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Request for Quotes
ABC with XYZ Acquisition
Page
8
of
14
XYZ Rates & Contribution
ASO fees for enrollment of 5,000+ lives was to be $5.90 PEPM from 1/2015 – 12/2016. This was
a No Change renewal from 1/2013-12/2014. This amount includes no commission.
Requested Dental Quotes
•
Disruption analysis
•
Re-pricing/Network discounts
•
GEO Access summary: 2 General Dentists within 15 miles and 2 Specialists within 15 miles
•
Quote same plan as in force with ABC through MetLife using out of network
reimbursement at MAC
•
Please quote fully insured and ASO
•
For the High Option plan, provide your quote with the out of network Preventive Care
benefit covered at 100% - all other coinsurance levels to remain the same
•
Ortho: on both plans, include Adult & Child coverage. Increase low option ortho max to
$1,000 and high option ortho max to $2,000
LIFE & DISABILITY
ABC Plan
Effective 1/1/2012, ABC became insured by The Standard. Employees are eligible for coverage the
1
st
of the month following 60 days.
Basic Life/AD&D – Employer Paid
Basic Life/AD&D benefit 1.5 x earnings, round to next $1,000, up to $1,000,000
*
maximum.
AD&D equal to same.
*
Prior to 1/1/2016, the Life benefit was not to exceed $500,000 or $1M combined w/Basic
Dependent Basic Life – Employer Paid
Spouse - $5,000
Children - $2,000