavior. The Plan will base its reimbursements for Substance Abuse benefits on Reasonable Fees incurred as a result of necessary care and treatment subject to the following terms, conditions and limitations: * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 21 Florida Municipal Insurance Trust Medical Master Plan of Benefits Care and treatment must be provided by, provided under the supervision of, or prescribed by a Physician or Psychologist licensed as such by the appropriate governmental or regulatory authority as reasonably determined by the Trust; (1) Care and treatment must be pursuant to a program accredited by the Joint Commission on Accreditation of Hospitals or approved by the appropriate governmental or regulatory authority as reasonably determined by the Trust; (2) The Lifetime Maximum number of Outpatient visits shall be 44 and the maximum benefit payable for each Outpatient visit shall be $35.00. Detoxification will not be considered a benefit under an Outpatient program. (3) (4) The Lifetime Maximum Benefit shall be $2,000.00. (S) Maternity Care Benefit - The Plan will consider the Reasonable Fees for the services and supplies for maternity care provided to a Participant other than a Dependent child by a Physician, a Hospital, a Birth Center, a Midwife, or a Certified Nurse Midwife, including prenatal care, delivery and postpartum care rendered within 24 hours of delivery. Maternity care for a mother and her newborn child includes a postpartum assessment and newborn assessment, a physical assessment of the newborn and the mother, and any Medically Necessary clinical tests and immunizations called for under then prevailing medical standards. Maternity care must be provided at a Hospital, a Birth Center, an attending Physician's office, and Outpatient maternity center, or in the home by a qualified licensed health care professional trained in care for a newborn child and mother. (T) Maternity care benefits are not provided for a Dependent child. Maternity care does not include care and treatment for complications of pregnancy or care and treatment for false labor, occasional spotting, bed rest prescribed by a Physician, morning sickness, pre - eclampsia (protein in urine, sudden increase in weight, continual increase in blood pressure without convulsions), or similar problems associated with a difficult pregnancy. Maternity care benefits are not subject to the pre- existing exclusion section in this Plan. Care for Complications of Pregnancy - The Plan will consider the Reasonable Fees for services and supplies to treat complications of pregnancy. Coverage for complications of pregnancy is limited to services and supplies to treat the Sickness caused by the complication. "Complications of pregnancy" means a Sickness, which is diagnosed as separate from a normal, uncomplicated, low -risk pregnancy. Complications of pregnancy include, but are not limited to: (1) Acute nephritis; (2) Nephrosis; (3) Cardiac decompensation; (4) Eclampsia (toxemia with convulsions); (5) Uncontrolled vomiting requiring fluid replacement; (6) Therapeutic abortion (i.e., termination of pregnancy before the time of fetal * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 28 Florida Municipal Insurance Trust Medical Master Plan of Benefits (7) viability due to danger to the pregnant Participant or when the pregnancy would result in the birth of an infant with grave malformation); Conditions which may require other than a vaginal delivery, such as: a. Uterine wound separation. b. Premature labor unresponsive to tocolytic therapy. c. Failed trial labor. d. Dystocia (i.e., cephalopelvic disproportion, failure to progress, dysfunctional labor). e. Fetal distress requiring neonatal support /intervention. f. Breech presentation where external version is unsuccessful. g. Active clinical herpes at delivery. h. Placenta previa. i. Transverse lie where external version is unsuccessful. j. Presence of fetal anomaly. Tubal pregnancy; Miscarriages; or Sicknesses of similar severity. Complications of pregnancy do not include false labor, occasional spotting, bed rest prescribed by a Physician, morning sickness, pre - eclampsia (protein in urine, sudden increase in weight, continual increase in blood pressure without convulsions) or similar problems associated with a difficult pregnancy. Maternity care is not included in care for complications of pregnancy unless delivery is required to resolve the complication. The Plan will not consider the Reasonable Fees for services or supplies to treat the complication of pregnancy of a Dependent child. (U) Newborn Children Care Benefit — The Plan will consider the Reasonable Fees for the necessary care and treatment of a Participant's newborn child from the moment of birth. Newborn children care will include the necessary care and treatment of medically diagnosed congenital defects, birth abnormalities, prematurity, and transportation costs of a newborn to and from the nearest available facility appropriately staffed and equipped to treat the newborn's Condition; however, any such transportation costs must be certified by the attending Physician as necessary to protect the health and safety of the newborn child and transportation costs shall be limited to Reasonable Fees, not to exceed $1,000. (V) Child Health Supervision Services Benefit — The Plan will consider the Reasonable Fees for Child Health Supervision Services, subject to the following terms, conditions and limitations: (1) Child Health Services Benefit shall include Physician visits to accomplish a * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 29 Florida Municipal Insurance Trust Medical Master Plan of Benefits (W) history, physical examination, a developmental assessment and anticipatory guidance, appropriate immunizations and lab tests. All such services provided under this benefit shall be provided in accordance with and not to exceed the prevailing medical standards consistent with the Recommendations for Preventative Pediatric Health Care of the American Academy of Pediatrics. (2) Benefits are limited to one visit payable to one Physician for all services provided at that visit. Child Health Supervision Services are not subject to the Calendar Year Deductible, but are subject to the Co- Insurance and Co- Payments requirements stated in the Schedule of Benefits. Hospice Care Benefit — A Participant will be eligible for Hospice Care under this Plan if written approval is provided in advance by the Trust. The Trust will not provide written approval unless a written statement is submitted to the Trust by the Hospice Care Agency and the attending Physician outlining: (1) and attesting the Participant is terminally ill, (2) and attesting the Participant has a life expectancy of six (6) months or less, and (3) the range of and charges for services that will or could be rendered to the Participant. Hospice Care is for Reasonable Fees incurred for the palliation or management of terminal illness. Benefits shall be payable for routine and continuous home care. Hospice care will only be approved once for a Participant. (X) TMJ Benefit — The Plan will consider the Reasonable Fees for diagnostic or surgical procedures involving bones or joints of the jaw and facial region if, under accepted medical conditions, such procedures are Medically Necessary to treat conditions caused by congenital or developmental deformity, disease or injury. This Benefit shall not cover the care or treatment of the teeth or gums, intraoral prosthetic devices or procedures for cosmetic purposes. (Y) Acquired Immune Deficiency Syndrome Benefit — The Plan will consider the Reasonable Fees for services and supplies related to the care and treatment of Acquired Immune Deficiency Syndrome up to the Lifetime Maximum Benefit. (Z) Cardiac Rehabilitation Benefit — The Plan will consider the Reasonable Fees for the services of a Cardiac Rehabilitation Facility for cardiac rehabilitation on an Outpatient basis provided such services are prescribed by a Physician and are provided under the direct supervision of a Physician, and provided the Participant meets the following criteria: (1) Myocardial Infarction - post myocardial infarction, Participant may enter the program anytime at the discretion and referral of the Physician; (2) Post -op Cardiovascular Surgery - a minimum of three weeks aorta - coronary bypass surgery, or at the discretion and referral of the Physician; Adequate control of complications, i.e., angina, congestive heart failure or (3) "Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 30 Florida Municipal Insurance Trust Medical Master Plan of Benefits arrhythmias; (4) Pacemaker patients with any of the above diagnosis and /or decreasing functional capacity. (AA) Home Health Care Benefit — The Plan will consider the Reasonable Fees, up to a maximum of $1,000 per Calendar Year, for Home Health Services performed by a Home Health Agency, provided the services are necessitated by an Accident or Sickness, subject to the following terms, conditions and limitations: the services must be performed pursuant to a written plan of treatment prescribed by a Physician, the plan of treatment must be Pre - Authorized, and the Participant must be confined to home and unable to carry out the basic activities of daily living. (BB) Skilled Nursing Facility Benefit - The Plan will consider the Reasonable Fees for the following services and supplies when furnished to a Participant while an Inpatient in a Skilled Nursing Facility. (1) Room and board, not to exceed the average rate of a semi - private room; (2) Respiratory therapy (e.g., oxygen); (3) Drugs and medicines administered while an Inpatient; (4) Intravenous solutions; (5) Dressings, including ordinary casts; (6) Transfusion supplies and equipment, including blood administration expenses, but excluding blood, blood plasma and /or blood derivatives unless otherwise specifically stated in this Plan; (7) Diagnostic services, including radiology, ultrasound, laboratory, pathology and approved machine testing (e.g., electrocardiogram); (8) Chemotherapy treatment for proven malignant disease; (9) Services of a Occupational, Physical or Speech Therapist (in connection with a covered Condition); and (10) Other Medically Necessary services and supplies. The services and supplies must be provided pursuant to a written plan of treatment prescribed by a Physician and Pre - authorized by the Trust. Benefits shall be limited to a maximum stay in the Skilled Nursing Facility of 60 days per Calendar Year. (CC) Mastectomy Benefit — The Plan will consider the Reasonable Fees for services and supplies for a Mastectomy, for Breast Reconstructive Surgery incident to a Mastectomy, and for the Outpatient post - surgical follow -up care following Breast Reconstructive Surgery. Post - surgical follow -up care shall be provided at the most medically appropriate setting, which may include the Hospital, the treating Physician's office, an Outpatient facility, or the home of the Participant. All services and supplies must be Medically Necessary and related to the Mastectomy. (DD) Mammogram Benefit — The Plan will consider the Reasonable Fees for the following * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 31 Florida Municipal Insurance Trust Medical Master Plan of Benefits mammogram screening services, subject to the following terms, conditions and limitations: (1) Coverage for mammograms is limited to one base line mammogram, with or without prescription, for a Participant who is 35 years of age or older, but younger than 40 years of age; a mammogram every 2 years, with or without a prescription, or more frequently if prescribed by the Participant's Physician, for a Participant who is 40 years of age or older, but younger than 50 years of age; a mammogram, with or without prescription, every year for a Participant who is 50 years of age or older; and one or more mammograms a year, based upon a Physician's recommendation, for a Participant who is at risk of breast cancer because of a personal or family history of breast cancer, because of a history of biopsy- proven benign breast disease, because the Participant's mother, sister, or daughter has or has had breast cancer, or because a Participant has not given birth before the age of 30. (2) Except for mammograms done more frequently than every two years for women 40 years of age or older, but younger than 50 years of age, the Plan will consider the Reasonable Fees for mammogram screening services only when the Participant obtains a mammogram in a medical office, medical treatment facility or through a health testing service that uses radiological equipment registered with the Florida Department of Children and Family Services for breast cancer screening. Unless otherwise stated in the Schedule of Benefits, mammogram- screening services shall be subject to the Calendar Year Deductible, Co- Insurance and Co- Payment requirements stated in the Schedule of Benefits. (EE) Diabetes Treatment Benefit — The Plan will consider the Reasonable Fees for Medically Necessary and appropriate equipment, supplies, and diabetes outpatient self - management training and educational services used to treat diabetes, subject to the following terms, conditions and limitations: (1) All diabetes treatment services shall be performed pursuant to a written plan of treatment prescribed and approved by a Physician. (2) A licensed Dietician shall provide any associated nutritional counseling. (3) All diabetes outpatient self- management training and educational services shall be provided under the direct supervision of a Certified Diabetes Educator or a Board - Certified Endocrinologist. (4) All diabetes outpatient self- management training and educational services shall conform to standards adopted by the Florida Agency for Health Care Administration. Diabetic Supplies do not require pre - authorization. (FF) Dental Care Benefit — The Plan will consider the Reasonable fees for general anesthesia and hospitalization services Medically Necessary to assure the safe delivery of necessary dental care to a Participant in a Hospital or Ambulatory Surgical Center, subject to the following terms, conditions, and limitations: **Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 32 Florida Municipal Insurance Trust Medical Master Plan of Benefits (1) The Plan shall not pay for fees incurred in the diagnosis or treatment of a dental disease, including any decay or periodontal disease, and the Participant must comply with the Trust's pre- admission hospital certification program; and (2) The services must be provided to a Participant under eight (8) years of age and a licensed dentist and the Participant's Physician must have either determined dental treatment in a Hospital or Ambulatory Surgical Center is necessary due to a significantly complex dental condition or determined the Participant has a developmental disability that makes patient management in the dental office ineffective; or The Participant has one or more medical conditions that would create a significant or undue medical risk for the Participant in the course of delivery of the necessary dental treatment or surgery if not rendered in a Hospital or an Ambulatory Surgical Center. Covered services otherwise shall not include the diagnosis or treatment of a dental disease, including any decay or periodontal disease and the Patient must comply with the Trust's Hospital Pre - Admission Certification guidelines contained in Section VI. (GG) Osteoporosis Screening, Diagnosis, Treatment and Management Benefit — The Plan will consider the Reasonable Fees for the Medically Necessary diagnosis and treatment of osteoporosis for High -Risk Participants. (HH) Cleft Lip and Cleft Palate Benefit — The Plan will consider the Reasonable Fees for the Medically Necessary care and treatment of a Participant, under the age of 18, for cleft lip or cleft palate, including medical, dental, speech therapy, audiology, and nutrition services and supplies, provided the care and treatment is pursuant to a written plan of treatment prescribed and certified by the treating Physician. (II) Tissue or Organ Transplant Benefit — The Plan will consider the Reasonable Fees for services and supplies connected with the following transplants, including services and supplies relating to pre - transplant, transplant, post- discharge, and complications after transplantation, subject to the terms, conditions and limitations described below: (1) Bone Marrow Transplants specifically approved by Florida's Agency for Health Care Administration and listed in Ch. 59B- 12.001, Florida Administrative Code; (2) Heart transplants; (3) Lung transplants; (4) Corneal transplants; (5) Kidney transplants; (6) Pancreas transplants; (7) Liver transplants; Transplants are subject to the following terms, conditions and limitations: (1) Expenses incurred in connection with any organ or tissue transplant listed in (3) ` *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 33 Florida Municipal Insurance Trust Medical Master Plan of Benefits this provision will be covered subject to referral and to pre- authorization by the Trust's authorized review specialist. (Kidney and cornea transplants are not subject to the provision, but will be considered on the same basis as any other medical expense coverage under the Plan. Tissue or Organ Transplant Coverage is offered under the Plan through a preferred provider network of duly licensed facilities and by duly credentialed Physicians acceptable to the Trust. Tissue or Organ Transplant Coverage must be pre- authorized by the Trust and /or its designated medical review and pre- authorization specialist to receive Coverage at the level reserved for utilization of the preferred provider network benefits. As soon as reasonably possible, but in no event more than ten (10) days after a Participant's attending Physician has indicated that the Participant is a potential candidate for a transplant, the Participant or his /her Physician should contact the Trust for referral to the network's medical review specialist for evaluation and pre- authorization. A comprehensive treatment plan must be developed for review by the Trust's medical review specialist, and must include such information as diagnosis, the nature of the transplant, the setting of the procedure, (i.e. the name and address of the hospital), any secondary medical complications, a five (5) year prognosis, two (2) qualified opinions confirming the need for the procedure, as well as a description and the estimated cost of the proposed treatment. (The Trust's medical review specialist may waive one or both confirming second opinions). Additional attending Physician's statements may be required. Pre - authorization approval will result in the Participant being asked to obtain transplant services in network at a Participating Network Transplant Center of Excellence. Failure to pre- authorize a transplant procedure will result in the application of a $5,000 deductible to all Covered Expenses incurred as a result of the transplant. This deductible is in addition to any other plan Deductible, Co- payment, and /or Co- insurance requirements that would normally be applicable to the transplant procedure. (2) The Coverage is also provided for transplant services obtained outside of the preferred provider network, though, at limited benefit levels as described below. As a condition of such non - network Coverage, the Participant's Physician must provide the Trust with advance notification of the Participant's initial evaluation for the transplant procedure and the Trust must be given a reasonable opportunity to evaluate the clinical results of the Participant's initial evaluation and all applicable protocols. Additionally, the Trust must advise such non - network Physician the extent to which the proposed transplant is covered by the Plan. If a transplant is performed out of network, but the Participant has received approval from the Trust's medical review specialist for out of network services, then network benefits will apply to the transplant and its related expenses. If services are provided out of network without approval from the Trust's medical review specialist, then limited, non - network benefits will apply. (3) The respective Tissue and Organ Transplant Network and Non - Network * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 34 Florida Municipal Insurance Trust Medical Master Plan of Benefits Schedule of Benefits is as follows: (a) Heart: Network Benefits - 100% of eligible charges Non - Network Benefits - 100% of eligible charges, up to an overall maximum of $110,000 including a Physician's maximum of $20,000. (b) Lung: Network Benefits - 100% of eligible charges Non - Network Benefits - 100% of eligible charges up to an overall maximum of $155,000 including a Physician's maximum of $20,000. (c) Bone Marrow: Network Benefits - 100% of eligible charges Non - Network Benefits - 100% of eligible charges up to an overall maximum of $130,000, including a Physician's maximum of $20,000. (d) Liver: Network Benefits -, 100% of eligible charges Non - Network Benefits - 100% of eligible charges, up to an overall maximum of $130,000 including a Physician's maximum of $20,000. (e) Heart /Lung: Network Benefits - 100% of eligible charges Non - Network Benefits - 100% of eligible charges, up to an overall maximum of $150,000 including a Physician's maximum of $20,000 (f) Pancreas: Network Benefits - 100% of eligible charges; Non - Network Benefits - 100% of eligible charges up to an overall maximum of $70,000 including a Physician's maximum of $20,000. (g) Kidney: Network Benefits - 100% of eligible charges; Non - network Benefits - 100% of eligible charges, up to an overall maximum of $55,000 including a Physician's maximum of $20,000. (4) Covered Transplant Expenses will accumulate during a Transplant Benefit Period, and will be charged toward the transplant benefit period maximums, if any, shown in the Transplant Schedule of Benefits. The term "Transplant Benefit Period" means the period that begins on the date of the initial evaluation establishing potential transplantation candidacy and ends on the date, which is twelve consecutive months following the date of the transplant. (If the transplant is a bone marrow transplant, the date the marrow is reinfused is considered the date of the transplant). Covered Transplant Expenses, with respect to transplants, includes the (5) * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 35 Florida Municipal Insurance Trust Medical Master Plan of Benefits Reasonable Fees for services and supplies covered under the Plan (or which are specifically identified as covered only under this provision) and which are Medically Necessary and appropriate to the transplant. Benefits will be limited to the following expenses and costs: (a) Charges incurred in the evaluation, screening, and candidacy determination process. (b) Charges incurred for organ transplantation. (c) Charges for organ procurement, including donor expenses not covered under the donor's plan of benefits. (1) Coverage for organ procurement from a non - living donor will be provided for costs involved in removing, preserving and transporting the organ. (2) Charges for organ procurement for a living screening the potential donor, transporting the donor to and from the site of the transplant, as well as for medical expenses associated with removal of the donated organ and the medical services provided to the donor in the interim and for follow -up care. If the transplant procedure is a bone marrow transplant, coverage will be provided for the cost involved in the removal of the patient's bone marrow, (autologous) or donated marrow (allogenic). Pursuant to State Law, Coverage will also include the reasonably necessary costs associated with the donor - patient to the same extent and limitations as costs associated with the Participant, except the covered reasonably necessary costs associated with any donor search are limited in scope to the tissue or organ recipient- Participant's immediate family members and the National Bone Marrow Donor Program. (d) Charges incurred for follow -up care, including immuno- suppressant therapy. (e) Charges for transportation to and from the site of the covered organ transplant procedure for the Participant- recipient and one other individual, or in the event that the recipient- Participant is a minor, two (2) other individuals. In addition, all reasonable and necessary lodging and meal expenses incurred during the Transplant Benefit Period will be covered up to a maximum of $10,000 per transplant period. (6) Retransplantation will be covered up to two retransplants, for a total of three transplants per Participant, per lifetime. Each transplant and retransplant will have a new benefit period and a new maximum benefit. (7) Accumulation of Expenses incurred during any one Transplant Benefit Period for the Participant- recipient will apply towards the Participant- recipient's (3) * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 36 Florida Municipal Insurance Trust Medical Master Plan of Benefits (8) (9) (10) transplant Benefit and will be included in the Plan's overall Maximum Lifetime Benefit. Donor Expenses, to the extent reasonable and Medically Necessary, will be covered under this provision to the extent that they are not covered elsewhere under the Plan or any other benefit plan covering the donor. In addition, medical expense benefits for a donor who is not a Participant under this plan are limited to a maximum of $10,000 per transplant benefit period when the transplant services are provided out of network. This does not include the donor's transportation and lodging expenses. The Plan's Pre - Existing Condition Limitation shall apply to transplant charges. Extended Benefits in the event of termination shall be provided. In the event of termination of the Plan, or of the Participant- recipient's termination of membership in an eligible class, if a transplant treatment program had commenced while coverage was in force and benefits had not been exhausted, then benefits will be paid for expenses related to the same organ transplant which are incurred during the lesser of the remainder of that Transplant Benefit Period or one month after termination of the Plan or membership in an eligible class, as though Coverage had not ended. SECTION VII — HOSPITAL BILL SELF -AUDIT The Trust will provide a payment to the Participant in the amount of 50% of the savings (the total dollar difference between the original Hospital bill and the revised Hospital bill), not to exceed $1,000. The Participant will receive a payment from the Trust for any errors that the Participant identifies and the Hospital corrects. The Participant must take the following steps before contacting the Trust: (1) Obtain a copy of the itemized bill before leaving the Hospital or make arrangements for an itemized bill to be sent to the Participant. (2) Review the hospital bill for overcharges or errors on the bill. (3) If the Participant feels an error was made, the business office of the Hospital must be contacted to review the possible error(s). (4) Request the business office of the Hospital to satisfactorily explain the possible error(s) or issue a revised bill, which contain the credit(s) for the incorrect charge (s). Send the revised bill to the Trust with a letter outlining the Participant's actions, the amount of savings and the Participant's request for payment. SECTION VIII — EXCLUSIONS AND LIMITATIONS Unless otherwise expressly covered in Section VI of the Plan and then only to the extent of such Coverage, Coverage under this Plan for Participants is subject to the following exclusions and limitations for which no benefits will be paid: (5) * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 37 Florida Municipal Insurance Trust Medical Master Plan of Benefits (1) Services or supplies to improve the appearance or self - perception of a Participant, including without limitation, procedures or supplies to correct hair loss or skin wrinkling, and cosmetic surgery unless the cosmetic surgery is: (a) necessitated by an Accident while covered under this Plan and performed within six (6) months of the Accident, or (b) required to restore a normal bodily function or to correct a deformity. (2) Services or supplies that are custodial in nature, including without limitation, services or supplies provided in rest homes, nursing homes, sanitariums, health spas, health resorts, places of rest, institutions or homes for the aged, drug addicts, or alcoholics, or places for the treatment of pulmonary tuberculosis or mental or nervous disorders, domestic maid services, services of home health aides, sitters, or home mothers, or any other services or supplies designed primarily to assist the Participant in the activities of daily living. Services or supplies to prevent the development of a Sickness, including without limitation, surgical removal of tissue or organs solely because of the probability of developing a malignancy, periodic health assessments, or routine physical examinations, except as provided under the Child Health Supervision Benefit and except as otherwise specifically stated in this Plan. Services or supplies to a Participant hospitalized primarily for respite care, rest or rest /cure. (3) (4) (5) Services or supplies to diagnose or treat an injury or a Sickness resulting, directly or indirectly, from or in connection with drug or alcohol abuse by a Participant, or resulting, directly or indirectly from or in connection with the Participant being under the influence of drugs or alcohol. (6) Services or supplies to diagnose or treat vision or hearing problems, including without limitation, eye refractions, keratotomies, lasik surgery, eye glasses, contact lenses, fitting of such glasses or lenses, eye examinations, eye exercise, visual training or orthoptics, hearing aids, external or implanted hearing devices, and any service or supply in connection with the fitting of such aids or devices. This exclusion shall not apply to initial eyeglasses or contact lenses (including those surgically implanted) provided to a Participant immediately following cataract or glaucoma surgery covered under this Plan. Travel expenses, whether or not recommended, ordered or prescribed by a Physician. Services or supplies provided a Participant in a Hospital after the attending Physician advises further Inpatient care and treatment is no longer necessary. Dental care and treatment of the teeth and their supporting structures and gums, including without limitation, removal or addition of teeth, teeth fillings, crowns or other materials, bridges, teeth cleaning, dental implants, dentures, intraoral prosthethic devices, palatal expansion devices, bruxism appliances, dental x -rays, oral surgery for cosmetic purposes, oral surgery, or any services for orthodontia, prosthodontia or periodontia, except services and supplies (7) (8) (9) * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 38 Florida Municipal Insurance Trust Medical Master Plan of Benefits expressly provided under the Supplemental Accident Dental Care Benefit, the TMJ Benefit, the Dental Care Benefit, and the Cleft Lip and Cleft Palate Benefit. (10) Massage, whether or not the massage is recommended, ordered or prescribed by a Physician. (11) Training or educational programs or materials, including without limitation, programs or materials for pain management, vocational rehabilitation, and management of diabetes, except as provided under the Diabetes Treatment Benefit. (12) Rehabilitative Services, except as provided under the Inpatient Hospital Services Benefit, the Ambulatory Surgical Center Benefit, the Therapeutic Services Benefit, the Skilled Nursing Facility Care Benefit and the Home Health Care Benefit. (13) Services or supplies provided by an Occupational Therapist, including occupational therapy, for vocational rehabilitation, maintenance, job training, or those services that fall under the Workers' Compensation benefit. (14) Services or supplies provided by a Speech Therapist, including speech therapy, to treat either a lisp or stuttering. (15) Services or supplies provided by a Physical Therapist, including physical therapy, except as provided under the Hospital Care Benefit, the Hospice Care Benefit, the Therapeutic Services Benefit, the Skilled Nursing Facility Care Benefit, and the Home Health Care Benefit. (16) Services or supplies, including without limitation, surgery or psychiatric services, related to sexual disorders, impotence, whether organic in origin or not, or to sexual reassignments, reconstructions or modifications. (17) Services or supplies connected with sterilization or reverse sterilization, including without limitation, tubal ligations and vasectomies and reversals of tubal ligations and vasectomies. (18) Services or supplies connected with the treatment of infertility or any form of artificial fertilization, including without limitation, medications, artificial insemination, in -vitro fertilization, gamete intra - fallopian transfer, and any other form of artificial impregnation. (19) Contraceptive devices, appliances, medications or other services or supplies used for contraception. This exclusion does not apply to oral contraceptives for female Participants. (20) Services or supplies connected with abortions, including the abortion, unless the Physician certifies to the Trust the pregnancy would constitute a danger to the health of the pregnant woman or the pregnancy would result in the birth of an infant with grave malformation. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 39 Florida Municipal Insurance Trust Medical Master Plan of Benefits (21) Services or supplies connected with an autopsy or postmortem examination, including the autopsy. (22) Blood, blood plasma and /or blood derivatives. (23) Services or supplies to lose, gain, or maintain weight, including without limitation, gastric bypasses, gastric balloons, stomach stapling, jejunal bypasses, jaw wiring, weight control /loss programs, food /nutritional supplements, appetite suppressants, and exercise programs, equipment or memberships. (24) Private duty nursing services. (25) Services and supplies connected with Biofeedback and other forms of self -care or self -help, including without limitation, any related diagnostic testing, exercise programs, hypnosis or meditation. (26) Services or supplies for routine foot care including but not limited to the removal of warts, corns, calluses, the cutting and trimming of toe nails, flat feet, fallen arches, chronic foot strain, or other foot care, except where the need for professional performance of the service is required due to an underlying severe systemic disease affecting the feet. (27) Services or supplies to reduce or eliminate addiction to or dependency on tobacco, including without limitation, nicotine withdrawal programs and nicotine products such as nicotine gum or transdermal patches. (28) Services or supplies connected with any transplant, except as provided under the Tissue or Organ Transplant Benefit, including without limitation any services or supplies connected with the implant of an artificial organ, including the implant of the artificial organ; any organ, tissue, marrow, or stem cells which are sold rather than donated to the Participant; any Bone Marrow Transplant not specifically listed in Ch. 59B- 12.001, F.A.C.; any service or supply connected with the identification of a donor from a local, state or national listing; any transportation costs for the Participant to and from a facility approved to perform the transplant; and any direct, non - medical costs for the immediate family for transportation to and from the facility approved to perform the transplant or for temporary lodging. (29) Services or supplies determined by the Trust to be Experimental or Investigational as defined by the appropriate federal regulatory agency, (including without limitation, the U.S. Food and Drug Administration (FDA) and the Health Care Financing Administration (HCFA)) (30) Services and supplies which, in the opinion of the Trust, are not Medically Necessary for the diagnosis, care or treatment of an Accident or a Sickness. The fact a Physician may prescribe, order, recommend, or approve a service or supply does not in and of itself make it Medically Necessary. (31) Services or supplies provided by a Provider who is related to the Participant by blood or by marriage. (32) Services or supplies obtained without cost to the Participant, or services or * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 40 Florida Municipal Insurance Trust Medical Master Plan of Benefits supplies the cost of which is discounted or waived to satisfy the Calendar Year Deductible, Co- Insurance, or Co- Payment requirements stated in the Schedule of Benefits. (33) Service or supplies furnished to a Participant or paid under any of the following plans or insurance coverages: (a) any plan, program or insurance policy providing benefits for hospital, medical and /or other health care expenses under a group master policy including, but not limited to, policies issued to any health maintenance organization or any entity to which such policies may legally be issued in the State of Florida for the purpose of insuring a group of individuals; (b) any plan, program or insurance policy, and /or Personal Injury Protection automobile insurance required and defined under Florida law, which provides benefits or makes payments to or on behalf of a Participant for hospital, medical and /or other health care expenses; (c) any group contract issued to this Trust; (d) any coverage under a plan or a law of any federal, state or local government or any political subdivision thereof, including but not limited to, coverage under Medicare, and /or any other federal, state or local government- sponsored program or programs, unless otherwise provided by law; A Participant shall have no right to benefits under this Plan if said Participant elects to waive any entitlement to benefits provided under any plan described in this paragraph. The Participant shall provide, execute and deliver such information, instruments and papers, and do whatever else is necessary to secure the instruments and papers, and the Trust's rights under this paragraph. (34) Services and supplies covered under Parts A and B of Medicare if the Participant is not an active Employee or the Dependent of an active Employee. (35) Services or supplies received in a veterans hospital or other government facility due to an armed forces or military service connected Accident, Sickness or disability. (36) Services or supplies provided before Coverage commences or after Coverage terminates for the Participant, except to the extent and in the manner provided by Florida law and in the manner provided under Sections X, XIII, XIV and XV of the Plan. (37) Services or supplies primarily for the personal comfort or convenience of the Participant, including without limitation, beauty and barber services, radios, televisions, telephone charges, take -home supplies, guest meals, and lodging accommodations. (38) Services or supplies not expressly covered under this Plan. (39) Services or supplies to diagnose or treat any Accident or Sickness which, directly or indirectly, resulted from or is in connection with the Participant's * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 41 Florida Municipal Insurance Trust Medical Master Plan of Benefits participation in, or commission of, any act punishable by law as a felony. This exclusion will not be imposed on injuries resulting from domestic violence. (40) Services or supplies to diagnose or treat any Accident or Sickness which, directly or indirectly, resulted from or is in connection with a riot, rebellion, or war or act of war, whether or not declared. (41) Pre - existing conditions except to the extent and in the manner provided in Section X. (42) Services or supplies for care or treatment to the extent the Participant is covered or required to be covered by the workers' compensation laws of the State of Florida, for the care or treatment of any occupational condition, ailment or injury arising out of or in the course of employment or other endeavor for wage, profit or gain, or for services or supplies furnished to a Participant under the laws of the United States or any state or political subdivision thereof, all of which are excluded under this Plan, even though the Participant elects to waive the right to such services or supplies. (43) Services or supplies for care or treatment resulting directly or indirectly from self - inflicted or self - induced injury or illness. This exclusion will not be imposed on injuries resulting from an underlying medical condition. (44) Services or supplies for care or treatment resulting directly or indirectly from the Participant's participation in or incitement of an altercation. This exclusion will not be imposed on injuries resulting from domestic violence. (45) Services or supplies for care and treatment resulting directly or indirectly from or in connection with the Participant's service in the armed forces, including the reserves and /or the National Guard. (46) Services or supplies for care and treatment resulting directly or indirectly from deliberately and voluntarily undertaking activities that subject the Participant to unnecessary exposure to danger or unnecessary exposure to obvious risk of injury. This exclusion shall not apply to services or supplies for care and treatment resulting from the Participant's participation in sponsored sporting events or traditional recreational activities. (47) Services or supplies for care and treatment of complications which result from or arise out of the provision of services or supplies that are excluded under this Section. (48) Fees in excess of the percentage specified in the Schedule of Benefits, or in excess of Reasonable Fees. (49) Services or supplies connected with acupuncture, including acupuncture, whether or not recommended, prescribed, or ordered by a Physician. (50) Services or supplies for the care and treatment of temporomandibular joint dysfunction (TMJ), including without limitation, Phase II treatments, except as provided under the TMJ Benefit. (51) Services or supplies provided to a Participant as a result of or in connection * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 42 Florida Municipal Insurance Trust Medical Master Plan of Benefits with a court order, unless the services or supplies are otherwise expressly covered under Section VI. (52) Equipment, other than equipment provided under the Durable Medical Equipment Benefit, including, without limitations, modifications to motor vehicles and /or homes such as wheelchair lifts or ramps, water therapy devices such as Jacuzzis or hot tubs, and exercise equipment. In addition, maintenance on purchased equipment is excluded under this plan. (53) In the event a Participant suffers receives brain damage, brain injury, or any brain Condition related to head trauma following a motorcycle Accident, the amount of available Benefits related to such condition shall be reduced by 50 %, where police or medical reports indicate that a helmet or other generally recommended headgear or head safety equipment was not utilized by the Participant. (54) Services or supplies required in relation to a Total Disability for which a prior health insurer, health maintenance organization, or policy is required to provide an extension of benefits pursuant to section 627.667, Florida Statutes. (55) Laboratory handling and material conveyance fees. (56) Fees or charges designated as after -hours fees or charges or reasonably understood to be after -hours fees or charges. (57) Charges related to medical testimony of any Physician or Provider. (58) Educational supplies except those related to a diabetic Condition. (59) School, sports, travel and employment - related physical examinations. (60) Vaccinations or immunizations related or required to undertake any travel. (61) Any claim for services submitted to the Trust more than 365 days after the date of service. (62) Charges related to "no shows ". This is where the patient does not show for a scheduled appointment. (63) Ambulance Service for non - emergency transport. (64) Services and supplies for future dates. Benefits payable under this Plan will be limited to services and supplies provided and expenses incurred within the continental United States. Any expenses incurred by a Participant outside the continental United States will be subject to approval by the Trust. SECTION IX — COORDINATION OF BENEFITS The purpose of health care coverage is to help meet actual expenses. In line with that purpose, this Plan contains a non - profit provision coordinating it with other plans, including group plans under which a Participant is covered, so that the total Benefits available will not exceed 100% of the allowable expenses. * *Unless otherwise stated in the Schedule of Benefits (rev. 01 /03) Page 43 Florida Municipal Insurance Trust Medical Master Plan of Benefits Primary Coverage — A plan without a coordination of benefits provision is always the primary plan. If all potentially applicable plans have this provision: (1) the plan covering the person as an employee rather than as a dependent is primary; (2) the plan covering the person as an