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1989-130NO 89 - /30 AN ORDINANCE ACCEPTING THE PROPOSAL OF SUN FINANCIAL GROUP FOR LIFE AUTHORIZING INSURANCE HE EXPENDITURE THCOVERAGE EREFORE, FOR CITY AND DECLARING AN EMPLOYS, EFFECTIE DATE OF F THE CITY COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS SECTION I That the proposal of Sun Financial Group for life insurance coverage for city employees, a copy of which is attached hereto and incorporated by reference herein, is hereby accepted SECTION II. That the City Council hereby authorizes the expenditure of funds in the manner and amount as specified in the agreement SECTION III That this ordinance shall become effective immediately upon its passage and approval 9 PASSED AND APPROVED this the /~9 day of L ~u(~X7~~''i~`~-' 1989 RAY ST P °NS, MAYOR ATTEST JENNIFER WALTERS, CITY SECRETARY BY APPROVED AS TO LEGAL FORM DEBRA ADAMI DRAYOVITCH, CITY ATTORNEY BY .Cl'/`YI92 ~L~ lC/ t 9/14/89 Sun Financial Group SunLNOOON&WOMM August 24, 1989 Nedra White Personnel Specialist - Benefits City of Denton 324 East McKinney Denton, TX 76201 RE. RFP #1009 Life and AD&D H 1 Nwrk m. A. CW ftatm ft W OfMO erouPMOASOW 40LOUMM *m suit im Houston, Tom 77= TM 2188310 I We will continua the rates of 111.248 - Life and 111.04 - AND Valid to 1/1/91- 401 Sh Id you have ny questions, please do not hesitate to dt glv me a call. r, ~i Croup CLU /as T BY Sun Financial Group , 8-14-89 , 4 34PM 171322568174CITY OF DENTON uA of 1 0 Sun Financial Group 5unkife of Canada and offiUsm September 14, 1989 Via Facsimile 9/14/89 Nedra White Personnel Specialist/benefits City of Denton Municipal Building 324 East McKinney Denton. TX 75201 RE #84127 Group Life Coverage H J Herrington Jr. CLU Houston GroupOMke Group Manager 44OLCUMMA90M Sump 1420 Houston Tozer 77002 Tel M3)296OW FAX (799)22Sba17 0 Per your request we will be revising the policy anniversary to be October 1 This change sl I shell confirm Harry Group make the rata change date to be February 1 February 1 date ASAP /as POLICY SPECIFICATIONS Policy Number Policyholder - City of Denton Effective Date - Policy Anniversaries - October 1, 1989 Premium Due Dates - The Effective Date and thereafter the 1st day of each month Currency - United States Dollars Insurance Benefits* Employee Life (for each $1,000 of insurance) Accidental Death and Dismemberment (for each $1,000 of insurance) Monthly Premium Rates Employees Dependents (for each Employee) (for the insured Dependent of each Employee) To Be Advised To Be Advised * for benefit details refer to appropriate Benefit Provision means that the benefit is not in force 2714s -1- INDEX Action Against Us Assignments Benefit Provisions Accidental Death and Dismemberment Insurance - Employee Life Insurance with Extended Death Benefit - Employee Change in Beneficiary Clerical or Mechanical Errors Commencement of Insurance Definitions Due Proof Entire Contract Examinations Experience Rating Refund Facility of Payment Gender Governing Law Grace Period Incontestability Individual Certificates Individual Termination of Insurance Data Methods of Payment Minimum Benefit Provision Misstatement of Age Notice of Claim Payment of Benefits Premium Ad3ustments Premium Calculation Premium Payments Proof Proof of Age Proof of Claim Insurance Requirement Termination of Benefits Provision(s) Termination of Policy Time of Payment Workers' Compensation Policy Addendum Page 14 12 19 15 12 10 7 4 14 10 14 10 12 14 14 9 11 11 7 10 12 8 10 13 11 9 8 9 14 10 13 8 8 13 11 21 2714s -2- COMPLAINT NOTICE Should any dispute arise about your premium or about a claim that you have filed, contact the agent or write to the company that issued the policy If the problem is not resolved, you may also write the State Board of Insurance, Department C, 1110 San Jacinto Street, Austin Texas 78786 This notice of complaint procedure is for information only and does not become a part or condition of this policy 2714s -3- DEFINITIONS Employer The Policyholder Employee A person classified as a permanent fu who is scheduled to hours a week at the of business or at where the Employer be by the Employer 11-time employee work at least 20 Employer's place some other site requires him to Employment Performance of work as an Employee except that classification as an individual employed on a basis excluded above will be applied toward completion of an Employee's waiting period Waiting Period Nil Actively at Work An Employee is actively at work on any day in which he performs all the usual and customary duties of his occupation at the Employer's place of business or at some other site where the Employer requires him to be In the case of an Employee who is not on a flexible schedule of working hours, the Employee must work for 6 hours or the scheduled number of hours for that day, whichever is longer In the case of an Employee who is on a flexible schedule, he must work the scheduled number of hours for that day An Employee is deemed Actively at Work on a scheduled non-working day if he was Actively at Work on the immediately preceding scheduled working day Termination of Employment Termination occurs on the last day of the month in which a person ceases to qualify as an Employee for any reason 2714s -4- Definitions (Continued) However, the Policyholder, acting in accordance with rules which preclude individual selection, may deem that Employment continues 1 for the period of the Employee's scheduled paid vacation, but not exceeding 3 months, 2 unless otherwise provided by law, for a period ending not later than the last day of the calendar month following the month in which the Employee is temporarily laid off or is granted leave of absence for any reason other than illness or paid vacation, or 3 for a period ending not later than 6 months (unless a longer period is approved by us) during which the Employee is absent from work due to illness Beneficiary The person who is entitled to receive death benefit proceeds as they become due under this Policy Illness Bodily injury, sickness, disease, pregnancy or mental infirmity Pregnancy Pregnancy, childbirth, miscarriage, abortion and conditions which result directly or indirectly from any of these Totally Disabled Employee Life - An Employee is totally disabled if he is wholly prevented by illness from performing any work for compensation or profit or from following any gainful occupation Ceasing to be Actively at Work does not, by itself, mean that an Employee is Totally Disabled Total Disability The condition of being Totally Disabled 2714s -5- Definitions (Continued) Basic Earnings The Employee's current salary or wage from the Employer, excluding any bonus, overtime or incentive pay Riot Unlawful assembly, civil commotion, disorderly conduct and all other forms of disturbance of the public peace by three or more persons assembled together Participation in a Riot Encouraging, promoting or taking part in a Riot, whether by signs, gestures, words or by distinctive devices which identify the person with the Riot Plan Administrator The person or organization designated by the Policyholder to maintain the records of the people insured under the Policy Office Our office at One Sun-Life Executive Park, Wellesley Hills, Massachusetts 02181 2714s -6- GENERAL PROVISIONS Commencement of Insurance Life Insurance An Employee is insured on the first day that the Employee is Actively at Work An Employee who had converted his Life Insurance under the Conversion Privilege of this Policy will have the Scheduled Amount of his Insurance reduced by the amount of any insurance remaining in force under the individual policy issued under the Conversion Privilege An Employee who declines for religious or other reasons t o be insured by s igning a refusal card, is insured on the date his subsequent written request for insurance and evidence of insurability are a pproved by Sun Life Commencement of Insurance on Policy Amendment If an insured Employee is not Actively at Work on full time on the date the Policy is amended to provide increased or additional benefits, the Employee will be insured for the increased or additional benefits only when he is again Actively at Work on full time Individual Termination of Insurance An the 1 2 3 Employee ceases to be insured on earliest of termination occurs on the last day of the month in which a person ceases to qualify as an Employee for any reason, the end of the period for which the last premium is paid to us for the Employee's insurance, or the date of termination of the Policy 2714s -7- General Provisions (Continued) Termination of Benefit Provision We may terminate any Benefit Provision on any Premium Due Date because one or more of the Minimum Benefit Provision Requirements is not met We will give the Policyholder 31 days' prior written notice Minimum Benefit Provision Requirements Requirement No 1 - At all times at least 25 insured Employees Requirement No 2 - 758 of the Employees who have completed the Waiting Period must be insured Termination of Policy This Policy will terminate 1 at the end of the applicable Grace Period if, at that time, any premium remains unpaid, 2 if the Policyholder gives us a written notice that the Policy is to be terminated The date of such termination will be the later of a the date specified in the notice, and b the date we receive the notice at our office, or 3 on the date all Benefit Provisions are terminated Premium Calculation The premium due on the Effective Date and on each subsequent Premium Due Date is the sum of the monthly premiums for all insured Employees based on our then current Monthly Premium Rates The Monthly Premium Rates shown in the Policy Specifications are our current rates on the Effective Date of this Policy We may change the Monthly Premium Rates after February 11 1991 The change in rates can only be made once in a policy year, unless the terms of the Policy change For 2714s -8- General Provisions (Continued) other than policy changes, we will give the Policyholder 31 days' prior written notice Premium Adjustments The additional premium for insurance that increases or commences on a date other than a Premium Due Date is payable from the next Premium Due Date The premium for insurance that decreases or cease on a date other than a Premium Due Date is payable until the next Premium Due Date However, any change in premium due to a policy change will take effect on the date of change The proportionate charge or refund will be made on the next Premium Due Date Premium Payments Premiums are to be paid