HomeMy WebLinkAbout22. Telecom Board Agenda Packet - November 29, 2023
,
BOARD
MEMBERS
Andrew
Van Fleet
Board Chair
Theodore
Batemon
Ritch
Kurtenbach
Mike
Young
Amy
Wienands
City Council
Liaison:
Rob
Nichols
November 29, 2023
City Council Chambers
4:00 p.m.
1. Roll call.
2. Approval of the agenda, as presented.
3. Approval of minutes of November 15, 2023 regular session, as presented.
4. Public Hearing on FY2024 Budget – Hearing cancelled.
5. Resolution setting date of public hearing as December 11, 2023 to adopt the
2024 budget.
6. Motion approving Change Order No. CR-2028-0005 with ITG
Communications for a decrease of $18.97, in conjunction with the Construction
of a Backbone and Fiber-To-The-Premise Project, Contract No. 1088.
7. Motion approving health insurance with Wellmark Blue Cross, dental
insurance with Delta Dental, vision insurance with Avesis/Wellmark Blue
Cross, group life and accidental death and disability with Mutual of Omaha,
group long-term disability with Mutual of Omaha, and a welfare benefit plan
with Advantage Administrators.
8. General comments from staff, consultants, and board members.
9. Adjourn.
Kelley Felchle
Board Secretary
WATERLOO
Telecommunications Utility Board of Trustees
TELECOMMUNICATIONS UTILITY
BOARD OF TRUSTEES
Harold E. Getty Council Chambers
November 15, 2023
4:00 p.m.
1. Roll Call
Members present: Van Fleet, Kurtenbach, and Young. Mr. Batemon arrived at 4:03. Absent:
Wienands
2. Approval of Agenda.
Moved by Kurtenbach seconded by Young that the Agenda, as amended by striking item seven,
be approved. Voice-vote Ayes: Three. Motion carried.
3. Approval of Minutes.
Moved by Kurtenbach seconded by Young that the minutes of November 1, 2023 Regular
Session, and November 8, 2023 Special Session, as proposed, be approved. Voice-vote: Three.
Motion carried.
4. Public Hearing on FY2023 Drops and Installation of a Fiber-to-the-Premise Network,
Contract No. 1094.
4.1 Motion to open the public hearing, and receive and file proof of publication of notice of
said hearing.
Moved by Kurtenbach seconded by Young. Voice-vote Ayes: Four. Motion carried.
This being the time and place for the public hearing, the board chair called for public
comments and there were none.
4.2 Motion to close the public hearing.
Moved by Kurtenbach seconded by Young Voice-vote Ayes: Four. Motion carried.
4.3 Resolution approving preliminary plans, specifications, form of contract, and authorizing
to proceed.
Warren Lyons, Entrust Engineering, provided an overview of the bid received from ITG
Communications. If everything goes into conduit, it will add nearly to $3 million to the
proposal.
Mr. Kurtenbach questioned if this would cover any areas where we have future housing
development, or would it be a separate item.
Eric Lage commented that it would be separate from this bid. He stated that it would be good
strategy to lay any conduit during the infrastructure building prior to any construction.
Mr. Kurtenbach questioned what damage might be anticipated with direct bury.
Eric Lage shared that if anything was cut, it would be the conduit and fiber. He stated there is
not a lot of benefit to putting in conduit to every house.
Mr. Van Fleet questioned the rating on the fiber itself, is it 15-20 years?
Warren Lyon explained that every manufacturer has their own specs. He has worked on fiber
that was in the ground over 20 years. It holds up well while buried, but does tend to get brittle
the more it is handled.
Mr. Van Fleet questioned the percentage of projects that are direct bury vs conduit.
Warren Lyon shared that 60 percent of projects are direct bury.
Page 2
Mr. Van Fleet questioned if there were any concerns with the bury depth of 8-12 inches with
our freeze/thaw cycles.
Warren Lyon commented that he does not anticipate any issues.
Mr. Young questioned if we control the ratio of conduit or does ITG.