active employee or as a dependent of an active employee rather than Medicare is primary; if a dependent child is covered under both parents' plans, the plan for the parent with the earliest birth date in the Calendar Year is primary; (4) if a dependent child is covered under both parents' plans, and both parents have the same birthday, the plan which has covered the parent for a longer period of time is primary . However, if a plan subject to the foregoing rule based on the birthday of the parents coordinates with an out -of -state plan which contains provisions under which the benefits cover a person as a dependent of a male are determined before those of a person covered as a dependent of a female, and, if as a result, the plans do not agree on the order of benefits, the provisions of the other plan shall determine the order of benefits. if a dependent child is covered under both parents' plans, and the parents are divorced or separated, the primary plan will be determined in the following order: (3) (5) • First, the plan of the parent with custody of the child; • Second, the plan of the spouse of the parent with the custody of the child; and • Third, the plan of the parent not having custody of the child; unless the specific terms of a court decree state that one of the parents is responsible for the health care expenses of the child in which case the plan covering such parent is primary. A copy of the court decree must be furnished to the Trust; (6) The Plan covering an employee, or the employee's dependents, rather than a retiree, or the retiree's dependents, is primary; The Plan covering a person as an employee who has not retired, or as the employee's dependents, rather than the plan covering a person, or the person's dependents, as a retiree, is primary; The Plan covering a person as an employee, or the employee's dependents, rather than a plan covering the person, or the person's dependents, under COBRA, shall be primary. If none of the above rules apply, the plan that covered an employee or dependent for a longer period of time is primary. Secondary Coverage — Services and benefits under this Plan will be coordinated with, and this Plan is hereby deemed secondary to plans providing coverage for services, supplies or benefits furnished to a participant or paid under any of the following plans of (7) (8) * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 44 Florida Municipal Insurance Trust Medical Master Plan of Benefits insurance coverage: (1) any plan, program or insurance policy providing benefits for hospital, medical and /or other health care expenses under a group master policy including, but not limited to, policies issued to any health maintenance organization or any entity to which such policies may legally be issued in the State of Florida for the purpose of insuring a group of individuals; (2) any plan, program or insurance policy and /or Personal Injury Protection automobile insurance as required and defined in the Florida Statutes or policy of No -Fault Insurance as defined by any other applicable state laws or provisions, which provide benefits or makes payments to or on behalf of a participant for hospital, medical and /or health care expenses; (3) any group contract issued to this Trust; (4) any coverage under a plan or law of any federal, state or local government or any political subdivision thereof, including but not limited to, coverage under Medicare and /or any other federal state or local government- sponsored program or programs, unless otherwise provided by law. A Participant shall have no right to benefits under this Plan if said participant elects to waive any entitlement to benefits provided under any plan described in this Section. The Participant shall provide, execute and deliver such information, instruments and papers, and do whatever else is necessary to secure the instruments and papers, and the Trust's rights under this paragraph. Medicare Coverage -- Secondary Payer Provisions - (1) When a Participant or Dependent becomes covered under Medicare and continues to be eligible and covered under this Plan, the Coverage hereunder shall be primary, and the Medicare benefits shall be secondary, as set forth below, but only to the extent required by law. In all other instances, Coverage hereunder shall be secondary to any Medicare benefits. To assure compliance with the Medicare statute, the Employer shall advise the Trust, without delay, of any Employees and /or their Dependent spouses, age 65 or older, who are covered under Medicare prior to or immediately following the date such Employee or Dependant spouse became covered under Medicare (such information shall be provided to the Trust prior to the Employee or Dependent spouse's 65th birthday). Additionally, the Employer shall advise the Trust, without delay, of the Medicare status of any Medicare beneficiary who applies for Coverage, prior to such individual's Effective Date under this Plan. Pursuant to federal law, in any circumstance under which the Medicare statute requires that the benefits under this Plan be primary for any Employee or Dependent spouse, the Employer may not offer, subsidize, procure or provide a Medicare supplement policy to such Employee or the Employee's Dependent spouse. Additionally, the Employer may not induce such Employee or Dependent spouse to decline or terminate his or her Coverage under this Plan and elect Medicare as a primary source of health benefit coverage. (5) * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 45 Florida Municipal Insurance Trust Medical Master Plan of Benefits (2) If the Employer employs /employed twenty (20) or more Employees for twenty (20) or more weeks of the current or preceding Calendar Year, this Plan will provide primary Coverage for an Employee and /or the Employee's Dependent spouse, age 65 or older, regardless of their eligibility for Medicare, provided they are not eligible for Medicare due to end stage renal disease (ESRD), pursuant to the following terms: A. The Employer shall provide the Trust, without delay, the names and other identifying information regarding Employees: (1) who are covered under the Plan; (2) who are employed (not retired); (3) who have not elected Medicare as primary payer of their health care claims; and (4) who are not eligible for Medicare due to ESRD. B. The Employer shall provide the Trust, without delay, the names of Employees and /or any Dependent spouses, age 65 or older: (1) who are covered under the Plan; (2) who have not elected Medicare as the primary payer of their health insurance claims; and (3) who are not eligible for Medicare due to ESRD. This information shall be provided to the Trust on or before the 65th birthday of the Employee or Dependent spouse, or on such later date when the Employee or Dependent spouse enrolls under this Plan. C. For an Employee or Dependent spouse who meets one of the descriptions set forth above in A. or B., the Plan shall provide primary coverage beginning the first day of the month in which the individual attains age 65 or beginning on the Effective Date if the individual is 65 or older at the time of enrollment. D. Individual entitlement to primary coverage under this sub - section will automatically terminate: (1) for a current Employee, age 65 or older, when he or she elects Medicare as the primary payer or when he or she becomes eligible for Medicare due to ESRD; (2) for the Dependent spouse, age 65 or older, of a current Employee, when the Dependent spouse elects Medicare as the primary payer or when the Dependent spouse becomes eligible for Medicare due to ESRD. (3) for the Employee and Dependent spouse, when the Employee is no longer an active Employee, as defined in this Plan. The Employer shall provide the Trust, without delay, the names and any other identifying information of such Employees, or Dependent Spouses of such Employees, age 65 or older, who choose Medicare as primary payer of their health care claims, who become eligible for Medicare due to ESRD, or who are no longer active Employees, as defined in this Plan. It is the Employer's sole responsibility to notify the Trust if the number of its employees changes from twenty (20) or more employees to less than twenty (20) * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 46 Florida Municipal Insurance Trust Medical Master Plan of Benefits employees or from fewer than twenty (20) employees to twenty (20) or more employees. (3) The Plan will provide primary Coverage for a Participant who is entitles to Medicare coverage solely because of ESRD, subject to the following terms, conditions and limitations: A. The Employer must provide the Trust without delay, the names of a Participant who is or will be undergoing a regular course of renal dialysis or will receive or already has received a kidney transplant, the beginning date of such dialysis or the date of such transplant, and any other identifying information requested by the Trust. B. The Plan will provide primary Coverage for such Participant for a period of thirty (30) months, beginning the earlier of the month in which the Participant became entitled to Medicare Part A ESRD benefits or the first month in which the Participant would have become entitled to Medicare Part A ESRD benefits if the Participant had made timely application for the benefits. If Medicare was the primary coverage prior to the Participant becoming entitled to Medicare Part A ESRD benefits, then Medicare will remain the primary coverage of the Participant. If this Plan was the primary Coverage for the Participant prior to the Participant becoming entitled to Medicare Part A ESRD benefits, then this Plan will remain the primary Coverage of the Participant for the ESRD 30 -month coordination period. (4) Medicare may become the primary coverage for Employees and /or their Dependent spouses aged 65 or older, when the employer employs fewer than twenty (20) employees, and the Medicare Administration (HCFA) grants approval for such primary Medicare coverage. Medicare Coverage -- Disabled Individuals - (1) If the Employer employs 100 or more Employees for at least 50% of its regular business days during the previous Calendar Year, this Plan will provide primary Coverage to a Participant who is entitled to Medicare coverage because of disability, provided the disability is not due to ESRD and subject to the following terms, conditions and limitations: A. The Employer must provide the Trust, without delay, the name of a Participant who is entitled to Medicare because of disability (other than disability due to ESRD) who has not elected Medicare as primary coverage. Together with any other identifying information requested by the Trust. B. The Plan will provide primary Coverage for the Participant during the month in which the Participant remains entitled to Medicare coverage because of disability (other the disability due to ESRD). * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 41 Florida Municipal Insurance Trust Medical Master Plan of Benefits C. The Plan's primary Coverage shall automatically terminate on the date the Participant turns 65 years of age, on the date the Participant no longer qualifies for Medicare coverage because of disability, or on the date the Participant elects Medicare as primary coverage. The Employer shall notify the Trust, without delay, of the occurrence of any of the events listed herein. It is the Employer's sole responsibility to notify the Trust that it employed 100 or more Employees at least 50% of its regular business days during the previous Calendar year. The Trust shall not be liable to the Employer or to any Participant for the non - payment of primary benefits if the non - payment resulted from the failure of the Employer to perform the Employer's obligations under this Medicare Coverage sub - section of the Plan. Should the Trust make primary payments for services rendered a participant in a period prior to receipt of the information required from the Employer under the terms of this sub- section, the Trust may require the Employer to reimburse the Trust for such payments. In the alternative, the Trust may require the Employer to pay the rate differential that resulted from the Employer's failure to timely discharge any of its obligations hereunder. The Employer shall indemnify and hold the Trust harmless to the extent of any liability, including attorneys fees and costs, that result directly or indirectly from the Employer's failure to notify the Trust as required herein. SECTION X — PRE- EXISTING CONDITIONS LIMITATIONS There is no coverage under this Plan for services or supplies to treat a Pre - Existing Condition or Conditions arising from a Pre - Existing Condition, until the Participant has been continuously covered under this Plan: (1) for a 12 month period beginning on the date of hire for Employees and their Dependents who enroll in the Plan during the initial enrollment period, and (2) for a 12 month period beginning on the Effective Date for Employees and their Dependents who enroll in the Plan during the Open Enrollment Period. All participants enrolled subsequent to the effective date of this Plan will be subject to this Pre - Existing Condition limitation, except newborn or adopted dependents that are properly enrolled in accordance with this Plan. Credit will be given for the time an eligible Participant was covered under previous coverage, if the previous coverage was similar to or exceeded the Coverage provided under this Plan and the previous coverage was continuous to a date not more than 62 days prior to the Participant's Effective Date of Coverage under this Plan, exclusive of any Waiting Period under this Plan. No Pre - Existing Condition limitation will apply for an eligible Participant presenting a certificate of Creditable Coverage indicating continuous coverage similar to or exceeding the coverage provided under this Plan, if the previous coverage was more than 12 months with no more than a 62 day break in coverage prior to the participant's effective date of coverage under this Plan, exclusive of any waiting period under this Plan. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 48 Florida Municipal Insurance Trust Medical Master Plan of Benefits The eligible Participant may prove periods of Creditable Coverage by providing a certificate of Creditable Coverage, which includes periods of coverage and benefit coverage levels. If there was a break in coverage of 63 days or more, no credit will be given for prior Creditable Coverage. SECTION XI — TIME OF PAYMENT, GRACE PERIOD All contributions are due and payable on the first day of each month for which Coverage under this Plan is provided. If the Employer fails to pay the contributions to the Trust within twenty (20) days after they become due and payable, the Plan is automatically terminated effective the first day of the month in which such contributions were due and payable; no Participant shall thereafter be entitled to any further Benefits hereunder. In the event this Plan terminates for any reason, the Employer shall be liable for all contributions due and unpaid as of the date of termination in the event that claims were paid after the contributions became due and payable. The Trust must give an Employer forty -five (45) days written notice of any change in the monthly rate of contribution or any changes in this Plan's terms or benefits. SECTION XII — CONDITIONS FOR RENDERING SERVICE The participant shall present proper identification issued by the Trust when applying for Hospital, Physician, pharmacy or other Covered Services under this Plan. The Plan does not confer upon the Trust or any Hospital any rights to select a Physician for the Participant. The Participant shall be at liberty to elect his or her Physician, provided such Physician is acceptable for practice in the Hospital to which the Participant is admitted. Nothing contained herein shall interfere with the ordinary relationship between the Participant and the Physician selected by the Participant. Some Employers may elect to make special arrangements with specific Providers and /or Preferred Provider Networks. If an Employer makes such an arrangement, the arrangement must be submitted to the Trust and benefits under such an agreement will be paid on such terms and conditions as are agreed to in writing by the Employer and the Trust. The Trust does not undertake to furnish any services, but merely to pay for Covered Services to the Participant to the extent herein specified. The Trust shall not, in any event, be liable for any negligence, misfeasance, nonfeasance, malfeasance, malpractice or any act of commission or omission on the part of any Physician, Hospital or other Provider or the agent or employee of any Physician, Hospital or Provider. SECTION XIII — EMPLOYER'S TERMINATION AND RENEWAL Except as provided in Section XI, this Plan may be terminated by either party hereto by giving not less than forty -five (45) days written notice of termination to the other. This Plan shall continue in force from month to month unless terminated pursuant to the foregoing provision. Except as hereafter provided, Coverage for all employees and their Dependents covered under this Plan shall automatically terminate immediately on the earliest of the following dates: * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 49 Florida Municipal Insurance Trust Medical Master Plan of Benefits (1) On the date Coverage is terminated. (2) On the expiration date as provided in Section XI, if the Employer fails to make the required contributions. All claims must be submitted no later than ninety (90) days after the date of termination of the policy in order to be eligible for payment. SECTION XIV — PARTICIPANT'S TERMINATION OF COVERAGE Unless a Participant qualifies for and elects continuation of Coverage pursuant to and in the manner provided in Section XV of the Plan: (1) Coverage for any Participant shall terminate automatically at the end of the month for which payment of the contributions specified herein shall have been made by the Employer for such Participant, in the event the Employer notifies the Trust that the Coverage of such Participant under this Plan is to be terminated. (2) Coverage of the spouse of an Employee shall automatically cease upon a legal separation of the spouse and Employee or termination of the marriage between the spouse and Employee. Coverage of the spouse and Dependents of an Employee shall automatically cease upon the death of the Employee. (4) Coverage of a Dependent child of an Employee shall automatically cease as provided under the definition of Dependent in Section I. Subject to the provisions of Paragraphs (1) and (2) of Section III, the Coverage of any Participant shall terminate automatically when the maximum benefits for which such Participant is eligible have been paid. Coverage for any remaining family Participants shall, unless otherwise terminated in accordance with provisions hereof, continue so long as payment of required contributions is timely made. A certificate of Creditable Coverage will be issued to all Participants whose Coverage terminates. The certificate will be sent by First Class Mail to the Participant's last known address. In addition, the Trust shall issue a certificate of Creditable Coverage to a Participant upon request, for up to 24 months following the end of the Participant's Coverage under this Plan. (3) (5) Conversion Privilege on Termination of Eligibility (1) A Participant whose Coverage under this Plan is terminated for any reason and who has been validly and continuously covered under this Plan for at least three (3) months immediately prior to such termination shall be entitled to purchase a converted policy, providing benefits that may differ from but in no event shall exceed those of the Plan. The Participant must apply to the Trust for the converted policy in writing and must pay the first premium attributable to the converted policy not later than sixty -three (63) days after termination of * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 50 Florida Municipal insurance Trust Medical Master Plan of Benefits the Participant's Coverage. The premium for such policy will be determined with premium rates applicable to the age and class of risk of each Participant that is to be covered under the policy and to the type and amount of coverage provided, however, in no event shall such premium exceed 200 percent of the standard risk rate as established by the Florida Department of Insurance. The converted policy will be issued without evidence of insurability and will be effective on the day following the termination of Coverage under this Plan. (2) A Participant is not entitled to a converted policy: (a) If termination is the result of the Participant or Employer's failure to timely pay a required contribution. (b) If any discontinued Coverage under this Plan is replaced by similar group coverage within thirty -one (31) days of the date of termination of this Plan. (3) (c) If the Participant is covered or eligible to be covered by Medicare. (d) If the Participant is covered or eligible to be covered under a group policy or similar benefits are available to the Participant under state or federal law, and the coverage or benefits, when combined with the benefits of the converted policy, will result in the participant's over insurance, according to standards utilized by the Trust. The terms and coverage conditions in and benefits provider under the converted policy will be designed to comply with section 627.6675, Florida Statutes, and the terms of section 627.6675, Florida Statutes, shall prevail to the extent of any conflict with the terms of this Plan. (4) An authorized insurer selected by the Trust to provide conversion coverage may issue the converted policy. The Trust may request and the Participant shall provide the Trust with reasonable information sufficient to determine whether the Participant is covered for similar benefits by another medical insurance policy or by any arrangement of coverage for individuals in a group, whether on an insured or uninsured basis. (6) A Participant's failure to provide any information requested regarding subsection (5) hereinabove, any fraud or intentional misrepresentation by the Participant, or any over insurance resulting from any available coverages referenced in subsection (5) hereinabove, will serve as a basis for the Trust's non - renewal of a converted policy. The converted policy may not exclude a pre - existing condition not excluded under the Plan coverage or policy from which conversion is made. However, the converted policy shall not provide coverage duplicative of any Coverage otherwise payable under the Plan after the termination of Coverage under the Plan. (5) (7) (8) A Participant who retires prior to his or her coverage or eligibility for coverage * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 51 Florida Municipal Insurance Trust Medical Master Plan of Benefits (9) under Medicare, shall be entitled to the converted policy privileges described herein. However, upon coverage or eligibility for coverage under Medicare, the available benefits under a converted policy may be reduced to the extent Medicare or any other state or federal law provides benefits similar to those provided by the converted policy. This conversion privilege may be exercised by the Dependents (including spouse and children) of a deceased Participant, when coverage for such Dependents would otherwise immediately terminate and following the expiration of any period of Continuation of Coverage as outlined in Section XV under this Plan. (10) The former spouse of a Participant whose coverage would otherwise terminate due to annulment or dissolution of marriage may exercise this conversion privilege, if the former spouse seeking a converted policy is dependent for financial support upon the Participant. (11) This conversion privilege may be exercised by a child of a Participant by reason of ceasing to be an eligible Dependent under the Plan. Extended Coverage for Total Disability A temporary extension of Benefits, only for treatment of the Condition causing Total Disability shall be available to a Participant who is Totally Disabled as a result of an Accident or Sickness incurred while the policy was in effect. Coverage provided by the Plan shall remain in effect until the Total Disability ceases, the Lifetime Maximum has been received, the Participant becomes covered under a replacement contract or policy without limit as to the disabling condition, or until the expiration of twelve (12) months following the date of discontinuance, whichever occurs first. Extended coverage for Total Disability is subject to all other terms, conditions, exclusions and limitations of the Plan. SECTION XV — CONTINUATION OF COVERAGE - COBRA The Plan provides an election for continuation of Coverage to qualified beneficiaries who would otherwise lose Coverage under the Plan as a result of a qualifying event. A qualified beneficiary means the Dependent spouse or Dependent child of an Employee who is a Participant in the Plan on the day before the qualifying event. In the case of termination (other than for gross misconduct), the term also includes the Employee. One exception to this rule is when a child is born to (or placed for adoption with) an Employee during the COBRA continuation period. These children will receive all rights of a qualified beneficiary throughout the COBRA continuation period. A qualifying event means the occurrence of any of the following events, which would result in the loss of Coverage to: (1) Employee: (a) Termination of employment for any reasons other than gross misconduct. (b) Reduction of work hours. (2) Spouse: * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 52 Florida Municipal Insurance Trust Medical Master Plan of Benefits (3) Continuation requirements. beneficiaries is (1) (a) (b) (c) (d) (e) (i Termination of Employee's employment. Reduction of Employee's work hours. Death of Employee. Divorce or legal separation from Employee. Employee becomes enrolled in Medicare. A Dependent child ceases to be a Dependent under the Plan. Dependent: (a) Termination of Employee's employment. (b) Reduction of Employee's work hours. (c) Death of Employee. (d) Divorce or legal separation from Employee. (e) Employee becomes enrolled in Medicare. (f) Dependent child ceases to be an eligible Dependent as defined by the Plan. of Coverage is conditioned upon satisfaction of the following notice The notice requirement relating to election of Coverage by qualified as follows: In the event of an Employee's death, termination of employment or Medicare eligibility, the Employer shall notify the Trust within sixty (60) days of such event. Upon receipt of notice, the Trust shall, within fourteen (14) days, notify the qualified beneficiary of his /her right to elect continuation Coverage under the Plan. (2) In the event of divorce, legal separation or a Dependent child ceasing to qualify as a Dependent under the Plan, the Employee or the qualified beneficiary is required to notify the Trust within sixty (60) days of such qualifying event. Upon receipt of notice, the Trust shall, within fourteen (14) days, notify the qualified beneficiary of his /her right to elect continuation of Coverage under the Plan. (3) Notice hereunder to Employees or qualified beneficiaries shall be by First Class Mail to their last known address; notice to the Trust shall be by First Class Mail to the Board of Trustees of the Florida Municipal Insurance Trust. A qualified beneficiary's election of continuation of Coverage must be made within sixty (60) days following notice of continuation rights being provided to the qualified beneficiary. If the qualifying event is termination, the covered Employee's election of continuation Coverage shall be deemed to include an election of continuation of Coverage on behalf of any other qualified beneficiary who would lose Coverage under the Plan by reason of the termination. If any other qualifying event occurs, the election of continuation of Coverage by the spouse shall be deemed to include an election of continuation Coverage on behalf of any other qualified beneficiary who would lose Coverage under the Plan by reason of the qualifying event. The cost of Coverage to the qualified beneficiary shall be 102% of the cost of providing Coverage for such period to a similarly situated participant under the Plan to whom a * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 53 Florida Municipal Insurance Trust Medical Master Plan of Benefits qualifying event has not occurred. In the event the qualifying event entitling the qualified beneficiary to continuation of Coverage is the covered beneficiary's disability as defined by the Social Security Act, the cost of Coverage to the qualified beneficiary for any month after the 18th month of continuation Coverage following the date of termination shall be 150% of the cost of providing Coverage or such period to a similarly situated participant under the Plan to whom the qualifying event has not occurred. The cost of Coverage shall be paid directly to the Employer in monthly installments. In the event of a covered employee's termination, the period of continuation of Coverage is: (1) Up to eighteen (18) months from the date of said termination for such employee and the employee's qualified beneficiaries. (2) Up to thirty -six (36) months from the date of employee's death, divorce, or legal separation for such employee's covered surviving spouse, divorced spouse, legally separated spouse and such employee's covered dependents. Up to thirty -six (36) months from the date a covered dependent child ceases to be covered as an eligible dependent under the Plan. (4) Up to thirty -six (36) months from the date the covered employee becomes entitled to Medicare benefits for the employee's covered spouse and dependents. Up to twenty -nine (29) months from the date of such termination for such Employee and such Employee's qualified beneficiaries, if it is determined, under Title II or XVI of the Social Security Act, the covered employee was disabled on the date of termination. The Employee must notify the Trust of said determination within sixty (60) days of said determination and within eighteen (18) months of the date of termination. In the event another qualifying event occurs during the eighteen (18) months following the date of the employee's termination, the period of continuation of Coverage is up to thirty -six (36) months from the date of termination for such Employee and his qualified beneficiaries. (3) (5) A qualified beneficiary's continuation cif Coverage shall cease on the earliest of the following: (1) The maximum Coverage period date allowed for the qualifying event; (2) The date on which the Employer ceases to provide any group health plan to all Employees; As provided in Section XI, if the qualified beneficiary fails to pay contributions within thirty (30) days after they become due; (4) The date the qualified beneficiary becomes covered under another group health plan (as an employee or otherwise) with similar coverage, which does not contain any exclusions or limitations for pre - existing conditions, and if there is any pre- existing condition exclusion or limitation, coverage shall terminate on the date such limitation or exclusion ends; (5) The date the qualified beneficiary becomes entitled to Medicare benefits; (6) If the Coverage period is twenty -nine (29) months and the Employee ceases to be totally disabled, on the first day of the month within the Coverage period that begins more than eighteen (18) months after the date of termination and is (3) **Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 54 Florida Municipal Insurance Trust Medical Master Plan of Benefits more than thirty (30) days after the date on which the Employee ceased to be totally disabled under Title II or XVI of the Social Security Act. Notwithstanding the above, in no event shall said Coverage extend beyond the twenty -nine (29) month Coverage period. A certificate of Creditable Coverage will be issued at the end of the continuation of Coverage period. The certificate will be sent by First Class Mail to the Participant's last known address. In addition, the Trust shall issue a certificate of Creditable Coverage to a Participant upon request, for up to 24 months following the end of the Participant's Coverage under this Plan. If COBRA is elected and the eighteen (18) or thirty -six (36) months maximum time frame is exhausted, the qualified beneficiary may be eligible for Coverage under an individual plan (through an insurer of their choice) on a guaranteed issue basis without any pre- existing condition limitations. In the event the Plan offers a conversion privilege, the qualified beneficiary shall be entitled to said conversion privilege provided the qualified beneficiary applies for such conversion plan during the last 180 days of the period of continuation Coverage. Coordination of Benefits with other plans for COBRA recipients will follow current National Association of Insurance Commissioners (NAIC) recommendations. SECTION XVI — PRESCRIPTION DRUGS Coverage is provided for prescription medications prescribed by a Physician that is intended for use outside a Hospital, Skilled Nursing Facility or treatment facility. Benefits will be paid at the coverage level shown on the Schedule of Benefits. Presenting your prescription identification card each time you request a prescribed medication will ensure that the Provider knows that you are part of the. Plan. A generic prescription drug will be provided unless the prescribing Physician specifies a brand name drug. In addition to the applicable exclusions specified in Section VIII, no Coverage is provided for: (1) Drugs related to a course of treatment excluded, or a condition limited under the Plan. (2) Injectable products and syringes (other than insulin and insulin syringes). (3) Prescription Vitamins. (4) Nicorette Gum, Nicotine patches such as Habitrol, ProStep, Nicoderm and Ziban. (5) Viagra and other similar virility enhancement drugs. (6) Rogaine and other similar medications for baldness. (7) Anorexics (appetite depressants such as "diet pills "). (8) Diabetic Test Strips and glucometors. (9) Over the Counter medications and supplies. (10) Over the Counter Vitamins. (11) Drug prescriptions of thirty (30) or more days' duration. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 55 Florida Municipal Insurance Trust Medical Master Plan of Benefits A Prescription Mail Program is available to meet the maintenance drug prescription needs of a Participant. Only maintenance drug prescriptions of over thirty (30) days and less than ninety -one (91) days' duration are eligible for this program. No Coverage is provided for the exclusions specified in Section VIII, and Items (1) through (11) listed above. SECTION XVII — GENERAL PROVISIONS The Trust will issue to the Employer for delivery to each participating Employee covered hereunder, a Schedule of Benefits, a copy of this Plan and appropriate identification cards, which the Employee or eligible covered Dependents can present to a Hospital, Physician, or other service Provider in claiming Benefits due under this Plan. It shall be the Employer's responsibility to disseminate to the eligible Employee the Schedule of Benefits, a copy of this Plan and the appropriate identification cards. The Employee's Benefits are non - assignable prior to a claim. If any amendment to this Plan shall materially affect any Benefits, the amendment, a new Schedule of Benefits and an updated copy of this Plan shall be delivered to the participating Employer to be distributed to Employees. The Trustees shall provide benefits that are designed to meet the needs of the Participants and that are based on actuarial soundness. The Plan may be modified or discontinued by the Trustees at any time. Notices of modification or discontinuance shall be mailed to the employer's last known address at least forty -five (45) days prior to the effective date of such modification or discontinuance. All statements made by Employers or the Employees of such Employers shall be deemed representations and not warranties and no statement made for the purpose of effecting Coverage shall void such Coverage or reduce Benefits unless contained in a written instrument signed by the Employer or Employee of such Employer, a copy of which has been furnished to such Employer or Employee as the case may be. No reduction in Benefits shall be made by reason of change in the occupation of any Employee while in the employ of the Employer or by reason of the Employee's doing any act or thing pertaining to any other occupation. No representative has authority to change this Plan or waive any of its provisions. No change in this Plan shall be valid unless approved by the Board of Trustees. Written proof of a claim for services must be furnished to the Trust within 365 days after the date of such services. Benefits provided in this Plan would be payable to the Hospital, Physician, or other service Provider rendering service under this Plan or to the Participant upon receipt, by the Trust, of paid bills in acceptable form. No action at law or in equity shall be brought to recover under this Plan prior to the expiration of sixty (60) days written notice to the Trust. No such action shall be brought after the expiration of the specified statute of limitations on such action. Such notice to the Trust shall be sufficient if given to: The Florida Municipal Insurance Trust Attention: Health Department 125 E. Colonial Drive Orlando, Florida 32801 An Employee applying for Coverage under this Plan for himself /herself or eligible "Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 56 Florida Municipal Insurance Trust Medical Master Man of Benefits Dependents and the Participant and /or each Dependent of the Participant agrees that, as a condition of payment of Benefits, services and supplies, Hospital, Physician, or other Provider that has made or may hereafter make a diagnosis, render service, attendance or treatment of or to a Participant, may furnish and is authorized to furnish to the Trust at any time upon its request, a report containing all information and records or copies of records pertaining to diagnosis, attendance, service or treatment. The applicant or Participant and /or each Dependent of the applicant or Participant agree as a condition of payment of Benefits, or services, to execute such medical authorization as may be required by the Trust. The Trust shall not be responsible for the payment of any expense for services or supplies not covered by this Plan or any amounts in excess of the maximum benefits allowed by this Plan. Eligible new Participants may be added to the Plan in accordance with the terms and conditions of the Plan. No otherwise eligible Employee or Dependent of a participating Employer shall be refused Coverage or be charged an unfairly discriminatory rate for participation solely because such Employee or Dependent is mentally or physically handicapped; provided, however, nothing in this Plan shall be construed to require the Trust to provide Coverage against a handicap which the applicant sustained on or before the applicant's Effective Date of Coverage. In the event Coverage under this Plan is conditioned upon a certain event or condition, or conditioned upon the continuation of a certain event or condition, the burden is on the Participant to establish the existence of such event or condition or the continuation of such event or condition. To the extent of any conflict, the express words and language in this Plan will prevail over any oral or written communications to or by the Trust concerning the terms and conditions expressed in this Plan and such communications are hereby deemed to be modified to reflect the terms and conditions in this Plan in the event such conflict arises. The burden is on the applicant or Participant to make complete and accurate representations to the Trust concerning questions of eligibility, Coverage and services or Benefits under this Plan. To ensure any Provider is in the Employee /Participant's network of approved Providers, the Employee /Participant should check the label affixed to his or her identification card. This label identifies the network to which the Employee /Participant's Employer belongs. The Trust recommends the Employee /Participant call the number(s) listed below with inquiries for either network: FIRST HEALTH (800) 778 -1463 If an Employee /Participant's identification card does not identify the network to which his or her Employer Belongs, Please contact the Trust's Customer Service Department at 1 (800) 756- 3042 for assistance. DO NOT RELY UPON THE PROVIDER DIRECTORY FOR CONFIRMATION OF NETWORK PROVIDERS. THE ULTIMATE RESPONSIBILITY TO ENSURE A PROVIDER IS WITHIN A GIVEN NETWORK RESTS WITH THE EMPLOYEE /PARTICIPANT. * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 57 Florida Municipal Insurance Trust Medical Master Plan of Benefits SECTION XVIII — PAYMENT OF BENEFITS, ASSIGNMENT Benefits provided under this Plan for a specified injury or Condition may be paid to the Participant or to the Provider who has provided or paid for services or supplies for which such benefits are payable. Such Benefits may be assigned by the Participant to such Provider and will be paid according to the Participant's designation on the claim form, but only to the extent such Provider's interest shall appear; otherwise this Plan and such Benefits are non - assignable. If Benefits are paid prior to the receipt and acceptance by the Trust of any assignment of such Benefits, the assignment shall be null and void and unenforceable against the Trust. In the event an Employee or Dependent dies, or is physically, mentally or otherwise incapable of making payment due to a Provider, Benefits may be paid directly to the Provider or to any person or institution appearing to assume responsibility for the expense, and such payment shall discharge the Trust's obligation for such expense. SECTION XIX — GRIEVANCE PROCEDURE There are situations when Participants have questions about their Coverage or are dissatisfied with Plan services. Such inquiries and complaints will be handled in a timely manner. In the event that a claim is denied and the Participant disagrees with the denial, a re- determination may be requested in writing detailing the reasons for the disagreement. This request must be received within sixty (60) days of the initial claim denial. The Plan will respond with a written decision, within sixty (60) days from receipt of the request. SECTION XX — SUBROGATION If any payments are made to or on behalf of a Participant and such payments arise as a result of an injury, illness or other condition for which the Participant has, or may have, or asserts any claim or right of recovery (including, without limitation, claims for pain and suffering, loss of consortium, consequential, punitive, exemplary or other damages) against a third party or parties, then any benefits advanced by the Trust for such medical expenses shall be made on the condition and with the agreement and understanding that the Participant shall reimburse the Trust to the extent of (but not exceeding) any amount or amounts recovered by or on behalf of the Participant (including the Participant's estate) from any third party by way of settlement or in satisfaction of any judgment relating to said claim. The Trust shall maintain a lien on any such recovery and be entitled to reimbursement in full in accordance with this Section irrespective of whether the Participant has been fully compensated for all or any of said claims. The Trust shall be entitled to such reimbursement from first dollar recovery amounts received by the Participant. As security for the Trust's rights to such reimbursements the Trust shall be subrogated to all claims, demands, actions or rights of recovery of the Participant against any third party or parties (or their insurers) to the extent of any and all benefits advanced by the Trust; and any Participant that takes any action prejudicing or otherwise impairing the subrogation rights of the Trust shall be liable to the Trust for any losses to the Trust caused by such action. Any action prejudicing or otherwise impairing the subrogation rights of the Trust made by the Participant shall also terminate the Trust's obligation to advance benefits to or on behalf of the Participant. The Trust shall withhold payments of claims made under this Plan, to the extent that the Trust has reason to believe that said claims arise as a result of any act of a third party, until the Participant or the * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 58 Florida Municipal Insurance Trust Medical Master Plan of Benefits Participant's legal representative executes a subrogation agreement. The subrogation rights of the Trust, as set forth in this Section, also apply to payments made by the Participant's own auto insurance (with the exception of payment for property damage). For purposes of this Section and any subrogation agreement executed pursuant hereto, the term Participant shall include the heirs, guardians, executors or other representatives of the Participant. For purposes of this Section and any subrogation agreement executed pursuant hereto, the spouses, children and other Dependents as Participants under the Plan are third party beneficiaries under the Plan and therefore subject to the same duties and obligations as Employees who are Participants under the Plan. If the Participant is a minor, any amount recovered by or on behalf of such minor- Participant shall be subject to this provision, to the fullest extent permissible under State Law. The Trust shall have no obligation to share the cost of, or pay any part of, the Participant's attorney fees and costs incurred in obtaining any recovery against the third party. The Trust retains the right, at its sole discretion, to sue third parties on behalf of the Participant should the Participant not commence lawsuit within a reasonable period of time. The Trust reserves the right to make changes to this provision, as necessary, provided appropriate advance notice is given to the Participant. SECTION XXI — NOTICE Notice to an Employer given under the Plan shall be sufficient if given to the Employer when addressed to its office location stated in the Participation Agreement. Notice to the Trust, except as otherwise herein expressly provided, shall be sufficient if given to: The Florida Municipal Insurance Trust Attention: Health Department 125 E. Colonial Drive Orlando, Florida 32801 * *Unless otherwise stated in the Schedule of Benefits (rev. 01/03) Page 59 ❑ Administration/ Marketing ❑ Risk Control ❑ Underwriting Property & Casualty Health Post Office Box 530065 125 East Colonial Drive Orlando, FL 32853 -0065 800 - 445 -6248 407 - 425 -9142 Suncom 344 -0725 Fax 407 - 425 -9378 Health Claims Post Office Box 538140 Orlando, FL 32853 -8140 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 ❑ Workers' Compensation Claims Post Office Box 538135 Orlando, FL 32853 -8135 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 ❑ Property & Liability Claims Post Office Box 538135 Orlando, FL 32853 -8135 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 FLORIDA LEAGUE OF CITIES, INC. PUBLIC RISK SERVICES May 30, 2003 City of Okeechobee Procurement Management Office 55 S.E. Third Avenue Okeechobee, FL 34974 -2903 Re: RFP - Group Health Insurance Dear Procurement Management Office: We appreciate the opportunity to provide you with this proposal of insurance for employee benefits. Medical coverage has been proposed on a Point of Service (POS) managed care basis through the Florida Municipal Insurance Trust, a non- profit, non - accessible, group - pooled program. The Trust also provides dental and short -term disability benefits and a prescription drug card plan. The Trust offers First Health to provide a statewide managed care network for its participants. These Comprehensive networks of doctors and hospitals are available in most regions. All rates quoted are guaranteed for sixty (60) days from the date of the proposal. The rates include costs of administration, reinsurance and estimated claims costs. Monthly, quarterly and annual loss reports are provided at no additional charge. We welcome the opportunity to further discuss our proposal and should you have any questions, please contact me at 1- 800 - 445 -6248. Sincerely, Chuck Wilde Marketing Representative CW /jr Enclosure Florida Municipal Insurance Trust ❑ Administration/ Marketing ❑ Risk Control ❑ Underwriting Property & Casualty Health vf Post Office Box 530065 125 East Colonial Drive Orlando, FL 32853 -0065 800 - 445 -6248 407 - 425 -9142 Suncom 344 -0725 Fax 407 - 425 -9378 Health Claims Post Office Box 538140 Orlando, FL 32853 -8140 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 ❑ Workers' Compensation Claims Post Office Box 538135 Orlando, FL 32853 -8135 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 ❑ Property & Liability Claims Post Office Box 538135 Orlando, FL 32853 -8135 800 - 756 -3042 407 - 245 -0725 Suncom 344 -0725 Fax 407 - 425 -9378 FLORIDA LEAGUE OF CITIES, INC. PUBLIC RISK SERVICES PROPOSAL OF INSURANCE FOR CITY OF OKEECHOBEE Effective Date: 10/01/2003 Provided by Florida Municipal Insurance Trust Administered by: The Florida League of Cities, Inc. PUBLIC RISK SERVICES P.O. Box 530065 Orlando, FL 32853 -0065 407 - 425 -9142 or Toll Free 1- 800 - 445 -6248 May 30, 2003 Florida Municipal Insurance Trust Florida League of Cities City of Okeechobee MedicaURx First Health Network Contract Type Enrollment Current Rates Monthly Premium Annual Premium Single 47 $297.09 $13,963.23 $167,558.76 EE + Spouse 8 $642.00 $5,136.00 $61,632.00 EE + Child(ren) 9 $536.45 $4,828.05 $57,936.60 Family 1 $881.36 $881.36 $10,576.32 4-.,--, ,, '3.