HomeMy WebLinkAbout61-06 61-06
RESOLUTION NO.
A RESOLUTION OF
THE CITY COUNCIL OF THE TOWN
OF LOS ALTOS HILLS AUTHORIZING EXECUTION OF AN
AGREEMENT WITH ASSURANT EMPLOYEE BENEFITS
FOR EMPLOYEE DENTAL INSURANCE PLAN SERVICES
WHEREAS, the City Council of the Town of Los Altos Hills has approved the
establishment of an Employee Dental Plan for the benefit of its employees;
WHEREAS, Assurant Employee Benefits has offered an Employee Dental Plan with a
full range of services at a competitive rate;
NOW,THEREFORE, BE IT RESOLVED by the City Council of the Town of Los
Altos Hills that the City Manager is hereby authorized and directed to execute the
attached Agreement/Application between the Town and Los Altos Hills and Assurant
Employee Benefits on behalf of the Town of Los Altos Hills.
PASSED AND ADOPTED this 27th day !!:.
By: `-Q`�"►
ayor
ATTES :
City IV
• •
Union Security Insurance Company agrees to provide the insurance described in
this and the following pages of the policy, subject to payment of premiums.
Policyholder: Town of Los Altos Hills
Policy Number: G 55,259
Delivered In: California and governed by its laws.
Effective Date: August 1, 2006-The date the policy takes effect which is also its date of issue.
Premium Due Dates: The first premium is due on the Effective Date. Future premiums are due on the
first day of each month after that.
Policy Anniversary: January 1, 2007, and each January 1 after that.
Insurance Provided: Group Dental Insurance—Contributory
Group Dental Insurance for Dependents—Contributory
Cleidaa •6/14114' 001:414s, pe vezylen.
Assistant Secretary Executive Vice-President
Union Security Insurance Company 2323 Grand Boulevard Kansas City Missouri 64108-2670
•
GP-90
PF
• •
NOTICE
If you need to contact someone about this Policy for any reason, please contact your agent. Please refer
to your Policy Number in all correspondence. If you have any additional questions, you may contact our
company by mailing your questions to:
Union Security Insurance Company
Customer Relations
P.O. Box 419596
Kansas City, Missouri 64141-9958
You may also reach Union Security by telephone at 800.733.7879.
If you have not been able to contact or obtain satisfaction from your agent or Union Security, you may
contact the California Department of Insurance by writing to:
California Department of Insurance
Ronald Reagan Building
300 South Spring Street
Los Angeles, CA 90013
Toll-Free Number: 800.927.4357 (927.HELP) inside California except area codes 213 and 310.
Hotline for Callers in area codes 213 and 310 and Outside of California: 213.897.8921.
This notice of complaint procedure is for information only and does not become a part or condition of this
Policy or Certificate.
• • .
CALIFORNIA LIFE AND HEALTH INSURANCE
GUARANTEE ASSOCIATION ACT
SUMMARY DOCUMENT AND DISCLOSURE
Residents of California who purchase life and health insurance and annuities should know that the
insurance companies licensed in this state to write these types of insurance are members of the
California Life and Health Insurance Guarantee Association (CLHIGA). The purpose of this Association is
to assure that policyholders will be protected,within limits, in the unlikely event that a member insurer
becomes financially unable to meet its obligations. If this should happen, the Guarantee Association will
assess its other member insurance companies for the money to pay the claims of insured persons who
live in this state and, in some cases, to keep coverage in force. The valuable extra protection provided
through the Association is not unlimited, as noted in the box below, and is not a substitute for consumers'
care in selecting insurers.
The California Life and Health Insurance Guarantee Association may not provide coverage for this policy.
If coverage is provided, it may be subject to substantial limitations or exclusions, and require continued
residency in California. You should not rely on coverage by the Association in selecting an insurance
company or in selecting an insurance policy.
Coverage is NOT provided for your policy or any portion of it that is not guaranteed by the insurer or for
which you have assumed the risk, such as a variable contract sold by prospectus.
Insurance companies or their agents are required by law to give or send you this notice. However,
insurance companies and their agents are prohibited by law from using the existence of the
Guarantee Association to induce you to purchase any kind of insurance policy.
Policyholders with additional questions should first contact their insurer or agent or may then contact:
California Life and Health Insurance or Consumer Service Division
Guarantee Association California Department of Insurance
P. O. Box 17319 300 South Spring Street
Beverly Hills, CA 90209-3319 Los Angeles, CA 90013
Below is a brief summary of this law's coverages, exclusions and limits. This summary does not cover all
provisions of the law; nor does it in any way change anyone's rights or obligations under the Act or the
rights or obligations of the Association.
COVERAGE
Generally, individuals will be protected by the California Life and Health Insurance Guarantee Association
if they live in this state and hold a life or health insurance contract, or an annuity, or if they are insured
under a group insurance contract, issued by a member insurer. The beneficiaries, payees or assignees
of insured persons are protected as well, even if they live in another state.
EXCLUSIONS FROM COVERAGE
However, persons holding such policies are not protected by this Guarantee Association if:
• Their insurer was not authorized to do business in this state when it issued the policy or contract;
• (14
• Their policy was issued by a health care service plan (HMO), Blue Cross, Blue Shield, a
charitable organization, a fraternal benefit society, a mandatory state pooling plan, a mutual
assessment company, an insurance exchange, or a grants and annuities society;
• They are eligible for protection under the laws of another state. This may occur when the
insolvent insurer was incorporated in another state whose guarantee association protects
insureds who live outside that state.
The Guarantee Association also does not provide coverage for:
• Unallocated annuity contracts;that is, contracts which are not issued to and owned by an
individual and which guarantee rights to group contract holders, not individuals;
• Employer and association plans, to the extent they are self-funded or uninsured;
• Synthetic guaranteed interest contracts;
• Any policy or portion of a policy which is not guaranteed by the insurer or for which the individual
has assumed the risk, such as a variable contract sold by prospectus;
• Any policy of reinsurance, unless an assumption certificate was issued;
Interest rate yields that exceed an average rate;
• Any portion of a contract that provides dividends or experience rate credits.
LIMITS ON AMOUNT OF COVERAGE
The Act limits the Association to pay benefits as follows:
LIFE AND ANNUITY BENEFITS
• 80% of what the life insurance company would owe under a life policy or annuity contract up to:
o $100,000 in cash surrender values,
o $100,000 in present value of annuities, or
o $250,000 in life insurance death benefits.
• A maximum of$250,000 for any one insured life no matter how many policies and contracts there
were with the same company, even if the policies provided different types of coverages.
HEALTH BENEFITS
• A maximum of$200,000 of the contractual obligations that the health insurance company would
owe were it not insolvent. The maximum may increase or decrease annually based upon
changes in the health care cost component of the consumer price index.
PREMIUM SURCHARGE
Member insurers are required to recoup assessments paid to the Association by way of a surcharge on
premiums charged for health insurance policies to which the Act applies.