Eric Lage commented that it would be up to Waterloo Fiber.
Mr. Van Fleet questioned if cost increases are planned in this bid.
Warren Lyon shared that this is a flat rate for three years. After three years they can adopt
rates into the agreement.
Mr. Kurtenbach questioned that if after three years we exceed the numbers in the bid, would
we need to come back for a re-bid or would it be a change order.
Warren Lyon shared that there can be a change order for the difference.
Mr. Van Fleet questioned who would manage the work on the job, Magellan or Waterloo
Fiber.
Warren Lyon commented that the drops will be scheduled through Waterloo Fiber in the CSR
system. Magellan would manage the invoicing.
Eric Lage questioned the process.
Warren Lyon commented that the orders would go through the OSS/BSS software.
Eric Lage questioned if ITG would have access.
Warren Lyon confirmed access could be granted.
Mr. Van Fleet concurred that the process should be coordinated.
Roll call-vote Ayes: Four. Motion carried. Resolution No. 2023-030.
4.4 Motion to receive, file, and direct the Board Secretary to read bids.
Moved by Kurtenbach seconded by Young Voice-vote Ayes: Four. Motion carried.
Bidder: ITG Communications
Ft. Lauderdale, FL
5% Bid Security – Base Bid Amount: $7,485,965.00.
Mr. Van Fleet questioned if ITG has any other banking relationships in the area aside from
Regions, due to the financial climate with the banking industry.
Brian with ITG Communications, shared that their main banking relationship is with Regions,
and said he would follow up with the CFO regarding additional relationships.
Mr. Kurtenbach questioned when they will start to work.
Eric Lage commented that work will start in December.
Mr. Kurtenbach questioned how many people ITG is planning to do this portion of the work.
Brian explained that it really depends on customer sign up and what workflow Waterloo Fiber
can handle. If they were doing 100 drops per week, there would be twelve people working on
the project in the field.
Mr. Van Fleet questioned if drops can be done year round.
Page 3
Brian commented that there would be a limitation due to the weather. They would put in a
temporary drop if the weather was too cold.
4.5 Resolution awarding bid to ITG Communications, in the amount of $7,485,965.00 and
authorizing the General Manager to execute said document.
Moved by Kurtenbach seconded by Batemon. Roll call-vote Ayes: Four. Motion carried.
Resolution No. 2023-031.
5. Resolution setting date of public hearing as November 29, 2023 to adopt the 2024 budget.
Moved by Kurtenbach seconded by Young.
Eric Lage provided an overview of the budget process.
Roll call-vote Ayes: Four. Motion carried. Resolution No. 2023-032.
6. Resolution approving an Employment Agreement with Eric Lage.
Moved by Kurtenbach seconded by Young. Roll call-vote Ayes: Four. Motion carried.
Resolution No. 2023-033.
7. Motion approving appointment of Tim Knaack to the position of Products and Services
Manager, effective _______, subject to the approval of an employment agreement.
Moved by _____ seconded by _____. Voice-vote Ayes: _____. Motion carried.
8. General comments from staff, consultants, and board members.
Eric Lage, General Manager, shared that Ian and Erica are conducting interviews for
customer service representatives. He has been working with Kelley and PDCM on the
handbook and employee insurance. Bids are currently coming in for the foundation,
electrical and grounding field for the pre-fab shelter and they are working on a temporary
solution for the Proof of Concept Network, which is the first test customers being brought on
before the end of the year. He provided an update on locates, marketing, etc.
Marcellus Nixon, Entrust Solutions, provided background on himself and his experience. He
is looking forward to working with Waterloo Fiber.
Warren Lyon, provided a brief update on production and upcoming RFP’s.
Mr. Kurtenbach requested that the board have an opportunity to see the actual types of fiber
being installed.
Kelley Felchle shared that work continues on both the employee health insurance and
handbook. She anticipates having the health insurance on next agenda for board approval
with the goal of having insurance in place on January 1, 2024. She also shared that the
accounting and payroll manager begins on Monday.