-fi,-:;:.-','' Proposed PPO Rates (FLC) Contract Type Enrollment 10/1/03 - 9/30/04 Monthly Premium Annual Premium Single 47 $424.44 Gold Plan $19,948.64 Gold Plan $239,383.66 Gold Plan EE + Spouse 8 $917.20 Gold Plan $7,337.57 Gold Plan $88,050.87 Gold Plan EE + Child(ren) 9 $766.40 Gold Plan $6,897.62 Gold Plan $82,771.41 Gold Plan Family 1 $1,259.16 Gold Plan $1,259.16 Gold Plan $15,109.91 Gold Plan Single 47 $387.22 Silver Plan $18,199.14 Silver Plan $218,389.71 Silver Plan EE + Spouse 8 $836.76 Silver Plan $6,694.07 Silver Plan $80,328.80 Silver Plan EE + Child(ren) 9 $699.19 Silver Plan $6,292.70 Silver Plan $75,512.36 Silver Plan Family 1 $1,148.73 Silver Plan $1,148.73 Silver Plan $13,784.77 Silver Plan Single 47 $356.95 Bronze Plan $16,776.80 Bronze Plan $201,321.66 Bronze Plan EE + Spouse 8 $771.36 Bronze Plan $6,170.90 Bronze Plan $74,050.78 Bronze Plan EE + Child(ren) 9 $644.54 Bronze Plan $5,800.90 Bronze Plan $69,610.76 Bronze Plan Family 1 $1,058.95 Bronze Plan s4.28 GdPlis '41: $1,058.95 Bronze Plan „;i.:', $3.,e10.99, 00jd Plaii - $12,707.44 Bronze Plan 0 fl' 3' - ,,-, 1,1D,:lt:::45. , "‘...!..t 'Z'''''';'-t-': : .':::: . '„ PIan S32,334 .64;$1iverylin -,,,i: -,;:. :. -'" . Silver PIan . : , iiAtita:,. ..;.;i;".•', ‘,. ' r117: '10,-3, :5 ',65D-il:',":?:.. ,F:: -.;i-f.:::, ,. ziiiiwiiiplan s . .:: S2,807.02Broni Mari' , .,. _."2 ;1'.' -272 ition4 k... : ' ' ' . ',--; T.7,11:',WL':. 'Z-5-,'::- .;,-. - z 0.4iii... kit. itingik7a iik,-,i-a-21i.!;..;j2::':,.4--: ,,:-.'i: 7::Ilkidiii,,,z,-- ..'. :7 :,7: -.:'-"--.-':- -- - ' -::.:7 -:;_ _. erJn ......r.. PiWireiiiiiiii,:::I ' ri,„:°K:',,!!:=',I.:::. !,i'i if-'. f.'" ''',.:•"-..:'',.' ..]?-:-:;,'k.:,. .:ii-g'.::' a: i:- .'_„-::-::,:;:,,,:i,:!,:, :::: ,-.,:::: **Medicare Supplement $256.30 * All rates are subject to Large Claim Disclosure and acceptance by the League's stop loss insurance carrier. ** Medicare Supplement is available for retirees over age 65 GROUP f)FNTAI SCHEDULE OF BENEFITS FLORIDA MUNICIPAL INSURANCE TRUST GFNFRAL DFNTAL CARF BFNFFIT Lifetime Maximum Benefit - Unlimited Calendar Year Maximum Benefit - $1,000 per individual SUMMARY OF GFNFRAL CARF SFRVICFS 1. Examinations and recall services, check -ups and cleaning of teeth 2. Palliative treatment 3. Endodontic treatment 4. Space maintainer 5. X -rays 6. Oral surgery 7. Periodontal treatment 8. Normal extraction of teeth 9. Silver and synthetic permanent fillings, crowns and jackets 10. Fixed bridges consisting of crowns or jackets 11. Dentures and removable bridges DFll1CTIRI E $50 per individual per calendar year. COINS' IRANCF Plan pays 80% of first $1,250 of eligible expenses per calendar year. DFNTAI RATFS (PFR MONTH) Employee Dental Dependent Dental Family Dental $28.91 S42.50 $71.41 ORTHODONTIC CARE BFNFFIT Lifetime Maximum Benefit - $1,000 per individual. SUMMARY OF ORTHODONTIC CARF 1. Diagnostic procedures 2. Appliances for tooth guidance and control of harmful habits 3. Retention appliances 4. Comprehensive treatment with fixed and removable appliances for correction of malocclusion in permanent, primary and mixed dentition 5. Orthodontic treatment must be completed prior to attainment of age 19. J IFFTIMF DFDl1CTIRI F $50 per individual. COINS( JRANCF Plan pays 50% of first $2,000 of eligible expenses per individual in their lifetime. STAND ALONE - (Without Health) Employee Dental Dependent Dental Family Dental $32.30 S47 60 $79.90 Dental coverage written in the Florida Municipal Insurance Trust is subject to a 25% participation of those employees quoted. * ** This summary was designed only to give you a brief description of benefits provided and does not include all of the provisions, limitations or exclusions in the policies. In an actual claim situation, the policy provisions, limitations, exclusions will apply. If this outline disagrees with the Plan Document in any way, the Plan Document will govern. FLORIDA MUNICIPAL INSURANCE TRUST DENTAL BENEFIT PLAN SUMMARY Reasonable and customary limits will apply to all covered eligible expenses. GFNFRAI DFNTAI CARF Calendar Year Maximum $1,000 Deductible $50 calendar year After the deductible has been met, unless otherwise stated, the following coinsurance will apply: This plan will pay 100% preventative services, not subject to the calendar year deductible, as follows: 1. Oral examinations 2. Dental X -rays (Bitewings twice per calendar year, Full Mouth or Panoramic once every 2 years) 3. Fluoride application (for dependents under age 15) 4. Prophylaxis This plan will pay 80% for basic dental services as follows: 1. Emergency treatment for pain 2. Space maintainers 3. Dental X -rays 4. Biopsies of oral tissue 5. Pulp vitality tests 6. Fillings 7. Extractions 8. Oral Surgery 9. Endodontics 10. Periodontics This plan will pay 50% for dental restorations and specialty services as follows: 1. Inlays, onlays 2. Crowns 3. Bridges, dentures SCHFfIII F OF ORTHODONTIC RFNFFIT (applies only to eligible dependents under age 19). Lifetime maximum (per person) Lifetime deductible $1,000 $50 per person Covered eligible expenses are payable after the deductible at 50 %. 1. Diagnostic procedures. 2. Appliances for tooth guidance and control of harmful habits. 3. Retention Appliances. 4. Comprehensive treatment with fixed and removable appliances for correction of malocclusion in permanent, primary and mixed dentition. These summaries are designed only to give you a brief description of the benefits provided and does not include all of the provisions, limitations or exclusions in the policies. In an actual claim situation, the policy provisions, limitations, exclusions will apply. If this outline disagrees with the Plan Document in any way, the Plan Document will govern. CLAIM ADMINISTRATOR. Florida League of Cities, Inc. Claims Center P.O. Box 538135 (407) 245 -0725 Orlando, FL 32853 -8135 (800) 756 -3042 GROUP VISION VISION SERVICE PLAN SCHEDULE OF BENEFITS f)FDL JCTIRI F A deductible amount of $10.00 is required for any service(s) rendered payable out of pocket by the eligible person to the panel doctor at the time of service. COVFRFD FXPFNSFS VISION EXAMINATION The primary purpose of the Vision Service Plan is to provide for professional vision examination and care. This examination comprises an analysis of the vision functions, including the prescription and supply of glasses where indicated. J ENSFS AM") FRAMFS A. LENSES - The VSP Panel Doctor will order the proper lenses from a VSP approved laboratory. VSP provides any necessary lenses, including single vision, bifocal, trifocal or other more complex and expensive lenses, when necessary for the patient's visual welfare. This assures the finest American - made lenses and quality workmanship. The doctor verifies the accuracy of the finished lenses. B. FRAMES - The patient is assisted in the selection of frames. VSP provides a wide selection of quality frames. Because of the cosmetic nature of frames and the rapidly changing styles, VSP has a limit on the cost of the frames provided under the program. The limit is designed to cover a majority of frames in current use. Patients who select frames that exceed the limit are required to pay the additional wholesale cost, plus a modest additional fee. C. MEDICALLY NECESSARY CONTACT LENSES - Contact lenses are allowed under the program in any of these instances provided prior approval is obtained from VSP by your doctor with documentation. 1) Following cataract surgery. 2) When visual acuity cannot be corrected to 20/70 in the better eye except by use of contact lenses. 3) Anisometropia of greater than 350 diopters and asthenopia or diplopia, with spectacles. 4) Keratoconus diagnosis where contact lenses is the treatment of choice. 5) Monocular aphakia and /or binocular aphakia where the doctor certifies medically necessary contact lenses are necessary for safety and rehabilitation to an occupational productive life. All five (5) categories of "medically necessary" contacts are subject to coordination of benefits with the medical insurance carriers. VSP will provide the contacts or glasses, but not both. D. COSMETIC CONTACT LENSES - When cosmetic contact lenses are selected, an indemnity allowance will be made in lieu of all other services. HOW OFTFN SFRVICFS ARF AVAII ARI F A. A VISION EXAMINATION - is available to each covered person every 12 months. B. LENSES - Are available every 12 months when required. C. FRAMES - Are available every 24 months. 1 IMITATION EXTRA COST - The plan is designed to cover visual needs rather than elective materials. If any of the following are selected and the VSP doctor does not receive prior authorization, there will be an extra charge: a) Oversized lenses b) A frame costing more than plan allowance c) Tinted or photochromic lenses (other than Pink 1 and 2) d) Coated lenses e) No -line bifocals (blended type) and progressive lenses f) Cosmetic Faceting g) Other cosmetic items. ITEMS NOT COVERED: a) Orthoptics or vision training b) Subnormal vision aids c) Aniseikonia lenses d) Two pair of glasses in lieu of bifocals e) Plano (non - prescription) lenses f) Cosmetic contact lenses. Replacement or repair of lost or broken lenses and frames, except at normal intervals. Medical or surgical treatment of the eyes. Services or materials provided as a result of any Workers' Compensation Law, or similar legislation, or obtained through or required by any government agency or program whether Federal, State or any subdivision thereof. Any eye examination required by an employer as a condition of employment, unless agreed upon in writing by VSP and included in the original contract. Di JAI CHOICF C:OVFRAC=,F Eligible persons not wishing to secure services from a Vision Service Plan Doctor may secure services from a non - participating doctor and submit bills for reimbursement. The amounts reimbursed are limited and may not cover the full charges. Fl IGIRILITY Each group electing vision care must maintain their vision care coverage for a minimum of one year from the time of inception. All employees and dependents who meet the eligibility requirements of their enrolled group are covered for vision care benefits. Neither employees nor dependents have the right to individually select vision care coverage. Requirements for participation are: a) 100% of all city employees, or b) 100% of all City employees carrying any coverages with FMIT. PRFMIUM RATFS• Employee $ 5.74 Dependent $ 8 43 Family Total $14.17 THE FIRST HEALTH NETWORK Internet Provider Directory City of Okeechobee Current As Of: May 30, 2003 QFirst Health. This Provider Directory is provided by First Health Group Corp. to present to you information on hospitals, physician and other providers who have agreed to provide their usual services to you at specially contracted rates of payment. All decisions about the type of care you receive are the responsibility of you and the physician whom you select. The quality and results of the care provided are the responsibility of the physician. Some health services may be provided by resident physicians under the supervision of the listed physicians. While First Health Group Corp. makes every effort to maintain accurate and up- to-date information, we cannot be responsible for any omissions or errors after publication. Please confirm provider participation prior to your visit. Okeechobee County Hospitals Okeechobee County Hospitals The First Health® Network Internet Provider Directory Current As Of: May 30, 2003 QFirst Health® This Provider Directory is provided by First Health Group Corp. to present to you information on hospitals, physicians and other providers who have agreed to provide their usual services to you at specially contracted rates ofpayment. All decisions about the type of care you receive are the responsibility of you and the physician whom you select. The quality and results of the care provided are the responsibility of the physician. Some health services may be provided by resident physicians under the supervision of the listed physicians. While First Health Group Corp. makes every effort to maintain accurate and up -to -date information, we cannot be responsible for any omissions or errors after publication. Please confirm provider participation prior to your visit. 1 Okeechobee County Hospitals Directory Criteria Product: FIRST HEALTH HOSPITAL NETWORK Sorted By: City Counties Included: OKEECHOBEE States Included: FLORIDA The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited. 2 Okeechobee County Hospitals OKEECHOBEE OKEECHOBEE HOSPITAL INC DBA RAULERSON HOSPITAL (863) 763-2151 1796 HIGHWAY 441 N OKEECHOBEE, FL 34973 THIS LIST IS SUBJECT TO CHANGE The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited. 3 Okeechobee County Facilities Okeechobee County Facilities The First Health® Network Internet Provider Directory Current As Of: May 30, 2003 QFirst Health This Provider Directory is provided by First Health Group Corp. to present to you information on hospitals, physicians and other providers who have agreed to provide their usual services to you at specially contracted rates of payment All decisions about the type of care you receive are the responsibility of you and the physician whom you select. The quality and results of the care provided are the responsibility of the physician. Some health services may be provided by resident physicians under the supervision of the listed physicians. While First Health Group Corp. makes every effort to maintain accurate and up -to -date information, we cannot be responsible for any omissions or errors after publication. Please confirm provider participation prior to your visit. 7 Okeechobee County Facilities Directory Criteria Product: FIRST HEALTH FACILITY CARE NETWORK Sorted By: City Counties Included: OKEECHOBEE States Included: FLORIDA The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited 2 Okeechobee County Facilities OKEECHOBEE LAB CORP FLORIDA (863) 357-7715 1008 N PARROTT AVE OKEECHOBEE, FL 34972 LAKE OKEECHOBEE REGIONAL CANCER CENTER (863) 763-7100 301 NE 19TH DR OKEECHOBEE, FL 34972 LOOKADOO SKYLINE LAB (863) 357-2666 1006 N PARROTT AVE OKEECHOBEE, FL 34972 MEDFOCUS FLORIDA (800) 398-8999 204 SE PARK ST OKEECHOBEE, FL 34972 MEDFOCUS FLORIDA (800) 398-8999 115 NE 3RD ST #A OKEECHOBEE, FL 34972 ONCOLOGY ASSOCIATES FL (863) 763-7100 301 NE 19TH DR OKEECHOBEE, FL 34972 OPEN MRI OF OKEECHOBEE (863) 824-6736 115 NE 3RD ST OKEECHOBEE, FL 34972 SURGERY CENTER OF OKEECHOBEE INC (863) 357-6220 1655 US HIGHWAY 441 OKEECHOBEE, FL 34972 THIS LIST IS SUBJECT TO CHANGE The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited 3 Okeechobee County Physicians Okeechobee County Physicians The First Health® Network Internet Provider Directory Current As Of: May 30, 2003 9First Health. This Provider Directory is provided by First Health Group Corp. to present to you information on hospitals, physicians and other providers who have agreed to provide their usual services to you at specially contracted rates of payment. All decisions about the type of care you receive are the responsibility of you and the physician whom you select. The quality and results of the care provided are the responsibility of the physician. Some health services may be provided by resident physicians under the supervision of the listed physicians. While First Health Group Corp. makes every effort to maintain accurate and up -to -date information, we cannot be responsible for any omissions or errors after publication. Please confirm provider participation prior to your visit. Okeechobee County Physicians Directory Criteria Product: FIRST HEALTH OUTPATIENT CARE NETWORK Sorted By: Specialty, City Counties Included: OKEECHOBEE States Included: FLORIDA The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited 2 Okeechobee County Physicians ANESTHESIOLOGY OKEECHOBEE MID FLORIDA ANESTHESIA ASSOCIATES (863) 763-7015 1655 US HIGHWAY 441 OKEECHOBEE, FL 34972 MW FLORIDA ANESTHESIA ASSOCIATES (863) 763-7015 1796 US HIGHWAY 441 OKEECHOBEE, FL 34972 MW FLORIDA ANESTHESIA ASSOCIATES (863) 763-7015 300 NW 5TH ST #312 OKEECHOBEE, FL 34972 CARDIOVASCULAR DISEASE OKEECHOBEE ARAIN, SHAKOOR A (863) 467-9400 1600B SW 2ND AVE OKEECHOBEE, FL 34974 RIAZ, MOHAMMAD (863) 467 -1156 204 NE 19TH DR OKEECHOBEE, FL 34972 CHIROPRACTIC MEDICINE OKEECHOBEE DOUGLAS, EDWARD W (863) 763 -4320 916 NW PARK ST OKEECHOBEE, FL 34972 PLATT, KEVIN (863) 763-2400 280 SW 32ND ST OKEECHOBEE, FL 34974 STEPHENS, PETER W (863) 763-0880 375 SW 32ND ST OKEECHOBEE, FL 34974 CRITICAL CARE MEDICINE OKEECHOBEE SHAKOOR, ARIF (863) 357-2300 265 NE I9TH DR OKEECHOBEE, FL 34972 DERMATOLOGY OKEECHOBEE SCHIFF, THEODORE A (863) 467-6767 301 NE 19TH DR OKEECHOBEE, FL 34972 EAR NOSE & THROAT (OTOLARYNGOLOGY) OKEECHOBEE BEQUER, NAPOLEON G (863) 357-3333 212 NE I9TH DR OKEECHOBEE, FL 34972 EAR NOSE & THROAT (OTOLARYNGOLOGY) OKEECHOBEE BERGHASH, LESLIE R (863) 357-7791 1916 US HIGHWAY 441 OKEECHOBEE, FL 34972 EAR NOSE & THROAT (OTOLARYNGOLOGY) OKEECHOBEE LANZA, JOHN T (863) 357-7791 1916 US HIGHWAY 441 OKEECHOBEE, FL 34972 EMERGENCY MEDICINE OKEECHOBEE SCOTT, JOSEPH A (863) 763-2151 1796 US HIGHWAY 441 OKEECHOBEE, FL 34972 FAMILY PRACTICE OKEECHOBEE ARAGON, GLORIA R (863) 763 -6496 1004 N PARROTT AVE OKEECHOBEE, FL 34972 HELLER, LELAND M (863) 467-8771 109 NE 19TH DR OKEECHOBEE, FL 34972 SWEDA, STANLEY H (863) 763 -1107 204 SE PARK ST OKEECHOBEE, FL 34972 GENERAL PRACTICE OKEECHOBEE CROUCH, JOHN C (863) 357-3600 115 NE 3RD ST #C OKEECHOBEE, FL 34972 GENERAL VASCULAR SURGERY OKEECHOBEE KOTHALANKA, RAMA (863) 467-5873 107 NE 19TH DR OKEECHOBEE, FL 34972 GERIATRIC MEDICINE OKEECHOBEE MAVROIDES, CHRISTOPHER J (863) 763-5666 1922 US HIGHWAY 441 OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE COLLINS, EVAN M (772) 219-1080 250 NE 2ND AVE OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE DELOACH, VICTOR E (863) 763-7481 308 NW 5TH AVE OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE GARCIA, TRINIDAD E (863) 763-6427 GASTROENTEROLOGY 306 NE I9TH DR OKEECHOBEE, FL 34972 OKEECHOBEE CHANG, JOHN (863) 357-0888 235 NE 19TH DR OKEECHOBEE, FL 34972 HAAS, KENNETH F (863) 357-7447 1930 US HIGHWAY 441 OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE HUSAIN, SURAIYA (863) 763-8000 1300 N PARROTT AVE OKEECHOBEE, FL 34972 GYNECOLOGY (NO OB) OKEECHOBEE THOMSON JR, ALTON (561) 219-1080 250 NE 2ND AVE OKEECHOBEE, FL 34972 HEAD & NECK SURGERY OKEECHOBEE BERGHASH, LESLIE R (863) 357-7791 1916 US HIGHWAY 441 OKEECHOBEE, FL 34972 LANZA, JOHN T (863) 357 -7791 1916 US HIGHWAY 441 OKEECHOBEE, FL 34972 HEMATOLOGY OKEECHOBEE AKHTAR, VASEEM S (863) 467-9000 1101 N PARROTT AVE OKEECHOBEE, FL 34972 INTERNAL MEDICINE OKEECHOBEE AHMED, IQBAL (863) 357-6030 202 NE I9TH DR OKEECHOBEE, FL 34972 AKHTAR, VASEEM S (863) 467 -9000 1101 N PARROTT AVE OKEECHOBEE, FL 34972 ARAGON, CANDIDO P (863) 763 -6496 1004 N PARROTT AVE OKEECHOBEE, FL 34972 ARAIN, SHAKOOR A (863) 467 -9400 1600B SW 2ND AVE OKEECHOBEE, FL 34974 BERGER, JAY S (863) 467-1117 1105 N PARROTT AVE OKEECHOBEE, FL 34972 CHAUDHARY, MUHAMMAD A (863) 763-1917 206 NE 19TH DR OKEECHOBEE, FL 34972 HAAS, KENNETH F (863) 357-7447 1930 US HIGHWAY 441 OKEECHOBEE, FL 34972 KHAN, SAEED A (863) 467-4788 1924 US HIGHWAY 441 OKEECHOBEE, FL 34972 KOTHALANKA, JANIKAMMA (863) 467-5873 107 NE I9TH DR OKEECHOBEE, FL 34973 LADIA, FELIPE P (863) 763-6431 210 NE 1 9TH DR OKEECHOBEE, FL 34972 LADIA, LILIA D (863) 763-6431 210 NE I9TH DR OKEECHOBEE, FL 34972 MAVROIDES, CHRISTOPHER J (863) 763 -5666 1922 US HIGHWAY 441 OKEECHOBEE, FL 34972 MEHANNI, MAGED A (863) 763 -3622 300 NW 5TH ST #300 OKEECHOBEE, FL 34972 NAEEM,TAHIR (863) 357-0104 1924 US HIGHWAY 441 OKEECHOBEE, FL 34972 RIAZ, MOHAMMAD (863) 467-1156 204 NE 19TH DR OKEECHOBEE, FL 34972 SHAKOOR, ARIF (863) 357-2300 265 NE 19TH DR OKEECHOBEE, FL 34972 MEDICAL ONCOLOGY OKEECHOBEE AKHTAR, VASEEM S (863) 467-9000 1101 N PARROTT AVE OKEECHOBEE, FL 34972 MULTISPECIALTY CLINIC OKEECHOBEE JUPITER HAND REHABILITATION CENTER INC (863) 357-4994 210 NE 3RD AVE OKEECHOBEE, FL 34972 MULTISPECIALTY FACILITY OKEECHOBEE ALLIANCE ANESTHESIA P A (863) 763 -7015 300 NW 5TH ST #312 OKEECHOBEE, FL 34972 FLORIDA COMMUNITY HEALTH CENTERS INC (863) 763-1951 1100 N PARROTT AVE OKEECHOBEE, FL 34972 THIS LIST IS SUBJECT TO CHANGE The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited 3 Okeechobee County Physicians FLORIDA COMMUNITY HEALTH CENTERS INC (863) 763-7481 308 NW 5TH AVE OKEECHOBEE, FL 34972 NEUROLOGY OKEECHOBEE ALDANA, PETER R (863) 763 -5181 115 NE 3RD ST #C OKEECHOBEE, FL 34972 ALI, ABULFAZAL S (863) 357-2777 225 NE 19TH DR OKEECHOBEE, FL 34972 OBSTETRICS & GYNECOLOGY OKEECHOBEE COLLINS, EVAN M (772) 219-1080 250 NE 2ND AVE OKEECHOBEE, FL 34972 GONZALEZ, PABLO R (863) 763-7481 308 NW 5TH AVE OKEECHOBEE, FL 34972 THOMSON JR, ALTON (561) 219-1080 250 NE 2ND AVE OKEECHOBEE, FL 34972 OCCUPATIONAL THERAPY OKEECHOBEE DURAND, DONNA (863) 357-4994 210 NE 3RD AVE OKEECHOBEE, FL 34972 WILLETTE, MICHAEL (863) 357-4994 210 NE 3RD AVE OKEECHOBEE, FL 34972 OPHTHALMOLOGY OKEECHOBEE ESPIRITU, MIGUEL A (863) 467-0533 304 NE 19TH DR OKEECHOBEE, FL 34972 KELLY, KEVIN T (863) 467-4111 710 S PARROTT AVE OKEECHOBEE, FL 34974 KELLY, KEVIN T (863) 467-4111 8551 W SUNRISE BLVD OKEECHOBEE, FL 34974 ORTHOPEDIC SURGERY OKEECHOBEE SLUTSKY, BRADFORD A (863) 763-8100 1920 US HIGHWAY 441 OKEECHOBEE, FL 34972 PAIN MANAGEMENT OKEECHOBEE MID FLORIDA ANESTHESIA ASSOCIATES (863) 763-7015 1655 US HIGHWAY 441 OKEECHOBEE, FL 34972 MID FLORIDA ANESTHESIA ASSOCIATES (863) 763 -7015 1796 US HIGHWAY 441 OKEECHOBEE, FL 34972 MID FLORIDA ANESTHESIA ASSOCIATES (863) 763-7015 300 NW 5TH ST #312 OKEECHOBEE, FL 34972 PATHOLOGY OKEECHOBEE HUSSAIN, MUSHTAQ (863) 467-7084 210 NW PARK ST #204 OKEECHOBEE, FL 34972 SCHIFF, THEODORE A (863) 467-6767 301 NE 19TH DR OKEECHOBEE, FL 34972 PEDIATRICS OKEECHOBEE ARAGON, GLORIA R (863) 763 -6496 1004 N PARROTT AVE OKEECHOBEE, FL 34972 BROWN, FRED D (863) 763 -1951 1100 N PARROTT AVE OKEECHOBEE, FL 34972 HUSSAIN, ANJUM P (863) 467-8398 255 NE 19TH DR OKEECHOBEE, FL 34972 ROBSHAW, CHRISTOPHER (863) 357-1117 1100 N PARROTT AVE OKEECHOBEE, FL 34972 PHYSICAL THERAPY OKEECHOBEE KIRTON, CHERYL L (863) 467-6669 332 SW 32ND ST OKEECHOBEE, FL 34974 NEW AMERICAN PHYSICAL THERAPY (863) 763-7773 1103 N PARROTT AVE OKEECHOBEE, FL 34972 NOORUDDIN, MUHAMMAD S (863) 763 -7733 1103 N PARROTT AVE OKEECHOBEE, FL 34972 PODIATRIC SURGERY OKEECHOBEE GARVIN, MICHAEL A (863) 357 -1166 105 NE 19TH DR OKEECHOBEE, FL 34972 PARRATTO, SCOTT F (863) 467 -4311 1105 N PARROTT AVE OKEECHOBEE, FL 34972 PSYCHIATRY OKEECHOBEE ALI, ABULFAZAL S (863) 357-2777 225 NE 19TH DR OKEECHOBEE, FL 34972 PULMONARY DISEASE OKEECHOBEE MEHANNI, MAGED A (863) 763-3622 300 NW 5TH ST #300 OKEECHOBEE, FL 34972 SHAKOOR, ARIF (863) 357-2300 265 NE I9TH DR OKEECHOBEE, FL 34972 RADIATION ONCOLOGY OKEECHOBEE HARTER, DAVID J (863) 467-9500 1115 N PARROTT AVE OKEECHOBEE, FL 34972 KRIMSLEY, ALAN S (863) 467-9500 1115 N PARROTT AVE OKEECHOBEE, FL 34972 KUMAR, RAMESH T (863) 467-9500 1115 N PARROTT AVE OKEECHOBEE, FL 34972 WOODY III, RONALD H (863) 467-9500 1115 N PARROTT AVE OKEECHOBEE, FL 34972 REHAB & OCCUPATIONAL MEDICINE CTR OKEECHOBEE JUPITER HAND REHABILITATION CENTER INC (863) 357-4994 210 NE 3RD AVE OKEECHOBEE, FL 34972 SURGERY OKEECHOBEE HUSAIN, MUZAFFAR (863) 763 -8000 1300 N PARROTT AVE OKEECHOBEE, FL 34972 KURTIN, ADAM D (772) 219-4026 250 NE 2ND AVE OKEECHOBEE, FL 34972 SANTELICES, ARMANDO A (863) 467-8181 212 NE 19TH DR OKEECHOBEE, FL 34972 UROLOGY OKEECHOBEE PANGILINAN, TRISTAN H (863) 467-7666 200 NE 19TH DR OKEECHOBEE, FL 34972 SIGALOW, DAVID A (863) 763-0217 215 NE 19TH DR OKEECHOBEE, FL 34972 YOUNG, MARVIN J (863) 467-0909 245 NE 19TH DR OKEECHOBEE, FL 34972 WORK HARDENING CENTER OKEECHOBEE JUPITER HAND REHABILITATION CENTER INC (863) 357-4994 210 NE 3RD AVE OKEECHOBEE,FL34972 THIS LIST IS SUBJECT TO CHANGE The information herein is protected proprietary information of First Health. Use of this information for any purpose other than for which it is provided is prohibited. 4 ORIGINAL q1. i r =, 1sr ;��` t� PUBLIC RISK MANAGEMENT OF FLORIDA (PRM) HEALTH PLAN Proposal for Group Health Insurance For: City of Okeechobee Bid Number: FIN 01-00-05-02 July 5, 2002 Presented By: RICHARD G.SCHELL Area Assistant Vice President Timothy R.Reynen Account Executive Arthur J. Gallagher&Co. Gallagher Benefit Services One Boca Place 2255 Glades Road, Suite 400E Boca Raton,FL 33431 (561)995-6706 . PUBLIC RISK MANAGEMENT OF FLORIDA (PRM) HEALTH PLAN TABLE OF CONTENTS Section I Introduction Section II Medical Plan Section III Dental Plan Section IV Life Insurance Plan Section V Blue Cross Blue Shield of Florida Gallagher Benefit Services Section VI Current PRM Members Section VII Agreement to Participate PRM Bi-Laws Section VIII Benefit Summary Comparison AM Best Ratings 1 i t PUBLIC RISK MANAGEMENT OF FLORIDA (PRM) HEALTH PLAN TABLE OF CONTENTS Section I Introduction Section II Medical Plan Section III Dental Plan Section IV Life Insurance Plan Section V Blue Cross Blue Shield of Florida Gallagher Benefit Services Section VI Current PRM Members Section VII Agreement to Participate PRM Bi-Laws Section VIII Benefit Summary Comparison AM Best Ratings 1 t � Gallagher Benefit Services, Inc. A Subsidiary of Arthur J. Gallagher & Co. July 3, 2002 Lola Parker, Account Supervisor City of Okeechobee 55 S.E. Third Avenue Okeechobee, PL 34974 Re: Public Risk Management Medical, Dental and Life Proposal Dear Lola, We appreciate the opportunity to present the enclosed Public Risk Management Health Trust proposal. The proposal contains quotes for the High Option PPO, Low Option PPO, Blue Care HMO as well as the PRM Dental and Life Insurance program. The medical rates illustrated would be for the period August 1, 2002 through September 30, 2003, to coincide with the PRM plan year (a fourteen month contract). The Dental rates are effective August 1, 2002 through September 30, 2002. The Life Insurance rates illustrated would be from August 1, 2002 through September 30, 2004. The PRM Health Trust, like the P&C Pool, will offer the City of Okeechobee increased value and the opportunity to provide a more stable renewal process as health trends continue to escalate. Groups with good claims experience receive additional credit at renewal. The Trust requires a two-year commitment from the City of Okeechobee in order to participate. The advantages of self-funding and the pooling concept are the results of long term commitment as demonstrated by the continued success of the PRM program. Should you have any questions, please contact me or Tim Reynen at 561-995-6706. Again, thank you for the opportunity to provide the City of Okeechobee a proposal from the Public Risk Management Health Trust. Sincerely, .AL-4.1 44e- 1 TR. Richard G. Schell Area Assistant Vice President encl. One Boca Place 2255 Glades Road, Suite 400 E Boca Raton, FL 33431 /� 561.995.6706 G , Fax 561.995.6708 l I-:I.I.HK,1 i l;yl,7511.,�H www.alg.com 9 ' INTRODUCTION Gallagher Benefit Services, a division of Arthur J. Gallagher & Co., is pleased to provide the enclosed information on behalf of Public Risk Management of Florida concerning the benefit programs available through the PRM Health Plan. PRM is a purchasing cooperative of governmental agencies founded in 1988 for the purpose of banding together to obtain the most competitive contracts for provision of Property & Casualty and Employee Benefit insurances. Arthur J. Gallagher & Co. acts as insurance consultant and broker to the PRM risk pools, working with the membership and their individual consultants to provide quality programs to participating entities. Members of the Property& Casualty risk pool have first hand knowledge of the expertise and experience Arthur J. Gallagher & Co. brings to the membership. Gallagher Benefit Services brings the same talents to the Employee Benefits arena, providing the PRM membership with expertise and guidance through the quickly changing and heavily mandated employee benefits areas. The PRM Health Plan is governed by a Board of Directors which meets quarterly to review plan operation, financials, legislative issues and any other pertinent information. Each participating entity delegates its' own Board Member, and each entity receives one vote. Each member has input regarding the plan, future enhancements, funding levels, etc. The plan year begins on October 1 of each year. Due to budgetary requirements, renewal discussions begin in April and are finalized at the end of June each year. All contracts and funding levels are based on an October 1 through September 30 plan year, although multi year rate guarantees are obtained from the carriers whenever possible. Medical coverage is required for participation in the PRM Health Plan. Other coverages offered as part of the PRM Health Plan to participating entities are dental, life, AD&D and Dependent Life insurances. These are offered for the convenience of the membership and are not required for participation. Gallagher Benefit Services is also available for and happy to work with individual entities and their advisors in the development of other additional employee benefits. 3 PR1VI MEDICAL PLAN The Medical program provided through the Public Risk Management of Florida Health Plan is a self funded plan using the Blue Cross Blue Shield of Florida network, administered by Blue Cross Blue Shield of Florida and reinsured by Lincoln Re. At the close of each fiscal year an actuarial report is submitted to the State of Florida pursuant to Florida Statute 112.08, and each year the State has certified the Plan to be actuarially sound and fully reserved. Administration/claims services, network access and excess reinsurance are negotiated by the PRM Health Plan on behalf of its' members. This allows the Plan to utilize a larger purchasing group and obtain more competitive rates than could be purchased individually. Any actual purchases must be approved by the Board of Directors. A choice of three medical plans is offered: A High Option PPO, a Low Option PPO, and an HMO. Participating entities may select whichever plan, or combination of plans, best suit their needs. Plan designs can be found on the following pages. As PRM members are first and foremost individual entities, all Personnel parameters, i.e.; employee eligibility for participation in the Plan, are decided by the individual entity. This allows the entities to retain the personnel practices in place. Prospective participants are initially underwritten based on individual group demographics and experience. 5 PUBLIC RISK MANAGEMENT OF FLORIDA SUMMARY OF BENEFITS HIGH OPTION PPO Lifetime Maximum $2,000,000 Copay $15 Per Office Visit at PPC Physician's Office(Deductible and Coinsurance Waived) Deductibles Calendar Year $200 (3 Per Family-Aggregate) Per Admission(Non PPC Hospital Only) $100 Coinsurance 90%of PPC Schedule For Utilization of PPC Providers; 70%Of Allowance For Utilization of Non- PPC Providers Prescription Drugs Rx Card(See Attached) Maternity Delivery,Pre-and Postpartum Care Subject to Deductible and Coinsurance Adult Well Care $15 Copay per visit up to $250 combined adult wellness and OB/GYN Well Child Care $15 Copay Per Well Child Care Visit at PPC Birth to Age 16 (18 Visits) Physician's Office; Out of Network, Deductible Waived Accident Care 90%of allowance(Deductible and Coinsurance waived) Mental Nervous Inpatient -30 Days; 30 Visits $15 Copay Per Office Visit at PPC Physician's Office; Per Calendar Year Outpatient- Up to 20 Visits Per Out of Network, Subject to Deductible and Calendar Year Coinsurance Partial Hospitalization Alcohol and Drug $2,500 Lifetime Maximum $15 Copay Per Office Visit at PPC Physician's Office; (Inpatient, Outpatient of any Combination) Out of network, Subject to Deductible and Coinsurance Skilled Nursing Facility 60 Days Per Calendar Year Home Health Care $12,000 Per Calendar Year Hospice $7,500 Lifetime Maximum Maximum Out-Of-Pocket Coinsurance Expense $1,500 Per Person Amount Per Calendar Year (Maximum 3 Per Family-Aggregate) 6 PUBLIC RISK MANAGEMENT OF FLORIDA HIGH OPTION PPO $7 GENERIC/$14 BRAND NAME PRESCRIPTION DRUG COVERAGE BlueScriptsm Pharmacy Program The cost of prescription drugs accounts for a significant share of your total health care expense. Blue Cross and Blue Shield of Florida has developed the BlueScript Pharmacy Program in an effort to help control the increasing cost of prescription drugs. BlueScript covers most medications, which,by law, may only be dispensed by a written prescription. No claims to file. When your employees select a BlueScript participating pharmacy, they simply present their Blue Cross and Blue Shield of Florida identification card and pay the applicable copayment amount for each covered prescription drug. The participating pharmacy will file the claim for your employees. Participating Pharmacies. More than 2,400 pharmacies participate in BlueScript statewide. Selection of a pharmacy for participating in BlueScript is based on quality,service,competitive pricing, convenience to our customers,and ability to provide all necessary information for claims filing. The pharmacy also must have on-line capability to provide timely verification of eligibility,coverage and pricing information at the point-of-sale. Non-Participating Pharmacies. Covered prescription drugs purchased at non-participating pharmacies are subject to the copayment amount and reimbursed at a lower percentage. At the point-of-sale,your employees will pay the full cost of the prescription drug and obtain an itemized receipt. It will be the employee's responsibility to complete a prescription drug claim form, attach the itemized paid receipt, and submit both to Blue Cross and Blue Shield of Florida for payment. After processing,payment will be made directly to the employee. BlueScript Key Features: • Broad accessibility with more than 2,400 participating pharmacies statewide,giving your employees more choices with convenient locations. • Participating pharmacies file claims for you, so you and your employees receive hassle-free service. • Program flexibility with coverage designed to meet your needs at the point-of-sale. • On-line claims information,providing quick answers on eligibility,pricing and coverage. BlueScript provides hassle-fee service with no claims to file when using a participating pharmacy. It's another way Blue Cross and Blue Shield of Florida is helping to control the high cost of health care. sMService mark of Blue Cross and Blue Shield of Florida,Inc. 7 PUBLIC RISK MANAGEMENT OF FLORIDA SUMMARY OF BENEFITS LOW OPTION PPO Lifetime Maximum $2,000,000 Copay $15 Per Office Visit at PPC Physician's Office(Deductible and Coinsurance Waived) Deductibles Calendar Year $500 (3 Per Family- Aggregate) Per Admission(Non PPC Hospital Only) $500 Coinsurance 80%of PPC Schedule For Utilization of PPC Providers; 60%Of Allowance For Utilization of Non- PPC Providers Prescription Drugs Rx Card(See Attached) Maternity Delivery,Pre- and Postpartum Care Subject to Deductible and Coinsurance Adult Well Care $15 Copay per visit up to $250 combined adult wellness and OB/GYN Well Child Care $15 Copay Per Well Child Care Visit at PPC Birth to Age 16 (18 Visits) Physician's Office;Out of Network,Deductible Waived Accident Care 80%of allowance(Deductible and Coinsurance waived) Mental Nervous Inpatient -30 Days; 30 Visits $15 Copay Per Office Visit at PPC Physician's Office; Per Calendar Year Outpatient- Up to 20 Visits Per Out of Network,Subject to Deductible and Calendar Year Coinsurance Partial Hospitalization Alcohol and Drug $2,500 Lifetime Maximum $15 Copay Per Office Visit at PPC Physician's Office; (Inpatient,Outpatient of any Combination) Out of network, Subject to Deductible and Coinsurance Skilled Nursing Facility 60 Days Per Calendar Year Home Health Care $2,500 Per Calendar Year Hospice $7,500 Lifetime Maximum Maximum Out-Of-Pocket Coinsurance Expense $1,500 Per Person Amount Per Calendar Year (Maximum 3 Per Family-Aggregate) 8 PUBLIC RISK MANAGEMENT OF FLORIDA LOW OPTION PPO $10 GENERIC/$25 BRAND NAME PRESCRIPTION DRUG COVERAGE BlueScriptSm Pharmacy Program The cost of prescription drugs accounts for a significant share of your total health care expense. Blue Cross and Blue Shield of Florida has developed the BlueScript Pharmacy Program in an effort to help control the increasing cost of prescription drugs. BlueScript covers most medications which, by law,may only be dispensed by a written prescription. No claims to file. When your employees select a BlueScript participating pharmacy, they simply present their Blue Cross and Blue Shield of Florida identification card and pay the applicable copayment amount for each covered prescription drug. The participating pharmacy will file the claim for your employees. Participating Pharmacies. More than 2,400 pharmacies participate in BlueScript statewide. Selection of a pharmacy for participating in BlueScript is based on quality,service, competitive pricing, convenience to our customers, and ability to provide all necessary information for claims filing. The pharmacy also must have on-line capability to provide timely verification of eligibility,coverage and pricing information at the point-of-sale. Non-Participating Pharmacies. Covered prescription drugs purchased at non-participating pharmacies are subject to the copayment amount and reimbursed at a lower percentage. At the point-of-sale,your employees will pay the full cost of the prescription drug and obtain an itemized receipt. It will be the employee's responsibility to complete a prescription drug claim form,attach the itemized paid receipt, and submit both to Blue Cross and Blue Shield of Florida for payment. After processing,payment will be made directly to the employee. BlueScript Key Features: • Broad accessibility with more than 2,400 participating pharmacies statewide, giving your employees more choices with convenient locations. • Participating pharmacies file claims for you,so you and your employees receive hassle-free service. • Program flexibility with coverage designed to meet your needs at the point-of-sale. • On-line claims information,providing quick answers on eligibility,pricing and coverage. BlueScript provides hassle-fee service with no claims to file when using a participating pharmacy. It's another way Blue Cross and Blue Shield of Florida is helping to control the high cost of health care. sMService mark of Blue Cross and Blue Shield of Florida, Inc. 9 PUBLIC RISK MANAGEMENT OF FLORIDA SUMMARY OF BENEFITS HMO PLAN Benefit Authorized Out of Pocket Maximum Individual $1,500 Family $3,000 Hospital per Admission Copay $250 Physician Office Services Primary Care Physician $10 Copay Specialist $10 Copay Office Surgery $10 Copay Routine Services $10 Copay Preventive Care $10 Copay Well Child Care $10 Copay Allergy Testing $0 Copay Allergy Immunization $10 Copay Annual GYN exam $10 Copay X-Ray& Lab $0 Copay Infertility Services $10 Copay Hospital Services: Inpatient $250 per Admission Copay Outpatient Hospital/Surgical $100 Copay Emergency Room $50 Copay Hospice Care $0 Copay Home Health Care $0 Copay $0 Copay Skilled Nursing Facility 90 days/yr. max Mental & Nervous Inpatient $250 Copay/admission; 30 days/yr. Outpatient $25 Copay/visit; 20 visits/yr. Substance Abuse Inpatient/Outpatient Inpatient $250 Copay/admission; Detox only Outpatient $15 Copay/visit; 20 visits/yr. Other Healthcare Providers(Ambulance,DME) $0 Copay Prescription Drug Program Drug Card: Generic $7.00 Copay Brand $14.00 Copay Mail Order: Generic $14.00 Copay Brand $28.00 Copay 10 , . City of Okeechobee • PRM Health Trust Rate Breakdown - Medical Effective: 8/1/02 - 9/30/02 ft,7eferre4,PruyiderOjA.,.;,iii,; ,,,r"::: ',,:p,j:''.';'c:'%;z::::,1:: :Einploy,06',* '4EniplOyee,i lEinplayee #iglidtiliOnV4:';NA'!::M: :AV:i6iiii14:60°i'AW;14.4,!A '2.:'4014,473/4;:;:.'siFinllY, Attachment Factor $450.90 $1,014.19 $941.26 $1,504.72. Specific Excess @ $80,000 $42.79 $96.25 $89.33 $142.81 Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $42.89 $42.89 $42.89 $42.89 PRM Administration $5.11 $5.11 $5.11 $5.11 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate $545.551 $1,162.301 $1,082.451 $1,699.39 Preferred Pr4A40P.,roic: ,,.: : 1,: .,:;:li,:sc:i;:,::::,-= 4:=: :: g'04)!oi-:'o:744 Employee Employee. Low izili:::ii '', . J:::'''T,:-,::4,:fi'fs :',.cfl.:::iiiiiii4,-W,,,!.,, S,.::::ii,,,$ai44-1-:'1*.tii4; •:' *itio0 - , Attachment Factor $392.28 $882.34 $818.90 $1,309.10 Specific Excess @ $80,000 $42.79 $96.25 $89.33 $142.81 Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $42.89 $42.89 $42.89 $42.89 PRM Administration $5.11 $5.11 $5.11 $5.11 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate $486.93 $1,030.451 $960.09 $1,503.77 Health Maintenance ,.:::::::,,,:', Organization Option ;, : ::;:-' ',-:,: ' ‘s,i-s,. :':;,'-''7!' .'