701 B Street, 6th Floor, San Diego, CA 92101
September 10, 2024
Danita Mitchell
Blue Shield
Please accept this as formal confirmation to Blue Shield on behalf of the City of Vernon for their medical plans.
PLAN AND RATE CONFIRMATION
Line of Coverage: Access + HMO 15, Trio ACO HMO 15, PPO, HDHP PPO Policy #: W0065496
Rate Guarantee: 1 year rate guarantee (1/1/2025 – 12/31/2025) Renewing as is with the following changes:
- ALL Rx Riders, All PPO Savings Plans:
o Brand Drugs with generic equivalents or biosimilar drugs - To encourage the use of generic and biosimilar drugs, a member must pay the difference between the brand drug and its generic equivalent or biosimilar drug plus the applicable copay of the brand drug when the member or provider requests the brand drug. - Rx Home Delivery - Amazon Rx Home delivery will be replacing CVS Caremark as our mail order partner. Impacted members will be notified fall of 2024. - Full PPO Savings Two-Tier Embedded Deductible 2800/3300/5200 with $0 HDHP Preventive Drug Benefit
o In accordance with IRS guidelines, the High Deductible Health Plan deductible will be increased to the minimum value of $1,650 per individual and $3,300 per family. The out-of-pocket maximum has also been raised to align with these minimum deductible values.
Blue Shield Access + HMO 15:
EE Only: $902.87
EE + SP: $1701.90
EE + Child(ren): $1543.59
EE + Family: $2399.29
Blue Shield TRIO ACO HMO 15:
EE Only: $682.78
EE + SP: $1502.10
EE + Child(ren): $1229.00
EE + Family: $2116.60
Blue Shield PPO:
EE Only: $998.62
EE + SP: $2196.99
EE + Child(ren): $1797.53
EE + Family: $3095.76
701 B Street, 6th Floor, San Diego, CA 92101
Blue Shield HDHP PPO:
EE Only: $698.97
EE + SP: $1542.16
EE + Child(ren): $1261.06
EE + Family: $2174.54
Special Premium Arrangement
SPA in the amount equivalent to 25% of first month’s gross premium (premium + producer service fee) not to exceed $101,918 from 1/1/2025 through 12/31/2025 policy year. Dollars will be paid by BSC directly to the group in the form of a credit to billed premium. However, if the group terminates with Blue Shield prior to 12/31/2025, the group will be required to remit all the money associated with the SPA at the time of termination.
Wellness Allowance
$40,000
ALLIANT INSURANCE SERVICES COMMISSION CONFIRMATION
Net Commissions
Once the below items are available, please provide:
• SBCs
• Electronic Versions of Enrollment Materials (anything that would normally be included in an open enrollment packet so the group can have it electronically – employee enrollment and change forms, etc.)
• Final Sold Plan Summaries
• Contracts
• Contact Sheet for Employer Use
If all the above is confirmed by you, please sign this letter below.
Sincerely,
Paul Cocanour
Alliant Insurance Services, Inc. ____________________________________ _________________________________ Date September 11, 2024
Peter Cassidy
Anthem
Please accept this as formal confirmation to Anthem on behalf of the City of Vernon for their Medicare plans.
PLAN AND RATE CONFIRMATION
Line of Coverage: Anthem Advantage HMO and Anthem LPPO $10P High plans.
Policy #: CAEGR030
Guarantee: 1 year rate guarantee (1/1/2025 – 12/31/2025) Renewing as is with no benefit changes.
Anthem Advantage HMO:
Medicare HMO PEPM: $435.03
Anthem LPPO:
Medicare PPO PEPM: $524.96
ALLIANT INSURANCE SERVICES COMMISSION CONFIRMATION
Net of commissions
Once the below items are available, please provide: • SBCs • Electronic Versions of Enrollment Materials (anything that would normally be included in an open enrollment packet so the group can have it electronically – employee enrollment and change forms, etc.) • Final Sold Plan Summaries • Contracts • Contact Sheet for Employer Use If all the above is confirmed by you, please sign this letter below.
Sincerely,
Paul Cocanour
Alliant Insurance Services, Inc.
____________________________________ ___9/11/24______________________ Date
Please accept this as formal confirmation to MetLife on behalf of the City of Vernon for their Dental PPO plan.
PLAN AND RATE CONFIRMATION
Line of Coverage: MetLife Dental PPO
Policy #: 5956024
Rate Guarantee: 1 year rate guarantee (1/1/2025 12/31/2025) Renewing as is with no plan changes.
EE only: $64.48
EE + Spouse: $127.07
EE + Child(ren): $155.63
EE + Family: $237.42
ALLIANT INSURANCE SERVICES COMMISSION CONFIRMATION
Net Commissions (please confirm)- Correct
Once the below items are available, please provide:
SBC- These are only updated when there have been changes to the plans.
Electronic Versions of Enrollment Materials (anything that would normally be included in an open enrollment packet so the group can have it electronically employee enrollment and change forms, etc.) Since the group is on a file feed all eligibility updates should be fed over directly on the file feed. Attached are EE facing flyers.
Final Sold Plan Summaries- Attached
Contracts- We only provide updated contracts when there have been changes to the plans and even then we would only provide a certificate rider. Since there are no changes for 2025 the current contracts remain valid.
Contact Sheet for Employer Use- Attached
If all the above is confirmed by you, please sign this letter below.