9. Adjourn.
With no further business before the board, it was moved by Kurtenbach seconded by Young
that the meeting be adjourned at 4:35 p.m. Voice-vote Ayes: Four. Motion carried.
Kelley Felchle
Board Secretary
No
CR-2023-0005
ITG
Michael Regan
PM Broadband Implementation
City of Waterloo/Waterloo
Fiber/Eric Lage
Change Request Overview
Description of Change (include location)
Reason for Change
Labor and material quantities have been confirmed by Magellan & ITG. Original BOM volume and pricing
has been used to calculate the reduction in cost. Adjusted BOM Units for the installation labor of rack
mounted patch panel increases by 109 units and the installation labor of wall mount fiber enclosures reduces
by (109) units.
Unit Type Quantity (188) and Unit Pricing $389.34 for 24-port rack mount panels will be replaced by Unit
Type Quantity 297 and Unit Pricing $492.02 for the 12-port rack mount panels.
Unit Type Quantity (188) and Unit Pricing $111.24 for 24-port wall mount fiber enclosure will be replaced by
Unit Type Quantity 79 and Unit Pricing $217.47 for the 12-port wall mount fiber enclosures.
Material Submittals/ Specifications
The proposed rack mount panels and wall mount fiber enclosures will change from 24-port to 12-port counts
to align with the actual applications in the field.
The following Change Order has been created to account for an adjustment in labor, pricing, material type,
and quantities; removing the 24-port rack mount and wall mount fiber enclosures and adding the 12-port
rack mount panels and wall mount fiber enclosures to the BOM.
Change Order Request
Gene Allred
Director of Construction
Construction Contractor
11/14/2023
($13.97)Change Order Name:
Construction Contractor Name (Attn)
Magellan Project Manager:
Client/Owner (Attn)
Change Order Type
Change Order Cost:
Request Date:
Requested By:
Magellan Sign-Off
Design/Engineering
Will Be Subject To The Withholdings and Release Set Forth In The
Contract Sections 6.2(f)(i) and (ii)Retainage
Location
Work Order #
Labor
Install rack mounted patch panel
(Any Size) and tails 109 $ 115.00 $ 12,535.00
Install Wall Mount Fiber Enclosure -109 $ 750.00 $ (81,750.00)
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
*** $ (69,215.00)
Materials
24 port rack mount panel -188 $ 389.34 $ (73,195.92)
24 PortWall Mount Fiber Enclosure -188 $ 111.24 $ (20,913.12)
12 port rack mount panel 297 $ 492.02 $ 146,129.94
12 PortWall Mount Fiber Enclosure 79 $ 217.47 $ 17,180.13
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
*** $ 69,201.03
*** $ (13.97)
Increase BOM Units by 109. Original BOM Unit Quantity was 188,
updated to 297
Remove material quantity and pricing from Original BOM
Add updated material quantity and pricing to BOM
Add updated material quantity and pricing to BOM
Amount
Decrease BOM Units by (109). Original BOM Unit Quantity was 188,
updated to 79
CR Materials Subtotal
TOTAL CR COST
CR Labor Subtotal
Description
Remove material quantity and pricing from Original BOM
Itemized Breakdown of Work
Quantity Unit Price
Print Name / Title:
Signature:
Date:
Print Name / Title:
Signature:
Date:
Print Name / Title:
Signature:
Date:
**End**
Client/Owner (Attn)
Contractor Manager (not needed for design change requests)
Gene Allred Director of Construction
Approvals
Magellan Sign-Off
11/16/2023
Bryan Siebenberg VP of Operations
11/20/23
Jamie Knutson, P.E. City Engineer
11/20/2023
Benefits Meeting
October 13, 2023
Presented by:
Dennis Curtis
Vice-President, Employee Benefits
Waterloo Fiber
7/1/2023 11/1/2023
Alliance Select
PL1945/RL2054
EnhancedBlue 1500
PG007/RG018
Plan Type/Network Traditional/PPO Traditional/PPO
Embedded or Non-Embedded Embedded Embedded
Employee Deductible $500/$1,000
Deductible In Network $500/$1,000 $1,500/$3,000
(Individual/Family)Out of Network $1,000/$2,000 $3,000/$6,000
Coinsurance In Network 80%/20%80%/20%