-',, 1.'t' ,iiiiiiiiii4,4*: Employee e':: *,, ii-004 111u Car : : :‘ ,-• ' ': ':. : ': ' ,:", Enipi4ee,,', ;::'-'8piniSe:::'1' ;:A:Child'',' 4 Faintly Attachment Factor $378.75 $851.92 $790.66 $1,263.96 Specific Excess @ $80,000 $36.08 $81.15 $75.32 $120.40 Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $62.00 $62.00 $62.00 $62.00 PRM Administration $5.11 $5.11 $5.11 $5.11 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate $485.80 $1,004.041 $936.95 $1,455.33 , • City of Okeechobee PRM Health Trust Rate Breakdown - Medical Effective: 10/1/02 - 9/30/03 E Pr,,,q0tqATTO14#1,S9RiNit'i,VF*M.. MI* P.,,P1::PiX0.# 'i:',";E#14,1t40,4440110i, 1000iiifiiii:::rAMig'C'Ai'':::P4; ;,''S':;: .' -i1ilti*4'-,4':&:si191401ii itikAn'0***: Attachment Factor $450.90 $1,014.19 $941.26 $1,504.72 Specific Excess @ $80,000 $42.79 $96.25 $89.33 $142.81 Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $48.90 $48.90 $48.90 $48.90 PRM Administration $5.32 $5.32 $5.32 $5.32 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate I $551.77 $1,168.52 $1,088.67 $1,705.61 15' Cf0:•04Pro14071?r9: :: ,L;: -:';''':',:: '.,;,:: :::: , .!Pii0.19Y0:84i:;'';''PA401.00: ':AP4PA0):.0 Low Option ,1.: :::::,:f:: ,:;,,:''''::::::::, :'i' .:,iEnitilcii-e01:•: .: '::::N'5ii:$4gem:;14417ghttog '-:*****: Attachment Factor $392.28 $882.34 $818.90 $1,309.10 Specific Excess @ $80,000 $42.79 $96.25 $89.33 $142.81 Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $48.90 $48.90 $48.90 $48.90 PRM Administration $5.32 $5.32 $5.32 $5.32 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate $493.15 $1,036.671 $966.31 $1,509.99 ,) .:!,-,:: .,,i?„:. :,:;,::,4i554, , ,, ,, , ',040'St__,Ik.W'< 11. 1 :#44 grgoi.: 49!1:Poro,:: :,;‘;:''' !1: :::]-:•!?,gi,:gl :f;'::: :-'6-i:::gTntiv,Alif‘viA.9,„ :1,,„m.P41,,,. . tiii'oloo ;s,t',i'.!,:i,$1;01011 140-44;WO** Attachment Factor $378.75 $851.92 $790.66 $1,263.96 Specific Excess @ $80,000 $36.08 $81.15 $75.32 $120.40 Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $62.00 $62.00 $62.00 $62.00 PRM Administration $5.32 $5.32 $5.32 $5.32 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate $486.01 $1,004.25 $937.16 $1,455.54 i Conditions and Limitations: • Completion of Plan Sponsor Disclosure Form. Disclosure pertains to: 1) any claim relating to a serious medical condition, 2) each claim in the last 12 months that has exceeded or expected to exceed 50% of the specific deductible, 3) employees absent from work due to disability and dependents, retirees or COBRA beneficiaries who are hospital confined. • A Plan Document. The Excess Loss Policy cannot be issued until the Plan Document has been received and approved by Lincoln Re Risk Management Services. • Paid Claims experience from 4/1/02 — 9/30/02. • A census of final enrollment. Terms are subject to change if final enrollment varies by more than 15% from proposal assumptions. • Capitation is included as an eligible expense under the aggregate. • Minimum participation requirement is 75% of eligible employees. Employees who waive coverage on this plan due to coverage elsewhere will be considered non participating. • We assume implementation of the proposed PRM schedule of benefits with Blue Cross & Blue Shield. • The proposed program complies with State and Federal Statutes currently and in the future. HIPAA compliance is included. • Specific applies to all claims for all conditions for each individual. • Specific applies to the mother and each child separately. • The agent/broker is properly licensed and appointed with the carrier noted above for which business is written. • We assume the experience reflects a standard claims processing time of approximately two weeks from date of receipt to date paid by the Third Party Administrator. Terms are subject to change on a retrospective basis if subsequent experience demonstrates a significant, undisclosed backlog of claims. • Aggregate Monthly Settlement Option is included. • Medical coverage options outlined in the proposal are contingent upon network availability. Excess Loss Insurance Exclusions: • Transplant Services, except for human to human organ or tissue transplant procedures. • Expenses eligible for or covered by any worker's compensation, occupational disease law or similar law. • Losses due to war or any act of war. • Penalties, interest, fines or fees imposed under the Policyholder. • Punitive, exemplary, compensatory or extra-contractual damages paid by the Policyholder. • Losses resulting from any professional or other liability claims arising from services rendered by the Policyholder or any employee of affiliated organizations or person. • Expenses from which the Policyholder is eligible for or receives any payment or reduction in charges resulting from, but not limited to coordination of benefits or subrogation. • Sales or use taxes, surcharges, or other such taxes or assessments, unless Lincoln expressly agrees to make such payments as Lincoln agreed to with New York and Massachusetts surcharges. • Cost of claims administration or other administrative expenses and any expense for litigation involving disputed claims under the plan document. Swiss Re Lincoln National • r•� Health&Casualty Insurance Co. I' 7300 Corporate Center Drive Suite 205 Miami,Fl 33126-1222 • • Watts 800-352-0042 Voice 305-715-6145 Fax 305-715-6199 Plan Sponsor Disclosure Statement E-Mail:Eric_Hicks @SwissRe.com It is the intention of the Plan sponsor to purchase Excess Liability Insurance in connection with the funding of an employee welfare benefit plan. The following information is provided to the Excess Liability Carrier for use with the Plan Sponsor's application for coverage. Listed below are: A. Claims in the last 12 months exceeding 50%of the specific deductible level selected; B. Any current claims which may be potentially serious regardless of current claim amount; C. Dependents,retirees, or COBRA beneficiaries who are hospital confined within 30 days of this report; and D. Employees absent from work due to disability as of the date of this report. *CLAIMANT# **E/D/R/C DATE OF SEX DATE DIAGNOSIS OR NATURE OF CURRENT STATUS AND TOTAL BIRTH DISABLED DISABILITY PROGNOSIS BILLS TO • DATE($) * For purposes of confidentiality,please identify the claimants as claimant#1,#2, #3, etc. ** E=Employee, D=Dependent, R=Retiree, C=COBRA beneficiary(include date COBRA coverage is expected to terminate) The Plan Sponsor named below,through its authorized person,hereby represents that the above list is true,complete and accurate to the best of his/her knowledge and belief and that nothing has been knowingly or intentionally omitted. The Plan Sponsor acknowledges that,as a minimum,its claims administrator,utilization review vendor,and medical case management vendor participated in the collection of the above data. PLAN SPONSOR Authorized Person Address - Signature Date of Disclosure Title This information will be treated confidentially by the Excess Liability Carrier. Additional sheets may be attached. Number of Claims Listed Number of Sheets Attached www.lincolnre.com Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. PUBLIC RISK MANAGEMENT OF FLORIDA DENTAL PLAN The dental program provided through the Public Risk Management of Florida Health Plan is also a self funded plan. The dental plan is administered by Florida Combined Life, a division of Blue Cross Blue Shield of Florida, and reinsured by Lincoln Re as part of the overall plan. The dental program is included as part of the actuarial report submitted to the State of Florida annually pursuant to Florida Statute 112.08, and each year the State has certified the PRM Health Plan to be actuarially sound and fully reserved. Administration/claims services and excess reinsurance are negotiated by the PRM Health Plan on behalf of dental participants. This allows the Plan to utilize a larger purchasing group and obtain more competitive rates than could be purchased individually. Any actual purchases must be approved by the Board of Directors. The Dental Program provided through the Public Risk Management of Florida I-Iealth Plan is an indemnity plan without network or provider requirements. As in the medical plan, all Personnel parameters, ie; employee eligibility for participation in the Plan, are decided by the individual entity. Participation in the dental plan is not required for participation in the PRM Health Plan consortium. 12 • PUBLIC RISK MANAGEMENT OF FLORIDA DENTAL PLAN Benefits Maximum Basic Dental $1,500 per calendar year Orthodontia $1,500 lifetime (Available to dependent children under age 19 only) Deductible $50 per calendar year, per person (Waived for Preventive Services 2 per family and Orthodontia) Copayment percentage for: • Preventive Services 100% • Basic Services 80% • Major Services 50% • Orthodontia 50% Covered Dental Expenses include reasonable and customary necessary expenses incurred for the services and supplies listed below: Covered Preventive Services • Initial oral examination • Periodontic oral examinations, 2 per calendar year. • Prophylaxis, including cleaning, routine scaling and polishing, 2 per calendar year. • Topical Fluoride application once per calendar year for individuals under age 19. • Palliative (to relieve pain) emergency treatment and emergency oral examinations. • Sealants for individuals age 6 through 13 years of age, one application per 36 consecutive months. • Dental X-rays as follows: One set of full mouth x-rays every 36 months; 2 sets of bitewing x-rays per calendar year; Other dental x-rays as deemed necessary. • Space maintainers, except if covered under Orthodontia benefits. • Pulp vitality tests. • Caries susceptibility tests. 13 ' r • PUBLIC RISK MANAGEMENT OF FLORIDA DENTAL PLAN (Continued) Covered Basic Services • Fillings (amalgam, composite, plastic and acrylic). • Extractions. • Endodontics (root canal). • Recementing of crowns, inlays and/or bridges. • Biopsies of oral tissue. • Home visits by a physician or dentist when medically necessary in order to render a Covered dental service. • Oral surgery. • Apicoectomy. • Hemisection. • General anesthesia administered in connection with a covered dental service if administered by an individual licensed to administer general anesthesia, other than the dentist or physician performing the service for which administered. • Injection of antibiotic drugs. • Periodontics: Occlusal equilibration, when no restoration is involved; Gingivectomy and gingivoplasty; Gingival curettage; Scaling and root planing; Osseous surgery(osteoplasty and ostectomy), including flap entry and closure; Surgical Periodontic examination; Mucogingivoplastic surgery; Management of acute periodontal infection and oral lesions. • Denture adjustments, not including relining or rebasing. • Fixed bridge repair as follows: Replacement of broken pins; Replacement of broken pontic; Replacement of bridgework when the existing bridgework was installed at least 5years prior to its replacement and the existing bridgework cannot be made serviceable. • Repairs to existing removable denture (full or partial) as follows: Repair of broken complete or partial denture and/or replacement of broken teeth; Replacement or addition of teeth due to the extraction of natural teeth which occurred while covered under this Plan; Reattachment of damaged clasp or replacement of broken clasp; Replacement of denture when the existing denture was installed at least 5 years prior to its replacement and the existing denture cannot be made serviceable. 14 PUBLIC RISK MANAGEMENT OF FLORIDA DENTAL PLAN (Continued) Covered Major Services • Inlays (not part of bridge). • Onlays (not part of bridge). • Crowns (not part of bridge). • Inlays, onlays, gold foil restorations, crowns (including precision attachments for dentures). • Denture adjustments and relining and/or rebasing once each 36 months. • Dentures, full and partial, and bridges, fixed and removable as follows: Initial installation of dentures; Dentures to replace one or more natural teeth extracted while covered under these benefits; Initial installation of bridges; Bridgework to replace one or more natural teeth extracted while covered under these benefits (including inlays and crowns to form abutments); Six months of post-delivery care. Covered Orthodontia Services (available only to dependent children age 19 or less at the date treatment commences.) • Installations of orthodontic appliances and all orthodontic treatments concerned with the reduction or elimination of an existing malocclusion and conditions resulting from that malocclusion through correction of abnormally positioned teeth. • Diagnostic services, including examination, study models, radiographs and all other diagnostic aids used to determine orthodontic needs once each 5 years, commencing with the date of the initial visit to the dentist or physician. • Active and retentive orthodontic treatment for 24 consecutive months or less. Also, the amount of orthodontia charges included as covered expenses during the initial calendar year quarter of treatment will be limited to 30% of the total allowable charges for the cost of the entire orthodontia treatment. The balance of the covered expenses will be prorated over the remaining calendar year quarters of the treatment plan or 7 calendar year quarters, whichever is less. 15 City of Okeechobee Dental Plan Rates 8/01/02 - 9/30/03 Single: =,; _ � . ._.. Family: , $31.15 $63.76 4 PUBLIC RISK MANAGEMENT OF FLORIDA LIFE INSURANCE PLAN The Life Insurance Plan provided through the Public Risk Management of Florida Health Plan is fully insured and written by The Standard Insurance Company. Insured benefit per employee is elected by individual entity and may be based on salary or a flat amount. The standard PRM Life Plan benefits include Basic Life, Basic Accidental Death & Dismemberment and Dependent Life. Additional PRM Life Plan benefits include Supplemental employee and dependent life. Participation in the life insurance plan is not required for participation in the PRM Medical Plan Consortium. Gallagher Benefit Services would be happy to assist in alternate plans. 17 City of Okeechobee Life Insurance Rates 8/01/02 - 9/30/04 Basic Life Rate AD&D Rate $0.28 per $1,000 $0.03 per $1,000 SECTION V Blue Cross Blue Shield of Florida Gallagher Benefit Services 18 PUBLIC RISK MANAGEMENT OF FLORIDA BLUE CROSS BLUE SHIELD PROFILE OF SERVICES Blue Cross Blue Shield provides the following administrative services as part of their contract with the PRM Health Plan. • Claims Administration • Eligibility Maintenance • PPO/HMO Network • Customer Service • Employee Meetings/ Enrollment • Utilization Review, Pre-Certification, Case Management • PPO/HMO Claims Filing by Providers • Prescription Drug Card • Mail Order Drug Service • COBRA Administration • Reports Entities participating in the PRM Health Plan program will receive all of the above member services. Employees, entity administrators and providers will deal with Blue Cross representatives assigned exclusively to PRM for routine issues. Additionally, Blue Cross PPO providers will be responsible for obtaining pre-certification authorization and for filing PPO claims. We anticipate soft dollar savings to PRM Health Plan members in the form of less plan administration, less time resolving claims issues, less time reporting to various vendors, and less time answering employee questions and complaints. 19 PUBLIC RISK MANAGEMENT OF FLORIDA BLUE CROSS BLUE SHIELD ADVANTAGES • PRM commitment to pooling concept. Fourteen year track record of quality service and plan implementation. • Flexibility in plan designs offering two PPO's in addition to an HMO. • In addition to the Blue Cross Blue Shield service staff, PRM staff, and Gallagher Benefits Services assist in all areas of plan management. • Quarterly board meetings include Health Trust status reports, industry updates, and the sharing of ideas and concepts. • National recognition and acceptance of I.D. card. The ITS Program offers a reduction in changes and hold harmless against balance billing when employees incur a claim out-of-state with a participating Blue Cross/Blue Shield in that state. • Local presence throughout the state with walk-in service to track all customer inquiries for prompt resolution or questions. • Largest PPO network in Florida. Employees have more hospitals and doctors to choose from. The average reduction of billed charges results in savings of 35-45%. • Blue Cross/Blue Shield allowances are accepted as payment in full. No balance billing except for copy or deductible as co-insurance. Providers agree not to require full payment at time of service and providers will file the claim. • Network in and out of PPC network. Physicians and hospitals that participate with Blue Cross/Blue Shield, but not with PPC network agree to accept our allowance at the lower and will not balance. They will also file claim on behalf of employee. • Blue Cross/Blue Shield's Cobra Administration(CobraServe)simplifies and holds the account harmless for errors and omissions in the administration of the Cobra program. No annual fee. • Personal health advisor available 24 hours a day, 7 days a week. Toll free number to access a medical nurse confidentially and immediate answer employees health care questions and concerns. • Virtual Office 20 • PUBLIC RISK MANAGEMENT OF FLORIDA GALLAGHER BENEFIT SERVICES SCOPE OF SERVICES Gallagher Benefit Services is experienced in all facets of employee benefits. We provide services for our clients' benefit programs including, but not limited to, medical, dental, life, disability, cafeteria, drug card, vision, voluntary coverage, and long term care plans. The Scope of Services below reflects the services available to PRM members and their consultants/advisors for all lines of coverage contained in their employee benefit plans. A. Plan Analysis B. Benefit Analysis C. Financial Analysis D. Benefits Marketing E. Optional Services and Fees As a full service brokerage and consulting firm, Gallagher has extensive internal resources available, including but not limited to benefits brokerage and specialty services. All of these services can be provided or arranged by the Gallagher Benefit Services Boca Raton office. 1. Flexible Benefits/Cafeteria Plan Administration 2. ERISA Audits/Compliance Services 3. COBRA Administration 4. Capital Accumulation/Retirement Planning Services 5. Human Resource Outsourcing Services The Arthur J. Gallagher organization, and Gallagher Benefit Services, has extensive experience with a diverse client base utilizing self-funded and/or insured funding arrangements, as well as general plan administration. We have several specialty divisions allowing us to offer the most comprehensive employee benefit consulting services. Our first hand experience and variety of services makes us uniquely qualified to assist our clients in the design and implementation of their benefit plans. 21 CURRENT PRM MEMBERS /REFERENCES Gallagher Benefit Services -- Consultant One Boca Place, 2255 Glades Road, Suite 400E Boca Raton, FL 33430 Phone (561) 995-6706 Fax (561) 995-6708 Jeff Angello, Area President Richard Schell, Area Assistant Vice President Glen Volk, Vice President Actuarial Services Colleen Ramos, Account Coordinator Tim Reynen, Account Executive Colleen Ferguson, Technical Support PRM Administrative Office—7 Employees 2013 Altamont Avenue, Unit 25 Fort Myers, FL 33901 Phone (800) 367-1705 Fax (941) 476-8889 Ross D. Furry, Executive Director Judy Hearn, Assistant Executive Director/Secretary Desoto County Board of Commissioners—269 Employees 201 East Oak Street, Suite 202 Arcadia, FL 34266 Phone (863) 993-4808 Fax (863)993-4857 Paul Erickson, Human Resources and Community Services Director Glades County Board of Commissioners—98 Employees 500 Avenue J Moore Haven, FL 33471 Phone (863) 946-2140 Fax (863) 946-2860 Mary Ann Dotson, Administrative Secretary Hendry County Board of Commissioners—226 Employees 18 Hicopochee Avenue Labelle, FL 33935 Phone (863) 675-5221 Fax (863) 675-5317 Lester Baird, County Administrator Hendry County Sheriff's Department— 130 Employees 101 S. Bridge Street Labelle, FL 33935 Phone (941) 674-4630 FX (863) 674-4635 Susie Hicks, Personnel Town of Longboat Key— 133 Employees 501 Bay Isles Road Longboat Key, FL 34228-3196 Phone (941) 316-1999 Fax (941) 316-1656 Bonnie Mims, Administrative Services Director Okeechobee County Board of Commissioners— 179 Employees 304 N.W. 2"d Street, Room 109 Okeechobee, FL 34972 Phone (863) 763-9312 Fax (863) 763-9312 Robbie Chartier, Deputy County Administrator City of Punta Gorda—273 Employees 326 West Marion Avenue Punta Gorda, FL 33950-4492 Phone (941) 575-3302 Fax (941) 575-3310 Willard Beck, City Manager Sarasota-Manatee Airport Authority— 116 Employees 6000 Airport Circle Sarasota, FL 34243-2105 Phone (941) 359-5200 Fax (941) 359-5054 Martin Lange, Senior Director of Finance and Administration Levy County Board of Commissioners —222 Employees 355 South Court Street Bronson, FL 32621 Phone (352) 486-5217 Fax (352) 486-5167 Fred Moody, County Coordinator Hamilton County Board of Commissioners— 156 Employees 207 Northeast First Street, Room 106 Jasper, FL 32052 Phone (904) 792-1288 Fax (904) 792-3524 Greg Godwin, City Clerk City of Crystal River—53 Employees 123 North West Highway 9 Crystal River, FL 334428-3930 Phone (352) 795-6994 Fax (352)795-6351 Linda Stilson, Assistant to the Finance Director South Florida Conservancy District— 14 Employees 2852 US Highway 441 Belle Glade, FL 33430 Phone: (561) 996-2940 Fax: (561) 996-2960 Ron Graydon, General Manager ARTICLES OF ASSOCIATION AND BY-LAWS OF PUBLIC RISK MANAGEMENT OF FLORIDA (P RM) BE IT KNOWN THAT: The below named public agency or agencies of the State of Florida for the purpose of forming a risk management and self-insurance association pursuant to the terms of Florida Statutes Sections 768.28(15)(a), 440.57, and 163.01, Florida Interlocal Cooperation Act of 1969, do bind themselves contractually to and adopt these Articles of Association and By-Laws. Article 1 -Name and Duration 1.1 Name. The name of this association shall be Public Risk Management of Florida, referred to hereinafter as the Pool. Article 2 - Definitions and Purpose 2.1. Definitions. As used in this agreement, the following terms shall have the meaning hereinafter set out: "Annual Payments": The amount each Member must annually pay to fully fund the costs of the full operation of the Pool. "Aggregate Excess Insurance": Stop Loss Insurance purchased by the Pool from insurance companies and/or Lloyd's of London, or other similar entities, approved by the Board of Directors, or any committee appointed by the Board for such purpose, to protect the Pool from an accumulation of losses in any policy year should the "Loss Fund" be exhausted. Once the "Aggregate Excess Insurance" is triggered, any further losses within the "Self Insured Retention" will be paid by this coverage. "Fiscal Year": The fiscal year of the Pool shall begin on October IS` and end on September 30`h "Joint Self-Insurance" or "Self-Funded": A self-insurance or self-funded program in which Members agree to annual payments to fully fund the operations of the Risk Management Pool. "Loss Fund": The fund established to pay claims occurring within the "Self Insured Retention." The "Loss Fund" represents the maximum amount for which the Pool is exposed in a single fiscal period. 1 "Maintenance Deductible": The amount paid by the "Member" before the loss is paid by the "Self Insured Retention." This is a nominal amount designed to protect the "Loss Fund" from small claims. The "Maintenance Deductible" applies only to property, automobile physical damage and crime losses." "Members": The public agencies of the State of Florida which initially or later enter into the intergovernmental association established by this Intergovernmental Agreement. "Multi-Loss Coverage": This multiple loss protection limits a loss involving more than one line of coverage from one occurrence.(i.e. property, liability, workers' compensation) to one "Self Insured Retention." "Pool": Public Risk Management of Florida established pursuant to the Constitution and the Statutes of the State of Florida by this Intergovernmental Agreement. "Risk Management": A program attempting to reduce or limit casualty and property losses to Members and injuries to employees caused by or arising out of the operations of Members. Where claims arise the Pool will provide processing of claims, investigation, defense and settlement within the financial limits of the Pool as established in accordance with this Intergovernmental Agreement and will tabulate such claims, costs and losses. "Risk Management Pool": A fund of public monies established by the Pool to jointly self-insure and self-fund property coverages, general liability, automobile liability, professional liability, public officials' liability and workers' compensation, and any other coverage lines approved by the Board of Directors. "Self-Insurance": The decision by a public agency not to purchase insurance coverage for risks below certain limits; to seek and maintain immunities provided by law for a noninsured public agency; to rely upon its financial capabilities to pay covered losses which occur in case third-party claims are held valid and not barred or capped by available immunities: and to purchase some insurance to protect against catastrophic or aggregate losses. The purchase of liability insurance by the Pool or any of its Members is not intended to, and does not, waive sovereign immunity. Purchase of liability insurance shall only be pursuant to Florida Statutes, which allow for the purchase of insurance by the Pool without the waiver of sovereign immunity by the Pool or any of the Pool's Members and is not pursuant to any other statute of the State of Florida. "Self Insured Retention": A layer of assumed risk where the pool self-insures a pre- determined amount of loss per occurrence. "Specific Excess Insurance": Insurance purchased by the Pool from insurance companies and/or Lloyd's of London, approved by the Board of Directors, or any committee appointed by the Board for such purpose, that provides catastrophe coverage up to the limit(s) chosen by the Pool. 2.2. Purpose: The Pool is a cooperative agency voluntarily established by Members as set forth in Florida Statutes Sections 163.01, 768.28 and 440.57 for the purpose of seeking the prevention or lessening of casualty and property losses to Members and injuries to persons or employees which might result in claims being made against Members. The purpose of this Pool is to carry out and effect the agreed upon functions and purposes of this Intergovernmental Agreement as stated herein. It is the intent of the Members of this Pool to create an entity, which will administer a Risk Management Pool and utilize such funds to defend and protect, in accordance with this Intergovernmental Agreement, any Member of the Pool against liability for a covered loss. This Agreement shall constitute the substance of a contract among the Members. All funds contained within the Risk Management Pool are funds directly derived from its Members who are public agencies of the State of Florida. It is the intent of the Members in entering into this Intergovernmental Agreement that, to the fullest extent possible, the scope of Risk Management undertaken by them through a Joint Self-Insurance or Self-funded program using governmental funds shall not waive, on behalf of any Member or such Member's employees as defined in Florida Statutes Section 768.28, any defenses or immunities therein provided, or provided by the laws of the State of Florida. The Pool and the Members of this Pool intend to effect no waiver of sovereign immunities through their use of public funds retained within the Risk Management Pool. Such funds being utilized to protect against risks in accordance with Florida Statutes Section 768.28 are not intended to constitute the existence, issuance or purchase of a policy for insurance. This Intergovernmental Agreement is not to be considered such as would cause this Pool to be treated as an "insurer" within the meaning of any legislation giving risk to liability or applicability to "insurer", for damages, costs, fees or expenses, etc., under Florida Statutes Sections 624.155, 626.9541, 626.9561, 627.426, 627.428, or other statutes applicable to Public Entity Self Insurance in the State of Florida. 2.3 Non- Assessable: Public Risk Management is a non-assessable pool. Article 3 - Power and Duties 3.1. Powers: The powers of the Pool to perform and accomplish the functions and purposes set forth herein, within the budgetary limits and procedures set forth in this Intergovernmental Agreement, shall be as follows: 3.1.1. To establish By-Laws and Amendments to By-Laws, and operational procedures governing the operations of the Pool which are consistent with this Intergovernmental Agreement as set forth in Florida Statutes Sections 768.28, 163.01 and 440.57, and to not waive any sovereign immunity not waived statutorily under Florida Law, and to expressly negate any past, present, or future waiver of sovereign immunity under Florida Statutes, and to continue to negate any waiver of sovereign immunity for discretionary and planning functions of government. 3.1.2. To employ agents, employees and independent contractors and approve the rate of compensation, benefits and/or contracts that apply to Pool employees, Pool 3 officers and service providers, and to ensure all benefits of Florida Statutes Section 163.01(9)(a) and all other applicable Florida Statutes. 3.1.3. To lease real property and to purchase or lease equipment, machinery or personal property necessary for the carrying out of the purpose of the Pool. 3.1.4. To carry out educational and other programs relating to risk reductions. 3.1.5. To cause the creation of this Pool and see to the collection of funds for the continued administration of the Risk Management Pool. 3.1.6. To purchase Aggregate Excess Insurance and Specific Excess Insurance to supplement the Risk Management Pool without such being a waiver of sovereign immunity under Florida Law. 3.1.7. To establish reasonable and necessary loss reduction and prevention procedures, which shall be followed by the Members. 3.1.8. To provide Risk Management services including the defense of and settlement of claims and to have the authority granted by Florida Statutes Section 768.28(14). 3.1.9. To negate, pursuant to Florida Statutes, any implication of a waiver of sovereign immunity, and to negate any waiver of sovereign immunity other than to the extent required under Florida Statutes Section 768.28. 3.1.10. To act solely within the budgetary limits established by the Members to carry out such other activities as are necessarily implied or required to carry out the purposes of the Pool. 3.1.11. To sue or be sued as a separate legal entity. Article 4 - Participation and Term 4.1. Term: The initial term of the Pool shall be from 12:01 a.m. on October 1, 1987 to 12:01 a.m. September 30, 1989. After the initial two (2) year term of the Pool, the term shall automatically be renewed for an additional term of one (1) year each. Provided, however, the Members may, through the manner provided in Section 6.9.4., terminate the Pool as of the end of the initial or any additional term during which such action is taken. 4.2. Notice of Withdrawal: So long as the Pool shall continue in existence, any current or new Member joining the Pool shall remain a Member for an initial two-year term, except a new Member coming into the Pool after the first day of the fiscal year shall be obligated to be a member for not less than eighteen (18) months. A new member's rates will be guaranteed for their initial term. 4 Any Member may withdraw from the Pool at the end of the fiscal year upon serving on the Pool by mail, fax or hand delivery at least one year's prior written notice. Such notice shall be addressed to the Executive Director of the Pool and shall be accompanied by a resolution of the governing body of the Member electing to withdraw from the Pool. 4.3. Actual Withdrawal/Required Withdrawal. Any Member who has served the Executive Director with prior written notice of its intent to withdraw at least one (1) year prior to the beginning of the fiscal year for which the notice to withdraw is applicable, shall serve in writing to the Executive Director, by mail, fax or hand delivery on or before August 15 prior to the beginning of such fiscal year, a verification as to whether the Member intends to actually withdraw from the Pool at the end of the current fiscal year. Failure to serve such verification on or before August 15 prior to the beginning of the fiscal year for which notice of intent to withdraw is applied, shall be deemed a revocation of the prior notice of intent to withdraw; thus, binding the Member to the Pool for the ensuing fiscal year. Provided, however, any Member who serves written notice of its intent to withdraw from the Pool more than once during any three (3) year period may be required, at the option of the Board of Directors, to withdraw from the Pool on the second such notice. An action to expel a Member in this manner shall be taken by the Board of Directors prior to August 1 of the current fiscal year in the manner described in Article 16 hereafter. 4.4. Admission of New Members: The Pool's Executive Committee shall establish and periodically review standards and the approval process for the admission of new Members. Upon approval of these standards and of the approval process for admission by the Board of Directors, the Pool's Executive Committee may grant or deny admission to proposed new Members based upon such criteria. Consideration of new Members will be communicated to all PRM Board Members by the Executive Director for any information or feedback that a Member may have regarding the prospective member. Article 5 - Commencement of the Pool 5.1. Commencement Date: The Pool shall commence operations on October 1, 1987. Article 6 - Board of Directors of the Pool 6.1. The Board: There is hereby established a Board of Directors (sometimes hereinafter referred to as the "Board") of the Pool. Each Member shall appoint one (1) person to represent that body (the "Representative") on the Board of Directors along with another person to serve as an alternate representative (the "Alternate") when the Representative is unable to carry out that Representative's duties. The Representative and Alternate shall be appointed in writing by the governing body of the Member and a copy of the written appointment shall be provided to the Executive Director of the Pool. Once such appointments are made known to the Pool, the persons appointed shall remain in office until the Pool receives evidence in writing of the appointment of other persons by the Member's governing body. The Representative and Alternate selected must be an employee, an appointed official or elected official of the entity. 5 6.2. The Chairman and Vice Chairman: The Board of Directors shall bi-annually select a Chairman and Vice Chairman during the final quarter of each two-year term to serve during the subsequent two-year term. The term of office for the Chairman & Vice Chairman shall begin on the 1 s` day of a fiscal year and expire on the last day of a fiscal year. No person may serve as Chairman of the Board of Directors for more than two (2) consecutive full two-year terms. The Chairman shall preside at all meetings of the Board. The Chairman shall vote on all matters that come before the Board. The Chairman shall have such other powers as he may be given from time to time by action of the Board. The Vice Chairman shall carry out all duties of the Chairman of the Board during the absence or inability of the Chairman to perform such duties and shall carry out such other functions as are assigned from time to time by the Chairman or the Board of Directors. The Board of Directors may from time to time appoint other officers of the Board. 6.3. Board Responsibilities. The Board of Directors shall have the responsibility for: (1) hiring of Pool officers, agents, non-clerical employees and independent contractors; (2) setting of compensation for all persons, firms and corporations employed by the Pool; (3) approval of amendments to the Intergovernmental Agreement; (4) approval of the acceptance of new Members and expulsion of Members, except that the approval may be delegated to the Executive Committee under Article 4 above, or by such procedures as are contained in the motion making delegation; (5) approval and amendment of the annual budget of the Pool; (6) approval of the operational procedures developed by the Executive Director; (7) approval of educational and other programs relating to risk reduction; (8) approval of reasonable and necessary loss reduction and prevention procedures which shall be followed by all Members; (9) approval of Annual Payments to the Risk Management Pool for each Member; and (10) termination of the Pool in accordance with this Intergovernmental Agreement. 6.4. Voting: Each Member shall be entitled to one (1) vote on the Board of Directors. Such vote may be cast only by the Representative of the Member or in the Representative's absence by the Alternate. No proxy votes or absentee votes shall be permitted. Voting shall be conducted by show of hands or any method established by the Board that is consistent with Florida law. A simple majority vote of those Representatives present shall be required to pass on any motion. On such matters, the Chairman and the Executive Director of the Pool shall cause each Member's Representative and Alternate to receive the proposed ballot which will include at a minimum the text of the motion to be voted upon and the purpose of such motion. Only the Representative or the Alternate may vote on such ballots (not both). If both the Alternate and Representative submit ballots, only the Representative's ballot will be counted. Favorable votes by a majority of the Members' Representatives (or Alternates in their absence) entitled to vote shall pass any action unless an action is taken which is subject to 6.9 below, in which case passage will be based on the required number of votes as if each Member's Representative or Alternate was present at a regular or special meeting called to decide such question. 6.5 Representatives: The Representative selected by the Member shall serve until a successor has been selected. The Representative chosen by the Member may be removed at any time by the vote of the Member's governing body. In the event that a vacancy occurs in the position of Representative or Alternate selected by the governing body of a Member, that body 6 shall appoint a successor in writing within 60 days of such vacancy occurring. The failure of a Member to select a Representative or the failure of that person to participate shall not affect the responsibilities or duties of a Member under this Intergovernmental Agreement. 6.6. The Executive Committee and other Committees: The Board of Directors shall have the power to establish both standing and ad hoc committees to further the functions and purpose of this Pool. Unless the Board of Directors establishes some other procedure, the authority for selection of Representatives or Alternates serving on the Board of Directors who shall serve on such committees and chair them shall reside with the Chairman of the Board of Directors. The Chairman of the Board of Directors may appoint non-voting and non-paid persons who are not Members of the Board of Directors to serve on committees of the Pool. The Board of Directors shall dictate to the Executive Director the guidelines for authorizing the settlement of claims. The Board of Directors shall establish an Executive Committee. That Executive Committee shall consist of the Chairman of the Board, the Vice Chairman of the Board, the Treasurer and two Representatives elected by the Board, one from the southern area and one from the northern area of the Pool, as such areas are designated on the attached map, Exhibit 6.6. The Board of Directors may grant to the Executive Committee the authority to approve expenditures, authorize a settlement of claims and suits and take such other action as shall be specifically delegated to the Executive Committee. 6.7. Operating Rules: The Board of Directors may establish rules governing its own conduct and procedure not inconsistent with this Intergovernmental Agreement. 6.8. Quorum: A quorum shall consist of a majority of the Representatives (or in their absence their Alternates) serving on the Board of Directors. Except as provided in Section 6.9 herein, or elsewhere in this Intergovernmental Agreement, a simple majority of a quorum shall be sufficient to pass upon all matters. 6.9. Super-Majority Voting: A greater vote than a majority of a quorum shall be required to approve the following matters: 6.9.1. Such matters as the Board of Directors shall establish within its rules as requiring for passage a vote greater than a majority of a quorum, provided, however, that such a rule can only be established by a greater than a majority vote at least equal to the greater than majority vote required by the proposed rule. 6.9.2. The expulsion of a Member shall require two-thirds (2/3) vote of all the Representatives serving on the Board of Directors. 6.9.3. Any amendment of this Intergovernmental Agreement, except as provided in Subsection 4 below, shall require two-thirds (2/3) vote of all the Representatives serving on the Board of Directors. 6.9.4. The amendment of this Intergovernmental Agreement to cause the termination of this Agreement sooner than two (2) years after its commencement or a reduction or elimination in the scope of loss protection set out in Article 10 to be 7 furnished by the self-insurance pool derived from payments from the Members, shall require that specific written notice of the proposed change be sent by registered or certified mail to the governing body of the Member and to the Representative and Alternate of the Member serving on the Board of Directors, no less than ten (10) days prior to a meeting at which this matter is proposed and the amendment as proposed or as amended at such Board meeting must receive the approval of two-thirds (2/3) vote of all of the then current Representatives (or in their absence their Alternates) representing the then Members of the Pool. 6.10. Compensation of Board of Directors: No Representative or Alternate serving on the Board of Directors shall receive any salary from the Pool. 6.11 Conflict of Interest: Representatives and Alternates shall abide by the guidelines established by the State Ethics Commission in the performance of their duties, particularly as it applies to conflicts of interest and financial disclosure. Article 7 - Board of Directors Meetings 7.1. Meetings: Regular meetings of the Board of Directors shall be held at least four (4) times a year. The tentative times, dates, and locations of regular meetings of the Board shall be established at the beginning of each fiscal year. Any item of business may be considered at a regular meeting, including the scheduling of future regular meetings. The Executive Director shall attend all Board meetings and Executive Committee meetings to serve as an advisor and to report as the administrative officer of the Pool. 7.2. Special Meetings: Special meetings of the Board of Directors may be called by its Chairman, or by any three Representatives (or in their absence their Alternates). The Chairman or in his absence, the Vice Chairman, shall give ten (10) days written notice of regular or special meetings to the Representative and Alternate of each Member and an agenda specifying the subject of any special meeting shall accompany such notice. Business conducted at special meetings shall be limited to those items specified in the agenda. The time, date and location of special meetings of the Board of Directors shall be determined by the Chairman of the Board of Directors, or in his absence, by the Vice Chairman. 7.3. Conduct of Meetings: To the extent not contrary to this Intergovernmental Agreement and except as modified by the Board of Directors, Robert's Rules of Order, latest edition, shall govern all meetings of the Board of Directors. Minutes of all regular and special meetings of the Board of Directors shall be sent to all Representatives (or in their absence their Alternates) serving on the Board of Directors. Article 8 - Pool Officers 8.1. Officers: Officers of the Pool shall consist of an Executive Director, a Treasurer, a Secretary and such other officers as are established from time to time by the Board of Directors. All Pool officers shall be appointed by the Board of Directors. 8 8.2. Executive Director: The Executive Director shall be the chief administrative officer of the Pool and shall in general supervise and control the day to day operations of the Pool and shall carry out the policy and operational procedures of the Pool as established in this Intergovernmental Agreement and by the Board of Directors. Among the Executive Director's duties shall be the following: 8.2.1. The Executive Director may sign, with such other person authorized by the Board of Directors, any instruments which the Board of Directors have authorized to be executed and, in general, shall perform all duties incident to the office of Executive Director and such other duties as may be prescribed by the Board of Directors. 8.2.2. The Executive Director shall prepare a proposed annual budget and proposed Risk Management Pool Annual Payment and shall submit such proposals to the Board of Directors. 