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HomeMy WebLinkAboutNational Insurance Services-6/9/2014NATIONAL INSURANCE SERVICES INSURANCE TRUST JOINDER AGREEMENT FOR LONG-TERM DISABILITY INSURANCE WATERLOO CITY OF (the `Employer") hereby requests application for participation in National Insurance Services Trust (the "Trust") for group long-term disability insurance benefits under a master group policy underwritten by Madison National Life Insurance Company, Inc. (the "Insurer"). The "Group Policy" means only the provisions of the master group policy that apply to the Employer, based upon the coverage requested under this Joinder Agreement. A. Administrative 1. Employer: 2. Plan Number: 3. Nature of Business: 4. Frequency of Billing: 5. Original Plan Effective Date: 6. Revised Joinder Effective Date: B. Class and Benefit Summary WATERLOO CITY OF 715 Mulberry Street Waterloo, IA 50703 0378 Government Monthly July 1, 1994 July 1, 2014 Class Number: 01 02 Eligible Class: All Other Eligible Employees Library Employees excluding sworn Police and Fire Employees and Employees who work 29 hours or less at Leisure Services Employer Premium Contribution: 100% 100% Initial Premium Rate: .41% of covered payroll .41 % of covered payroll Initial Premium Rate Guarantee: 24 months until July 1, 2016 24 months until July 1, 2016 Elimination Period: 90 consecutive calendar days 90 consecutive calendar days Minimum Hourly Work Requirement: 30 hours per week 20 hours per week Waiting Period: None None Evidence of Insurability: Required for Late Enrollees, Required for Late Enrollees, Increases and amounts exceeding Increases and amounts exceeding the Guarantee Issue the Guarantee Issue New Employee Eligibility Date: Upon completion of the Waiting Upon completion of the Waiting Period Period Minimum Participation Required: 100% 100% WATERLOO CITY OF 0378 Page 1 Class Number: 01 02 Eligible Class: All Other Eligible Employees excluding sworn. Police and Fire Employees and Employees who work 29 hours or less at Leisure Services Library Employees Leaves and Sabbaticals: Coverage with premium payment while on FMLA leave Coverage with premium payment for up to one year while on Paid or Unpaid Sabbatical Coverage with premium payment while on FMLA leave Coverage with premium payment for up to one year while on Paid or Unpaid Sabbatical Definition of Disability: Partial Partial Own Occupation Period: 24 months following the end of 24 months following the end of the Elimination Period the Elimination Period Any Occupation Period: From the end of the Own Occupation Period to the end of the Maximum Benefit Period From the end of the Own Occupation Period to the end of the Maximum Benefit Period Cumulative Elimination Period: 10 Working Days 10 Working Days Recurrent Disability: 6 months 6 months Predisability Earnings: Base pay plus Longevity Pay Base pay plus Longevity Pay Maximum Monthly Covered Salary: $10,000 $10,000 LTD Benefit Percentage: 66-2/3% 66-2/3% Maximum Monthly Benefit: $6,667 $6,667 Guarantee Issue: $6,667 $6,667 Minimum Monthly Benefit: $50 $50 State Plan Disability Benefits: No Application required for IPERS No Application required for IPERS Social Security Integration: Full Family Full Family Freeze Type: Social Security Freeze Social Security Freeze Pre -Existing Condition Exclusion: 3 months/12 months 3 months/12 months Mental Disorder Limitation: None - Same as any Physical Disease None - Same as any Physical Disease Substance Abuse Limitation: None - Same as any Physical Disease None - Same as any Physical Disease Claim Payment Method: Monthly Monthly WATERLOO CITY OF 0378 Page 2 Class Number: 01 02 Eligible Class: All Other Eligible Employees Library Employees excluding sworn Police and Fire Employees and Employees who work 29 hours or less at Leisure Services Presumptive Disability: Included Included Rehabilitation Benefit: Included Included Survivor Benefit: Included Included Maximum Benefit Period: Age at Disablement Benefit Duration Any Age of Disablement 24 months (including the Elimination Period) C. Payment of Premiums 1. Premium Due Date. Premium is due on the 1st of the month to which coverage for such premium applies (e.g., premium for coverage in October would be due October 1st). 2. The premium due on each Premium Due Date is the sum of the premiums for all Insured Persons under the Group Policy. Premium rates for each Employer covered under the Group Policy are shown in the Employer's Joinder Agreement. 3. The Employer determines the amount, if any, of each Insured Person's contribution toward the cost of insurance. 4. Each premium is payable on or before its Premium Due Date directly to the Insurer at their home office. 5. Premium is due for an Insured Person for each month in which such employee is covered under the Group Policy. The Employer must notify the Insurer immediately whenever an employee becomes eligible or ceases to be eligible for coverage. Effective dates of coverage or termination dates which occur mid -month will be billed as follows: a) If the effective date of coverage is between the 1st of the month and 1 5th of the month, premium for an entire month will be due to the Insurer. If the effective date of coverage is between the 16th of the month and the end of the month the Employer will be billed for the next full month of coverage. The Insurer does not prorate premium. b) If the date coverage ends is between the 1st of the month and the 15th of the month, no premium will be due for that month. If the date of termination is between the 16th of the WATERLOO CITY OF 0378 Page 3 month and the end of the month the Employer will be responsible for an entire month's premium. 