(Carrier/Member)Out of Network 60%/40%50%/50%
Employee Out-of-Pocket Maximum $1,000/$2,000
Out-of-Pocket Maximum In Network $1,000/$2,000 $6,500/$13,000
(Individual/Family)Out of Network $2,000/$4,000 $13,000/$26,000
OFFICE VISITS
Primary Care Provider $30
Urgent Care & Chiropractic Therapy $30
Non-Primary Care Provider $60
HOSPITAL BENEFITS
Hospital Inpatient & Outpatient Deductible & Coinsurance Apply Deductible & Coinsurance Apply
Emergency Room Deductible & Coinsurance Apply $500
NETWORK ACCESS
Mayo Clinic In Network In Network
University of Iowa In Network In Network
PRESCRIPTION DRUG BENEFITS
Tier 1: $15; Tier 2: $30; Tier 3: $50; Tier 4: $50 Tier 1: $15; Tier 2: $50; Tier 3: $100; Tier 4: N/A
Included Above Generic: $150; Preferred: $200; Non-Preferred: $500
Covered 100%Covered 100%
Not Covered Pediatric Covered
MONTHLY PREMIUMS Age Rated
E Lage (Family) AGE 37,42,3 $1,446.06
E Crowther-Green (Employee/Spouse) Age 48, 54 $1,638.11
$3,084.17
$37,010.04
HRA
$146.00
$6,600.00
$43,756.04
Retail Pharmacy
Specialty Pharmacy
OTHER
Waterloo Fiber
2023 Wellmark ACA Health Insurance
Effective Date
HEALTH INSURANCE
This proposal is intended only as a vehicle for information and comparison. The acceptance of your application and the final premium rates will be determined by each issuer of the insurance based on final enrollment information along with other factors. The issuing insurance
company makes available brochures setting forth additional information which may be valuable to you in evaluating their products.
Preventative Care
(Follows U.S. Task Force Preventive Care Guidelines)
Routine Vision Examinations
TOTAL HEALTH PLAN COST PER MONTH
TOTAL HEALTH PLAN ANNUAL COST
ANNUAL PSF ADMIN FEE ($5.25 PMPM)
ANNUAL PSF BUDGETED CLAIMS (30%)
PROJECTED ANNUAL COST
We do not represent your current benefit offereings. This proposal is intended only as a vehicle for information and comparision.
Client Name
Total Number of Employees
Single Family Single Family
Plan Deductible $1,500.00 $3,000.00 $500.00 $1,000.00
Out of Pocket Max $6,500.00 $13,000.00 $1,000.00 $2,000.00
Number of Employees with Single Coverage
Maximum HRA Funding per Employee $5,500.00
Total $0.00
Number of Employees with Employee/Spouse Coverage
Maximum HRA Funding per Employee $11,000.00
Total $11,000.00
Number of Employees with Employee/Child Coverage
Maximum HRA Funding per Employee $11,000.00
Total $0.00
Number of Employees with Family Coverage
Maximum HRA Funding per Employee $11,000.00
Total $11,000.00
Over-all Total $22,000.00
First Year Setup Fee N/A
Annual Administration Fee WAIVED
Monthly Cost Per Contract Per Month $5.25
Annual Cost $126.00
Proposed
Premium HRA Funding Admin Fee
Employer Savings Assuming 100% Employee HRA Utilization $37,010.04 $22,000 $126.00
Employer Savings Assuming 80% Employee HRA Utilization $37,010.04 $17,600 $126.00
Employer Savings Assuming 60% Employee HRA Utilization $37,010.04 $13,200 $126.00
Employer Savings Assuming 30% Employee HRA Utilization $37,010.04 $6,600 $126.00
Employer Savings Assuming 25% Employee HRA Utilization $37,010.04 $5,500 $126.00
Employer Savings Assuming 20% Employee HRA Utilization $37,010.04 $4,400 $126.00
Employer Savings Assuming 10% Employee HRA Utilization $37,010.04 $2,200 $126.00
Estimated Administrative Costs with Advantage Administrators
Health Reimbursement Arrangement (HRA)
Waterloo Fiber
Client Information
Waterloo Fiber
2
Plan Target
HRA Funding (Wellmark)
0
1
0
1
$42,636.04
$41,536.04
$39,336.04
The HRA funding information and calculations provide summary information on how an HRA may work with a high deductable health plan and are examples only. Actual results will vary based on several factors including, but
not limited to, the type and characteristics of the HRA plan design and are not guaranteed. If tax or legal advice is required, seek the services of a professional advisor.
