September 8, 2023
Danita Mitchell
Senior Account Executive, Core Accounts
Blue Shield of California
El Segundo, CA 90245
Re: City of Vernon Renewal Confirmation
Dear Danita,
This is in regard to the proposed agreement between Blue Shield of California and the City of Vernon for renewal of employee insurance benefits.
Please confirm the following effective date, rate guarantee, monthly rates, plan changes, wellness allowance, and producer service fee are correct for their January 1, 2024 renewal:
EFFECTIVE DATE:
• January 1, 2024
RATE GUARANTEE:
• 1 Year (1/1/2024 - 12/31/2024)
MONTHLY RATES:
• Blue Shield Access+ HMO 15:
• Employee Only: $876.57
• Employee + Spouse: $1,652.33
• Employee + Child(ren): $1,498.63
• Employee + Family: $2,329.41
• Blue Shield Trio ACO HMO 15:
• Employee Only: $662.89
• Employee + Spouse: $1,458.35
• Employee + Child(ren): $1,193.20
• Employee + Family: $2,054.95
• Blue Shield PPO Combined Deductible:
• Employee Only: $969.53
• Employee + Spouse: $2,133.00
• Employee + Child(ren): $1,745.17
• Employee + Family: $3,005.59
• Blue Shield HDHP PPO Savings Embedded Deductible (Two-Tiered):
• Employee Only: $678.61
• Employee + Spouse: $1,497.24
• Employee + Child(ren): $1,224.33
• Employee + Family: $2,111.20
MANDATORY PLAN CHANGES:
High Deductible Health Plans, the applicable deductible will be increased to meet the threshold requirement. All plan names have been updated to reflect the new deductible values.
WELLNESS ALLOWANCE:
$30,000
PRODUCER SERVICE FEE:
• Net of Commission
If all the above is confirmed by you, please sign this letter below.
Sincerely,
Chris Quijano
Benefits Analyst
Alliant Insurance Services, Inc.
- DocuSigned by:
9/8/2023
Danita Mitcuell
TADC080229C28438.
Senior Account Executive Date
Blue Shield of California
September 8, 2023
Agnes Altounian
Group Retiree Solutions Account Manager
Anthem
Re: City of Vernon Renewal Confirmation
Dear Agnes,
This is in regard to the proposed agreement between Anthem and the City of Vernon for renewal of employee insurance benefits.
Please confirm the following effective date, rate guarantee, monthly rates, and commission are correct for their January 1, 2024 renewal:
EFFECTIVE DATE:
• January 1, 2024
RATE GUARANTEE:
• 1 year (1/1/2024 - 12/31/2024)
MONTHLY RATES:
• HMO $ 5 Rx 5/20/50 PMPM: $342.86
• LPPO $10P High (no deductible) Rx 5/20/50 PMPM: $432.79 COMMISSION:
• Net of Commission
PLAN CHANGES:
• Part D true Out of Pocket Amount: $7,400 - $8,000 (Both plans) If all the above is confirmed by you, please sign this letter below.
Sincerely,
Chris Quijano
Benefits Analyst
Alliant Insurance Services, Inc.
Agnes Altounian September 8, 2023
GRS Account Manager | Anthem Date
September 11, 2023
Matt Muler
Senior Account Executive
MetLife
Los Angeles, CA 90017
Re: City of Vernon Renewal Confirmation
Dear Matt,
This is in regard to the proposed agreement between MetLife and the City of Vernon for renewal of employee insurance benefits.
Please confirm the following effective date, rate guarantee, monthly rates, and commission are correct for their January 1, 2024 renewal:
EFFECTIVE DATE:
• January 1, 2024
RATE GUARANTEE:
• DHMO: 1 year (1/1/2024 - 12/31/2024)
• DPPO: 1 Year (1/1/2024 - 12/31/2024)
MONTHLY RATES:
• DHMO Met50
Employee Only $16.68
Employee + Spouse $31.69
Employee + Child(ren) $33.35
Employee + Family $47.53
• DPPO
Employee Only $60.83
Employee + Spouse $119.88
Employee + Child(ren) $146.82
Employee + Family $223.98
COMMISSION:
• Net of Commission
If all the above is confirmed by you, please sign this letter below.
Sincerely,
Chris Quijano
Benefits Analyst
Alliant Insurance Services, Inc.
Matt Muk 9/11/27
Senior Account Executive Date
MetLife
September 13, 2023
Selene Gomez
Group Management Specialist
EyeMed Vision
Lake Forest, CA 92610
Re: City of Vernon Renewal Confirmation
Dear Selene,
This is in regard to the proposed agreement between EyeMed Vision and the City of Vernon for renewal of employee insurance benefits.