8.2.3. The Executive Director shall, where necessary, make recommendations regarding policy decisions, the creation of other Pool officers and the employment of agents and independent contractors. At each regular meeting of the Board of Directors and at such other times, as he shall be required to do so, he shall present a full report of his activities and the fiscal condition of the Pool. 8.2.4. The Executive Director shall report quarterly to all Members on all claims filed and payouts made. 8.2.5. The Executive Director shall, within the constraints of the approved or amended budget, employ all secretarial, clerical and other similar help and expend funds for administrative expenses. 8.3. Treasurer: The Treasurer shall: 8.3.1. Have charge and custody of and be responsible for all funds and securities of the Pool; cause to be received and given all receipts for moneys due and payable to the Pool from any source whatsoever; cause to be deposited all such moneys in the name of the Pool in such banks, savings and loan associations or other depositories that are recognized as "Qualified Public Depositories" by the State Treasurer operating under Chapter 280 Florida Statutes, as shall be selected by the Board of Directors; cause to be invested the funds of the Pool as are not immediately required in such securities as the Board of Directors shall specifically or generally select from time to time; and cause to be maintained the financial books and records of the Pool. 8.3.2. In general, perform all duties incident to the office of Treasurer and such other duties as from time to time may be assigned to that individual by the Board of Directors. Nothing herein shall prevent the Treasurer from delegating, in writing, the functions of the office to third parties, whether members of the Board of Directors, employees of the Pool, or third parties, subject to the approval of the Board of Directors. However, the Treasurer shall maintain the control and responsibility for the execution of 9 • such functions by such delegates. 8.4 Secretary: The Secretary shall issue notices of all Board meetings, and shall attend and keep the minutes of same. The Secretary shall have charge of all corporate books, records and papers; shall be custodian of the corporate seal; and shall keep all written contracts of the Pool. In general, the Secretary shall perform all duties incident to the office of Secretary and such other duties as from time to time may be assigned by the Executive Director or the Board of Directors. 8.5. Third Party Delegations: The Board may select a financial institution or certified public accountant to carry out some or all of the functions which would otherwise be assigned to a Treasurer and may select a risk management company or agent to serve as claims administrator or to carry out some or all of the functions which would otherwise be assigned to the Executive Director. The Board may also employ persons or companies as independent contractors to carry out some or all of the functions of officers of the Pool. 8.6. Officer Vacancies: In the absence of the Executive Director, Treasurer or Secretary, or in the event of the inability or refusal of such officers to act, the Chairman of the Board of Directors may perform the duties of the Executive Director, Treasurer or Secretary, and, when so acting, shall have all of the powers of and be subject to all of the restrictions upon the Executive Director, Treasurer or Secretary. Article 9 - Finances and Risk Management Pool 9.1. Fiscal Year: The fiscal year of the Pool shall commence on October 1, and end on September 30, of each year. 9.2. Budget: The Board of Directors or the Executive Committee shall approve a preliminary budget for the administration of the Pool by June 1 of each year. Copies of all preliminary and final budgets shall be promptly mailed to each Member of the Board of Directors. The Board of Directors shall, by August 1 of the year prior to the start of each fiscal year adopt a final budget and determine the amount of the Annual Payment to be made by each Member and the date upon which the payment is due. Failure of the Board of Directors or the Executive Committee to approve a preliminary or final budget within the times set forth within this Section shall not relieve the Members of the obligation to make any payments to the Pool so long as such budgets are finally adopted, and the Members are given at least thirty (30) days after the passage of the final budget in which to make Annual Payments to the Pool. 9.3. Annual Payment Factors: In determining the amount of the Annual Payment due from each Member, the Board of Directors shall consider some or all of the following factors: 9.3.1. Number of employees; 9.3.2. Property values of the Member; 9.3.3 Number and type of vehicles owned by the Member and the use made of the vehicles; 10 • 9.3.4. Population of the geographic area represented by the Member; 9.3.5. The payrolls of the Member; 9.3.6. Any unusual exposures presented by the Member; 9.3.7. The operating expenditures of the Member; and 9.3.8 The claims and loss experience of the Member. The Board of Directors shall establish annually a cost of risk allocation, which is utilized in making the allocation of the amount of the Annual Payment due from each Member. This standard may, however, vary from year to year but it must be applied equally to all Members similarly situated during such period of time as it is utilized. The Board of Directors may grant debits or credits to Members with above or below average loss or claims records. The amount of such debits or credits may not vary more than 25% above or below the amount, which the Member would pay if it were not to have been granted the debit or credit. In establishing the loss and claims record of the Member, the Board of Directors may utilize the loss and claims experience of the Member during last 3 years of the Pool. 9.4. Budget Amendments: Budgets may be amended at any time by majority vote of the Board, provided, however, such amendments may not require payments, when added to previous payments by a Member for such fiscal year, to exceed such Member's Annual Payment determined for such year. The forwarding of such payments within a time specified in notices to the Members giving them not less than forty-five (45) days to make such payments shall be of the essence of this contract. 9.5. Payments — Timing: In subsequent years, the Board of Directors may permit the Annual Payments to be made on a monthly or quarterly basis. 9.6. Retirement Fund Obligations: Members shall be both severally and jointly liable to the State of Florida Department of Administration, Division of Retirement for any Florida Retirement Systems' contributions, which are owed by the Pool for Pool employees. Each member shall be responsible for expenses incurred which are attributable to the years of membership as outlined in the Intergovernmental Agreement, Article 11. 9.7. Distribution of Surplus: If, for any year during which the Pool was in existence, all claims known or unknown have either been paid or provision has been made for such payment, the Board of Directors as then constituted shall distribute surplus funds to the Members who constituted the membership of the Pool in that prior year, after first deducting there from reasonable administrative and other non-allocated costs incurred by the Pool in the processing of the claims in years other than the one in which the claim was made. The distribution among the Members shall be in the same proportion to the total as was their Annual Payment for that year to the Annual Payments of all Members for such year. 11 9.8. Audit: The Board of Directors shall provide to the Members an annual audit of the financial affairs of the Pool to be made by a certified public accountant at the end of each fiscal year in accordance with generally accepted auditing principles. The annual report shall be delivered to the Chairman of the governing body of each Member. Article 10 - Excess Insurance 10.1. Specific Excess Insurance: The Pool will purchase Specific Excess Insurance from underwriters of insurance, insurance companies and/or Lloyd's of London, approved by the Board of Directors, or any committee appointed by the Board for such purpose, in such amounts which shall be approved by the Board of Directors and underwriters, based upon but not limited to the current assets, risk analysis, and loss history of the Pool. The purchase of Specific Excess Insurance does not, and is not, intended to waive sovereign immunity under Florida law. 10.2. Aggregate Excess Insurance: The Pool will purchase Aggregate Excess Insurance from underwriters of insurance, insurance companies and/or Lloyd's of London, approved by the Board of Directors, or any committee appointed by the Board for such purpose, in such amounts which shall be approved by the Board of Directors and underwriters, based upon but not limited, to the current assets, risk analysis, and loss history of the Pool. The purchase of Aggregate Excess Insurance does not, and is not, intended to waive sovereign immunity under Florida law. 10.3. Multiple Loss Coverage: The Pool will purchase Multiple Loss Coverage in the event a single occurrence involves more than one line of coverage, limiting the occurrence to a single "Self Insured Retention." 10.4. Losses: The Risk Management Pool (Loss Fund), the Specific Excess Insurance and Aggregate Excess Insurance shall provide payment for covered losses in any one fiscal year for members up to the limits approved by the Board of Directors. Should losses in any one fiscal year extinguish all available funds provided by the Pool then the individual Member or Members whose judgment or settlement of claim has been perfected by Florida law shall be responsible for any additional payment. The Pool shall make payments in the order in which the judgments against the Pool have been entered or settlement of claims have been reached. Membership in the Pool shall not preclude any Member from purchasing any insurance coverage above those amounts purchased by the Pool. Article 11 - Obligations of Members 11:1. Member Obligations: The obligations of Members of the Pool shall be as follows: 11.1.1. To budget for, where necessary, to levy for and to promptly pay all payments to the Risk Management Pool at such times and in such amounts as shall be established by the Board of Directors within the scope of this Intergovernmental Agreement. Any delinquent payments shall be paid with a penalty, which shall be set by the Board, but such rate shall not exceed the highest interest rate allowed by statute to be paid by a Florida public agency. 12 * 11.1.2. To select, in writing, a Representative to serve on the Board of Directors and to select an Alternate Representative. 11.1.3. To allow the Pool reasonable access to all facilities of the Member and all records including, but not limited to, financial records, which relate to the purpose or powers of the Pool. 11.1.4. To allow attorneys employed by the Pool to represent the Member in investigation, settlement discussions and all levels of litigation arising out of any claim made against the Member within the scope of loss protection furnished by the Pool. 11.1.5. To furnish full cooperation with the Pool attorneys, claims adjusters, the Executive Director and any agent, employee, officer or independent contractor of the Pool relating to the purpose or powers of the Pool. 11.1.6. To follow in its operations all loss reduction and prevention procedures established by the Pool within its purpose or powers. 11.1.7. To report to the Executive Director or his designee within the time limit specified the following items: 11.1.7.1. To provide on or before May 1 of each fiscal year of the Pool, the Member's renewal application shall be completed by the member as required by the Underwriters. 11.1.7.2. To report, within five (5) days of receipt, any and all statutory notices of claims, as well as summons and complaint or other pleading before a court or agency involving any claim for which Pool coverage is sought. 11.1.7.3. To report, within ten (10) days of receipt, any oral or written demand for monetary relief for which coverage is sought to the Pool Executive Director. 11.1.7.4. To report to the Executive Director at the earliest practicable moment any information of an occurrence, claim or incident received by the Member and from which the Member could reasonably conclude that coverage will be sought by said Member for such an occurrence, claim or incident. In the event that the items set forth above are not submitted to the Executive Director within the time periods set forth above, the Board of Directors of the Pool, by a vote of a majority of a quorum of the Board, at a regular or special meeting, may in whole or part decline to provide a defense to the Member or to extend the funds of the Pool for the payment of losses or damages incurred. In reaching its decision, the Board shall consider whether and to what extent the Pool was prejudiced in its ability to investigate and defend the claim due to the failure of the Member to promptly furnish timely notice of the occurrence, claim or incident to the Executive Director. The decision of the Board of Directors shall be final. Failure of a Member to abide by these requirements shall also be grounds for expulsion from the Pool. 13 11.1.8. To make Payment of any "Maintenance" Deductible(s). Article 12 - Liability of Board of Directors or Officers of the Pool 12.1. Liability of Directors and Officers: The Representatives (or in their absence their Alternates) serving on the Board of Directors or officers of the Pool should use ordinary care and reasonable diligence in the exercise of their power and in the performance of their duties hereunder; they shall not be liable for any mistake of judgment or other action made, taken or omitted by them in good faith; nor for any action taken or omitted by any agent, employee or independent contractor selected with reasonable care; nor for loss incurred through investment of Pool funds, or failure to invest. No Representative shall be liable for any action taken or omitted by any other Representative. Representatives shall have the immunities provided by law and in particular Florida Statutes Section 163.01. The Pool may purchase insurance providing liability coverage for such Representatives or officers. Article 13 - Additional Insurance 13.1. Member's Option to Purchase Additional Insurance: The Pool, through the distribution of the minutes of the Board of Directors or through other means shall inform all Members of the scope and amount of Specific Excess and Aggregate Excess Insurance in force at all times. Membership in the Pool shall not preclude any Member from purchasing any insurance coverage above those amounts purchased by the Pool. Such purchase shall not be construed to waive sovereign immunity of the Members of the Pool or the Pool. The Pool shall make its facilities available to advise Members of the types of additional or different coverages available to Pool Members. Article 14 - Settlements 14.1. Settlement/Advance Notice: Whenever the Pool proposes to settle any pending claim or suit where the amount of that proposed settlement shall exceed Five Thousand Dollars ($5,000.00), the Member shall be given advance notice of that settlement. Such notice may be given by the establishment of a reserve amount in excess of Five Thousand Dollars ($5,000.00), provided that the amount of the settlement does not exceed the amount reserved. The officers and employees of the Pool shall, however, endeavor to give specific oral or written notice to the Member's Representative or Alternate of the exact amount of any proposed settlement in excess of Five Thousand Dollars ($5,000.00) prior to the date at which the Pool proposes to bind itself to pay such settlement amount. The officers, employees or independent contractors of the Pool shall attempt to give the Members, as much notice of the settlement negotiations as is possible under the circumstances of each case. Article 15 - Contractual Obligation 15.1. Enforcement: This document shall constitute a binding contract under the Florida Interlocal Cooperation Act of 1969 among those public agencies, which become Members of the Pool. The obligations and responsibilities of the Members set forth herein, including the obligation to take no action inconsistent with this Intergovernmental Agreement as originally 14 • written or validly amended, shall remain a continuing obligation and responsibility of the Member. The terms of this Intergovernmental Agreement may be enforced in a court of law by the Pool. The consideration for the duties herewith imposed upon the Members to take certain actions and to refrain from certain other actions shall be based upon the mutual promises and agreements of the Members set forth herein. This Intergovernmental Agreement may be executed in duplicate originals and its passage by the Member's governing body shall be evidenced by a certified copy of a resolution passed by the members of the governing body in accordance with the rules and regulations of such public agency, provided, however, that except to the extent of the limited financial contributions to the Pool agreed to herein or such additional obligations as may come about through amendments to this Intergovernmental Agreement no Member agrees or contracts herein to be held responsible for any claims in tort or contract made against any other Member. The Members intend in the creation of the Pool to establish an organization for Risk Management only within the scope herein set out and have not herein created as between Member and Member any relationship of surety, indemnification or responsibility for the debts of or claims against any Member. 15.2. Attorneys' Fees: In any legal action between the parties arising out of this Agreement, any attempts to enforce this Agreement, or any breach of this Agreement, the prevailing party may recover its expenses of such legal action including, but not limited to, its costs of litigation (whether taxed by the court or not) and its reasonable attorneys' fees (including fees generated on appeals) from the other party. Article 16 - Expulsion or Termination of Members 16.1. Expulsion. By the vote of two-thirds (2/3) of the Directors serving on the Board of Directors, any Member may be expelled. Such expulsion may be carried out for one or more of the following reasons: 16.1.1. Failure to make any timely payments due to the Pool. 16.1.2. Failure to undertake or continue loss reduction and prevention procedures adopted by the Pool. 16.1.3. Failure to allow the Pool reasonable access to all facilities of the Member and all records which relates to the purpose, powers or functioning of the Pool. 16.1.4. Failure to furnish full cooperation with the Pool's attorneys, claims adjusters, the Executive Director and any agent, employee, officer or independent contractor of the Pool relating to the purpose, powers and proper functioning of the Pool. 16.1.5. Failure to carry out any obligation of a Member which impairs the ability of the Pool to carry out its purpose or powers or functions. 15 16.1.6. The Member has given the one (1) year notice described in Section 4.2 and 4.3 above. 16.2. Notice: No Member may be expelled except after notice from the Pool of the alleged failure along with a reasonable opportunity of not less than thirty (30) days to cure the alleged failure. The Member may request a hearing before the Board before any decision is made as to whether the expulsion shall take place. The Board shall set the date for a hearing which shall not be less than fifteen (1 5) days after the expiration of the time to cure has passed. A decision by the Board to expel a Member after notice and hearing and a failure to cure the alleged defect shall be final. The Board of Directors may establish the date at which the expulsion of the Member shall be effective at any time not less than sixty (60) days after the vote expelling the Member has been made by the Board of Directors. If the motion to expel the Member made by the Board of Directors or a subsequent motion does not state the time at which the expulsion shall take place, such expulsion shall take place sixty (60) days after the date of the vote by the Board of Directors expelling the Member. 16.3. Responsibilities of Terminated Member: A former Member shall only continue to be fully responsible only for its' portion of any obligations incurred but not satisfied during the period of time they were a Member of the Pool. Such obligations may include, but not be limited to, premiums, loss fund payments, maintenance deductibles, workers' compensations, final audit and administrative fees, etc., owed or unpaid by the former Member. The former Member shall no longer be entitled to participate or vote on the Board of Directors. Article 17 - Special Provisions for Deferred Funding During the fiscal years commencing on October 1, 1987 and ending on September 30, 1990, the entire Annual "Loss Fund" Contribution was not required by the Board of Directors to be paid within the fiscal year to which it was applicable. The difference between the Annual "Loss Fund" Contribution and the amount required by the Board of Directors to actually be paid to the Pool during such year by a Member is referred to herein as Deferred Funding. Members and former Members during any year for which there existed Deferred Funding may be required by the Board of Directors upon recommendation of the Executive Director to pay their applicable portion of the Deferred Funding in subsequent years. _Members or former members will be allowed forty-five (45) days after notification to make any payments of Deferred Funding. The amount of any payments required for Deferred Funding as to each Member shall be based upon the same formula as was used in establishing the Annual "Loss Fund" Contribution for that year. Article 18 - Termination of the Pool 18.1. Termination: If, at the conclusion of any term of the Pool, the Board of Directors votes to discontinue the existence of the Pool in accordance with Section 6.9.4., then the Pool shall cease its existence at the close of the then current fiscal year. Under those circumstances, the Board of Directors shall continue to meet on such a schedule as shall be necessary to carry out the termination of the affairs of the Pool. It is contemplated that the Board of Directors may be required to continue to hold meetings for some substantial period of time in order to accomplish this task, including the settlement of all covered claims incurred during the term of 16 the Pool. The Pool shall continue to be fully responsible and obligated to pay covered claims and expenses owed by the Pool, which accrued before the Pool's termination. The money used to pay such covered claims and expenses shall remain with the Pool until such claims are settled and expenses are paid. 18.2. Post-Termination Responsibilities of Member: After termination of the Pool, the Member shall continue to hold membership on the Board of Directors but only for the purpose of voting on matters affecting their limited continuing interest in the Pool for such years as they were Members of the Pool. 17 • • In witness whereof, this agreement has been executed by the Entity: . The approval of the foregoing agreement was passed by the Entity: on the day of , 20_, and attached hereto, I do hereby execute and the does hereby attest to my signature as evidence that the has approved and hereby becomes a bound signatory member of the "Intergovernmental Cooperative Agreement" for Public Risk Management of Florida, a copy of which is attached hereto, and which is pursuant to Florida Statutes Section 163.01, which commenced its term on October 1, 1987. Chairperson of Board, or Council Chairperson, Public Risk Management of Florida ATTEST: This day of , 20! 1 ars t� 1'1 e s Sc.) Mug-./ •UNIMARY OF BENEFITS authorized non authorized LUE CROSS AND BLUE SHIELD OF FLORIDA yes no yes no alternative • 'DINT-OF-SERVICE PLAN A16 WITH BLUESCRIPTsnt iE.NEFITS AUTHORIZED NON-AUTHORIZED 7alendar Year Deductible Individual SO 5300 Aggregate Family 50 8900 UUhleScript Prescription Drug Rider 55.00 Generic 55.00 Generic lncludiug Otal Cuntlaceptives) 510.00 N.une llr:uul 510.00 Name flrand The deductible does not apply to services with a copayment or where indicated. _,ifetime Maximum No Maximum 51,000,000 :oinsuranee Requirement Limit Individual 50 52,000 Aggregate Family 50 56,000 Physician Office Services • Routine Services 55 Copayment 80%Allowed Amount • Preventive Care 85 Copayment Not Covered • Well-Child Care 55 Copayment 80%Allowed Amount No Deductible • Allergy Injection (Without Office Visit) 55 Copayment 80%Allowed Amount • Annual Gynecological Examination By A 1-101 OB/GYN Physician Up To S 150 Per Calendar Year (Does Not Require Authorization By Primary Care Physician) 55 Copayment Not Covered • Specialty Care 55 Copayment 80%Allowed Amount • Maternity Care First Office Visit S5 Copayment 80%Allowed Amount - Total Maternity Care No Copayment 80% Allowed Amount Hospital Services Hospital Per Admission Deductible SO 5300 (PAD) • Inpatient Primary Care Physician No Copayment Not Applicable Facility No Copayment 80%Allowed Amount All Other Providers No Copayment 80%Allowed Amount • Outpatient Hospital/Surgical Primary Care Physician No Copayment Not Applicable Facility No Copayment 80%Allowed Amount All Other Providers No Copayment 80%Allowed Amount • Non-Routine X-Rays (Inpatient or Outpatient) No Copayment 80%Allowed Amount ISCUSV,CAI x• lilac Cunt:u.l atuc 5h.la.d Flmu1..trc.It+n Indeis W.o, id the ahw COM,...I HI.:SIucW a,.u.wuuo • QJRR Nr B Na-rs� ,) 'UMNLA.RY OF BENEFITS authorized non authorized ILUE CROSS AND BLUE SHIELD OF FLORIDA yes no yes no alternative • 'DINT-OF-SERVICE PLAN A16 WITH BLUESCRIPTs"t iENEFITS AUTHORIZED NON-AUTHORIZED ';alendar Year Deductible Individual SO 5300 Aggregate Family SO 5900 UhieSeript Prescription Drug Rider 55.00 Generic 55.00 Generic Including Olal Cuullaceptivcs) SI0.1)0 N:unc ILaud 510.00 Name Dram! The deductible does—not apply to services with a copayment or where indicated. Lifetime Maximum No Maximum 51,000,000 Coinsurance Requirement Limit • Individual 50 52,000 Aggregate Family SO 56,000 Physician Office Services • Routine Services 55 Copayment 80%Allowed Amount • Preventive Care 55 Copayment Not Covered • Well-Child Care 55 Copayment 80%Allowed Amount No Deductible • Allergy Injection (Without Office Visit) 55 Copayment 80%Allowed Amount • Annual Gynecological Examination By A 1-101 OB/GYN Physician Up To 5150 Per Calendar Year (Does Not Require Authorization By Primary Care Physician) 55 Copayment Not Covered • Specialty Care 55 Copayment 80% Allowed Amount • Maternity Care First Office Visit 55 Copayment S0%Allowed Amount Total Maternity Care No Copayment 80%Allowed Amount Hospital Services Hospital Per Admission Deductible SO 5300 (PAD) • Inpatient Primary Care Physician No Copayment Not Applicable Facility No Copayment 80%Allowed Amount All Other Providers No Copayment 80%Allowed Amount • Outpatient Hospital/Surgical Primary Care Physician No Copayment Not Applicable Facility No Copayment 80%Allowed Amount All Other Providers No Copayment 80/Allowed Amount • Non-Routine X-Rays (Inpatient or Outpatient) No Copayment 80%Allowed Amount BC tt5Ylchl st. Illu.C...,3141 Olu.Sh..IJ 111 f,..L,.Inc.a.,lidcrcn,.m Lucn..cc of ill.Oluc Cn..a wul Ill...SIucld Aaa.1:111.M1 'CLUSIONS _t Services and supplies which are, in our opinion, experimental, investigational, Jr not medically necessary; ?rivate duty nursing services; Dental care(except accident-related); :osmetic surgery (surgery performed solely to improve appearance of an ndividual); Eye refractions, eye glasses and hearing aids or examinations for their -prescription or fitting, except as specified in the Preventive Health Services Section; toutine health examinations, except as covered under the Well-Child Care Section and the r'reventive Health Services Section; Rehabilitative services except as provided in the cardiac rehabilitation and pulmonary ehabilitation sections; Care obtained without cost; Services rendered by an individual who is related by blood or marriage; 'reatment in a VA hospital or government facility (due to service-related lisability); Treatment of any condition arising out of a felony, riot, rebellion, or war; Treatment of any condition or an intentionally self-inflicted condition, suicide, or ttempted suicide; speech therapy, except as provided under Home Health Care Services and Therapeutic Services sections; )iagnostic admissions; )ccupational therapy,except as provided under Home Health Care Services and Therapeutic Services sections; -ervices or supplies related to sexual reassignment; 'ravel expenses, even if prescribed by a physician (this exclusion does not apply to medically necessary transportation of a newborn child); custodial care; xercise programs of any kind; 'on-prescription drugs, vitamins, mineral supplements, or fluoride drugs; Work-related injuries; !rvices associated with autopsy or postmortem examination; °rvices and supplies not specifically covered under the BCBSF Care Manager Point Of Service Plan; ''ontraceptive devices, appliances or other supplies when used for contraception. I services rendered in the Emergency Room which are not Emergency Care Services will be subject to calendar year deductible and nsurancc amount listed above unless authorized by the Primary Care Physician. it a contract. The above Summary of Benefits is only a partial description of the many benefits and services covered by Blue Cross Shield of Florida,Inc. These benefits apply only to groups of 51 or more employees, For a complete description of benefits and s.please see Blue Cross and Blue Shield of Florida's Care Manager Point Of Service Contract#15483-1096 SR and Schedule of is#15499-1096 SR;its terms prevail. Blue Cross and Blue Shield of Florida,Inc.is an Independent Licensee of the Blue Cross and Blue Association. BCBSF/CM sl+ c Mark of Bine Cross said Blue Shield of Florida.Inc. Blue Cue,dud Blue Shield lit Honda.Itx; i'do ludepe wkm Licentic lit the Blue CS AN alit Blue Shield A.actduun. PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES BLUE CROSS/ BLUE SHIELD HIGH OPTION PPO Effective 10/1/2002 Pta ::. 902::. :,,; ;;� :: Platt 9Q2 _ `..._:r. •In hetworkx-: ., , N • uthoirzed ` 's: y; :' (NOn=Authorized) ", Maximum Lifetime Benefit $2,000,000 $2,000,000 Annual Deductible $200 $200 Family Deductible $600 $600 Annual Maximum Copayments N/A N/A Family Maximum Copayments N/A N/A Maximum Annual Out of Pocket $1,500 $1,500 Maximum Family Out of Pocket $4,500 $4,500 Coinsurance 90%of allowance 70%of allowance 4th Quarter Carryover Deductible Carryover applies Carryover applies Physician Office Visit $15 Copay Ded,then 70%of allowance Wellcare Visits-Annual exam Adult $15 copay.Covered up to$250- 70%of allowance,Ded waived. combined OB/GYN and Adult Covered up to$250-combined OB/GYN Wellness OB/GYN and Adult Wellness • -Child health $15 Copay.(Birth to age 16) 70%of allowance,Ded waived Mammograms 100%of allowance(Ded waived) 100%of allowance, Ded waived (may be balance billed) Specialist Office Visit $15 copay Ded,then 70%of allowance Second Opinion Surgical Ded,then 70%of allowance P g $15 Copay(Not Required) (Not Required) Infertility Services/Treatment Plans $15 Copay(diagnosis) /$20,000 Ded,then 70%of allowance (Treatment covers artificial insemination, (diagnosis)/$20,000 lifetime max for IVF,GIFT,&ZIFT lifetime max for treatment treatment $15 Copay(physician's office)Ded, Ded,then 70%of allowance Ph sical Thera then 90%of allowance y Py (inpatient/outpatient)up to$10,000 (inpatient/outpatient)up to$10,000 lifetime max(combined therapy) lifetime max(combined therapy) $15 Copay(physician's office)Ded, Ded,then 70%of allowance Speech then 90%of allowance p (inpatient/outpatient)up to$10,000 (inpatient/outpatient)up to$10,000 lifetime max(combined therapy) lifetime max(combined therapy) • $15 Copay(physician's office)Ded, Ded,then 70%of allowance Occupational then 90%of allowance P (inpatient/outpatient)up to$10,000 (inpatient/outpatient)up to$10,000 lifetime max(combined therapy) lifetime max(combined therapy) Acupuncture Not Covered Not Covered Injections/Immunizations(child health) $15 Copay 70%of allowance,Ded waived Allergy Testing $15 Copay Ded,then 70%of allowance Allergy Injections(not including serum) $5 copay Ded,then 70%of allowance Office Surgery $15 Copay Ded,then 70%of allowance Outpatient Surgery(hospital or surgery Ded,then 90%of allowance Ded,then 70%of allowance center) X-ray and Lab Outpatient-Physician's Ded,then 90%of allowance Ded,then 70%of allowance Office Outpatient Radiation Ded,then 90%of allowance Ded,then 70%of allowance PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES BLUE CROSS/ BLUE SHIELD HIGH OPTION PPO Effective 10/1/2002 Proposed .•:. '2. ' Plan 902 . •-": (ifon'-AiithOriied) RAP Providers Ded,then 70%of allowance (Non-PPO Radiologist,Anesthesiologist, Ded,then 90')/0 of allowance (If participating hospital,Ded,then pathologist,and ER phys.services at PPO 90%of allowance) hosp.) Emergency Room/Hospital -Illness Ded,then 90%of allowance Ded,then 70%of allowance -Accidents 90%of allowance,Ded waived — 70%of allowance,Ded waived Ambulance Ded,then 90%of allowance Ded,then 90%of allowance Ded,then 90%of allowance(Covers Ded,then 70%of allowance(Covers removal of impacted teeth,including removal of impacted teeth,including Dental Oral Surgery impacted wisdom teeth,related x- impacted wisdom teeth,related x-rays rays&anasthesia) &anasthesia) Ded,then 70%of allowance.$100 Inpatient Hospital Ded,then 90%of allowance per admission deductible X-ray and Lab Inpatient Ded,then 90%of allowance Ded,then 70%of allowance Ded,then 90%of allowance (no Ded,then 70%of allowance (no Blood and Blood Plasma limit) limit) Ded,then 90%of allowance. Ded,then 70%of allowance.$12,000 Home Health Care $12,000 Calendar year max. Calendar year max. Ded,then 90%of allowance Ded,then 70%of allowance.$7,500 Hospice $7,500 lifetime max lifetime max. Ded,then 90%of allowance.60 Ded,then 70%of allowance.60 days Skilled Nursing Facility days per calendar year. per calendar year. Durable Medical Equip. Ded,then 90%of allowance Ded,then 70%of allowance Maternity -Physician $15 copay initial visit Ded,then 70%of allowance -Hospital Ded,then 90%of allowance Ded,then 70%of allowance Covered as maternity benefit up to Covered as maternity benefit up to 18 Dependant Daughter Maternity 18 months (or longer) months (or longer) Birthing Centers Ded,then 70%of allowance Ded,then 70%of allowance Abortions Not Covered Not Covered Ded,then 90%of allowance.30 Ded,then 70%of allowance.30 In-Patient Mental/Nervous days per calendar year. days per calendar year $15 Copay.20 visits per calendar Ded,then 70%of allowance.20 visits Out-Patient Mental/Nervous year per calender year Attempted Suicide Ded,then 90%of allowance Ded,then 70%of allowance Ded,then 90%of allowance. Ded,then 70%of allowance.$2,500 In-Patient Substance Abuse $2,500 lifetime max lifetime max Ded,then 90%of allowance. Ded,then 70%of allowance. $2,500 Out-Patient Substance Abuse $2,500 lifetime max. lifetime max. Prescription Drugs - Includes coverage for oral contraceptives&diaphragms Ded,then 70%of allowance. -Generic $7 Copay-30 day supply 30 day supply Ded,then 70%of allowance. -Brand $14 Copay-30 day supply 30 day supply Prescription Card Yes No Prescription Mail Order Yes No Generic $14 Copay-90 day supply Not Applicable Brand $28 Copay-90 day supply Not Applicable • • • PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES BLUE CROSS/ BLUE SHIELD - LOW OPTION PPO Effective 10/1/2002 PrtiPo •�.'. + :�', a.�� ... =,f:.:.�.Proposed` ..... ... .. . J.,.b :!:3=�d �La i�d?':aY ,.{, .etr Plan 719::;,: y y£,4JXa•r _.ria,, ..r9., pa., _t'S,i In Netw ,,. ark, ��„ ;v.�:. ,..: £.�:;;::Outof.Network'•s .�` ^ . Attthorizedj•�, ..,,{�e;: ' ` t�` Non=tiutfioized ,.., . . Maximum Lifetime Benefit $2,000,000 $2,000,000 Annual Ded $500 $500 Family Ded $1,500 $1,500 Annual Maximum Copayments N/A N/A Family Maximum Copayments N/A N/A Maximum Annual Out of Pocket $1,500 $1,500 Maximum Family Out of Pocket $4,500 $4,500 Coinsurance 80%of allowance 60%of allowance 4th Quarter Carryover Ded Carry Over applies Carry Over applies Physician Office Visit $15 Copay Ded,then 60%of allowance Wellcare Visits-Annual exam $15 copay,$250 calendar year max 60%of allowance,Ded waived,$250 (combined OBGYN/adult wellness) calendar year max(combined Adult/OB/GYN OBGYN/adult wellness) -Child health $15 Copay.(Birth to age 16) 60%of allowance,Ded waived(Birth to age 16) Mammograms 80%of allowance,Ded waived 60%of allowance,Ded waived(may be balance billed) Specialist Office Visit $15 Copay Ded,then 60%of allowance Second Opinion Surgical $15 Copay(Not Required) Ded,then 60%of allowance Infertility Services/Treatment Plans (Treatment covers artificial insemination, No Coverage No Coverage IVF,GIFT,&ZIFT Ded,then 80%of allowance Physical Therapy u to$5,000 Ded,then 60%(inpatient/outpatient)up y py p to$5,000 lifetime max lifetime max Ded,then 80%of allowance Ded,then 60%of allowance Speech (inpatient/outpatient)up to$5,000 (inpatient/outpatient)up to$5,000 lifetime max lifetime max Ded,then 80%of allowance Ded,then 60%of allowance Occupational (inpatient/outpatient)up to$5,000 (inpatient/outpatient)up to$5,000 lifetime max lifetime max Acupuncture Not Covered Not Covered $15 Copay 60%of allowance,Ded waived(Birth to Injections/Immunizations(child health) age 16) Allergy Testing $15 Copay Ded,then 60%of allowance Allergy Injections(not including serum) $10 copay Ded,then 60%of allowance PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES BLUE CROSS/ BLUE SHIELD - LOW OPTION PPO Effective 10/1/2002 ‘; , -.;3:•Plan In Net*Yor-K,,:';4::!alOut of-NOOYPrY"?, tAiitthorilid) Athorized Office Surgery $15 Copay Ded,then 60%of allowance Outpatient Surgery(hospital or surgery Ded,then 80%of allowance Ded,then 60%of allowance center) X-ray and Lab Outpatient-Physician's Ded,then 80%of allowance Ded,then 60%of allowance Office Outpatient Radiation Ded,then 80%of allowance Ded,then 60%of allowance Ded,then 70%of allowance RAP Providers (Non-PPO Ded,then 80%of allowance (If participating hospital,Ded,then 80% Radiologist,anaesthesiologist,pathologist, of allowance) and ER phys.services at PPO hosp.) Emergency Room/Hospital -Illness Ded,then 80%of allowance Ded,then 60%of allowance -Accidents 80%of allowance,Ded waived 60%of allowance,Ded waived Ambulance Ded,then 80%of allowance Ded,then 80%of allowance Ded,then 80%of allowance Ded,then 60%of allowance Dental Oral Surgery (Injury due to external force of sound and (Injury due to external force of sound and natural teeth) natural teeth) $300 per admission Ded,then 60%of Inpatient Hospital Ded,then 80%of allowance allowance X-ray and Lab Inpatient Ded,then 80%of allowance Ded,then 60%of allowance Ded,then 80%of allowance (No Ded,then 60%of allowance (No Blood and Blood Plasma Limit) Limit) Ded,then 80%of allowance. $2,500 per Ded,then 60%of allowance. $2,500 per Home Health Care calendar year calendar year Ded,then 80%of allowance. $7,500 Ded,then 60%of allowance. $7,500 Hospice lifetime max. lifetime max. Ded,then 80%of allowance. 60 days per Ded,then 60%of allowance. 60 days/ Skilled Nursing Facility calendar yr. calendar year Ded,then 80%of allowance Ded,then 60%of allowance Durable Medical Equip. Maternity -Physician Ded,then 80%of allowance Ded,then 60%of allowance -Hospital Ded,then 80%of allowance Ded,then 60%of allowance Dependent Daughter Maternity Ded,then 80%of allowance Ded,then 60%of allowance Birthing Centers Ded,then 60%of allowance Ded,then 60%of allowance Abortions Not Covered Not Covered PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES BLUE CROSS/ BLUE SHIELD - LOW OPTION PPO Effective 10/1/2002 Proposed .. :Proposed.; Plan 719 " 'Plan 719°� In:Network':• • Out of Network= (Authorized):; tii (Non.Authorized)_. In-Patient Mental/Nervous Ded,then 80%of allowance.30 days;30 Ded,then 60%of allowance.30 days;30 visits per calendar yr. visits per calendar yr. Out-Patient Mental/Nervous Ded,then 80%of allowance.20 visits per Ded,then 60%of allowance.20 visits per calendar yr(partial hopitalization). calendar yr(partial hopitalization). Attempted Suicide Ded,then 80%of allowance Ded,then 60%of allowance In-Patient Substance Abuse Ded,then 80%of allowance.$2,500 Ded,then 60%of allowance.$2,500 lifetime max. lifetime max. Out-Patient Substance Abuse Ded,then 80%of allowance.$35 max per Ded,then 60%of allowance.$35 max per visit;44 visits max;$2,500 lifetime max. visit;44 visits max;$2,500 lifetime max. Prescription Drugs (Includes coverage for oral contraceptives and Diaphragms) -Generic $10 Copay,30 day supply Ded,then 60%of allowance -Brand $25 Copay,30 day supply Ded,then 60%of allowance Prescription Card Yes No Prescription Mail Order Yes No Generic $20 Copay,90 day supply Not Applicable $50 Copay,90 day supply Not Applicable Brand ' Florida inHealth Care Plans A Proud Partner of Halifax•Fish Community Health P.O.Box 9910,Daytona Beach,FL 32120 www.floridahealthcares.com May 28, 2002 Ms. Lola Parker Account Supervisor CITY OF OKEECHOBEE 55 S.E. Third Avenue Okeechobee,Florida 34974-2932 Dear Ms. Parker: On behalf of Florida Health Care Plan, Inc. (FHCP), I thank you for the opportunity to participate in the current RFP process for the City of Okeechobee. FHCP is licensed to operate in the counties of Volusia,Flagler, and Seminole, Florida. After review of the City of Okeechobee employee census supplied with the RFP, it appears not to contain residents of any of those three(3) counties; therefore we must decline to submit a proposal at this time. Again,we thank you for the invitation, and wish you success in your search for affordable, quality health coverage for the employees of the City of Okeechobee. Since I , i / Kitty Whitmar Membership Growth and Retention Coordinator Holly Hill -Administrative Offices-386/676-7100- 1-800-352-9824 Daytona Beach -386/238-3200- 1-800-321-1227 • DeLand -386/736-1948 Edgewater-386/427-4868 • Orange City-386/774-2550- 1-800-390-3427 Ormond Beach -386/671-4337 • Palm Coast-386/445-7073 Port Orange East-386/763-1000 • Port Orange West-386/756-6658 An Equal Opportunity-Affirmative Action Employer Marybeth O'Connor National Account Executive South Florida Sales CIGNA HealthCare April 16, 2003 Routing 362 1580 Sawgrass Corporate Parkway Suite 200 Sunrise,FL 33323 Telephone 954.693.7591 Facsimile 954.693.7540 marybeth.o'connor@cigna.com City of Okeechobee 55 S.E. Third Avenue Okeechobee, FL 34974-2932 Re: Invitation to Bid - City of Okeechobee - Bid Number: FIN 03-00-04-03 To Whom It May Concern, Thank you for your request for proposal for The City of Okeechobee. Your interest in CIGNA HealthCare is greatly appreciated. At this time, I must respectfully decline to quote on medical on this opportunity. We find that we are unable to provide a financially attractive alternative to the existing plan. Thank you again for considering CIGNA HealthCare. Hopefully the next opportunity will have more positive results. Cor•ially, (t0 Marybeth O'Connor MOC/mgb Proud National Sponsor of the March of Dimes®WalkAmerica...the Walk that Saves Babies "CIGNA HealthCare"or"CIGNA"refer to various operating subsidiaries of CIGNA Corporation.Products and services are provided by these subsidiaries and not by CIGNA Corporation.These subsidiaries include Connecticut General Life Insurance Company,Tel-Drug,Inc.and its affiliates,CIGNA Behavioral Health,Inc.,Intracorp, and HMO or service company subsidiaries of CIGNA Health Corporation and CIGNA Dental Health,Inc. ,r- (Tho y).4 c'inj ry( i 5,Nr?11- , , • it 0:), 11 )- `) )."-'‘) 47:4-7/(1) ' I PAY 20 132 • Realrea* 4101. mOvED,aft RIO ADDRESS p;.caRwARDINO ORDER EXPIRED r-1,ATTEMPTED-4W KNOW {.21 LINCLAPAED 1:3 REFUSED NO SUCH STREET NO SUCH HUMBER D 44510 f ICIENT ADDRESS C;No mAti RECEPTACLE U TEMPORARILY AWAY IA I S - '41-- won CM81040-1104••■••••••■••■••••••■• CHPA ATTN: MAJORIE SILBERMAN 4152 WEST BLUE HERON RIVIE BLVD, SUITE 226 RA,BEACH, F • } • RTT.T.T.ANF. Ft T,HF,AT,TH CHOTCF PT AN FLHE300 334842030 1401 02 05/22/02 RETURN TO SENDER :FLORIDA HEALTH CHOICE PLAN MOVED LEFT NO ADDRESS UNABLE TO FORWARD RETURN TO SENDER • 349)4 • - 4Y 2O '112 F, f0:•'■ t 1,4 of(' gailniiii0011.01011011 tio 401:fir 4.?d;# di. he IA/ S4fAit, TRUSylr'r t9)P • CE GROUP 5439 SW 147 'LACE 01011111111101.0041' MIAMI, F . 