Estimated Savings Based on Employee Usage of HRA Funds
Total HRA Cost
$59,136.04
$54,736.04
$50,336.04
$43,736.04
HEALTH PLAN DETAILED RATES
EFFECTIVE DATE: 11/01/2023
EnhancedBlue 1500SM
AGE
Wellmark Blue
HMO Network
provides
statewide provider
access.
Wellmark Health
Plan of Iowa, Inc.
HMO
Wellmark Blue
POS Network
combines the
state-based HMO
with access to
out-of-network
coverage.
Wellmark Blue
POS Network
combines the
state-based HMO
with access to
out-of-network
coverage.
Wellmark Blue
Cross and Blue
Shield of Iowa.
PPO
Wellmark Blue
PPO Network
offers national
care through
BlueCard
0-14 $283.55 $297.91 $332.4
15 $308.75 $324.4 $361.95
16 $318.39 $334.52 $373.25
17 $328.03 $344.65 $384.54
18 $338.41 $355.55 $396.71
19 $348.78 $366.45 $408.88
20 $359.53 $377.75 $421.48
21 $370.65 $389.43 $434.51
22 $370.65 $389.43 $434.51
23 $370.65 $389.43 $434.51
24 $370.65 $389.43 $434.51
25 $372.14 $390.99 $436.25
26 $379.55 $398.78 $444.94
27 $388.44 $408.12 $455.37
28 $402.9 $423.31 $472.32
29 $414.76 $435.77 $486.22
30 $420.69 $442 $493.17
31 $429.59 $451.35 $503.6
32 $438.48 $460.7 $514.03
33 $444.04 $466.54 $520.55
34 $449.97 $472.77 $527.5
35 $452.94 $475.88 $530.97
36 $455.9 $479 $534.45
37 $458.87 $482.11 $537.93
38 $461.83 $485.23 $541.4
39 $467.76 $491.46 $548.36
40 $473.69 $497.69 $555.31
41 $482.59 $507.04 $565.74
42 $491.12 $516 $575.73
43 $502.98 $528.46 $589.63
44 $517.8 $544.03 $607.01
45 $535.22 $562.34 $627.44
46 $555.98 $584.15 $651.77
47 $579.33 $608.68 $679.14
48 $606.02 $636.72 $710.43
49 $632.33 $664.37 $741.28
50 $661.99 $695.52 $776.04
51 $691.27 $726.29 $810.37
52 $723.51 $760.17 $848.17
53 $756.13 $794.44 $886.41
54 $791.34 $831.43 $927.68
55 $826.56 $868.43 $968.96
56 $864.73 $908.54 $1013.72
57 $903.28 $949.04 $1058.91
58 $944.42 $992.27 $1107.14
59 $964.81 $1013.69 $1131.04
60 $1005.95 $1056.91 $1179.27
61 $1041.54 $1094.3 $1220.98
62 $1064.89 $1118.83 $1248.36
63 $1094.17 $1149.6 $1282.68
64 $1111.95 $1168.29 $1303.53
6
Effective Date
PPO Premier PPO Premier
$0/$0 $25/$75 $25 per person $50 per person
Diagnostic & Preventative 0%0%0%
(Deductible Waived)10%
Routine & Restorative 15%20%20%30%
Major Restorative 50%50%50%50%
Implants 50%50%60%60%
50%50%50%50%
EMPLOYEE ONLY 0
EMPLOYEE+SPOUSE 1
EMPLOYEE+CHILD(REN)0
FAMILY 1
COINSURANCE (Member Pays)
TOTAL MONTHLY COST $195.66
TOTAL ANNUAL COST $2,347.92
$2,000 per person
$1,500 per person
None
None
Adult Calendar Year Maximum
(Not including Orthodontics)
Lifetime Maximum for Orthodontics
(Up to age 19)
Proposal
Deductible
(Individual/Family)
In Network Benefits
Waterloo Fiber
2023 Delta Dental
DENTAL INSURANCE Current
7/1/2023 11/1/2023
This proposal is intended only as a vehicle for information and comparison. The acceptance of your application and the final premium rates will be determined by each issuer of the insurance based on final enrollment information along with other factors. The issuing
insurance company makes available brochures setting forth additional information which may be valuable to you in evaluating their products.