6. All premiums will be based upon information provided by the Employer in the Census Reports. D. Changes in Premium Rates. 1. Special Circumstances. The Insurer may change premium rates, to be effective on the next Premium. Due Date, if any of the following occur: a) A change or clarification in a law or governmental regulation affects the amount payable under the Group Policy. Any such change in premium rates will reflect only the change in the Insurer's obligations. b) One or more changes occur in the factors material to the underwriting risk the Insurer assumed under the Group Policy with respect to the Employer, including, but not limited to, the number of persons insured, age, Predisability Earnings, gender and occupational classification. c) The premium contribution arrangement for insured employees changes or varies from that stated in the Employer's Joinder Agreement when issued or last renewed. d) Plan design changes are requested by the Employer. e) The Insurer and the Employer mutually agree to change premium rates. 2. In all other cases, and subject to a period for which the Insurer has provided the Employer with a written rate guarantee, the Insurer may change premium rates upon 90 days advance written notice to the Employer. Any such change in premium rates may be made effective on any Premium Due Date, but no such change will be made more than once in any Contract Year. Contract Years means successive 12 -month periods computed from the end of the initial rate guarantee period, or from a time agreed to in writing by the Employer and Insurer. E. Premium Adjustments. Premium adjustments involving a return of unearned premiums to an Employer will be limited to the 12 months just before the date the Insurer receives a request for premium adjustment. F. information Required from Employer 1. The Employer will furnish all information reasonably necessary to administer the Group Policy, including but not limited to the following: a) At least one Census Report during each plan year, no later than six months prior to the next plan renewal date. The Census Report means a written report providing the following information for each Employee insured under the Group Policy: name, social security number, date of birth, gender, occupational class, annual Pre -disability Earnings as defined under the Group Policy and the amount of coverage. b) A list of all eligible employees and documentation supporting employee eligibility under the Group Policy. c) Information about employees who become eligible, whose amounts of coverage change and/or whose coverage ends. d) Occupational information and any other information that may be required to manage a claim. e) Notification of an Employer's change in legal status, expansion of business, dissolution, merger, buyout or any other significant business operational change. f) Notice of any additional eligible employee segment(s). WATERLOO CITY OF 0378 Page 4 g) Any other information that may be reasonably required. 2. The Employer must provide such information to the Insurer or its agents in a regular and timely manner as may be reasonably specified by the Insurer and/or its agents. The Insurer and its agents have the right at all reasonable times to inspect the payroll and other records of the Employer which relate to insurance under the Group Policy. G. Grace Period and Termination for Nonpayment 1. If a premium is not paid on or before its Premium Due Date, it may be paid during the Grace Period. The coverage under the Group Policy will remain in force during the Grace Period. 2. Grace Period means the 31 days following the Premium Due Date. 3. .If the premium for coverage is not paid during the Grace Period, the coverage under the Group Policy will terminate automatically at the end of the Grace Period. 4. The Employer is liable for premium for coverage during the Grace Period. The Insurer may charge interest at the legal rate for any premium which is not paid during the Grace Period, beginning with the first day after the Grace Period. H. Termination for Other Reasons 1. The Policyowner may terminate the Group Policy and the Employer may terminate coverage under the Group Policy by giving the Insurer at least 31 days written notice. The effective date of termination will be the later of: a) The date stated in the notice; or b) The Premium Due Date immediately following date the Insurer receives the notice. 