at our office by the Policyholder on or before the Premium Due Dates We are not required to receive payment of any premium other than in one sum or from anyone other than the Policyholder We are not required to see 1 that any amounts referred to as contributions by Employees are, in fact, contributed by Employees, or 2 that all or any amounts so contributed by Employees are applied to the payment of premiums Grace Period If a premium, after the first premium, is not paid by its Premium Due Date, it may be paid by the Policyholder within 31 days after its Premium Due Date The Policy continues in force during this grace period If a premium is not paid by the end of the grace period, this Policy will terminate In any event, premiums are payable for any period of time during which the Policy remains in force 2714s -9- General Provisions (Continued) Experience Rating Refund On each Policy Anniversary an experience rating process is applied to this Policy such amount, if any, as we determine to be available as a refund as a result of that process We reserve the right to change the basis of that process Any refund is paid in cash to the Policyholder Insurance Data The Employer is to provide us with information about the Employees and their benefits This information is limited to that required for the calculation of premiums and to ensure that Policy terms are fulfilled We reserve the right to inspect pertinent records of the Employer Clerical or mechanical Errors No clerical or mechanical error by the Employer, the Plan Administrator or by us will cause insurance 1 which should be in force, not to commence, 2 which should continue, to cease, 3 which should not be in force, to commence, or 4 which should cease, to continue Misstatement of Age If the age of a person is misstated, factors affecting his insurance will be based on the true age Refunds or charges will be made accordingly Proof of Age We have the right to request proof of age for any person insured or entitled to benefits under this Policy If proof is not provided, benefits will not be paid Any benefits which later becomes payable will be based on the true age Entire Contract Your entire contract with us consists of the following 1 this Policy, and 2714s -10- General Provisions (Continued) 2 the Policyholder's Application, a copy of which is attached, and 3 the applications, if any, relating to persons insured under the Policy All statements made in the applications will be deemed representations and not warranties No statement of any person may be used in any contest unless it is written and signed by him, and a copy furnished to this or to his Beneficiary Only our President, Actuary, Secretary or one of our Vice Presidents can agree to change the Policy or to waive any of its provisions No change or waiver will be valid unless endorsed on or attached to the Policy No agent has authority to change the Policy or to waive any of its provisions Incontestability Except for non-payment of premiums, the Policy will be incontestable after it has been in force for a period of two years from the Effective Date No statement relating to the insurability of any person may be used in contesting the validity of the person's insurance after if has been in force for a period of two years during his lifetime, unless it is written and signed by him Individual Certificates A certificate is issued by us to the Policyholder for delivery to each insured Employee The certificate describes benefits payable and other essential information Workers' Compensation This Policy does not replace or affect any Workers' Compensation or similar law Payment of Benefits Benefits payable upon the death of an Employee are payable to the Beneficiary living at the time Unless otherwise specified, if more 2714s -11- General Provisions (Continued) than one Beneficiary survives the Employee, all surviving Beneficiaries will share equally If no Beneficiary is alive on the date of the Employee's death, payment will be made to the Employee's estate Benefits payable during the lifetime of the Employee will be paid to the Employee The above is subject to the rights of any assignee Change in Beneficiary All nominations of Beneficiaries are revocable unless otherwise stated by the Employee in the form provided by us No change will bind us unless it is made in written form satisfactory to us and filed with the Plan Administrator The change will then be effective as of the date it was signed, but it will be subject to any action taken before it was received by us at our office Assignments The insured person is permitted under this Policy to assign all his rights under the Policy Forms signed by the insured person must be received by us before payment is made, otherwise the assignment is of no effect Methods of Payment In lieu of payment of Death Benefits in one sum, another method of payment may be elected The available methods will be based on the benefit options in the individual policies then issued by us at the time of such election Facility of Payment If the Employee is not able to give a valid release for benefit payments then we may make payment up to $5,000 The payment can be made to any person we consider capable of giving a valid release 2714s -12- General Provisions (Continued) Time