HomeMy WebLinkAboutRes 1978-31 Award Bid to Washington National Insurance Co.1
RESOLUTION NO. 31-78
A RESOLUTION OF THE VILLAGE COUNCIL OF NORTH PALM BEACH,
FLORIDA, ACCEPTING THE BID OF WASHINGTON NATIONAL INSURANCE COMPANY
FOR MEDICAL ANI) LIFE INSURANCE.
BE IT RESOLVED BY THE VILLAGE COUNCIL OF NORTH PALM BEACH,
FLORIDA:
Section 1. The bid of Washington National Insurance
Company, copy of which is attached to this Resolution, is hereby
accepted by the Village of North Palm Beach in accordance with its
terms. The appropriate Village officials are hereby directed to
advise said bidder of this acceptance. The monies are to be expended
from various departmental fringe benefit accounts.
Section 2. This Resolution shall take effect immediately
upon passage.
PASSED AND ADOPTED THIS 10TH DAY OF AUGUST, 1978.
ATTEST:
/s/ Dolores R. Walker
Village Clerk
/s/ Al Moore
MAYOR
Gentlemen:
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The undersigned, as bidder, does declare that no other person other than the
bidder herein named has any interest in this proposal or in the contract to be taken,
and that it is made without any connection with any other person or persons making
proposal for the same article, and is in all respects fair and without collusion or
fraud.
The undersigned further declares that he has carefully examined the specifica-
tions and is thoroughly familiar with its provisions and with the quality, type and
grade of material called for. '
The undersigned further declares that he proposes to furnish the articles called
for within specified time set in this proposal for the following price, and guarantees
that parts and service for the articles listed below are available within the State
of Florida, to wit:
ITEM 1.
ITEM 2
In -Patient
DATE:
'PROPOSED BENEFITS
Life Insurance and Accidental Death
Proposed Life Benefit:
Proposed Acc. Death Benefit:
Major Medical (Comprehensive)
Lifetime Maximum :
Automatic Annual Restoration:
Calendar Year Deductible:
Deductible Accumulation Period:
Nervous and Mehtal:
June 12, 1978
t
$ 100%, of annual earnings to a
maximum of i[,,000. (rounded
$ to next lower $1,000)
$ 250,000.00
$ 2,000.00
$ 100.00 /Individual $ same as Family
present plan
Calendar Year
$ same' as In -Patient $same as Out -Patient
present plan present plan
Dependent Coverage to Age: 19 Un-married Children 23 Students
Co -Insurance:
- Daily Room & Board Rate: $ 65.00
Hospital Services & Supplies: $ 3,000 in full, 80% of next $3,000, balance 100%
Surgical Fees: Attach Separate Schedule
Physicians Visits Per Day: $ 80%
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Out -Pat-
ient
ITEM 2a
In -Patient
Laboratory Ftes: $ 80%
X-Ray: $ 80%
Radiation Therapy: $ 80%
Physical Therapy: $ 80% '
MAJOR MEDICAL (80/20)
Lifetime Maximum:
Automatic Annual Restoration:
Calendar Year Deductible: $ • /Individual $ /Family
Deductible Accumulation Period:
Nervous and Mental: $
Dependent Coverage to Age:'
in -Patient $ Out -Patient
Un-Married Children Students
Co -Insurance:
Daily Room & Board Rate: $
Hospital Services & Supplies: $
Surgical Fees: Attach Separate Schedule
Physicians Visits Per Day $
Laboratory Fees: $
X-Ray: $
Out -Patient •
Radiation Therapy: $
Physical Therapy: $
ALTERNATE 1.
Maternity Benefits: Attach a description of proposed plan or describe below.
ALTERNATE 2.
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Dental Benefits: Attach a description of proposed plan or describe below.
$100 calendar year deductible
80% co-insurance
$500 yearly maximum
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PROPOSAL TO THE VILLAGE OF NORTH PALM BEACH, FLORIDA (Con'td.)
{
ITEM 1.
ITEM 2.
ITEM 2a
ALTERNATE 1.
ALTERNATE 2.
RATE GUARANTEE:
RATE PROPOSAL
Life Insurance and Accidental Death
Rate Per $1,000. Coverage $. , (, 8
Major Medical (Comprehensive)
Employee Rate $ 23 S ,2 /Month
Dependent Rate $ 33. S 7 /Month
MAJOR MEDICAL (80/20)
Employee Rate $ /Month
Dependent Rate $ /Month
MATERNITY BENEFITS
Rate $ . / D e e. /Month 4- .642
DENTAL BENEFITS
Employee Rate $ 469 /Month
Dependent Rate $ t03 /Month
bNE Years
PRESENT PLAN WITIH $1,000,000 maximum
PRESENT PLAN WITH NO CO-INSURANCE LIMIT AND
NO 100% HOSPITAL COVERAGE
PRESENT PLAN WITH SEMI -PRIVATE HOSPITAL
ROOM RATE RECOGNIZED
IMMEDIATE ELIGIBILITY FOR EXECUTIVES
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/Month
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Employee Rate $ 23. 7 4 /Month
Dependent Rate $ .3 3.9 / Month
Employee Rate $ 2/4/ /Month
Dependent Rate $ 3/.32 /Month
Employee Rate $ 2422 /Month
Dependent Rate $ 3i% ,s"t /Month
No charge
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REMARKS/EXCEPTIONS: Washington national agrees to rlllnisn in
g yudLEEriy reports
indicating paid premiums and paid & incurred losses separately for life and accidental
death benefits and major medical.
Officers of Corporation or Members of Partnership:
NAME TITLE ADDRESS
E. E. CRAGG, CLU, FLMI PRESIDENT Evanston, Illinois 60201
FIRM: WASHINGTON NATIONAL INSURANCE COMPANY
O Corporation- 0 Partnership. 0 Individual
SIGNED BY: �(il.(/ 2
TITLE: Group Manager(((,,•Miami Group Office
WITNESSES:
ADDRESS:
Isso /hl a ct-..,-- l % .sue QarmSL C Qkao
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