Please confirm the following effective date, rate guarantee, monthly rates, and commission are correct for their January 1, 2024 renewal:
EFFECTIVE DATE:
• January 1,2024
RATE GUARANTEE:
• 4 years (1/1/2023 - 12/31/2026)
MONTHLY RATES:
Employee Only $11.59
Employee + 1 Dependent $20.87
Employee + 2 or more Dependents $29.90
COMMISSION:
• Net of Commission
If all the above is confirmed by you, please sign this letter below.
Sincerely,
Chris Quijano
Benefits Analyst
Alliant Insurance Services, Inc.
Selene Gomer 9/14/2023
EyeMed Vision Date
October 17, 2022
Fabian Huerta
Renewal Executive
Mutual of Omaha
Irvine, CA 92614
Re: City of Vernon Renewal Confirmation
Dear Fabian,
This is in regard to the proposed agreement between Mutual of Omaha and the City of Vernon for renewal of employee insurance benefits.
Please confirm the following effective date, rate guarantee, monthly rates, and commission are correct for their January 1, 2023 renewal:
EFFECTIVE DATE:
• January 1, 2023
RATE GUARANTEE:
• 2 years (1/1/2023 - 12/31/2024)
MONTHLY RATES:
• Basic Life and AD&D
Basic Life Rate per $1,000 $0.060
Basic AD&D Rate per $1,000 $0.020
Basic Dependent Life per unit $0.250
• Supplementary Life and AD&D
Age Employee / Spouse Rates per $1,000
Under 20 $0.070
20-24 $0.070
25-29 $0.070
30-34 $0.080
35-39 $0.100
40-44 $0.160
45-49 $0.270
50-54 $0.450
55-59 $0.710
60-64 $1.110
65-69 $1.990
70-74 $3.570
75+ $5.900
AD&D Rate per $1,000 $0.040
Dependent Child(ren) Rate per $1,000 $0.160
• Voluntary Long Term Disability
Age Employee Rates per $100 Covered Payroll
Under 20 $0.090
20-24 $0.100
25-29 $0.160
30-34 $0.240
35-39 $0.360
40-44 $0.560
45-49 $0.830
50-54 $1.370
55-59 $1.720
60-64 $1.800
65-69 $1.890
70+ $1.990
COMMISSION:
Basic Life/AD&D: Net of Commission
• Voluntary Life/AD&D and LTD: 10% Paid to Alliant by Mutual of Omaha If all the above is confirmed by you, please sign this letter below.
Sincerely,
Chris Quijano
Benefits Analyst
Alliant Insurance Services, Inc.
Fabian Auerta 10/17/22
Renewal Executive Date
Mutual of Omaha
PRISM Alliant
EMPLOYEE BENEFITS
June 13, 2022
City of Vernon
Re: PRISM Anthem EAP Program Renewal
Dear PRISM Anthem EAP Program Member:
We want to thank you for your continuing participation and support as a valued member and participant in the PRISM Anthem EAP Program. The PRISM Anthem EAP Program continues to successfully provide its members with cost stability and competitive costs.
Your Anthem EAP plan is scheduled to renew January 1, 2023 for a period of three (3) years continuing uninterrupted until December 31, 2025.
To finalize this renewal, please complete the PRISM Anthem EAP Program renewal confirmation notice included in this letter. Renewal confirmations are due by August 5, 2022. If we do not receive your renewal confirmation notice by August 5, 2022, we will assume that you approve the renewal and we will continue your coverage with no changes to your plan.
If you would like to make any plan changes, please let the Alliant Team know by July 29, 2022.
Finally, as part of the February Employee Benefits Committee Meeting, the Program Guidelines have been reviewed and updated. Please review the new guidelines at the link below and let your Alliant Account Executive or Alliant Program Team know if you have any questions.
Updated Program Administration and Underwriting Guidelines can be found at:
Employee Benefits Administrative Guidelines
Employee Benefits Underwriting Guidelines
Sincerely,
Sidney DiDomenico
Employee Benefits Director
© 2022 Alliant Insurance Services, Inc. All rights reserved. Alliant Empioyee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861 -PRISM Alliant
EMPLOYEE BENEFITS
PRISM ANTHEM EAP RENEWAL CONFIRMATION
City of Vernon
January 1, 2023 to December 31, 2025
_ Option A: Renew with no plan changes
_ Option B: We would like to confirm our renewal with the following plan changes.
Signature:
Printed Name:
Title:
Date:_
Please send your confirmation to Alliant Insurance Services by July 29, 2022.
Otherwise, we will assume no plan changes and will renew plans as-is.
Attention: Asia Prudholme
E-Mail: [email protected]
© 2022 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861 •PRISM Alliant
EMPLOYEE BENEFITS
PRISM Anthem EAP Program Renewal Action
City of Vernon
January 1, 2023 to December 31, 2025
Current Renewal Renewal
Rate Rate Rate
Client Name EAP Coverage (PEPM) Change (PEPM)
City of Vernon Enhanced 5-Visit $1.61 5% $1.69
© 2022 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861