3 85-4029 3t' ORIGINAL Aso iV 1%11611■ PUBLIC RISK MANAGEMENT OF FLORIDA (PRM) HEALTH PLAN Proposal for Group Health Insurance For: City of Okeechobee Bid Number: FIN 01-00-05-02 July 5, 2002 �. Presented By: RICHARD G.SCHELL Area Assistant Vice President Timothy R.Reynen Account Executive Arthur J. Gallagher&Co. Gallagher Benefit Services One Boca Place 2255 Glades Road,Suite 400E Boca Raton,FL 33431 (561)995-6706 .. PUBLIC RISK MANAGEMENT .. OF FLORIDA (PRM) HEALTH PLAN TABLE OF CONTENTS Section I Introduction Section II Medical Plan Section III Dental Plan .. Section IV Life Insurance Plan Section V Blue Cross Blue Shield of Florida Gallagher Benefit Services Section VI Current PRM Members .. Section VII Agreement to Participate PRM Bi-Laws Section VIII Benefit Summary Comparison . AM Best Ratings 1 Gallagher Benefit Services, Inc. A Subsidiary of Arthur J. Gallagher& Co. July 3, 2002 •• Lola Parker, Account Supervisor City of Okeechobee 55 S.E. Third Avenue Okeechobee, FL 34974 Re: Public Risk Management Medical, Dental and Life Proposal Dear Lola, We appreciate the opportunity to present the enclosed Public Risk Management Health Trust proposal. The proposal contains quotes for the High Option PPO, Low Option PPO, Blue Care HMO as well as the PRM Dental and Life Insurance program. The medical rates illustrated would be for the period August 1, 2002 through September 30, 2003, to coincide with the PRM plan year (a fourteen month contract). The Dental rates are effective August 1, 2002 through September 30, 2002. The Life Insurance rates illustrated would be from August 1, 2002 through September 30, 2004. The PRM Health Trust, like the P&C Pool, will offer the City of Okeechobee increased value and the opportunity to provide a more stable renewal process as health trends continue to escalate. Groups with good claims experience receive additional credit at renewal. The Trust requires a two-year commitment from the City of Okeechobee in order to participate. The advantages of self-funding and the pooling concept are the results of long term commitment as demonstrated by the continued success of the PRM program. Should you have any questions, please contact me or Tim Reynen at 561-995-6706. Again, thank you for the opportunity to provide the City of Okeechobee a proposal from the Public Risk Management Health Trust. Sincerely, .0441 RTr� �• Richard G. Schell Area Assistant Vice President encl. One Boca Place 2255 Glades Road, Suite 400 E Boca Raton, FL 33431 561.995.6706 Fax 561.995.6708 a www.ajg.com INTRODUCTION Gallagher Benefit Services, a division of Arthur J. Gallagher & Co., is pleased to provide the enclosed information on behalf of Public Risk Management of Florida concerning the benefit programs available through the PRM Health Plan. PRM is a purchasing cooperative of governmental agencies founded in 1988 for the purpose of banding together to obtain the most competitive contracts for provision of Property& Casualty and Employee Benefit insurances. Arthur J. Gallagher & Co. acts as insurance consultant and broker to the PRM risk pools, working with the membership and their individual consultants to provide quality programs to participating entities. Members of the Property& Casualty risk pool have first hand knowledge of the expertise and experience Arthur J. Gallagher & Co. brings to the membership. Gallagher Benefit Services brings the same talents to the Employee Benefits arena,providing the PRM membership with expertise and guidance through the quickly changing and heavily mandated employee benefits areas. The PRM Health Plan is governed by a Board of Directors which meets quarterly to review plan operation, financials, legislative issues and any other pertinent information. Each participating entity delegates its' own Board Member, and each entity receives one vote. Each member has input regarding the plan, future enhancements, funding levels, etc. The plan year begins on October 1 of each year. Due to budgetary requirements, renewal discussions begin in April and are finalized at the end of June each year. All contracts and funding levels are based on an October 1 through September 30 plan year, although multi year rate guarantees are obtained from the carriers whenever possible. Medical coverage is required for participation in the PRM Health Plan. Other coverages offered as part of the PRM Health Plan to participating entities are dental, life, AD&D and Dependent Life insurances. These are offered for the convenience of the membership and are not required for participation. Gallagher Benefit Services is also available for and happy to work with individual entities and their advisors in the development of other additional employee benefits. 3 SECTION II Medical Plan die r ale rr 4 PRM MEDICAL PLAN The Medical program provided through the Public Risk Management of Florida Health Plan is a self funded plan using the Blue Cross Blue Shield of Florida network, administered by Blue Cross Blue Shield of Florida and reinsured by Lincoln Re. At the close of each fiscal year an actuarial report is submitted to the State of Florida pursuant to Florida Statute 112.08, and each year the State has �. certified the Plan to be actuarially sound and fully reserved. Administration/claims services, network access and excess reinsurance are negotiated by the PRM Health Plan on behalf of its' members. This allows the Plan to utilize a larger purchasing group and obtain more competitive rates than could be purchased individually. Any actual purchases must be approved by the Board of Directors. A choice of three medical plans is offered: A High Option PPO, a Low Option PPO, and an HMO. Participating entities may select whichever plan, or combination of plans, best suit their needs. Plan designs can be found on the following pages. As PRM members are first and foremost individual entities, all Personnel parameters, i.e.; employee �. eligibility for participation in the Plan, are decided by the individual entity. This allows the entities to retain the personnel practices in place. .r Prospective participants are initially underwritten based on individual group demographics and experience. 5 .. PUBLIC RISK MANAGEMENT OF FLORIDA SUMMARY OF BENEFITS HIGH OPTION PPO Lifetime Maximum $2,000,000 Copay $15 Per Office Visit at PPC Physician's Office(Deductible and Coinsurance Waived) Deductibles Calendar Year $200 (3 Per Family-Aggregate) +- Per Admission(Non PPC Hospital Only) $100 Coinsurance 90%of PPC Schedule For Utilization of PPC Providers; 70%Of Allowance For Utilization of Non- i` PPC Providers Prescription Drugs Rx Card(See Attached) Maternity Delivery,Pre-and Postpartum Care Subject to Deductible and Coinsurance Adult Well Care $15 Copay per visit up to$250 combined adult wellness and OB/GYN Well Child Care $15 Copay Per Well Child Care Visit at PPC Birth to Age 16 (18 Visits) Physician's Office; Out of Network,Deductible Waived Accident Care 90%of allowance(Deductible and Coinsurance waived) Mental Nervous Inpatient -30 Days; 30 Visits $15 Copay Per Office Visit at PPC Physician's Office; Per Calendar Year Outpatient- Up to 20 Visits Per Out of Network, Subject to Deductible and Calendar Year Coinsurance .. Partial Hospitalization Alcohol and Drug $2,500 Lifetime Maximum $15 Copay Per Office Visit at PPC Physician's Office; (Inpatient,Outpatient of any Combination) Out of network,Subject to Deductible and Coinsurance Skilled Nursing Facility 60 Days Per Calendar Year Home Health Care $12,000 Per Calendar Year Hospice $7,500 Lifetime Maximum Maximum Out-Of-Pocket Coinsurance Expense $1,500 Per Person Amount Per Calendar Year (Maximum 3 Per Family-Aggregate) 6 AWN PUBLIC RISK MANAGEMENT OF FLORIDA HIGH OPTION PPO $7 GENERIC/$14 BRAND NAME PRESCRIPTION DRUG COVERAGE ..� BlueScript Pharmacy Program The cost of prescription drugs accounts for a significant share of your total health care expense. Blue Cross and Blue Shield of Florida has developed the BlueScript Pharmacy Program in an effort to help control the increasing cost of prescription drugs. BlueScript covers most medications,which,by law,may only be dispensed by a written prescription. ®• No claims to file. When your employees select a BlueScript participating pharmacy, they simply present their Blue Cross and Blue Shield of Florida identification card and pay the applicable copayment amount for each covered prescription drug. The participating pharmacy will file the claim for your employees. Participating Pharmacies. More than 2,400 pharmacies participate in BlueScript statewide. Selection of a pharmacy for participating in BlueScript is based on quality,service,competitive pricing,convenience to our customers, and ability to provide all necessary information for claims filing. The pharmacy also must have on-line capability to provide timely via verification of eligibility,coverage and pricing information at the point-of-sale. Non-Participating Pharmacies. Covered prescription drugs purchased at non-participating pharmacies are subject to the copayment amount and reimbursed at a lower percentage. At the point-of-sale, your employees will pay the full cost of the prescription drug and obtain an itemized receipt. It will be the employee's responsibility to complete a prescription drug claim form,attach the itemized paid receipt, and submit both to Blue Cross and Blue Shield of Florida for payment. After processing,payment will be made directly to the employee. BlueScript Key Features: �., • Broad accessibility with more than 2,400 participating pharmacies statewide,giving your employees more choices with convenient locations. • Participating pharmacies file claims for you,so you and your employees receive hassle-free service. • Program flexibility with coverage designed to meet your needs at the point-of-sale. • On-line claims information,providing quick answers on eligibility,pricing and coverage. BlueScript provides hassle-fee service with no claims to file when using a participating pharmacy. It's another way Blue Cross and Blue Shield of Florida is helping to control the high cost of health care. sMService mark of Blue Cross and Blue Shield of Florida,Inc. .r. all a. 7 PUBLIC RISK MANAGEMENT OF FLORIDA SUMMARY OF BENEFITS LOW OPTION PPO Lifetime Maximum $2,000,000 Copay $15 Per Office Visit at PPC Physician's Office(Deductible and Coinsurance Waived) �. Deductibles Calendar Year $500 (3 Per Family-Aggregate) Per Admission(Non PPC Hospital Only) $500 Coinsurance 80%of PPC Schedule For Utilization of PPC Providers; 60%Of Allowance For Utilization of Non- PPC Providers Prescription Drugs Rx Card(See Attached) Maternity Delivery,Pre-and Postpartum Care Subject to Deductible and Coinsurance Adult Well Care $15 Copay per visit up to$250 combined adult wellness and OB/GYN Well Child Care $15 Copay Per Well Child Care Visit at PPC Birth to Age 16(18 Visits) Physician's Office; Out of Network,Deductible Waived Accident Care 80%of allowance(Deductible and Coinsurance waived) Mental Nervous Inpatient -30 Days; 30 Visits $15 Copay Per Office Visit at PPC Physician's Office; Per Calendar Year "• Outpatient-Up to 20 Visits Per Out of Network, Subject to Deductible and Calendar Year Coinsurance Partial Hospitalization Alcohol and Drug $2,500 Lifetime Maximum $15 Copay Per Office Visit at PPC Physician's Office; (Inpatient, Outpatient of any Combination) Out of network,Subject to Deductible and Coinsurance Skilled Nursing Facility 60 Days Per Calendar Year Home Health Care $2,500 Per Calendar Year Hospice $7,500 Lifetime Maximum Maximum Out-Of-Pocket Coinsurance Expense $1,500 Per Person Amount Per Calendar Year (Maximum 3 Per Family-Aggregate) Aem 8 �... PUBLIC RISK MANAGEMENT OF FLORIDA LOW OPTION PPO $10 GENERIC/$25 BRAND NAME PRESCRIPTION DRUG COVERAGE BlueScripts m Pharmacy Program The cost of prescription drugs accounts for a significant share of your total health care expense. Blue Cross and Blue Shield of Florida has developed the BlueScript Pharmacy Program in an effort to help control the increasing cost of prescription drugs. BlueScript covers most medications which,by law,may only be dispensed by a written prescription. No claims to file. When your employees select a BlueScript participating pharmacy, they simply present their Blue Cross and Blue Shield of Florida identification card and pay the applicable copayment amount for each covered prescription drug. The participating pharmacy will file the claim for your employees. Participating Pharmacies. More than 2,400 pharmacies participate in BlueScript statewide. Selection of a pharmacy for participating in BlueScript is based on quality, service, competitive pricing,convenience to our customers,and ability to provide all necessary information for claims filing. The pharmacy also must have on-line capability to provide timely verification of eligibility,coverage and pricing information at the point-of-sale. Non-Participating Pharmacies. Covered prescription drugs purchased at non-participating pharmacies are subject to the .,, copayment amount and reimbursed at a lower percentage. At the point-of-sale,your employees will pay the full cost of the prescription drug and obtain an itemized receipt. It will be the employee's responsibility to complete a prescription drug claim form, attach the itemized paid receipt,and submit both to Blue Cross and Blue Shield of Florida for payment. After processing,payment will be made directly to the employee. BlueScript Key Features: • Broad accessibility with more than 2,400 participating pharmacies statewide,giving your employees more choices with convenient locations. • Participating pharmacies file claims for you, so you and your employees receive hassle-free service. • Program flexibility with coverage designed to meet your needs at the point-of-sale. • On-line claims information,providing quick answers on eligibility,pricing and coverage. BlueScript provides hassle-fee service with no claims to file when using a participating pharmacy. It's another way Blue Cross and Blue Shield of Florida is helping to control the high cost of health care. sMService mark of Blue Cross and Blue Shield of Florida, Inc. AO AO 9 . PUBLIC RISK MANAGEMENT OF FLORIDA SUMMARY OF BENEFITS HMO PLAN Benefit Authorized m. Out of Pocket Maximum Individual $1,500 Family $3,000 ' Hospital per Admission Copay $250 Physician Office Services me Primary Care Physician $10 Copay Specialist $10 Copay Office Surgery $10 Copay ""' Routine Services $10 Copay Preventive Care $10 Copay Well Child Care $10 Copay ,l, Allergy Testing $0 Copay Allergy Immunization $10 Copay Annual GYN exam $10 Copay X-Ray&Lab $0 Copay '" Infertility Services $10 Copay Hospital Services: .. Inpatient $250 per Admission Copay Outpatient Hospital/Surgical $100 Copay Emergency Room $50 Copay a. Hospice Care $0 Copay Home Health Care $0 Copay $0 Copay Skilled Nursing Facility 90 days/yr. max Mental& Nervous "' Inpatient $250 Copay/admission; 30 days/yr. Outpatient $25 Copay/visit; 20 visits/yr. are Substance Abuse Inpatient/Outpatient Inpatient $250 Copay/admission;Detox only Outpatient $15 Copay/visit; 20 visits/yr. on Other Healthcare Providers(Ambulance,DME) $0 Copay Prescription Drug Program Drug Card: Generic $7.00 Copay Brand $14.00 Copay Mail Order: Generic $14.00 Copay AN Brand $28.00 Copay 10 ... City of Okeechobee PRM Health Trust Rate Breakdown - Medical Effective: 8/1/02 - 9/30/02 'Plr.0* .r.re4:Prt,AMP: *- ElnP!Plfe644*' Employee,;Employee gigholitioi;" ',1..::„--;: i.,,: .:::::.::'5-,;'RI:::',:lt:- iiiieA.;:3:::1,:,,§ii0UseO:!;'7,,=ii:Ciiiid i,:.:::*Family Attachment Factor $450.90 $1,014.19 $941.26 $1,504.72 Specific Excess @ $80,000 $42.79 $96.25 $89.33 $142.81 .. Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $42.89 $42.89 $42.89 $42.89 .. PRM Administration $5.11 $5.11 $5.11 $5.11 Conversion $0.50 $0.50 $0.50 $0.50 . Monthly Funding Rate $545.55 $1,162.301 $1,082.451 $1,699.39 Prcferi0:100ilai:.11,Q :,4?-: .:1',..h,' ';:::,;:,.',i:::-,,: ,:,::,::;: ;jiq).,Y*o-* ,'.E*pi*:*•ftEtoii!(i*, Lovr'00*Ii',,, i'i'f ::- ',''t;;;:!‘:::; ,',1',:.:7:74.61144,t ::: '' 1.:'-(Siiiiii;:',,:k : ,!'ktiiiii(:':.4*i'fii*- Attachment Factor $392.28 $882.34 $818.90 $1,309.10 Specific Excess @ $80,000 $42.79 $96.25 $89.33 $142.81 . Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $42.89 $42.89 $42.89 $42.89 PRM Administration $5.11 $5.11 $5.11 $5.11 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate I $486.931 $1,030.451 $960.091 $1,503.77 Health Maintenance '--:-41:--:. :Z:LIA'r;i'll'1 ‘4::',:', :',**Wi'''' '4,-'',k-Y:5-V4 ';:ji;.:.-;-:'''•=!''Y' ' ,oriiiiiti4;0:0an;;7::411 *Ps:P?i'''::,:401":iliniiigii4 ;I:iiiii;4i4.:6*Zii. : ,,„ ,s , : -:,, ,-,,;,:,1;,,;:, : ,, ,,_,, , - Blue Cara, ,,'\: =::---: 1'''' ,':' ,:';',r';!1::r ' ';''kiiiPloYe :. .,:!:$1Siiiert:;" 840/14 :A TO/11/1Y" a■ Attachment Factor $378.75 $851.92 $790.66 $1,263.96 Specific Excess @ $80,000 $36.08 $81.15 $75.32 $120.40 . Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $62.00 $62.00 $62.00 $62.00 PRM Administration $5.11 $5.11 $5.11 $5.11 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate I $485.80 $1,004.04[ $936.951 $1,455.33 "` City of Okeechobee PRM Health Trust Rate Breakdown - Medical Effective: 10/1/02 - 9/30/03 Pr eferred ProVi, e tT PO: ;:V4,;4, ,. := � k4 ,Employ + : ms 10 • : �g...� ,i i • in � :"i+rS.= <x" :fqqt-n=Jyg;a="'ak ' �\ � &t �«@:p 4 - >,♦ i :' , t p $ ' a Attachment Factor $450.90 $1,014.19 $941.26 $1,504.72 ,,, Specific Excess @ $80,000 $42.79 $96.25 $89.33 $142.81 Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $48.90 $48.90 $48.90 $48.90 PRM Administration $5.32 $5.32 $5.32 $5.32 Conversion $0.50 $0.50 $0.50 $0.50 .., Monthly Funding Rate $551.77 $1,168.521 $1,088.671 $1,705.61 P neferi ed:,:'rovi_deir PPO' != .,,: , ..�:...,.w ° �r�: `Em Io .. ;aEi� lo° a „E`�n likyee_. i•:.J�•�r- z -'Y^dv`,:= �Z..v� �?Aa\'•••� '".Cx:r ..1.:. •.� i�ri..,,y .�..�a w •�y n N.4-�. .a:,. --, ;a°'M ,:q'',w,.i fi' tom.�i. .�°-�=r<e= �• , &•:•�'ss.:• ,- P. $4.:1;:,!::1; wEmplayee:_. ,Sgous�. � ';.&��"Ch�1 :;,..f,:',74� - '' Attachment Factor $392.28 $882.34 $818.90 $1,309.10 Specific Excess @ $80,000 $42.79 $96.25 $89.33 $142.81 . Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $48.90 $48.90 $48.90 $48.90 PRM Administration $5.32 $5.32 $5.32 $5.32 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate $493.15 $1,036.67 $966.311 $1,509.99 .. ealtl%t, •ainitenance = :> ,, r:.,;..,. Oanp 4 : E.. r g. i tiak tonr;.:_..:, p x? ��-. i'l' � �. . m�to �,. lo o e' � •, �gl ' e "y- Cd,- , '. ..� w.. n ." +3 SL � Z P N � ;;ye: . Bu aro l „ emploe . ; t�p0 WZ �Ch��2 . mmy Attachment Factor $378.75 $851.92 $790.66 $1,263.96 Specific Excess @ $80,000 $36.08 $81.15 $75.32 $120.40 .. Aggregate Excess $3.36 $3.36 $3.36 $3.36 BC/BS Administration $62.00 $62.00 $62.00 $62.00 PRM Administration $5.32 $5.32 $5.32 $5.32 Conversion $0.50 $0.50 $0.50 $0.50 Monthly Funding Rate $486.01 $1,004.25 $937.161 $1,455.54 .. Conditions and Limitations: • Completion of Plan Sponsor Disclosure Form. Disclosure pertains to: 1) any claim relating to a serious medical condition, 2) each claim in the last 12 months that has exceeded or expected to exceed 50% of the specific deductible, 3) employees absent from work due to disability and dependents, retirees or COBRA beneficiaries who are hospital confined. • A Plan Document. The Excess Loss Policy cannot be issued until the Plan Document has been received and approved by Lincoln Re Risk Management Services. • Paid Claims experience from 4/1/02 — 9/30/02. • A census of final enrollment. Terms are subject to change if final enrollment varies by more than 15% from proposal assumptions. • Capitation is included as an eligible expense under the aggregate. "r • Minimum participation requirement is 75% of eligible employees. Employees who waive coverage on this plan due to coverage elsewhere will be considered non participating. • We assume implementation of the proposed PRM schedule of benefits with Blue Cross & Blue Shield. • The proposed program complies with State and Federal Statutes currently and in the future. HIPAA compliance is included. • Specific applies to all claims for all conditions for each individual. • Specific applies to the mother and each child separately. • The agent/broker is properly licensed and appointed with the carrier noted above for which business is written. • We assume the experience reflects a standard claims processing time of approximately two weeks from date of receipt to date paid by the Third Party Administrator. Terms are subject to change on a retrospective basis if subsequent experience demonstrates a significant, ,, undisclosed backlog of claims. • Aggregate Monthly Settlement Option is included. • Medical coverage options outlined in the proposal are contingent upon network availability. .ti. Excess Loss Insurance Exclusions: • Transplant Services, except for human to human organ or tissue transplant procedures. • Expenses eligible for or covered by any worker's compensation, occupational disease law or similar law. • Losses due to war or any act of war. • Penalties, interest, fines or fees imposed under the Policyholder. • Punitive, exemplary, compensatory or extra-contractual damages paid by the Policyholder. • Losses resulting from any professional or other liability claims arising from services rendered by the Policyholder or any employee of affiliated organizations or person. • Expenses from which the Policyholder is eligible for or receives any payment or reduction in charges resulting from, but not limited to coordination of benefits or subrogation. • Sales or use taxes, surcharges, or other such taxes or assessments, unless Lincoln expressly agrees to make such payments as Lincoln agreed to with New York and Massachusetts surcharges. • Cost of claims administration or other administrative expenses and any expense for litigation involving disputed claims under the plan document. 1 Swiss Re Lincoln National Health&Casualty Insurance Co. I' 7300 Corporate Center Drive Suite 205 Miami,Fl 33126-1222 Watts 800-352-0042 Voice 305-715-6145 Fax 305-715-6199 Plan Sponsor Disclosure Statement E-Mail:Eric_Hicks @SwissRe.com It is the intention of the Plan sponsor to purchase Excess Liability Insurance in connection with the funding of an employee welfare benefit plan. The following information is provided to the Excess Liability Carrier for use with the Plan Sponsor's application for coverage. Listed below are: A. Claims in the last 12 months exceeding 50%of the specific deductible level selected; B. Any current claims which may be potentially serious regardless of current claim amount; C. Dependents,retirees, or COBRA beneficiaries who are hospital confined within 30 days of this report; and D. Employees absent from work due to disability as of the date of this report. *CLAIMANT# **E/D/R/C DATE OF SEX DATE DIAGNOSIS OR NATURE OF CURRENT STATUS AND TOTAL BIRTH DISABLED DISABILITY PROGNOSIS BILLS TO DATE($) * For purposes of confidentiality,please identify the claimants as claimant#1,#2,#3,etc. **E=Employee, D=Dependent, R=Retiree,C=COBRA beneficiary(include date COBRA coverage is expected to terminate) The Plan Sponsor named below,through its authorized person,hereby represents that the above list is true,complete and accurate to the best of his/her knowledge and belief and that nothing has been knowingly or intentionally omitted. The Plan Sponsor acknowledges that,as a minimum,its claims administrator,utilization review vendor,and medical case management vendor participated in the collection of the above data. PLAN SPONSOR Authorized Person Address - Signature Date of Disclosure Title This information will be treated confidentially by the Excess Liability Carrier. Additional sheets may be attached. Number of Claims Listed Number of Sheets Attached eww.lincolnre.com Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. ..r SECTION III AMP Dental Program all NO r 11 PUBLIC RISK MANAGEMENT OF FLORIDA DENTAL PLAN The dental program provided through the Public Risk Management of Florida Health Plan is also a self funded plan. The dental plan is administered by Florida Combined Life, a division of Blue ,,r Cross Blue Shield of Florida, and reinsured by Lincoln Re as part of the overall plan. The dental program is included as part of the actuarial report submitted to the State of Florida annually pursuant to Florida Statute 112.08, and each year the State has certified the PRM Health Plan to be actuarially sound and fully reserved. Administration/claims services and excess reinsurance are negotiated by the PRM Health Plan on behalf of dental participants. This allows the Plan to utilize a larger purchasing group and obtain more competitive rates than could be purchased individually. Any actual purchases must be approved by the Board of Directors. The Dental Program provided through the Public Risk Management of Florida Health Plan is an indemnity plan without network or provider requirements. As in the medical plan, all Personnel parameters, ie; employee eligibility for participation in the Plan, are decided by the individual entity. 0. Participation in the dental plan is not required for participation in the PRM Health Plan consortium. PUBLIC RISK MANAGEMENT OF FLORIDA •"' DENTAL PLAN Benefits Maximum Basic Dental $1,500 per calendar year Orthodontia $1,500 lifetime (Available to dependent children under age 19 only) Deductible $50 per calendar year, per person (Waived for Preventive Services 2 per family and Orthodontia) Copayment percentage for: • Preventive Services 100% • Basic Services 80% • Major Services 50% • Orthodontia 50% Covered Dental Expenses include reasonable and customary necessary expenses incurred for the services and supplies listed below: Covered Preventive Services • Initial oral examination • Periodontic oral examinations, 2 per calendar year. • Prophylaxis, including cleaning, routine scaling and polishing, 2 per calendar year. • Topical Fluoride application once per calendar year for individuals under age 19. • Palliative (to relieve pain) emergency treatment and emergency oral examinations. • Sealants for individuals age 6 through 13 years of age, one application per 36 consecutive months. • Dental X-rays as follows: One set of full mouth x-rays every 36 months; 2 sets of bitewing x-rays per calendar year; Other dental x-rays as deemed necessary. • Space maintainers, except if covered under Orthodontia benefits. • Pulp vitality tests. • Caries susceptibility tests. 13 PUBLIC RISK MANAGEMENT OF FLORIDA DENTAL PLAN (Continued) Covered Basic Services • Fillings (amalgam, composite, plastic and acrylic). • Extractions. • Endodontics (root canal). • Recementing of crowns, inlays and/or bridges. • Biopsies of oral tissue. • Home visits by a physician or dentist when medically necessary in order to render a Covered dental service. • Oral surgery. • Apicoectomy. • Hemisection. • General anesthesia administered in connection with a covered dental service if administered by an individual licensed to administer general anesthesia, other than the dentist or physician performing the service for which administered. • Injection of antibiotic drugs. • Periodontics: Occlusal equilibration, when no restoration is involved; Gingivectomy and gingivoplasty; Gingival curettage; Scaling and root planing; Osseous surgery(osteoplasty and ostectomy), including flap entry and closure; Surgical Periodontic examination; "" Mucogingivoplastic surgery; Management of acute periodontal infection and oral lesions. • Denture adjustments, not including relining or rebasing. • Fixed bridge repair as follows: Replacement of broken pins; Replacement of broken pontic; Replacement of bridgework when the existing bridgework was installed at least 5years prior to its replacement and the existing bridgework cannot be made serviceable. • Repairs to existing removable denture (full or partial) as follows: Repair of broken complete or partial denture and/or replacement of broken teeth; Replacement or addition of teeth due to the extraction of natural teeth which occurred while covered under this Plan; Reattachment of damaged clasp or replacement of broken clasp; Replacement of denture when the existing denture was installed at least 5 years prior to its replacement and the existing denture cannot be made serviceable. 14 PUBLIC RISK MANAGEMENT OF FLORIDA DENTAL PLAN (Continued) Covered Major Services • Inlays (not part of bridge). • Onlays (not part of bridge). • Crowns (not part of bridge). • Inlays, onlays, gold foil restorations, crowns (including precision attachments for dentures). • Denture adjustments and relining and/or rebasing once each 36 months. • Dentures, full and partial, and bridges, fixed and removable as follows: Initial installation of dentures; Dentures to replace one or more natural teeth extracted while covered under these benefits; Initial installation of bridges; Bridgework to replace one or more natural teeth extracted while covered under these benefits (including inlays and crowns to form abutments); Six months of post-delivery care. ,.. Covered Orthodontia Services (available only to dependent children age 19 or less at the date treatment commences.) • Installations of orthodontic appliances and all orthodontic treatments concerned with the reduction or elimination of an existing malocclusion and conditions resulting from that malocclusion through correction of abnormally positioned teeth. • Diagnostic services, including examination, study models, radiographs and all other diagnostic aids used to determine orthodontic needs once each 5 years, commencing with the date of the initial visit to the dentist or physician. • Active and retentive orthodontic treatment for 24 consecutive months or less. Also, the amount of orthodontia charges included as covered expenses during the initial calendar year quarter of treatment will be limited to 30% of the total allowable charges for the cost of the entire orthodontia treatment. The balance of the covered expenses will be prorated over the remaining calendar year quarters of the treatment plan or 7 calendar year quarters, whichever is less. 15 City of Okeechobee Dental Plan Rates 8/01/02 - 9/30/03 S�.ngle� � . $31.15 $63.76 al. SECTION IV Life Insurance Plan MIN Ala efts 1 F PUBLIC RISK MANAGEMENT OF FLORIDA LIFE INSURANCE PLAN The Life Insurance Plan provided through the Public Risk Management of Florida Health Plan is fully insured and written by The Standard Insurance Company. Insured benefit per employee is elected by individual entity and may be based on salary or a flat amount. The standard PRM Life Plan benefits include Basic Life, Basic Accidental Death & Dismemberment and Dependent Life. Additional PRM Life Plan benefits include Supplemental employee and dependent life. .. Participation in the life insurance plan is not required for participation in the PRM Medical Plan Consortium. Gallagher Benefit Services would be happy to assist in alternate plans. 17 City of Okeechobee Life Insurance Rates 8/01/02 - 9/30/04 Basic Life Rate: - .= k _. $0.28 per $1,000 $0.03 per $1,000 .• SECTION V Blue Cross Blue Shield of Florida Gallagher Benefit Services �- 18 PUBLIC RISK MANAGEMENT OF FLORIDA BLUE CROSS BLUE SHIELD PROFILE OF SERVICES Blue Cross Blue Shield provides the following administrative services as part of their contract with the PRM Health Plan. • Claims Administration •• • Eligibility Maintenance • PPO/HMO Network • Customer Service • Employee Meetings/ Enrollment • Utilization Review, Pre-Certification, Case Management • PPO/HMO Claims Filing by Providers • Prescription Drug Card • Mail Order Drug Service • COBRA Administration • Reports �.. Entities participating in the PRM Health Plan program will receive all of the above member services. Employees, entity administrators and providers will deal with Blue Cross representatives assigned exclusively to PRM for routine issues. Additionally, Blue Cross PPO providers will be responsible for obtaining pre-certification authorization and for filing PPO claims. We anticipate soft dollar savings to PRM Health Plan members in the form of less plan administration, less time resolving claims issues, less time reporting to various vendors, and less time answering employee questions and complaints. 19 PUBLIC RISK MANAGEMENT OF FLORIDA BLUE CROSS BLUE SHIELD ADVANTAGES • PRM commitment to pooling concept. Fourteen year track record of quality service and plan implementation. • Flexibility in plan designs offering two PPO's in addition to an HMO. • In addition to the Blue Cross Blue Shield service staff, PRM staff, and Gallagher Benefits Services assist in all areas of plan management. • Quarterly board meetings include Health Trust status reports, industry updates, and the sharing of ideas and concepts. ••• • National recognition and acceptance of I.D. card. The ITS Program offers a reduction in changes and hold harmless against balance billing when employees incur a claim out-of-state with a participating Blue Cross/Blue Shield in that state. • Local presence throughout the state with walk-in service to track all customer inquiries for prompt resolution or questions. • Largest PPO network in Florida. Employees have more hospitals and doctors to choose from. The average reduction of billed charges results in savings of 35-45%. • Blue Cross/Blue Shield allowances are accepted as payment in full. No balance billing except for copy or deductible as co-insurance. Providers agree not to require full payment at time of service and providers will file the claim. • Network in and out of PPC network. Physicians and hospitals that participate with Blue Cross/Blue Shield,but not with PPC network agree to accept our allowance at the lower and will not balance. They will also file claim on behalf of employee. • Blue Cross/Blue Shield's Cobra Administration(CobraServe)simplifies and holds the account harmless for errors and omissions in the administration of the Cobra program. No annual fee. • Personal health advisor available 24 hours a day, 7 days a week. Toll free number to access a medical nurse confidentially and immediate answer employees health care questions and concerns. • Virtual Office 20 PUBLIC RISK MANAGEMENT OF FLORIDA GALLAGHER BENEFIT SERVICES SCOPE OF SERVICES Gallagher Benefit Services is experienced in all facets of employee benefits. We provide services for our clients'benefit programs including, but not limited to, medical, dental, life, disability, cafeteria, drug card, vision, voluntary coverage, and long term care plans. .. The Scope of Services below reflects the services available to PRM members and their consultants/advisors for all lines of coverage contained in their employee benefit plans. A. Plan Analysis B. Benefit Analysis C. Financial Analysis D. Benefits Marketing E. Optional Services and Fees As a full service brokerage and consulting firm, Gallagher has extensive internal resources available, including but not limited to benefits brokerage and specialty services. All of these services can be provided or arranged by the Gallagher Benefit Services Boca Raton office. 1. Flexible Benefits/Cafeteria Plan Administration 2. ERISA Audits/Compliance Services .. 3. COBRA Administration 4. Capital Accumulation/Retirement Planning Services 5. Human Resource Outsourcing Services The Arthur J. Gallagher organization, and Gallagher Benefit Services, has extensive experience with a diverse client base utilizing self-funded and/or insured funding arrangements, as well as general plan administration. We have several specialty divisions allowing us to offer the most comprehensive employee benefit consulting services. Our first hand experience and variety of services makes us uniquely qualified to assist our clients in the design and implementation of their benefit plans. 21 SECTION VI A• Current PRM Members ION MEI ANN 22 CURRENT PRM MEMBERS/REFERENCES Gallagher Benefit Services -- Consultant One Boca Place, 2255 Glades Road, Suite 400E Boca Raton, FL 33430 Phone (561) 995-6706 Fax (561) 995-6708 •• Jeff Angello, Area President Richard Schell, Area Assistant Vice President Glen Volk, Vice President Actuarial Services Colleen Ramos, Account Coordinator Tim Reynen, Account Executive Colleen Ferguson, Technical Support PRM Administrative Office—7 Employees 2013 Altamont Avenue, Unit 25 Fort Myers, FL 33901 Phone (800) 367-1705 Fax (941) 476-8889 Ross D. Furry, Executive Director Judy Hearn, Assistant Executive Director/Secretary Desoto County Board of Commissioners—269 Employees �.. 201 East Oak Street, Suite 202 Arcadia, FL 34266 Phone (863) 993-4808 Fax (863)993-4857 Paul Erickson, Human Resources and Community Services Director Glades County Board of Commissioners—98 Employees 500 Avenue J Moore Haven, FL 33471 Phone (863) 946-2140 Fax (863) 946-2860 Mary Aim Dotson, Administrative Secretary Hendry County Board of Commissioners—226 Employees 18 Hicopochee Avenue Labelle, FL 33935 Phone (863) 675-5221 Fax (863) 675-5317 a Lester Baird, County Administrator a Hendry County Sheriff's Department— 130 Employees a 101 S. Bridge Street Labelle, FL 33935 Phone (941) 674-4630 FX (863) 674-4635 .® Susie Hicks, Personnel Town of Longboat Key— 133 Employees a 501 Bay Isles Road Longboat Key, FL 34228-3196 Phone (941) 316-1999 . Fax (941) 316-1656 Bonnie Mims, Administrative Services Director a.. Okeechobee County Board of Commissioners— 179 Employees 304 N.W. 2"d Street, Room 109 Okeechobee, FL 34972 Phone (863) 763-9312 Fax (863) 763-9312 Robbie Chartier, Deputy County Administrator City of Punta Gorda—273 Employees 326 West Marion Avenue a Punta Gorda, FL 33950-4492 Phone (941) 575-3302 Fax (941) 575-3310 a Willard Beck, City Manager a Sarasota-Manatee Airport Authority— 116 Employees 6000 Airport Circle Sarasota, FL 34243-2105 a Phone (941) 359-5200 Fax (941) 359-5054 r Martin Lange, Senior Director of Finance and Administration a Levy County Board of Commissioners —222 Employees 355 South Court Street Bronson, FL 32621 a Phone (352) 486-5217 Fax (352) 486-5167 a Fred Moody, County Coordinator Hamilton County Board of Commissioners— 156 Employees .. 207 Northeast First Street, Room 106 Jasper, FL 32052 .. Phone (904) 792-1288 Fax (904) 792-3524 .. Greg Godwin, City Clerk City of Crystal River—53 Employees -• 123 North West Highway 9 Crystal River, FL 334428-3930 Phone (352) 795-6994 Fax (352)795-6351 Linda Stilson, Assistant to the Finance Director South Florida Conservancy District— 14 Employees 2852 US Highway 441 .. Belle Glade, FL 33430 Phone: (561) 996-2940 ,. Fax: (561) 996-2960 Ron Graydon, General Manager AGREEMENT TO PARTICIPATE IN THE PRM GROUP HEALTH BENEFITS PROGRAM WHEREAS, Public Risk Management of Florida (PRM) has established a Group Health Benefits �• Program to provide group health benefits coverage for Members desiring to participate in the program (the "Group Health Benefits Program"). WHEREAS, ("Participant"), desires to participate in the aforementioned Group Health Benefits Program; and WHEREAS, PRM and Participant are desirous of setting forth the obligations and responsibilities of each party hereto; • WHEREAS, the finances of the Group Health Benefits Program (the "Trust") and Property and Casualty Fund are considered separate funds. The Trust shall not be responsible for financial obligations of the Property and Casualty Fund. The Property and Casualty Fund shall not be responsible for the financial obligations of the Group Health Benefits Program. NOW, THEREFORE, IN CONSIDERATION OF the mutual covenants herein contained, the parties hereto, intending to be legally bound hereby, agree as follows: I. PRM's GROUP HEALTH BENEFITS PROGRAM (the "PROGRAM") AGREES THAT: a. It will make available to Participants group health benefits through one or more group health benefit plans offered by or through insurance, including self-insurance, as may be from time to time approved and endorsed by the Program. b. It will provide for the administration of the Trust and its operations and any attendant and related costs of the Program. c. It may, from time to time, deposit a portion of funds received from the Participant's contributions or premiums into a designated reserve fund. Funds so designated shall become and remain the sole and exclusive property of the Program, provided, however, that should the Program cease to operate, all reserve funds remaining after settlement of all obligations of the Program shall be returned to the Participants. d. It will supply periodic reports to each Member in a format and upon such frequency as determined by the Program's Board of Directors. e. It will provide for an annual, audited financial statement. f. The Program Participants shall establish a separate Board of Directors to govern matters of the Program. II. THE PARTICIPANT AGREES THAT: a. It will abide by the Intergovernmental Cooperative Agreement of PRM. All rules and regulations adopted by the Program's Board of Directors, now in existence and as may be from time to time amended, abridged, modified or repealed. 1 b. It will enroll in the Program, for an initial period at a contribution or premium rate established by the Program's Board of Directors and as agreed to by the Member. c. It will continue to participate in the Program for the same period as it is obligated to participate in PRM as outlined in Article IV of PRM's Intergovernmental Cooperative Agreement. �• d. It will, upon termination of this Agreement, not be allowed to participate in the Program for a period of not less than 24 months. e. Upon termination of this Agreement, all contributions made to any designated �• reserve fund by the terminating Participant shall remain in reserve and held by Program and shall be utilized to pay the Participant's share of excess claim obligations and expenses for the time period in which the terminating Participant was a Participant in the Program. f. It will undertake and implement any cost containment programs approved by the Program. g. During the term of this Agreement, it will furnish in a timely manner the Program, insurers or other service entities ("Providers") when and as requested, all employment, dependency and identification information necessary for the proper operation of the Program and its programs. h. It will be solely responsible for payment of all premium or contributions for group health benefits. Failure to remit contributions or premiums due or to provide required information shall be grounds for immediate termination of coverage and benefits by the Program or Providers. i. It shall notify its employees of group health benefits being provided by the Program or Providers. Participants shall be solely responsible for furnishing all data and information to employees, dependents, or other beneficiaries required by applicable state or federal law. III. The operative date initiating obligations and rights of the parties under the Agreement shall commence on , 2000. IV. This Agreement shall be approved by the Participant's governing body and executed on ,.. behalf of the Participant by its duly authorized officer and shall be forwarded to the Program. A copy of the Minutes of the Participant's governing body adopting this Agreement shall be attached to this Agreement. •- MEMBER: BY: DATE: (It's Duly Authorized Officer) PRM's GROUP HEALTH BENEFITS PROGRAM BY: DATE: (It's Duly Authorized Officer) 9 AMENDMENT AGREEMENT TO PARTICIPATE IN THE PRM GROUP HEALTH BENEFITS PROGRAM V. Subject to the Intergovernmental Cooperative Agreement of PRM, which agreement shall �• control in the event of any inconsistencies, this Agreement may be modified by approval from two-thirds (2/3) of the Program's Board of Directors present at a meeting where a quorum of the Directors are present (a quorum shall consist of Directors representing a majority of the Members of the Program, one Director being appointed by each Member) at a meeting called for such purpose. Adopted 4-18-91 3 AMENDMENT AGREEMENT TO PARTICIPATE IN THE PRM GROUP HEALTH BENEFITS PROGRAM VI. All former Members of the Program, whether termination of membership occurs voluntarily or involuntarily or by termination of the Program, shall continue to be responsible fully and obligated to pay, their portion of covered claims payable by the Program, which covered claims occurred or were incurred during the period the Member was a participant in the Program, along with, its portion of all other obligations of the Program which relate to the period during which the terminated Member was a participant in the Program. Adopted 4-18-91 4 AMENDMENT AGREEMENT TO PARTICIPATE IN THE PRM GROUP HEALTH BENEFITS PROGRAM VII. In the event a Member intends to include the employees of a Constitutional Officer of the State of Florida, located within the jurisdiction of such Member (the "Sponsoring Member"), in the number of persons to be covered under the health insurance program established by the PRM Group Health Benefits Program (the "Health Trust"), then such •.