of Payment Benefits will be paid as soon as we have received the required written Proof of Claim, or, in the case of a Death Benefit, when we have received due Proof of death Notice of Claim We must receive written notice of claim within certain time limits except for those arising from the death of an insured The time limits for such notices are set forth in the respective Benefits Provisions The written notice is to be given to us at our office If it can be shown to us that the notice could not be given within the application period, then the notice must be given as soon as reasonably possible When we receive the notice of claim, we will send forms for filing Proof of Claim If these forms are not sent to the Employee within 15 days after we receive the notice of claim, then written proof of the nature and extent of loss given within the time specified in the Proof of Claim provision is deemed to meet our requirements Proof of Claim We must receive written proof of claim within certain time limits except for those arising from the death of an insured The time limits for such proofs are set forth in the respective Benefits Provisions The proof, which must be satisfactory to us, is to be given to us at our office If it can be shown that proof could not be given within the applicable period, we will not deny or reduce benefits payable However, proof of claim must be given within one year after the date such proof is due unless the Employee is legally incompetent 2714s -13- General Provisions (Continued) Action Against Us No legal action may be brought on any claim earlier than 60 days after a Proof of Claim is given No such action may be brought later than three years after the Proof of Claim is required Due Proof Written due proof of death must be given to us at our office before any Death Benefit is payable Examinations We have the right to examine, at our expense, any person for whom a claim for benefit payment has been made and to do so as often as we may reasonably require Gender In the context of this Policy, the use of "he," "his" and "him" refers to both males and females Proof We may require proof in connection with the terms of benefits of this Policy If proof is required, we must be provided with such evidence satisfactory to us as we may reasonable require under the circumstances Governing Law This Policy is governed by the laws of the jurisdiction where the Application was signed 2714s -14- EMPLOYEE LIFE INSURANCE BENEFIT PROVISION WITH EXTENDED DEATH BENEFIT The amount of each Employee's Life Insurance Benefit is based on the following schedule Classification AMOUNT OF INSURANCE BEFORE AGES 70 AGE 70 TO 74 A All Employees 1 x Annual 658 of Salary pre age rounded 65 to next coverage highest $1,000 B Directors & 2 x Annual Executive Salary Directors rounded to next highest $1,000 AGE 75 TO 79 458 of pre age 65 coverage AGE 80 OR OVER 308 of pre age 65 coverage All Employees are eligible for $15,000 minimum coverage before age 70 Change in Cover Change in Amount of Insurance due to - change in age will occur on the date of change Cover Ceases Coverage for an Employee under this Benefit Provision ceases on the earliest of - the applicable Individual Termination of Insurance date, - the date this Benefit Provision terminates for the Classification of Employees of which he is a member, or the date the Employee ceases to be eligible for this Benefit in accordance with the Classification shown in the schedule Death Benefit If we receive Due Proof that an Employee dies while insured, we will pay the Amount of Insurance in force on the Employee's date of death 2714s -15- Employee Life Insurance Benefit Provision With Extended Death Benefit (Continued) If an Employee's Life Insurance Benefit is being continued under the Extended Death Benefit, payment of the Amount of Insurance is subject to the terms and conditions of the Extended Death Benefit provision Extended Death Benefit (Applicable to an Employee who becomes Totally Disabled before age 60 or retirement, whichever is earlier) A Totally Disabled if we receive due Notice and Proof of Claim that an Employee becomes Totally Disabled while insured, the Amount of Insurance continues from the date of Total Disability without further payment of the Employee's Employee Life Insurance premiums We will require Proof each year that the Employee continues to be Totally Disabled The Amount of Insurance is subject to Policy terms and conditions in effect on the date such Total Disability commenced, including subsequent reductions or termination Such amount is reduced by the amount of any policy issued to the Employee under the Conversion Privilege of this Policy unless such policy is exchanged for a full refund of premiums paid B Time Limit for Notice and Proof of Claim The time limit for due Notice an Proof of Claim is - within 12 months after the Employee ceases to be Actively at Work C Termination of Extended Death Benefit This Extended Death Benefit ends on the earliest of the dates on which the Employee 1 ceases to be Totally Disabled, 2 fails to furnish due Proof that he continues to be Totally Disabled, or 3 fails to submit to an Examination D Amendment or Termination of Benefit Provision An Employee's rights to continued benefits under