2. The Insurer may terminate coverage under the Group Policy as follows: a) On any Premium Due Date if the number of persons insured is less than the minimum participation number or less than the minimum participation percentage provided for under Employer's Joinder Agreement. b) On any Premium Due Date if the Insurer determines that the Employer has failed to promptly furnish any necessary information requested or has failed to perform any other obligations relating to the Group Policy or coverage under the Group Policy. c) On any Premium Due Date by giving the Employer at least 31 days advance written notice. d) On the date the Employer breaches any part of the Entire Contract. L Certificates. The Insurer will prepare Group Long Term Disability Certificates of Coverage setting forth the main features of the Group Policy applicable to each Insured Person. The Insurer and Employer may agree to distribute the Certificates to Insured Persons in paper format, or to make the document available and accessible for review by Insured Persons on the Employer's website. The Employer will be responsible for providing sufficient notice to the Insured Person of the existence and availability of the Certificate, including instructions on how to view the document, and a statement that a paper copy of the document will be made available upon request. Upon receiving such a request from either the Employer or Insured Person, the Insurer will provide a written copy of the Certificate to the Employer for distribution to the Insured Person. If the terms of the Certificate of Coverage differ from the terms of the Employer's coverage under the Group Policy, the latter will govern. WATERLOO CITY OF 0378 Page 5 J. Agency and Release. Individuals selected by the Employer to secure coverage under the Group Policy or to perform their administrative function under it, represent and act on behalf of the person selecting them and do not represent or act on behalf of Madison National Life Insurance Company. The Policyowner, Employer and such individuals have no authority to alter, expand or extend the Insurer's liability or to waive, modify or compromise any defense or right the Insurer may have under the Group Policy. The Policyowner and Employer hereby release, hold harmless and indemnify Madison National Life Insurance Company from any liability arising from or related to any negligence, error, omission, misrepresentation or dishonesty of the Policyowner or Employer respectively, or any of their respective representatives, agents or employees. K. Notice of Suit. The Policyowner and Employer shall promptly give the Insurer written notice of any Lawsuit or other legal proceedings arising under the Group Policy. L. Entire Contract and Changes 1. The Group Policy, the Group Long Term Disability Insurance Certificate of Coverage, the Employer Joinder Agreement, the applications of the Policyowner, Employers and employees and any applicable riders, addenda and/or amendments constitute the Entire Contract. 2. The Group Policy may be changed in whole or in part. No change in the Group Policy will be valid unless it is approved in writing by one of the Insurer's executive officers and given to the Policyowner for attachment to the Group Policy. No change in an Employer's coverage under the Group Policy will be valid unless it is approved in writing by one of the Insurer's executive officers and given to the Employer for attachment to their Joinder Agreement. No agent has authority to change the Group Policy or an Employer's coverage under the Group Policy or to waive any provisions thereof. M. Effect on Workers' Compensation, State Disability Insurance. The coverage provided under the Group Policy is not a substitute for coverage under a Workers' Compensation or state disability income benefit law and does not relieve the Employer of any obligation to provide such coverage. N. The undersigned Employer adopts and agrees to be bound by the terms and conditions of National Insurance Services Trust Agreement, as amended from time to time (the "Trust Agreement") and master group policy. Copies of these documents are available for employer review at Madison National Life Insurance Company, 1241 John Q. Hammons Drive, Madison, WI 53717. 0. The Trust is a vehicle for obtaining group insurance plans in which employers join together as a single policyholder for the purchase and maintenance of group insurance policies. P. The Trust's Administrator shall provide participating employers the necessary information for applicable State and Federal compliance reporting requirements. Q. The signatures below constitute acceptance of the undersigned employer as a participating member of the Trust. Signed into effect this -%f 9 - day of 1''1 \Ci.(_l WATERLOO CITY OF 0378 Page 6 Signature %f Authorized Employee of Employer Printed Name & Title of Authorized Employee Signature of Authorized Employee of Employer Printed Name & Title of Authorized Employee Administrator: National Insurance Services of Wisconsin, Inc. By:Ca-` Bruce A. Miller, President May 16, 2014 WATERLOO CITY OF 0378 Page 7 THE IHC GROUP Independence Holding Company NOTICE OF PRIVACY PRACTICES AND PROTECTION This Privacy Notice is provided for your information -- keep a copy of it for your records. No response is required or requested Customer Privacy fs Our Business - We value our relationship with our customers and are dedicated to providing them with exceptional service and competitive product offers. As pact of our dedication to servicing their insurance needs, we are committed to protecting the confidentiality of nonpublic personal