+ Constitutional Officer must irrevocably agree to be bound by the rules and regulations, as such may be amended from time to time, of the Health Trust, in a writing approved by PRM's Executive Director upon advice of counsel, or become a Member of the Health Trust. This amendment shall be prospective in nature, and no covered employee presently included in the PRM Health Trust shall be denied coverage merely because of the Amendment. With respect to such presently covered employees, the Executive Vie Director and the Members will use their best faith efforts to obtain the membership of such Constitutional Officers in the Health Trust, or their agreement to be bound by the rules and regulations of the PRM Group Health Trust for so long as the Sponsoring Member is a Member of the Health Trust. Adopted 12-12-91 5 THE INTERGOVERNMENTAL COOPERATIVE AGREEMENT (A CONTRACT AND BY-LAWS FOR PUBLIC RISK MANAGEMENT OF FLORIDA) (PRM) AS AMENDED AND RESTATED THROUGH AUGUST 13, 1999 a THE INTERGOVERNMENTAL COOPERATIVE AGREEMENT (A CONTRACT AND BY-LAWS FOR PUBLIC RISK MANAGEMENT OF FLORIDA) (PRM) a INDEX a PAGE 1 Article 1 Name and Duration 1 Article 2 Definitions and Purpose 4 Article 3 Power and Duties 5 Article 4 Participation and Term 6 Article 5 Commencement of the Pool 6 Article 6 Board of Directors of the Pool 9 Article 7 Board of Directors Meetings 9 Article 8 Pool Officers 11 Article 9 Finances and Risk Management Pool 13 Article 10 Excess Insurance 14 Article 11 Obligations of Members 15 Article 12 Liability of Board of Directors or Officers of the Pool 15 Article 13 Additional Insurance 16 Article 14 Settlements 16 Article 15 Contractual Obligation 17 Article 16 Expulsion or Termination of Members 18 Article 17 Special Provisions for Deferred Funding a 18 Article 18 Termination of Pool ARTICLES OF ASSOCIATION AND BY-LAWS OF PUBLIC RISK MANAGEMENT OF FLORIDA (PRM) BE IT KNOWN THAT: The below named public agency or agencies of the State of Florida for the purpose of forming a risk management and self-insurance association pursuant to the terms of Florida Statutes Sections 768.28(15)(a), 440.57, and 163.01, Florida Interlocal Cooperation Act of 1969, do bind themselves contractually to and adopt these Articles of Association and By-Laws. Article 1 -Name and Duration 1.1 Name. The name of this association shall be Public Risk Management of Florida, referred to hereinafter as the Pool. Article 2 - Definitions and Purpose 2.1. Definitions. As used in this agreement, the following terms shall have the meaning hereinafter set out: "Annual Payments": The amount each Member must annually pay to fully fund the costs of the full operation of the Pool. "Aggregate Excess Insurance": Stop Loss Insurance purchased by the Pool from insurance companies and/or Lloyd's of London, or other similar entities, approved by the Board of Directors, or any committee appointed by the Board for such purpose, to protect the Pool from an accumulation of losses in any policy year should the "Loss Fund" be exhausted. Once the "Aggregate Excess Insurance" is triggered, any further losses within the "Self Insured Retention" will be paid by this coverage. "Fiscal Year": The fiscal year of the Pool shall begin on October 1st and end on September 30th "Joint Self-Insurance" or "Self-Funded": A self-insurance or self-funded program in which Members agree to annual payments to fully fund the operations of the Risk Management Pool. "Loss Fund": The fund established to pay claims occurring within the "Self Insured Retention." The "Loss Fund" represents the maximum amount for which the Pool is exposed in a single fiscal period. 1 "Maintenance Deductible": The amount paid by the "Member" before the loss is paid by the "Self Insured Retention." This is a nominal amount designed to protect the "Loss Fund" from small claims. The "Maintenance Deductible" applies only to property, automobile physical damage and crime losses." "Members": The public agencies of the State of Florida which initially or later enter into the intergovernmental association established by this Intergovernmental Agreement. "Multi-Loss Coverage": This multiple loss protection limits a loss involving more than one line of coverage from one occurrence (i.e. property, liability, workers' compensation) to one "Self Insured Retention." "Pool": Public Risk Management of Florida established pursuant to the Constitution and the Statutes of the State of Florida by this Intergovernmental Agreement. "Risk Management": A program attempting to reduce or limit casualty and property losses to Members and injuries to employees caused by or arising out of the operations of Members. Where claims arise the Pool will provide processing of claims, investigation, defense and settlement within the financial limits of the Pool as established in accordance with this Intergovernmental Agreement and will tabulate such claims, costs and losses. "Risk Management Pool": A fund of public monies established by the Pool to jointly ,.. self-insure and self-fund property coverages, general liability, automobile liability, professional liability, public officials' liability and workers' compensation, and any other coverage lines approved by the Board of Directors. "Self-Insurance": The decision by a public agency not to purchase insurance coverage for risks below certain limits; to seek and maintain immunities provided by law for a noninsured ... public agency; to rely upon its financial capabilities to pay covered losses which occur in case third-party claims are held valid and not barred or capped by available immunities: and to purchase some insurance to protect against catastrophic or aggregate losses. The purchase of liability insurance by the Pool or any of its Members is not intended to, and does not, waive sovereign immunity. Purchase of liability insurance shall only be pursuant to Florida Statutes, which allow for the purchase of insurance by the Pool without the waiver of sovereign immunity by the Pool or any of the Pool's Members and is not pursuant to any other statute of the State of Florida. "Self Insured Retention": A layer of assumed risk where the pool self-insures a pre- determined amount of loss per occurrence. "Specific Excess Insurance": Insurance purchased by the Pool from insurance companies and/or Lloyd's of London, approved by the Board of Directors, or any committee appointed by the Board for such purpose, that provides catastrophe coverage up to the limit(s) chosen by the Pool. 2.2. Purpose: The Pool is a cooperative agency voluntarily established by Members as set forth in Florida Statutes Sections 163.01, 768.28 and 440.57 for the purpose of seeking the prevention or lessening of casualty and property losses to Members and injuries to persons or employees which might result in claims being made against Members. The purpose of this Pool is to carry out and effect the agreed upon functions and purposes of this Intergovernmental Agreement as stated herein. It is the intent of the Members of this Pool to create an entity, which will administer a Risk Management Pool and utilize such funds to defend and protect, in accordance with this Intergovernmental Agreement, any Member of the Pool against liability for a covered loss. This Agreement shall constitute the substance of a contract among the Members. All funds contained within the Risk Management Pool are funds directly derived from its Members who are public agencies of the State of Florida. It is the intent of the Members in entering into this Intergovernmental Agreement that, to the fullest extent possible, the scope of Risk Management undertaken by them through a Joint Self-Insurance or Self-funded program using governmental funds shall not waive, on behalf of any Member or such Member's employees as defined in Florida Statutes Section 768.28, any defenses or immunities therein provided, or provided by the laws of the State of Florida. The Pool and the Members of this Pool intend to effect no waiver of sovereign immunities through their use of public funds retained within the Risk Management Pool. Such funds being utilized to protect against risks in accordance with Florida Statutes Section 768.28 are not intended to constitute the existence, issuance or purchase of a policy for insurance. This Intergovernmental Agreement is not to be considered such as would cause this Pool to be treated as an "insurer" within the meaning of any legislation giving risk to liability or applicability to "insurer", for damages, costs, fees or expenses, etc., under Florida Statutes Sections 624.155, 626.9541, 626.9561, 627.426, 627.428, or other statutes applicable to Public Entity Self Insurance in the State of Florida. 2.3 Non- Assessable: Public Risk Management is a non-assessable pool. Article 3 - Power and Duties 3.1. Powers: The powers of the Pool to perform and accomplish the functions and purposes set forth herein, within the budgetary limits and procedures set forth in this ®• Intergovernmental Agreement, shall be as follows: 3.1.1. To establish By-Laws and Amendments to By-Laws, and operational procedures governing the operations of the Pool which are consistent with this Intergovernmental Agreement as set forth in Florida Statutes Sections 768.28, 163.01 and 440.57, and to not waive any sovereign immunity not waived statutorily under Florida Law, and to expressly negate any past, present, or future waiver of sovereign immunity under Florida Statutes, and to continue to negate any waiver of sovereign immunity for discretionary and planning functions of government. 3.1.2. To employ agents, employees and independent contractors and approve the rate of compensation, benefits and/or contracts that apply to Pool employees, Pool 3 officers and service providers, and to ensure all benefits of Florida Statutes Section 163.01(9)(a) and all other applicable Florida Statutes. 3.1.3. To lease real property and to purchase or lease equipment, machinery or personal property necessary for the carrying out of the purpose of the Pool. 3.1.4. To carry out educational and other programs relating to risk reductions. 3.1.5. To cause the creation of this Pool and see to the collection of funds for the continued administration of the Risk Management Pool. 3.1.6. To purchase Aggregate Excess Insurance and Specific Excess Insurance to supplement the Risk Management Pool without such being a waiver of sovereign immunity under Florida Law. 3.1.7. To establish reasonable and necessary loss reduction and prevention procedures, which shall be followed by the Members. 3.1.8. To provide Risk Management services including the defense of and settlement of claims and to have the authority granted by Florida Statutes Section 768.28(14). 3.1.9. To negate, pursuant to Florida Statutes, any implication of a waiver of sovereign immunity, and to negate any waiver of sovereign immunity other than to the extent required under Florida Statutes Section 768.28. 3.1.10. To act solely within the budgetary limits established by the Members to carry out such other activities as are necessarily implied or required to carry out the purposes of the Pool. 3.1.11. To sue or be sued as a separate legal entity. Article 4 - Participation and Term 4.1. Term: The initial term of the Pool shall be from 12:01 a.m. on October 1, 1987 to 12:01 a.m. September 30, 1989. After the initial two (2) year term of the Pool, the term shall automatically be renewed for an additional term of one (1) year each. Provided, however, the Members may, through the manner provided in Section 6.9.4., terminate the Pool as of the end of the initial or any additional term during which such action is taken. 4.2. Notice of Withdrawal: So long as the Pool shall continue in existence, any current or new Member joining the Pool shall remain a Member for an initial two-year term, except a new Member coming into the Pool after the first day of the fiscal year shall be obligated to be a member for not less than eighteen (18) months. A new member's rates will be guaranteed for their initial term. 4 Any Member may withdraw from the Pool at the end of the fiscal year upon serving on the Pool by mail, fax or hand delivery at least one year's prior written notice. Such notice shall be addressed to the Executive Director of the Pool and shall be accompanied by a resolution of the governing body of the Member electing to withdraw from the Pool. 4.3. Actual Withdrawal/Required Withdrawal. Any Member who has served the Executive Director with prior written notice of its intent to withdraw at least one (1) year prior to the beginning of the fiscal year for which the notice to withdraw is applicable, shall serve in writing to the Executive Director, by mail, fax or hand delivery on or before August 15 prior to the beginning of such fiscal year, a verification as to whether the Member intends to actually withdraw from the Pool at the end of the current fiscal year. Failure to serve such verification on or before August 15 prior to the beginning of the fiscal year for which notice of intent to withdraw is applied, shall be deemed a revocation of the prior notice of intent to withdraw; thus, binding the Member to the Pool for the ensuing fiscal year. Provided, however, any Member who serves written notice of its intent to withdraw from the Pool more than once during any three (3) year period may be required, at the option of the Board of Directors, to withdraw from the Pool on the second such notice. An action to expel a Member in this manner shall be taken by the Board of Directors prior to August 1 of the current fiscal year in the manner described in Article 16 hereafter. 4.4. Admission of New Members: The Pool's Executive Committee shall establish and periodically review standards and the approval process for the admission of new Members. Upon approval of these standards and of the approval process for admission by the Board of Directors, the Pool's Executive Committee may grant or deny admission to proposed new Members based upon such criteria. Consideration of new Members will be communicated to all PRM Board Members by the Executive Director for any information or feedback that a Member may have regarding the prospective member. Article 5 - Commencement of the Pool 5.1. Commencement Date: The Pool shall commence operations on October 1, 1987. Article 6 - Board of Directors of the Pool 6.1. The Board: There is hereby established a Board of Directors (sometimes hereinafter referred to as the "Board") of the Pool. Each Member shall appoint one (1) person to represent that body (the "Representative") on the Board of Directors along with another person to serve as an alternate representative (the "Alternate") when the Representative is unable to carry out that Representative's duties. The Representative and Alternate shall be appointed in writing by the governing body of the Member and a copy of the written appointment shall be provided to the Executive Director of the Pool. Once such appointments are made known to the Pool, the persons appointed shall remain in office until the Pool receives evidence in writing of the appointment of other persons by the Member's governing body. The Representative and ,., Alternate selected must be an employee, an appointed official or elected official of the entity. 5 6.2. The Chairman and Vice Chairman: The Board of Directors shall bi-annually select a Chairman and Vice Chairman during the final quarter of each two-year term to serve during the subsequent two-year term. The term of office for the Chairman & Vice Chairman shall begin on the 1st day of a fiscal year and expire on the last day of a fiscal year. No person may serve as Chairman of the Board of Directors for more than two (2) consecutive full two-year terms. The Chairman shall preside at all meetings of the Board. The Chairman shall vote on all matters that come before the Board. The Chairman shall have such other powers as he may be given from time to time by action of the Board. The Vice Chairman shall carry out all duties of the Chairman of the Board during the absence or inability of the Chairman to perform such duties and shall carry out such other functions as are assigned from time to time by the Chairman or the Board of Directors. The Board of Directors may from time to time appoint other officers of the Board. 6.3. Board Responsibilities. The Board of Directors shall have the responsibility for: (1) hiring of Pool officers, agents, non-clerical employees and independent contractors; (2) setting of compensation for all persons, firms and corporations employed by the Pool; (3) approval of amendments to the Intergovernmental Agreement; (4) approval of the acceptance of new Members and expulsion of Members, except that the approval may be delegated to the Executive Committee under Article 4 above, or by such procedures as are contained in the motion making delegation; (5) approval and amendment of the annual budget of the Pool; (6) approval of the operational procedures developed by the Executive Director; (7) approval of educational and �., other programs relating to risk reduction; (8) approval of reasonable and necessary loss reduction and prevention procedures which shall be followed by all Members; (9) approval of Annual Payments to the Risk Management Pool for each Member; and (10) termination of the Pool in accordance with this Intergovernmental Agreement. 6.4. Voting: Each Member shall be entitled to one (1) vote on the Board of Directors. Such vote may be cast only by the Representative of the Member or in the Representative's absence by the Alternate. No proxy votes or absentee votes shall be permitted. Voting shall be conducted by show of hands or any method established by the Board that is consistent with �• Florida law. A simple majority vote of those Representatives present shall be required to pass on any motion. On such matters, the Chairman and the Executive Director of the Pool shall cause each Member's Representative and Alternate to receive the proposed ballot which will include at a minimum the text of the motion to be voted upon and the purpose of such motion. Only the Representative or the Alternate may vote on such ballots (not both). If both the Alternate and Representative submit ballots, only the Representative's ballot will be counted. Favorable votes by a majority of the Members' Representatives (or Alternates in their absence) entitled to vote shall pass any action unless an action is taken which is subject to 6.9 below, in which case passage will be based on the required number of votes as if each Member's Representative or Alternate was present at a regular or special meeting called to decide such question. 6.5 Representatives: The Representative selected by the Member shall serve until a successor has been selected. The Representative chosen by the Member may be removed at any time by the vote of the Member's governing body. In the event that a vacancy occurs in the position of Representative or Alternate selected by the governing body of a Member, that body 6 shall appoint a successor in writing within 60 days of such vacancy occurring. The failure of a Member to select a Representative or the failure of that person to participate shall not affect the responsibilities or duties of a Member under this Intergovernmental Agreement. 6.6. The Executive Committee and other Committees: The Board of Directors shall have the power to establish both standing and ad hoc committees to further the functions and purpose of this Pool. Unless the Board of Directors establishes some other procedure, the authority for selection of Representatives or Alternates serving on the Board of Directors who shall serve on such committees and chair them shall reside with the Chairman of the Board of Directors. The Chairman of the Board of Directors may appoint non-voting and non-paid persons who are not Members of the Board of Directors to serve on committees of the Pool. The Board of Directors shall dictate to the Executive Director the guidelines for authorizing the settlement of claims. The Board of Directors shall establish an Executive Committee. That Executive Committee shall consist of the Chairman of the Board, the Vice Chairman of the Board, the Treasurer and two Representatives elected by the Board, one from the southern area and one from the northern area of the Pool, as such areas are designated on the attached map, Exhibit 6.6. The Board of Directors may grant to the Executive Committee the authority to approve expenditures, authorize a settlement of claims and suits and take such other action as shall be specifically delegated to the Executive Committee. 6.7. Operating Rules: The Board of Directors may establish rules governing its own conduct and procedure not inconsistent with this Intergovernmental Agreement. 6.8. Quorum: A quorum shall consist of a majority of the Representatives (or in their absence their Alternates) serving on the Board of Directors. Except as provided in Section 6.9 herein, or elsewhere in this Intergovernmental Agreement, a simple majority of a quorum shall be sufficient to pass upon all matters. 6.9. Super-Majority Voting: A greater vote than a majority of a quorum shall be required to approve the following matters: 6.9.1. Such matters as the Board of Directors shall establish within its rules as requiring for passage a vote greater than a majority of a quorum, provided, however, that such a rule can only be established by a greater than a majority vote at least equal to the greater than majority vote required by the proposed rule. 6.9.2. The expulsion of a Member shall require two-thirds (2/3) vote of all the Representatives serving on the Board of Directors. 6.9.3. Any amendment of this Intergovernmental Agreement, except as provided ,., in Subsection 4 below, shall require two-thirds (2/3) vote of all the Representatives serving on the Board of Directors. 6.9.4. The amendment of this Intergovernmental Agreement to cause the termination of this Agreement sooner than two (2) years after its commencement or a reduction or elimination in the scope of loss protection set out in Article 10 to be 7 furnished by the self-insurance pool derived from payments from the Members, shall require that specific written notice of the proposed change be sent by registered or certified mail to the governing body of the Member and to the Representative and Alternate of the Member serving on the Board of Directors, no less than ten (10) days prior to a meeting at which this matter is proposed and the amendment as proposed or as amended at such Board meeting must receive the approval of two-thirds (2/3) vote of all of the then current Representatives (or in their absence their Alternates) representing the then Members of the Pool. 6.10. Compensation of Board of Directors: No Representative or Alternate serving on the Board of Directors shall receive any salary from the Pool. 6.11 Conflict of Interest: Representatives and Alternates shall abide by the guidelines established by the State Ethics Commission in the performance of their duties, particularly as it applies to conflicts of interest and financial disclosure. Article 7 - Board of Directors Meetings 7.1. Meetings: Regular meetings of the Board of Directors shall be held at least four (4) times a year. The tentative times, dates, and locations of regular meetings of the Board shall be established at the beginning of each fiscal year. Any item of business may be considered at a regular meeting, including the scheduling of future regular meetings. The Executive Director shall attend all Board meetings and Executive Committee meetings to serve as an advisor and to report as the administrative officer of the Pool. 7.2. Special Meetings: Special meetings of the Board of Directors may be called by its Chairman, or by any three Representatives (or in their absence their Alternates). The Chairman or in his absence, the Vice Chairman, shall give ten (10) days written notice of regular or special meetings to the Representative and Alternate of each Member and an agenda specifying the subject of any special meeting shall accompany such notice. Business conducted at special meetings shall be limited to those items specified in the agenda. The time, date and location of special meetings of the Board of Directors shall be determined by the Chairman of the Board of Directors, or in his absence, by the Vice Chairman. 7.3. Conduct of Meetings: To the extent not contrary to this Intergovernmental Agreement and except as modified by the Board of Directors, Robert's Rules of Order, latest edition, shall govern all meetings of the Board of Directors. Minutes of all regular and special meetings of the Board of Directors shall be sent to all Representatives (or in their absence their Alternates) serving on the Board of Directors. Article 8 - Pool Officers 8.1. Officers: Officers of the Pool shall consist of an Executive Director, a Treasurer, a Secretary and such other officers as are established from time to time by the Board of Directors. All Pool officers shall be appointed by the Board of Directors. 8 AMP 8.2. Executive Director: The Executive Director shall be the chief administrative officer of the Pool and shall in general supervise and control the day to day operations of the d• Pool and shall carry out the policy and operational procedures of the Pool as established in this Intergovernmental Agreement and by the Board of Directors. Among the Executive Director's duties shall be the following: 8.2.1. The Executive Director may sign, with such other person authorized by the Board of Directors, any instruments which the Board of Directors have authorized to be executed and, in general, shall perform all duties incident to the office of Executive Director and such other duties as may be prescribed by the Board of Directors. 8.2.2. The Executive Director shall prepare a proposed annual budget and proposed Risk Management Pool Annual Payment and shall submit such proposals to the Board of Directors. 8.2.3. The Executive Director shall, where necessary, make recommendations regarding policy decisions, the creation of other Pool officers and the employment of agents and independent contractors. At each regular meeting of the Board of Directors and at such other times, as he shall be required to do so, he shall present a full report of his activities and the fiscal condition of the Pool. 8.2.4. The Executive Director shall report quarterly to all Members on all claims filed and payouts made. 8.2.5. The Executive Director shall, within the constraints of the approved or amended budget, employ all secretarial, clerical and other similar help and expend funds for administrative expenses. 8.3. Treasurer: The Treasurer shall: WIN 8.3.1. Have charge and custody of and be responsible for all funds and securities of the Pool; cause to be received and given all receipts for moneys due and payable to the Pool from any source whatsoever; cause to be deposited all such moneys in the name of the Pool in such banks, savings and loan associations or other depositories that are recognized as "Qualified Public Depositories" by the State Treasurer operating under Chapter 280 Florida Statutes, as shall be selected by the Board of Directors; cause to be invested the funds of the Pool as are not immediately required in such securities as the Board of Directors shall specifically or generally select from time to time; and cause to be maintained the financial books and records of the Pool. 8.3.2. In general, perform all duties incident to the office of Treasurer and such other duties as from time to time may be assigned to that individual by the Board of Directors. Nothing herein shall prevent the Treasurer from delegating, in writing, the functions of the office to third parties, whether members of the Board of Directors, employees of the Pool, or third parties, subject to the approval of the Board of Directors. However, the Treasurer shall maintain the control and responsibility for the execution of 9 such functions by such delegates. �- 8.4 Secretary: The Secretary shall issue notices of all Board meetings, and shall attend and keep the minutes of same. The Secretary shall have charge of all corporate books, records and papers; shall be custodian of the corporate seal; and shall keep all written contracts of the Pool. In general, the Secretary shall perform all duties incident to the office of Secretary and such other duties as from time to time may be assigned by the Executive Director or the Board of Directors. 8.5. Third Party Delegations: The Board may select a financial institution or certified public accountant to carry out some or all of the functions which would otherwise be assigned to a Treasurer and may select a risk management company or agent to serve as claims administrator or to carry out some or all of the functions which would otherwise be assigned to the Executive Director. The Board may also employ persons or companies as independent contractors to carry out some or all of the functions of officers of the Pool. 8.6. Officer Vacancies: In the absence of the Executive Director, Treasurer or Secretary, or in the event of the inability or refusal of such officers to act, the Chairman of the Board of Directors may perform the duties of the Executive Director, Treasurer or Secretary, and, when so acting, shall have all of the powers of and be subject to all of the restrictions upon the Executive Director, Treasurer or Secretary. Article 9 - Finances and Risk Management Pool 9.1. Fiscal Year: The fiscal year of the Pool shall commence on October 1, and end on September 30, of each year. 9.2. Budget: The Board of Directors or the Executive Committee shall approve a preliminary budget for the administration of the Pool by June 1 of each year. Copies of all preliminary and final budgets shall be promptly mailed to each Member of the Board of Directors. The Board of Directors shall, by August 1 of the year prior to the start of each fiscal year adopt a final budget and determine the amount of the Annual Payment to be made by each Member and the date upon which the payment is due. Failure of the Board of Directors or the Executive Committee to approve a preliminary or final budget within the times set forth within this Section shall not relieve the Members of the obligation to make any payments to the Pool so WIN long as such budgets are finally adopted, and the Members are given at least thirty (30) days after the passage of the final budget in which to make Annual Payments to the Pool. 9.3. Annual Payment Factors: In determining the amount of the Annual Payment due from each Member, the Board of Directors shall consider some or all of the following factors: 9.3.1. Number of employees; 9.3.2. Property values of the Member; .., 9.3.3 Number and type of vehicles owned by the Member and the use made of the vehicles; 10 9.3.4. Population of the geographic area represented by the Member; 9.3.5. The payrolls of the Member; 9.3.6. Any unusual exposures presented by the Member; 9.3.7. The operating expenditures of the Member; and 9.3.8 The claims and loss experience of the Member. The Board of Directors shall establish annually a cost of risk allocation, which is utilized in making the allocation of the amount of the Annual Payment due from each Member. This standard may, however, vary from year to year but it must be applied equally to all Members similarly situated during such period of time as it is utilized. The Board of Directors may grant debits or credits to Members with above or below average loss or claims records. The amount of such debits or credits may not vary more than 25% above or below the amount, which the Member would pay if it were not to have been granted the debit or credit. In establishing the loss and claims record of the Member, the Board of Directors may utilize the loss and claims experience of the Member during last 3 years of the Pool. 9.4. Budget Amendments: Budgets may be amended at any time by majority vote of the Board, provided, however, such amendments may not require payments, when added to previous payments by a Member for such fiscal year, to exceed such Member's Annual Payment determined for such year. The forwarding of such payments within a time specified in notices to the Members giving them not less than forty-five (45) days to make such payments shall be of the essence of this contract. 9.5. Payments — Timing: In subsequent years, the Board of Directors may permit the Annual Payments to be made on a monthly or quarterly basis. 9.6. Retirement Fund Obligations: Members shall be both severally and jointly liable to the State of Florida Department of Administration, Division of Retirement for any Florida Retirement Systems' contributions, which are owed by the Pool for Pool employees. Each member shall be responsible for expenses incurred which are attributable to the years of membership as outlined in the Intergovernmental Agreement, Article 11. 9.7. Distribution of Surplus: If, for any year during which the Pool was in existence, all claims known or unknown have either been paid or provision has been made for such payment, the Board of Directors as then constituted shall distribute surplus funds to the Members who constituted the membership of the Pool in that prior year, after first deducting there from reasonable administrative and other non-allocated costs incurred by the Pool in the processing of the claims in years other than the one in which the claim was made. The distribution among the Members shall be in the same proportion to the total as was their Annual Payment for that year to the Annual Payments of all Members for such year. 11 9.8. Audit: The Board of Directors shall provide to the Members an annual audit of the financial affairs of the Pool to be made by a certified public accountant at the end of each fiscal year in accordance with generally accepted auditing principles. The annual report shall be delivered to the Chairman of the governing body of each Member. Article 10 - Excess Insurance 10.1. Specific Excess Insurance: The Pool will purchase Specific Excess Insurance from underwriters of insurance, insurance companies and/or Lloyd's of London, approved by the Board of Directors, or any committee appointed by the Board for such purpose, in such amounts which shall be approved by the Board of Directors and underwriters, based upon but not limited to the current assets, risk analysis, and loss history of the Pool. The purchase of Specific Excess Insurance does not, and is not, intended to waive sovereign immunity under Florida law. 10.2. Aggregate Excess Insurance: The Pool will purchase Aggregate Excess Insurance from underwriters of insurance, insurance companies and/or Lloyd's of London, approved by the Board of Directors, or any committee appointed by the Board for such purpose, in such amounts which shall be approved by the Board of Directors and underwriters, based upon but not limited, to the current assets, risk analysis, and loss history of the Pool. The purchase of Aggregate Excess Insurance does not, and is not, intended to waive sovereign immunity under Florida law. 10.3. Multiple Loss Coverage: The Pool will purchase Multiple Loss Coverage in the event a single occurrence involves more than one line of coverage, limiting the occurrence to a single "Self Insured Retention." 10.4. Losses: The Risk Management Pool (Loss Fund), the Specific Excess Insurance and Aggregate Excess Insurance shall provide payment for covered losses in any one fiscal year for members up to the limits approved by the Board of Directors. Should losses in any one fiscal year extinguish all available funds provided by the Pool then the individual Member or Members whose judgment or settlement of claim has been perfected by Florida law shall be responsible for any additional payment. The Pool shall make payments in the order in which the judgments against the Pool have been entered or settlement of claims have been reached. Membership in the Pool shall not preclude any Member from purchasing any insurance coverage above those amounts purchased by the Pool. Article 11 - Obligations of Members 11.1. Member Obligations: The obligations of Members of the Pool shall be as follows: 11.1.1. To budget for, where necessary, to levy for and to promptly pay all payments to the Risk Management Pool at such times and in such amounts as shall be established by the Board of Directors within the scope of this Intergovernmental Agreement. Any delinquent payments shall be paid with a penalty, which shall be set by the Board, but such rate shall not exceed the highest interest rate allowed by statute to be paid by a Florida public agency. 12 11.1.2. To select, in writing, a Representative to serve on the Board of Directors and to select an Alternate Representative. 11.1.3. To allow the Pool reasonable access to all facilities of the Member and all records including, but not limited to, financial records, which relate to the purpose or powers of the Pool. 11.1.4. To allow attorneys employed by the Pool to represent the Member in investigation, settlement discussions and all levels of litigation arising out of any claim made against the Member within the scope of loss protection furnished by the Pool. 11.1.5. To furnish full cooperation with the Pool attorneys, claims adjusters, the Executive Director and any agent, employee, officer or independent contractor of the Pool relating to the purpose or powers of the Pool. 11.1.6. To follow in its operations all loss reduction and prevention procedures established by the Pool within its purpose or powers. 11.1.7. To report to the Executive Director or his designee within the time limit specified the following items: 11.1.7.1. To provide on or before May 1 of each fiscal year of the Pool, the Member's renewal application shall be completed by the member as required by the Underwriters. 11.1.7.2. To report, within five (5) days of receipt, any and all statutory notices of claims, as well as summons and complaint or other pleading before a court or agency involving any claim for which Pool coverage is sought. 11.1.7.3. To report, within ten (10) days of receipt, any oral or written demand for monetary relief for which coverage is sought to the Pool Executive Director. 11.1.7.4. To report to the Executive Director at the earliest practicable moment any information of an occurrence, claim or incident received by the Member and from which the Member could reasonably conclude that coverage will be sought by said Member for such an occurrence, claim or incident. In the event that the items set forth above are not submitted to the Executive Director within the time periods set forth above, the Board of Directors of the Pool, by a vote of a majority of a quorum of the Board, at a regular or special meeting, may in whole or part decline to provide a defense to the Member or to extend the funds of the Pool for the payment of losses or damages incurred. In reaching its decision, the Board shall consider whether and to what extent the Pool was prejudiced in its ability to investigate and defend the claim due to the failure of the Member to promptly furnish timely notice of the occurrence, claim or incident to the Executive Director. The decision of the Board of Directors shall be final. Failure of a Member to abide by these requirements shall also be grounds for expulsion from the Pool. 13 11.1.8. To make Payment of any "Maintenance" Deductible(s). Article 12 - Liability of Board of Directors or Officers of the Pool 12.1. Liability of Directors and Officers: The Representatives (or in their absence their Alternates) serving on the Board of Directors or officers of the Pool should use ordinary care and reasonable diligence in the exercise of their power and in the performance of their duties hereunder; they shall not be liable for any mistake of judgment or other action made, taken or omitted by them in good faith; nor for any action taken or omitted by any agent, employee or independent contractor selected with reasonable care; nor for loss incurred through investment of Pool funds, or failure to invest. No Representative shall be liable for any action taken or omitted by any other Representative. Representatives shall have the immunities provided by law and in particular Florida Statutes Section 163.01. The Pool may purchase insurance providing liability coverage for such Representatives or officers. Article 13 - Additional Insurance 13.1. Member's Option to Purchase Additional Insurance: The Pool, through the distribution of the minutes of the Board of Directors or through other means shall inform all Members of the scope and amount of Specific Excess and Aggregate Excess Insurance in force at all times. Membership in the Pool shall not preclude any Member from purchasing any insurance coverage above those amounts purchased by the Pool. Such purchase shall not be construed to waive sovereign immunity of the Members of the Pool or the Pool. The Pool shall make its facilities available to advise Members of the types of additional or different coverages available to Pool Members. Article 14 - Settlements 14.1. Settlement/Advance Notice: Whenever the Pool proposes to settle any pending claim or suit where the amount of that proposed settlement shall exceed Five Thousand Dollars ($5,000.00), the Member shall be given advance notice of that settlement. Such notice may be given by the establishment of a reserve amount in excess of Five Thousand Dollars ($5,000.00), provided that the amount of the settlement does not exceed the amount reserved. The officers and employees of the Pool shall, however, endeavor to give specific oral or written notice to the Member's Representative or Alternate of the exact amount of any proposed settlement in excess of Five Thousand Dollars ($5,000.00) prior to the date at which the Pool proposes to bind itself to pay such settlement amount. The officers, employees or independent contractors of the Pool shall attempt to give the Members, as much notice of the settlement negotiations as is possible under the circumstances of each case. Article 15 - Contractual Obligation 15.1. Enforcement: This document shall constitute a binding contract under the Florida Interlocal Cooperation Act of 1969 among those public agencies, which become Members of the Pool. The obligations and responsibilities of the Members set forth herein, including the obligation to take no action inconsistent with this Intergovernmental Agreement as originally 14 written or validly amended, shall remain a continuing obligation and responsibility of the Member. The terms of this Intergovernmental Agreement may be enforced in a court of law by the Pool. The consideration for the duties herewith imposed upon the Members to take certain actions and to refrain from certain other actions shall be based upon the mutual promises and agreements of the Members set forth herein. This Intergovernmental Agreement may be executed in duplicate originals and its passage by the Member's governing body shall be evidenced by a certified copy of a resolution passed by the members of the governing body in accordance with the rules and regulations of such public agency, provided, however, that except to the extent of the limited financial contributions to the Pool agreed to herein or such additional of, obligations as may come about through amendments to this Intergovernmental Agreement no Member agrees or contracts herein to be held responsible for any claims in tort or contract made against any other Member. The Members intend in the creation of the Pool to establish an • organization for Risk Management only within the scope herein set out and have not herein created as between Member and Member any relationship of surety, indemnification or responsibility for the debts of or claims against any Member. 15.2. Attorneys' Fees: In any legal action between the parties arising out of this Agreement, any attempts to enforce this Agreement, or any breach of this Agreement, the prevailing party may recover its expenses of such legal action including, but not limited to, its costs of litigation (whether taxed by the court or not) and its reasonable attorneys' fees (including fees generated on appeals) from the other party. Article 16 - Expulsion or Termination of Members 16.1. Expulsion. By the vote of two-thirds (2/3) of the Directors serving on the Board of Directors, any Member may be expelled. Such expulsion may be carried out for one or more of the following reasons: 16.1.1. Failure to make any timely payments due to the Pool. 16.1.2. Failure to undertake or continue loss reduction and prevention procedures adopted by the Pool. 16.1.3. Failure to allow the Pool reasonable access to all facilities of the Member and all records which relates to the purpose, powers or functioning of the Pool. 16.1.4. Failure to furnish full cooperation with the Pool's attorneys, claims adjusters, the Executive Director and any agent, employee, officer or independent contractor of the Pool relating to the purpose, powers and proper functioning of the Pool. 16.1.5. Failure to carry out any obligation of a Member which impairs the ability of the Pool to carry out its purpose or powers or functions. 15 16.1.6. The Member has given the one (1) year notice described in Section 4.2 and 4.3 above. 16.2. Notice: No Member may be expelled except after notice from the Pool of the alleged failure along with a reasonable opportunity of not less than thirty (30) days to cure the alleged failure. The Member may request a hearing before the Board before any decision is made as to whether the expulsion shall take place. The Board shall set the date for a hearing which shall not be less than fifteen (15) days after the expiration of the time to cure has passed. A decision by the Board to expel a Member after notice and hearing and a failure to cure the alleged defect shall be final. The Board of Directors may establish the date at which the expulsion of the Member shall be effective at any time not less than sixty (60) days after the vote •• expelling the Member has been made by the Board of Directors. If the motion to expel the Member made by the Board of Directors or a subsequent motion does not state the time at which the expulsion shall take place, such expulsion shall take place sixty (60) days after the date of the vote by the Board of Directors expelling the Member. 