this Extended Death Benefit are determined on the date the Total Disability commenced These rights are subject to the terms of this Policy and will not be affected by subsequent amendment or termination of this Benefit Provision 2714s -16- Employee Life Insurance Benefit Provision With Extended Death Benefit (Continued) Conversion Privilege A Benefit 1 If all or part of an Employee's Amount of Insurance ceases due to termination of - Employment, or - membership in the class(es) which qualify for such insurance, the Employee may apply for an individual policy on his own life up to the amount that ceased 2 If an Employee's Amount of Insurance ceased due to termination of - this Provision, or - any class of insured persons by an amendment to this Provision, and the Employee has been continuously insured for five or more years under the Employee Life Insurance Benefit Provision, then the Employee may apply for an individual policy on his own life The maximum amount of such policy will be the lesser or the amount which ceased, reduced by the Amount of Insurance for which the Employee is eligible under any group policy within 31 days after his Amount of Insurance ceased, and - $2,000 3 If the Amount of Insurance for an Employee under the Extended Death Benefit ceases or reduces, the Employee may apply for an individual policy as in the above as applicable 4 The Employee will be issued such individual policy without evidence of insurability B Right The right of conversion is subiect to the following conditions 2714s -17- Employee Life Insurance Benefit Provision With Extended Death Benefit (Continued) 1 written application must be made to us along with payment of the first premium, within the 31 day period (the 31 day conversion period) following the date the insurance ceases or reduces in amount, 2 the policy may be any plan of life insurance, other than term, then usually issued by us at the attained age and amount requested, but without disability or other supplemental benefits, 3 the premium will be the rate we usually charge for the standard class of risk and age to which the Employee belongs on the effective date of the individual policy, and 4 the effective date of the individual policy will be the day after the end of the 31 day conversion period C Death Within 31 Days If the Employee dies during the 31 day Death Benefit will be paid The amount is the amount eligible for conversion conversion period, a of the Death Benefit 2714s -18- EMPLOYEE ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE BENEFIT PROVISION The amount of each Employee's Accidental Death and Dismemberment Insurance Benefit is based on the following schedule Classification AMOUNT OF INSURANCE BEFORE AGES 70 AGE 70 TO 74 A All Employees 1 x Annual 658 of Salary pre age rounded 65 to next coverage highest $1,000 B Directors & 2 x Annual Executive Salary Directors rounded to next highest $1,000 AGE 75 TO 79 458 of pre age 65 coverage AGE 80 OR OVER 308 of pre age 65 coverage All Employees are eligible for $15,000 minimum coverage before age 70 Change in Cover Change in Amount of Insurance due to - change in age will occur on the date of change Cover Ceases Coverage for an Employee under this Benefit Provision ceases on the earliest of - the applicable Individual Termination of Insurance date, - the date this Benefit Provision terminates for the Classification of Employees of which he is a member, or - the date the Employee ceases to be eligible for this Benefit in accordance with the Classification shown in the schedule 2714s -19- Employee Accidental Death and Dismemberment Insurance Benefit Provision (Continued) Accidental Death and Dismemberment Benefits If we received Due Proof or due Notice and Proof of Claim that and Employee while insured - dies from accidentally drowning, or - sustains bodily injury by accidental means, which results in loss of life, sight or limb within 365 days of the date of such injury, we will pay, subject to the Exclusions below, the following percentage of the Amount of Insurance in force on such date for such loss - life - 100% - sight of one eye - 50% - one limb - 50% - more than one loss from any one accident - 100% Loss of limb means severance of hand or foot at or above the wrist or ankle joint Loss of sight must be total and irrecoverable Exclusions Payment will not be made for a loss which is due to or results f rom - suicide while sane or insane, or intentionally self-inflicted injuries, - bodily or mental infirmity or disease of any kind, or infection unless due to an accidental cut or wound, - committing or attempting to commit an assault, felony or other illegal act, - war (declared or undeclared) or active duty in any armed service during a time of war, or Participation in a Riot, rebellion, or insurrection Time Limit for Notice and Proof of Claim If the loss is as a result of the Employee's death, then Due Proof must be given If the loss is other than death, then we must receive due Notice and Proof of Claim within 12 months after the date of loss 2714s -20- POLICY ADDENDUM - Life Only Coverage "Grandfathered" for eight retirees Permanent part-time employee working a minimum of 20 hours per week can elect coverage on a shared contribution basis 2714s -21- , , t , , , t , { I ~ , j ,