information about our customers. This Privacy. Notice will help you understand what type of information we collect about insured individuals, how the information we collect is used, and what measures we take to protectthat information. What Information We Collect And Bow Wes Collect It - Depending on the type of product, we collect nonpublic personal information about insured indivirtrmis that may include: • address, • telephone number, • social security number, • account information. • income, • employment, • health status, and • other personal information relevant to their coverage. We collect such information primarily from information we receive from individuals on applications or other forms. We may also collect information through telephone conversations or other electronic means, such as internet "coolies" (data stored on a computer by an intemet browser when you use the internet to access our website) that may be used to track website usage, remember passwords customers create, and provide customers with website content specific to their needs and interests. We may also obtain information from third parties such as employers, non-affiliated insurers, physicians, hospitals and other medical providers. How Information Is Protected - We restrict access to nonpublic personal information to those employees who need to know that information to provide products or services to our customers. We maintain physical, electronic, and procedural safeguards that comply with federal and state regulations to guard such information. Information about insured individuals is accessed by our employees only when such access is necessary to conduct our business. For example, we may access information to offer other compatible products or services we provide, to process customer requests, and to administer our products or services. All employees are requiredto maintain the confidentiality of nonpublic personal information and to follow policies we establish to secure such oonfidentiality Additionally, we require third parties to whom we disclose nonpublic personal information, or who receive or handle such information on our behalf; to adhere to our standard of privacy protection and to establish information security procedures. Disclosure - We do not disclose any nonpublic personal information about our customers or former customers to anyone, except as permitted by law. Information will only be disclosed for such purposes es conducting and auditing our business, administering the business of affiliated organizations, responding to requests from government [FORM_NUMBER] authorities, or as authorized or requested by an insured individual. Such disclosures include, but are not limited to: • Affiliates — we may provide information to affiliated companies to enable them to provide business services for us such es claims processing, underwriting, and maintenance of your accounts, and to offer products and services we provide. • Agents and Brokers —we may provide information to enable agents and brokers to provide business services for us and to offer products and services we provide. • Joint Marketing — we may provide information to non-affiliated third patties to jointly market insurance products or services. • Lending Institutions — we may provide information to non-affiliated lending institutions, such as banks and credit unions, to offer products and services we provide, and to provide business services for us, Government Entities — we may provide information upon request from a State Department of Insurance or other government entity. The purpose for the request may be to prevent fraud, conduct an audit of our business practices, or for any other reason for which the government entity is legally permitted to request information. • Servicing organizations - we may provide information to servicing organizations such as TPAs, reinsurers, attorneys, accountants, actuaries, underwriters, and other such organizations to enable them to provide business services for us. We do not share, trade, sell, exchange or in any other way disclose nonpublic personal information except as stated above or to otherwise conduct the business of insurance. About this Privacy Notice - The examples contained in this Privacy Notioe are provided as illustrations and are not a comprehensive account of the rights of any party under applicable federal and state laws. The policies and protections indicated in this Privacy Notice will remain effective even after an individual's coverage is terminated, to the extent we retain information about that individual. We may change this Privacy Notice at any time and will inform you of any changes as required by law. Other applicable privacy protections may exist under state laws and we will comply with all applicable state laws when we disclose information about individual insureds. This Privacy Notice is distributed on behalf of the following Independence Holding Company entities and their affiliated organizations: - Standard Security Life Insurance Company of New York - Madison National Life Insurance Company, Inc. - Independence American Insurance Company For additional information, contact us at: Attn: Privacy Committee Post Office Box 5008 Madison, WI 53705 1HCpn--1ND-0509