16.3. Responsibilities of Terminated Member: A former Member shall only continue to be fully responsible only for its' portion of any obligations incurred but not satisfied during the period of time they were a Member of the Pool. Such obligations may include, but not be limited to, premiums, loss fund payments, maintenance deductibles, workers' compensations, final audit and administrative fees, etc., owed or unpaid by the former Member. The former Member shall no longer be entitled to participate or vote on the Board of Directors. Article 17 - Special Provisions for Deferred Funding During the fiscal years commencing on October 1, 1987 and ending on September 30, 1990, the entire Annual "Loss Fund" Contribution was not required by the Board of Directors to be paid within the fiscal year to which it was applicable. The difference between the Annual "Loss Fund" Contribution and the amount required by the Board of Directors to actually be paid to the Pool during such year by a Member is referred to herein as Deferred Funding. Members and former Members during any year for which there existed Deferred Funding may be required by the Board of Directors upon recommendation of the Executive Director to pay their applicable *" portion of the Deferred Funding in subsequent years. .Members or former members will be allowed forty-five (45) days after notification to make any payments of Deferred Funding. The amount of any payments required for Deferred Funding as to each Member shall be based upon the same formula as was used in establishing the Annual "Loss Fund" Contribution for that year. Article 18 - Termination of the Pool 18.1. Termination: If, at the conclusion of any term of the Pool, the Board of Directors votes to discontinue the existence of the Pool in accordance with Section 6.9.4., then the Pool shall cease its existence at the close of the then current fiscal year. Under those circumstances, the Board of Directors shall continue to meet on such a schedule as shall be necessary to carry out the termination of the affairs of the Pool. It is contemplated that the Board of Directors may be required to continue to hold meetings for some substantial period of time in order to accomplish this task, including the settlement of all covered claims incurred during the term of 16 the Pool. The Pool shall continue to be fully responsible and obligated to pay covered claims and expenses owed by the Pool, which accrued before the Pool's termination. The money used to pay such covered claims and expenses shall remain with the Pool until such claims are settled and expenses are paid. 18.2. Post-Termination Responsibilities of Member: After termination of the Pool, the Member shall continue to hold membership on the Board of Directors but only for the purpose of voting on matters affecting their limited continuing interest in the Pool for such years as they were Members of the Pool. 17 In witness whereof, this agreement has been executed by the Entity: . The approval of the foregoing agreement was passed by the Entity: on the day of , 20_, and attached hereto, I do hereby execute and the does hereby attest to my signature as evidence that the has approved and hereby becomes a bound signatory member of the "Intergovernmental Cooperative Agreement" for Public Risk Management of Florida, a copy of which is attached hereto, and which is pursuant to Florida Statutes Section 163.01, which commenced its term on October 1, 1987. Chairperson of Board, or Council Chairperson, Public Risk Management of Florida ATTEST: This day of , 20, 1 .. CURREff BENEETI5 se_c_ Y3 ; t S v"fel Gs 'UNINLARY OF BENEFITS / authorized non authorized n,„„iLUE CROSS AND BLUE SHIELD OF FLORIDA yes no yes no alternative • 'OINT-OF-SERVICE PLAN Alb WITH BLUESCRIPTSNt ENEFITS AUTHORIZED NON-AUTHORIZED "'alendar Year Deductible - Individual $0 1300 '"" Aggregate Family SO $900 tlloeScript Prescription Drug Rider 55.00 Generic 15.00 Generic Including Oral Cuultaccptives) 1 0.110 N.uuc Hrand $10.00 Name ftrand _ The deductible does-not apply to services with a copayment or where indicated. _ifetime Maximum No Maximum $1,000,000 ANCoinsurance Requirement Limit Individual 10 12,000 Aggregate Family SO $6,000 Ave hysician Office Services • Routine Services 15 Copayment 80%Allowed Amount • • Preventive Care 55 Copayment Not Covered • Well-Child Care $5 Copayment 80%Allowed Amount '" No Deductible • Allergy Injection (Without Office Visit) 55 Copayment 80%Allowed Amount • Annual Gynecological Examination MIS By A FI01 OB/GYN Physician Up To$150 Per Calendar Year (Does Not Require Authorization at" By Primary Care Physician) 15 Copayment Not Covered • Specialty Care $5 Copayment 80%Allowed Amount • Maternity Care First Office Visit 55 Copayment S0%Allowed Amount "" Total Maternity Care No Copayment 80%Allowed Amount Hospital Services Hospital Per Admission Deductible SO $300 (PAD) • Inpatient r Primary Care Physician No Copayment Not Applicable Facility No Copayment 80%Allowed Amount - All Other Providers No Copayment 80%Allowed Amount • Outpatient Hospital/Surgical Primary Care Physician No Copayment Not Applicable Facility No Copayment 80%Allowed Amount All Other Providers No Copayment 80%Allowed Amount • Non-Routine X-Rays "" (Inpatient or Outpatient) No Copayment 80%Allowed Amount .r • SCUSPICSt St• Illu.CU.{anti Uluc Sl u:W ul Runt,I .a an IiWcpaukm l�tcmccc.J ilk Ulue Guar mul It$SIucW A W wu.•1 +WO • CURIUM' BENEFITS r ',UNIIYLARY OF BENEFITS authorized non authorized ,,.IILUE CROSS AND BLUE SHIELD OF FLORIDA yes no yes no alternative • 'DINT-OF-SERVICE PLAN A16 WITH BLUESCRUPTsnt ,®3ENEFITS AUTHORIZED NON-AUTHORIZED Talendar Year Deductible Individual 10 1300 .I. Aggregate Family 50 1900 Bluescript Prescription Drug Rider 55.00 Generic 55.00 Generic Including Oral Cunt,accptivcs) 510.00 Name Brand SI0.00 Name Brand The deductible does-not apply to services with a copayment or where indicated. Lifetime Maximum No Maximum 11,000,000 •Coinsurance Requirement Limit • Individual 50 12,000 Aggregate Family 50 16,000 • .+.Physician Office Services • Routine Services 15 Copayment 80%Allowed Amount • • Preventive Care 15 Copayment Not Covered • Well-Child Care 55 Copayment 80%Allowed Amount No Deductible • Allergy Injection (Without Office Visit) 15 Copayment 80%Allowed Amount • Annual Gynecological Examination By A F101 OB/GY• Physician Up To 1150 Per Calendar Year (Does Not Require Authorization r By Primary Care Physician) 15 Copayment Not Covered • Specialty Care 15 Copayment 80%Allowed Amount • Maternity Care First Office Visit 55 Copayment 80%Allowed Amount "' Total Maternity Care No Copayment 80%Allowed Amount Hospital Services Hospital Per Admission Deductible 10 1300 (PAD) • Inpatient ®r Primary Care Physician No Copayment Not Applicable Facility No Copayment 80%Allowed Amount All Other Providers No Copayment 80%Allowed Amount • Outpatient Hospital/Surgical . • Primary Care Physician No Copayment Not Applicable Facility No Copayment 80%Allowed Amount All Other Providers No Copayment 80%Allowed Amount • Non-Routine X-Rays (Inpatient or Outpatient) No Copayment 80% Allowed Amount eCUSV/CAI]l. I INC Cr■...u.l Ulw Si,I4 ul Fl.m u.Inc.a r..Luklniukni Lacnncc of■bc UL.c Cn.....I Ulu.Siueld 1m.+nuuc,. VON AMP _ t 1410 'CLUSIONS 1414 Services and supplies which are, in our opinion, experimental, investigational, Jr not medically necessary; +aPrivate duty nursing services; Dental care(except accident-related); 2osmetic surgery (surgery performed solely to improve appearance of an ndividual); Eye refractions,eye glasses and hearing aids or examinations for their -)rescription or fitting,except as specified in the Preventive Health Services Section; toutine health examinations, except as covered under the Well-Child Care Section and the ""Preventive Health Services Section; Rehabilitative services except as provided in the cardiac rehabilitation and pulmonary ehabilitation sections; are obtained without cost; Services rendered by an individual who is related by blood or marriage; -reatment in a VA hospital or government facility (due to service-related disability); Treatment of any condition arising out of a felony,riot,rebellion,or war; Treatment of any condition or an intentionally self-inflicted condition, suicide,or rtempted suicide; "Speech therapy, except as provided under Home Health Care Services and Therapeutic Services sections; )iagnostic admissions; ,a.)ccupational therapy, except as provided under Home Health Care Services and Therapeutic Services sections; -ervices or supplies related to sexual reassignment; ravel expenses,even if prescribed by a physician(this exclusion does not apply to medically necessary transportation of a newborn child); custodial care; xercise programs of any kind; '}Mon-prescription drugs, vitamins, mineral supplements, or fluoride drugs; Work-related injuries; srvices associated with autopsy or postmortem examination; ,,.ervices and supplies not specifically covered tinder the BCBSF Care Manager Point Of Service Plan; ontraceptive devices, appliances or other supplies when used for contraception. .taa d services rendered in the Emergency Room which are not Emergency Care Services will be subject to calendar year deductible and insurance amount listed above unless authorized by the Primary Care Physician. it a contract. The above Summary of Benefits is only a partial description of the many benefits and services covered by Blue Cross Shield of Florida,Inc. These benefits apply only to groups of 51 or more employees. For a complete description of benefits and dos,please see Blue Cross and Blue Shield of Florida's Care Manager Point Of Service Contract#15483-1096 SR and Schedule of is#15499-1096 SR.:its terms prevail. Blue Cross and Blue Shield of Florida.Inc.is an Independent Licensee of the Blue Cross and Blue Association. s BCBSF/CM 51. e Mark of Blue Cross and Blue Shield of Florida.lie. Blue Crux,and Blue Shield it Honda.Inc.is:a,InJcjxnJcm Licenox if the Blue Cross and Blue Shield Awlecwim. PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES BLUE CROSS/ BLUE SHIELD HIGH OPTION PPO Effective 10/1/2002 - °;Froosed : : °; w, ;<Proposed : ;,.< , >.�-: x- .;:E,,,,.• ..-- :.." '��cL rsH"�° �-i�:a�.�.i��i E .: -In,Network -,C3ut a (iYuithoized) ° : '_ '(Non-Authorized) Maximum Lifetime Benefit $2,000,000 $2,000,000 Annual Deductible $200 $200 Family Deductible $600 $600 Annual Maximum Copayments N/A N/A Family Maximum Copayments N/A N/A Maximum Annual Out of Pocket $1,500 $1,500 Maximum Family Out of Pocket $4,500 $4,500 Coinsurance 90%of allowance 70%of allowance 4th Quarter Carryover Deductible Carryover applies Carryover applies Physician Office Visit $15 Copay Ded,then 70%of allowance Wellcare Visits-Annual exam Adult $15 copay.Covered up to$250- 70%of allowance,Ded waived. combined OB/GYN and Adult Covered up to$250-combined r OB/GYN Wellness OB/GYN and Adult Wellness -Child health $15 Copay.(Birth to age 16) 70%of allowance,Ded waived Mammograms 100%of allowance, Ded waived g 100%of allowance(Ded waived) (may be balance billed) Specialist Office Visit $15 copay Ded,then 70%of allowance Second Opinion Surgical Ded,then 70%of allowance P g $15 Copay(Not Required) (Not Required) ++ Infertility Services/Treatment Plans Ded,then 70%of allowance (Treatment covers artificial insemination, $15 Copay(diagnosis) /$20,000 lifetime max for treatment (diagnosis)/$20,000 lifetime max for IVF,GIFT,&ZIFT treatment $15 Copay(physician's office)Ded, Ded,then 70%of allowance Physical Therapy then 90%of allowance (inpatient/outpatient)up to$10,000 in up to$10,000 lifetime max(combined therapy) lifetime max(combined therapy) $15 Copay(physician's office)Ded, then 90%of allowance Ded,then 70%of allowance Speech (inpatient/outpatient)up to$10,000 (inpatient/outpatient)up to$10,000 ..r lifetime max(combined therapy) lifetime max(combined therapy) $15 Copay(physician's office)Ded, Ded,then 70%of allowance Occupational then 90%of allowance (inpatient/outpatient)up to$10,000 (inpatient/outpatient)up to$10,000 lifetime max(combined therapy) lifetime max(combined therapy) Acupuncture Not Covered Not Covered Injections/Immunizations(child health) $15 Copay 70%of allowance,Ded waived Allergy Testing $15 Copay Ded,then 70%of allowance Allergy Injections(not including serum) $5 copay Ded,then 70%of allowance ,rr Office Surgery $15 Copay Ded,then 70%of allowance Outpatient Surgery(hospital or surgery Ded,then 90%of allowance Ded,then 70%of allowance center) X-ray and Lab Outpatient-Physician's Ded,then 90%of allowance Ded,then 70%of allowance ""' Office Outpatient Radiation Ded,then 90%of allowance Ded,then 70%of allowance PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES 4.. BLUE CROSS/ BLUE SHIELD HIGH OPTION PPO Effective 10/1/2002 Proposed Proposed an: .` • I Network � ut�o Network , (Authorized) _(Non-Authorze d) RAP Providers (Non-PPO Radiologist,Anesthesiologist, Ded,then 70%of allowance pathologist,and ER phys.services at PPO Ded,then 90%of allowance (If participating hospital,Ded,then hosp.) 90%of allowance) Emergency Room/Hospital -Illness Ded,then 90%of allowance Ded,then 70%of allowance "" -Accidents 90%of allowance,Ded waived 70%of allowance,Ded waived Ambulance Ded,then 90%of allowance Ded,then 90%of allowance Ded,then 90%of allowance(Covers Ded,then 70%of allowance(Covers Dental Oral Surgery removal of impacted teeth,including removal of impacted teeth,including impacted wisdom teeth,related x- impacted wisdom teeth,related x-rays rays&anasthesia) &anasthesia) Inpatient Hospital Ded,then 70%of allowance.$100 P P Ded,then 90%of allowance AND per admission deductible X-ray and Lab Inpatient Ded,then 90%of allowance Ded,then 70%of allowance Blood and Blood Plasma Ded,then 90%of allowance (no Ded,then 70%of allowance (no limit) limit) ..r Home Health Care Ded,then 90%of allowance. Ded,then 70%of allowance.$12,000 $12,000 Calendar year max. Calendar year max. Hospice Ded,then 90%of allowance Ded,then 70%of allowance.$7,500 $7,500 lifetime max lifetime max. Skilled Nursing Facility Ded,then 90%of allowance.60 Ded,then 70%of allowance.60 days days per calendar year. per calendar year. Durable Medical Equip. Ded,then 90%of allowance Ded,then 70%of allowance ar Maternity -Physician $15 copay initial visit Ded,then 70%of allowance -Hospital Ded,then 90%of allowance Ded,then 70%of allowance Dependant Daughter Maternity Covered as maternity benefit up to Covered as maternity benefit up to 18 18 months (or longer) months (or longer) Birthing Centers Ded,then 70%of allowance Ded,then 70%of allowance Abortions Not Covered Not Covered In-Patient Mental/Nervous Ded,then 90%of allowance.30 Ded,then 70%of allowance.30 days per calendar year. days per calendar year Out-Patient Mental/Nervous $15 Copay.20 visits per calendar Ded,then 70%of allowance.20 visits year per calender year Attempted Suicide Ded,then 90%of allowance Ded,then 70%of allowance In-Patient Substance Abuse Ded,then 90%of allowance. Ded,then 70%of allowance.$2,500 $2,500 lifetime max lifetime max Out-Patient Substance Abuse Ded,then 90%of allowance. Ded,then 70%of allowance. $2,500 $2,500 lifetime max. lifetime max. Prescription Drugs - Includes coverage for oral contraceptives&diaphragms Generic Ded,then 70%of allowance. INS $7 Copay-30 day supply 30 day supply -Brand $14 Copay-30 day supply Ded,then 70%of allowance. 30 day supply s Prescription Card Yes No Prescription Mail Order Yes No Generic $14 Copay-90 day supply Not Applicable Brand $28 Copay-90 day supply Not Applicable PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES BLUE CROSS/ BLUE SHIELD - LOW OPTION PPO Effective 10/1/2002 Prropo s ,:' ? �`" �Proposed: .: • in'Netwark. '.::.<•' Out of ;._He ( )...,r t�.y'� - ` Nain=Aattiorized)��' .. . - Maximum Lifetime Benefit $2,000,000 $2,000,000 Annual Ded $500 $500 r _ Family Ded $1,500 $1,500 Annual Maximum Copayments N/A N/A Family Maximum Copayments N/A N/A Maximum Annual Out of Pocket $1,500 $1,500 Maximum Family Out of Pocket $4,500 $4,500 01111 Coinsurance 80%of allowance 60%of allowance 4th Quarter Carryover Ded Carry Over applies Carry Over applies Physician Office Visit $15 Copay Ded,then 60%of allowance Wellcare Visits-Annual exam $15 copay,$250 calendar year max 60%of allowance,Ded waived,$250 (combined OBGYN/adult wellness) calendar year max(combined +r Adult/OB/GYN OBGYN/adult wellness) Child health $15 Copay.(Birth to age 16) 60%of allowance,Ded waived(Birth to age 16) Mammograms 60%of allowance,Ded waived(may be AID g 80%of allowance,Ded waived balance billed) Specialist Office Visit $15 Copay Ded,then 60%of allowance Second Opinion Surgical $15 Copay(Not Required) Ded,then 60%of allowance Infertility Services/Treatment Plans (Treatment covers artificial insemination, No Coverage No Coverage IVF,GIFT,&ZIFT Ded,then 80%of allowance aim Physical Therapy Ded,then 60%(inpatient/outpatient)up Ph Y py (inpatient/outpatient)up to$5,000 to$5,000 lifetime max lifetime max Ded,then 80%of allowance Ded,then 60%of allowance Speech (inpatient/outpatient)up to$5,000 (inpatient/outpatient)up to$5,000 lifetime max lifetime max Ded,then 80%of allowance Ded,then 60%of allowance Occupational (inpatient/outpatient)up to$5,000 (inpatient/outpatient)up to$5,000 411• lifetime max lifetime max Acupuncture Not Covered Not Covered $15 Copay 60%of allowance,Ded waived(Birth to Injections/Immunizations(child health) age 16) Allergy Testing $15 Copay Ded,then 60%of allowance Allergy Injections(not including serum) $10 copay Ded,then 60%of allowance PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES BLUE CROSS/ BLUE SHIELD - LOW OPTION PPO Effective 10/1/2002 Propose Proposed`,: • +:Phut 4i9:';:e .s Pfarr7l In Network Out of Network (Authorized) (Non-A u tho rize d).: 41110 .. Office Surgery $15 Copay Ded,then 60%of allowance Outpatient Surgery(hospital or surgery center) Ded,then 80%of allowance Ded,then 60%of allowance ,,r X-ray and Lab Outpatient-Physician's Ded,then 80%of allowance Ded,then 60%of allowance Office Outpatient Radiation Ded,then 80%of allowance Ded,then 60%of allowance a RAP Providers (Non-PPO Ded,then 70%of allowance Radiologist,anaesthesiologist,pathologist, Ded,then 80%of allowance (If participating hospital,Ded,then 80% and ER phys.services at PPO hosp.) of allowance) Emergency Room/Hospital -Illness Ded,then 80%of allowance Ded,then 60%of allowance -Accidents 80%of allowance,Ded waived 60%of allowance,Ded waived Ambulance Ded,then 80%of allowance Ded,then 80%of allowance Ded,then 80%of allowance Ded,then 60%of allowance Dental Oral Surgery (Injury due to external force of sound and (Injury due to external force of sound and natural teeth) natural teeth) Inpatient Hospital Ded,then 80%of allowance $300 per admission Ded,then 60%of N allowance AN X-ray and Lab Inpatient Ded,then 80%of allowance Ded,then 60%of allowance Blood and Blood Plasma Ded,then 80%of allowance (No Ded,then 60%of allowance (No Limit) Limit) Home Health Care Ded,then 80%of allowance. $2,500 per Ded,then 60%of allowance. $2,500 per calendar year calendar year Hospice Ded,then 80%of allowance. $7,500 Ded,then 60%of allowance. $7,500 lifetime max. lifetime max. Ded,then 80%of allowance. 60 days per Ded,then 60%of allowance. 60 days/ Skilled Nursing Facility calendar yr. calendar year Durable Medical Equip. Ded,then 80%of allowance Ded,then 60%of allowance Maternity -Physician Ded,then 80%of allowance Ded,then 60%of allowance -Hospital Ded,then 80%of allowance Ded,then 60%of allowance Dependent Daughter Maternity Ded,then 80%of allowance Ded,then 60%of allowance Birthing Centers Ded,then 60%of allowance Ded,then 60%of allowance .r1 Abortions Not Covered Not Covered arr q.. PUBLIC RISK MANAGEMENT SCHEDULE OF BENEFIT SUMMARIES BLUE CROSS/ BLUE SHIELD - LOW OPTION PPO Effective 10/1/2002 • .. - ` Pro�osed Plan 7]9 PIe rp 719:.. •.; '; n Network -. _ put ofNetwork. _ _ .r • (Authorized). (Non-Authorized) In-Patient Mental/Nervous Ded,then 80%of allowance.30 days;30 Ded,then 60%of allowance.30 days;30 visits per calendar yr. visits per calendar yr. .r Out-Patient Mental/Nervous Ded,then 80%of allowance.20 visits per Ded,then 60%of allowance.20 visits per calendar yr(partial hopitalization). calendar yr(partial hopitalization). Attempted Suicide Ded,then 80%of allowance Ded,then 60%of allowance „10 In-Patient Substance Abuse Ded,then 80%of allowance.$2,500 Ded,then 60%of allowance.$2,500 lifetime max. lifetime max. Out-Patient Substance Abuse Ded,then 80%of allowance.$35 max per Ded,then 60%of allowance.$35 max per visit;44 visits max;$2,500 lifetime max. visit;44 visits max;$2,500 lifetime max. sw Prescription Drugs (Includes coverage for oral contraceptives and Diaphragms) ..r -Generic $10 Copay,30 day supply Ded,then 60%of allowance -Brand $25 Copay,30 day supply Ded,then 60%of allowance ar Prescription Card Yes No Prescription Mail Order Yes No Generic $20 Copay,90 day supply Not Applicable $50 Copay,90 day supply Not Applicable Brand .r r melP aro • i ..I IBESPr IS RATti1G REPORT ... n Lincoln Financial Group ... llnnaln Naci n aL Health&Cavalry Lnsursacx Co. 170H Magra.vrrx Way P.O.Brix 7Ha8 „r ELarc Wtync,IN 4660L•7808 (219) 455.3896 +r <r BEST'S RATING:A (Excellent) The inairnnca taiomwliort Source +i. w wama of*corn a.n er err ..• , .. - -.- - • .. .''' ". 1.,.•-•. 4:-....-i“..L.,..- - 1 -, , -•g-. :•-.1..,.-"'' ''V.'" '74,-4''''.7'''''' . '' .s.' . _ , , . ,.... ,I.•,: ,,. 1..F.,. i r1 4- ...,.. .,,, k..,:,,,.,,,,,--.,- . -, ' - • -...r • - -, " ,' '','--; '1/4'i-'4 ....f-g" ,Fi .• •4 '•t'I..'-'• •4 ..•.. .T,-•i- -' i - - - „.,.•" .-e.•g .- ••.-....•,.' ,f.`„,,,,.•' 4-LI:. ,..,,4,..1,r.,'. , ,,,•.,..' -- , •.. 4, —, ,',14.i.-4-,•,V',1',.., r fr; ..'' I''' '' ,,,, ',f,....4...;i ikil.,„c,...,),W.-y-',. ..i&74,1';',.-r : `,Q1,,kis --'''- -:,— -, ..,- -,-. - .,,. r,. - t ' '' ?..e'''. ' - -,-".'-' ,...,-4 114: ill 1..it:iYeafq,i&i...r,,AtilitIAK,,eafi ,;' .....fi 6 lc 3.ot.:;•■■■•41:•1•:e.... .4•-liii•A11036' - 1 4• i t.,:ier:Ltr4'.1.:;:faXii:Afflite...4"ts:Pt!NI '.q !) ,-%....-74.,-.,;.;....n.::.„1..:.4,-.44,..„•:-_-,,rr---.-ir S,.•.1.11.ts• ; :; i 4 j;-.:*.f: t ..!.*•3'i 1;14,41;f0t14144 i. ' '' ••4... • :.-::,44.1'..."'.'11.,11,4••iri:'41410...3.*,U.No, 446 41: 1,{P,,* h.,A••••45.r. s.1.p•it;..•.11,..:11*.t4:-..441.4ilt•P14,4t*•,1,-•''. ) in.-v.v.,' aii ;14.ii,f;tiiii4 i 1 fkiiriatigth'ilii Z:41.1 0':- i 11 NI'l t•t!7:11.a t:•.1,..1i.',O.--,,,Idtp,M..4.74 1,241 ,c41 v.,. Ail!II•ii.b144:'4 8 f tt ar.4• 1gritt?' :' -• 't' l'O'f434TAS:,11't41A1 PIXArfirrsLirst:IftitIV. ;11' ,r- 'i. 4 BLUE CROSS & BLUE SHIELD 0-4i, . 'i't1":"4•"1*il!.:('..9)re.t:t"-•741:::ov...;:litt , 4:n ... ......1(.0. . .g-...4-•-!••-.1,-"'its ..,..-:.. ---,,,t l• -', ak.,!:,:.;f;t:';4.4,-fir.:t.i ...f.t. ',; :,.,•15),Vats;k: - -t'ro i OF FLO RI DA, IN C. 1 :.v.....;"0...c4,1„t ir...1.-..e..0.,04.....,wc.....4,....,..e....,..14. ..., ,.- •...? J.,,e4...j94.4—14*g,"„*.51-Vr547:47...4-,14)-..ri 11• igiaOXitSvilet.4.4%N-1.z14.11.T.,4•-,..,•-atgli ../. Vi :■4 d te q ?...1.;,,..r., so,.to...A.,17:4,:,..-1.11,o%.,.....,t): ,.., Is hereby authorized to transact 4*.•,•4_11,0,,,t!,,614.3,5:...-4.....A.:t.A.-41,:iiit.:4-T. ,...i-_:v, -,#•-,A,leiics,--.0,A 4.4:34T-44':t•,ftf;Vie?* i,it,h..1 ,,,-0-17, .4.11.r.ell■ti4.1.044...:E;r4.14:41:tojaVvi i VI., insurance in the State of Florida. i.44 ree.itc.Ye4::.:.:••.liit.:.,p4f,,:4,5,-4,-4--.-44-i V i ) 4--, ,..#.144.,...e...iti•s•vit.g.a,%r, ,:„....;‘.v,IT.:1.. .... ..-cw-r..... ...t.44.....p..w...,.... -.4.4„....-....---ea • . ..., lar.Lpt -e-i■Fi's•t•&s.'i..41'1 iv/. k•*3/43 It&' ' N • • a .OW1',Tydr•lificn6T1:11.4,041; 44:. This certificate signifies that the company tkr:0,11:1Virv,4, .•,',;.-.4,),,J0 Apg-11:,.t,',..v.r vt..16.;:"..1'"44 V! -4..',"'; i;:.;,.,.444.:,4'.::;-...;:74.;:';.;,:2,-.%f:t."-.:I ity:,..f.r;;,:,7...4,::•:.:f. has satisfied all requirements of the V- 21.1a.f.,-t';'::r. P • II if i ' ...1 1 9 •'.•, .'•••• :".' iilte.!;:,.,:;.;.Mt....-.: ''.Li .r-4.•-ti4 ..0 i;:...! . :',:.:.....• *.1%:1".::""t.... :: 1E:1. : :q• • . - • .• Florida Insurance Code for the issuance of a license and remains subject to f..:. „Ai:. . • .. .v....,4 all applicable laws of Florida. .1.1;::,... .... . ••• ...., . ...,-. . ... . .. ::.. . • • • •... • .:.'-i-....-::/-..•-•-•:,-..'....:: . Oiiiiidi•• *:.::•:.;.1:1:::......;': Date of Issuance-. July 1 , 1980 VI.' • ../ •.. . • • • ! - •.: t...... .•. NO. 91-59-2015094 Department --:..,-. . . b.; . .. .. .....•,-. ..... . .. : - • -. .. --, ..c.-- - - . .., - •!. of Insurance .,:.. :- r----- "") / ,- • . . .• . - •• • .- . • • . . ... . • • . : = . :.- Tom Gallagher • .. . Treasurer and Insurance Commissioner • . • -•. 1 7 _ .. .• • t: U CIO e4� 0�� a �CaCav V t~V Ul- iU �U v U U�uUGI v N( I ' , as CD c�0 Cfl Ct� CO CO GCS QD tlern C{7 Ca CO O 4 C 6ecz � �_,� n do do d� do nA n n� n Jai n�dn d£�b n n n n n n d'n n ��� a DnC 4 ..-i v.: p ff 1:1 -fin 0 „,,,..,. „. ,,,,,, 0 , ,. :4. ,.. . . t a , . , ,,-. . , tt i 0 a -114-1()\:3 ,44 ..., , , ., ,...r.re:-;e: — _........ .......,. ,..r. t,..,.. __.--,, ..—„:„. ..,,._ • -ft- 1...,.... 1 -4.;,....::., r T V ttIC) -.,, „, ,,,,, , . ... O y „1 A. Mt):`�; Itaptic fruit! tit ibtut? `-` d D C u.:. �a I certify thst the attached is a true and correct copy of the X '�� Articles of Amendment, filed on October 27, 1987, to Articles of OPc t rr lnt✓orpoi tion far BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC., ; + ai nw S Iorida Pat-13'2(460n. es Show b e eco d of is office. ,.yUa F n by the .records s f t h office. Hu 4,a w;' The document number of this corporation is 753198. sy p�U IT'-11-CI Inc w ItnQ 'Ze CI 'ZS; n Xa Q� a N „:.,,,$, .„,.. ip,, , ,hSiUet1 ttt►brr tit Ilui►d u tb llle Inc ,wa Crettlsaul of lile3ttiiG of lurtbtt, }�.( U - nw t,t`attlltdtun,spe, tilo alts itti(,ttlia Ole • and na 27111 NIU µf October, 1987. Q�nc �itesz ;3114.ci '13 cti_.,,;:-.tie :, _.■_ 'IN z L.,f).- „IL,,., to. aes It;i, • `�i � l enz P` •CLAM 41.4;4'..: ,ry a ' ,4 . oatt � �ittt uttt(j 5 �C .. fin. tti',.,"• 5Krrt:lttry of tutr D1(C cfizaca2(11-01 UU 'aUa V U �Ud UC�apU qp � � � �C%tii°N HAi� ��r �afl(1 / a n anakdr aid C?(1 avadmdnu an �flnC 1 , n n n n ;fig' Introduction Blue Cross and Blue Shield of Florida, Inc. (BCBSF) is a leader in the health care benefits industry, committed to the effective financing, delivery and administration of health care benefits. We bring our clients the benefit of over 57 years of health care experience, combined with the strength of the state's largest health insurer. BCBSF and .xrFT: our subsidiaries serve more than 5 million Floridians. Eighteen years ago, the first generation of Blue Cross and Blue Shield of Florida's managed care programs began successfully controlling quality, price and use of hospital inpatient and physician services. Our HMO subsidiary, Health Options, Inc., began operations in 1983. Our PPO program was introduced in 1984. Today, Health Options has the largest commercial HMO market share in Florida. Our PPO has the largest PPO membership in Florida. Through extensive data analysis and satisfaction surveys ' y ; of our members and providers, we continually monitor the effectiveness of our products and programs to ensure BCBSF remains at the forefront of the industry in meeting the needs of our customers. c : Over the years, we have established a reputation for solid financial stability. Like all commercial carriers, BCBSF is regulated by the Florida Department of Insurance. We maintain a reserve level well within established standards. Our earnings, enrollment and policyholders' equity show a pattern of steady growth. This strong financial performance has resulted in BCBSF receiving an "A" rating from Standard & Poor's, an "A" rating from A.M. Best, and an "A3" rating from Moody's, the 17;4 highly respected insurance rating services, in their most recent rating reports. They noted our strong core market presence, our established managed care capabilities, our k.' consistent revenue growth, adequate capital level, diverse product portfolio, and extensive provider networks. Florida Combined Life Insurance Company (FCL), a BCBSF subsidiary, has an A.M. Best rating of"A" and has been writing group life insurance since it was established in 1988. BCBSF formed FCL in order to provide its customers with a broader array of products, including life, accidental death and dismemberment, disability income and a variety of pretax programs. Today, FCL also offers voluntary group insurance, as well as dental insurance. Why should all of this matter to you? Because the stronger we are as a company, the better we can serve you in researching and developing new and better ways to deliver health care benefits. Our stability has allowed us to invest in managed care programs that help control health care costs. That is only part of what you get as a Blue Cross and Blue Shield of Florida r 2 member. .1: 'A. • Here is what Blue Cross and Blue Shield of Florida can mean to you.Introduction • Blue Cross and Blue Shield Recognition The Blue Cross and Blue Shield identification card is recognized and accepted as a symbol of quality health care benefits around the world. t#. • A Managed Care Company All of our products and services are designed to provide cost-effective health care coverage that meets or exceeds the needs of employers and employees. • HMO Accredited by NCQA The National Committee for Quality Assurance (NCQA) has awarded our Southern Geographical Business Unit an Excellent rating. Our Northern Geographical Business Unit has earned a Commendable rating. ;; • Local Presence Through local offices located across the state, BCBSF offers a personalized touch to customer service and managed care programs. • Medical Management Teams Each of Florida's five major metropolitan areas has a local medical management team that regularly reviews and monitors physician and hospital services to ensure appropriate cost-effective quality health care. 2f.4' • Customer Service Units • We offer toll-free customer service telephone lines, as well as walk-in service at 11 of our 14 local offices throughout the state. We track all customer inquiries to ensure you receive prompt, efficient resolution of any questions or problems. • Personal Service A Field Service Representative (FSR) and Account Representative will be available " to handle and address any questions your group administrator may have. Also, a Personal Service Representative (PSR) will be assigned to handle your group's eligibility and billing. • Employee Benefit Programs We offer a full range of integrated health, life, disability, dental and flexible benefit programs. • Reduced Paperwork When using our networks, you eliminate claim filing and balance billing of members. • Combined Billing Coverages included in the benefit programs can be conveniently and efficiently administered through combined billing arrangements. w• Introduction s Flexibility in Plan, Benefit and Funding Design BCBSF provides customized plan, benefit and funding designs that adhere to sound practices of underwriting and risk management. • Our HMO benefit plans provide a comprehensive level of benefits, including • preventive health care, with care managed via a Primary Care Physician; • We offer PPO benefit plans for those employees who want more freedom of choice. Our PPO product includes the added value of access to our traditional provider network; • Our Traditional indemnity plans provide broad access medical care through a wide variety of providers; and • Specific benefit levels are designed to meet your needs. Local and National Support The BCBSF corporate office is located in Jacksonville, Florida. Blue Cross and Blue Shield of Florida has divided the Florida marketplace into two Geographical Business Units (GBUs), the Northern GBU and the Southern GBU. The Northern GBU consists of a main office in Jacksonville, Florida and additional offices in Tampa, Gainesville, Sarasota, Tallahassee, Panama City, Ft. Myers and Pensacola. The Southern GBU consists of a main office in Miami, Florida and additional offices in Orlando, Lakeland, Ft. Lauderdale, West Palm Beach, and Port St. Lucie. BCBSF is able to operate effectively on the national, state and local level. Each local Blue Cross and Blue Shield plan participates in the national Blue Cross and Blue Shield Association. The Association is empowered to develop and enforce national standards, business policies, customer service arrangements and benefits administration. Each local plan has access to the resources and experience of the national organization. BlueCard PPO Program Under the PPO plan, for employees living outside of Florida and Florida employees ••� receiving covered services outside of Florida, BCBSF participates in the BlueCard PPO program through the Blue Cross and Blue Shield Association. Under the BlueCard PPO program, employees receive the benefit of the local Blue Cross and Blue Shield plan's provider network, including the following: • Accept prenegotiated allowances; • File all claims directly with the local Blue Cross and Blue Shield plan; and • Not balance bill for the difference in the prenegotiated allowance and the provider's charge. The provider will bill only for any deductibles, copays, coinsurance and non- ,,, covered services. Aim Introduction A. BlueCard HMO Program AS Under the HMO plan, for members traveling outside the Health Options service area, BCBSF participates in the BlueCard program through the Blue Cross and Blue Shield Association. Under the BlueCard Program, members seeking medical care receive the . benefit of the local Blue Cross and Blue Shield plan's traditional provider network, including the following: • Accept prenegotiated allowances; a.. • File all claims directly with the local Blue Cross and Blue Shield Plan; and • Not balance bill for the difference in the prenegotiated allowance and the provider's ,,, charge. The provider will bill only for any applicable copays, any non-covered services and expenses for services where an Authorization from the Primary Care Physician was required and not obtained. (Authorizations are the member's ,,, responsibility.) Away From Home Care® HMO Program Also, Health Options is part of the Blue Cross and Blue Shield Association's HMO l network, Away From Home Care®, which is designed to provide benefit coverage outside the State of Florida via a network of participating Blue Cross and Blue Shield HMOs. The Away From Home Care® Guest Membership program enables an individual who is away from home for at least 90 days to enroll in another participating, operational HMO , plan service area and receive medical services as a guest member. Subscribers are eligible to be out of the service area up to six months; dependents do not have a time limit out-of-area. An example of someone who meets the eligible criteria would be a tstudent attending college in another state or in a "families apart" situation. The member will work with an Away From Home Care® Coordinator who will assist in identifying the availability of a participating, operational HMO in the area in which the member is residing. FCompatibility with Current and Future Systems 1 BCBSF is continually improving operations to meet customer needs and expectations. Our present operational capacity allows us to provide you with: f • The administration of both in and out-of-network claims; • Combined billing for health and life products; and I • Our commitment to accommodating future needs. . BCBSF's systems capture detailed claims and benefit information. Our systems provide 1 a major base of data, which is used to analyze and monitor claims performance and medical costs. This database is able to satisfy the management information needs of even our largest accounts. 1, Introduction Virtual Office In order to meet future needs of our customers, BCBSF is developing Virtual Office (VO). VO is a new business process using new technology to support online interaction below is an and information exchange with providers serving our customers. Provided be overview of VO. • Technology Components: - VO streamlines most transactions between physicians, hospitals and BCBSF on behalf of our customers; and VO dramatically reduces the time required to complete a transaction and enhances relationships with physicians and customers. • Organizational Components: VO will literally transform the way we do business to ensure more effective physician relationships as well as improve the experiences of our customers; and A single point of accountability, through a Provider Focus Team (PFT), will help r to strengthen and better manage relationships with providers. • BCBSF information will be available "virtually" in the physician's office. - VO will improve the total health care experience for customers, physicians and hospitals; `L. - In the rapidly-expanding age of electronic commerce, VO offers a new way of 7`4: using technology to support online interaction and information exchange with •i participating physicians and hospitals; - Customers will know their financial responsibility up front and have abetter overall medical encounter; and - VO will build relationships with providers by eliminating the need to contact BCBSF for routine tasks like eligibility, benefits and copay status. • To maintain our leadership position in Florida, BCBSF must continue to sign, differentiate itself. s<> - VO improves access to quality health care; - VO provides online settlement and patient's responsibility for deductibles, copays . .. and other payments at the time of service; - VO instantly verifies eligibility at the physician's office; - VO immediately issues referrals to other providers or specialists; and - VO reduces administrative hassle by eliminating paperwork. • VO capabilities offer providers the following benefits: ,N f - Physicians can collect payment from the member/patient at the time of service; - Reduced administrative expenses and improved cashflow/profitability; - Reduced/eliminated phone calls for referrals, authorizations and eligibility; - Improved patient satisfaction due to reduced "wait time" for referrals; and - Potential to electronically reconcile patient accounts and reduce administrative overhead. j it; Introduction Other Employee Benefit Programs Although we are best known for providing state-of-the-art health care benefits, BCBSF is also dedicated to providing other types of employee benefits. We employ professional staff and maintain affiliate relationships, which enable us to provide you with the latest, first-rate cost sharing and employee choice benefit programs. We offer a variety of ancillary group benefits and Section 125 pretax programs through Florida Combined Life which include: • Group term life, supplemental life, dependent life and accidental death and dismemberment plans; • Short term and long term disability plans; • Voluntary plans: group term life, accidental death and dismemberment, short term — disability and long term disability; • Group Dental plans: BlueDental Care (HMO-type), BlueDental Choice (PPO) and BlueDental Freedom (Indemnity) -- on both an employer sponsored and voluntary basis; and • Pretax programs, including premium conversion plans, flexible spending accounts, flexible benefit plans and 401(k) salary deferral and retirement plans. Group, Member and Provider Satisfaction BCBSF provides high levels of quality service to the employer, the employee members and the medical providers. • Customer and member services are available at both centralized and regional levels depending on the benefit plans selected; • Centralized and regional medical management and provider relations departments are staffed by MDs, RNs, LPNs and other managed care professionals; • "Transparent" claims processing. Participating providers bill BCBSF directly. Members need not deal with claim forms or bills beyond deductibles, coinsurance or copayments when receiving services from network participating providers; and • Periodic surveys of providers and general membership are carried out by both BCBSF and independent outside survey organizations to monitor the customer's level of satisfaction with our programs and performance. 1 • i. : . CUSTOMER SERVICE Brand Recce n§bno BCBSF T| e! Blue Cross Blue Shield ide%ƒc tioncard is recognized and accepted a a symbo l of quality health care benefits around the world. Local Customer Service We service member inquiries within each of the Geographic Busilelss Units (GBUs) within the state. The main service centers are located in Tampa, Miami and Jacksonville and handle walk-in inq uiries, as well as telephone or written inquiries. Our customer service representatives are experienced in resolving all levels of customer inquiries regarding the part icipant's questions, including, but not limited to eligible covered services, pmGder partb\26nandpayment amounts . �, We offer toll-free customer service telephone lines, as well as walk-in service at II our 14 local offices throughout the state. We track all customer inquiries to ensure you receive prompt, efficient resolution of any questions or probl ems. �\ r{ �\ u \ �\ \/;z �\ . »�} ll4 !''�=��✓:il.�!a��:i'i.i)i'..Vii:r.,i.'.,t. ' . .. :.., .. '�c''iti''".�i: i'j.{€":^i :.�j,,.ilaar.' ".4�i `'`:;:°j'.' ,,;r:yl�;;,"=•`-:...- _ n▪ �'ii �C,:. ,..:._ b'ego tiri : ,r,.. ., • atn . : .a _ +cj PEO sr: AM Best A A 07/10/2000 07/10/2000 Standard & A A 11/2/2001 11/2/2001 Poor Standard & Poor's and A.1Y1. Best ' The independent financial rating firms of Standard & Poor's and A.M. Best have given BCBSF high marks, underscoring the fact that the company is financially strong. Standard & Poor's gave a rating of"A" for claims paying ability. A.M. Best awarded BCBSF its "A" rating with a size category of"X." Standard & •r" ' Poor's rating was based on BCBSF's strong market position, diverse product portfolio, and extensive •y; 4, provider networks. Insurers rated "A" offer good financial security. BCBSF is the largest writer of health : < insurance in Florida, which has allowed us to develop important local market expertise. Heavy investments in and commitment to managed care have also contributed to strong growth in earnings and capital. ~n; HIP AA Ya; We support the protection of patient identifiable information. We are also sensitive to the information needs of the health plans and plan sponsors. We are currently assessing the recent regulations on privacy and are developing plans to comply with the regulations while satisfying our customers needs. • In 1996, Congress approved the Health Insurance Portability and Accountability Act- Administrative Simplification title (H[PAA-AS). This law is intended to "improve the efficiency and effectiveness of the health care system through the establishment of standards and requirements for electronic transmission of certain health information" and "to protect the security and privacy of health care information by setting standards regarding its use and disclosure". • Preparing for the business implications and legal requirements imposed by HIPAA-AS will be a challenge t.'., for the entire health care industry. At Blue Cross Blue Shield of Florida we are responding to the law with a continued commitment of servicing our customers and providing affordable, quality health plans. • `.; Blue Cross Blue Shield of Florida established the HIPAA-AS Project Team to facilitate and coordinate � r enterprise H[PAA-AS compliance activities. The HIPAA-AS team is comprised of a cross section of 3 • management and experienced representatives from within our organization and is chartered with interpreting regulations, providing staff education and awareness programs, analyzing risk factors to our ••i y business, facilitating g the design and implementation of the necessary changes to achieve compliance, and p g p } , tracking enterprise progress toward HIPAA-AS compliance. 4. ``o We recently completed an assessment of our applications and business processes to identify the systems and procedures that are impacted by HIPAA-AS law. We are actively working on the changes necessary to bring our claims, membership and other systems and associated business processes into compliance with the "' transactions, codes and privacy rules. Design and planning activities are in progress for security and I identifiers based on the proposed rules. Testing of the new transactions and codes is scheduled to begin in the first quarter 2002. We plan to complete all of the necessary changes for compliance within the yo mandated timeframes. We will make every effort to ensure customer service is maintained through the i transition of our activities. You can expect the same level of service and programs that you've come to know from Blue Cross Blue 7 Shield health plans. We anticipate that implemented changes resulting form HIPAA-AS law will improve our capabilities and the delivery of health care administration functions. It will also provide a more secure, retention of health records for all our members. COBRA . Blue Cross and Blue Shield of Florida has contracted with COBRAServ, a third party COBRA administrator to provide COBRA compliance services for all of our eligible groups. COBRASery will provide these services: 1 • Generation of monthly invoices to all continuants with a remittance stub requesting certification that there is no other coverage invalidating COBRA; • Collection of monthly premiums from continuants; • Remittance of the monthly premium received along with detailed accounting statements for ease of reconciliation; • Generation of grace letters for continuants who have not paid their COBRA premiums approximately fifteen days prior to the end of the grace period; • Concise weekly and monthly eligibility reports broken down by coverage and division; • Telephone support for continuants and employers; and r • Updates on legislative and judicial changes that impact COBRA administration. • COBRASery is included in our proposed funding. is k ii 0 'q