Orthodontics (children up to age 19)
$33.56
$71.94
We do not represent your current benefit offereings. This proposal is intended only as a vehicle for information and comparision.
$123.72
$78.76
RATES
Current
050130NYL3
Proposal
L3 Adult Buy-Up Option 150
Examination (Once every 12 months)$10 Copay $10 Copay $10 Copay
Materials Copay $25 $15 $10
Frames $150 Allowance
(Once every 12 months)
$150 Allowance
(Once every 24 months)
$150 Allowance
(Once every 24 months)
Covered in Full Covered in Full Covered in Full
Standard: Up to $75 (L1) / $110 (L2)
Premium: $50 Allowance + up to 20% discount
Standard: Up to $75 (L1) / $110 (L2)
Premium: $50 Allowance + up to 20% discount
Standard: Up to $75 (L1) / $110 (L2)
Premium: $50 Allowance + up to 20% discount
Covered in Full Covered in Full Covered in Full
Transitions: $70/$80*
Polarized: $75*
Transitions: $70/$80*
Polarized: $75*
Transitions: $70/$80
Polarized: $75
$130 Allowance
(not subject to materials copay)
$150 Allowance
(not subject to materials copay)
$150 Allowance
(not subject to materials copay)
OTHER
Waiting Period None None None
Rate Guarantee 24 Months 24 Months 24 Months
RATES: Monthly Voluntary Employer Paid; All Employees Required to
Enroll Voluntary
Employee Only $8.84 $10.04 $12.78 per adult
Employee + Spouse $17.33 $17.79
Employee + Child(ren)$18.94 $20.98
Employee + Family $24.44 $26.17
Standard Lenses (Once every 12 months)
Includes single, bifocal, trifocal and
lenticular
Progressive Lenses
Lens Options:
(Polycarbonate, Scratch-Resistent, UV Screening, Solid or
Gradiant Tint, Anti-Reflective Coating)
Contact lenses (once every 12 months)
In lieu of spectacle lenses and frames
Additional Lens Options (Single/Muilti-Vision)
*Member out-of-pocket maximum
We do not represent your current benefit offereings. This proposal is intended only as a vehicle for information and comparision.
This proposal is intended only as a vehicle for information and comparison. The acceptance of your application and the final premium rates will be determined by each issuer of the insurance based on final enrollment information along with other factors.
The issuing insurance company makes available brochures setting forth additional information which may be valuable to you in evaluating their products.
Waterloo Fiber
2023 Avesis Vision
Current Proposal
Madison National Mutual of Omaha
Effective Date 10/1/2023
Class Definition(s)All Eligible Non-Bargaining Employees
working 30 hours per week
All Active Elligible Employees
working 30 hours per week
LIFE AND AD&D
Life Amount 1x Annual Salary up to $135,000 1x Annual Salary up to $100,000
AD&D Amount Matches Life Benefit Matches Life Benefit
Reductions None
At age 65: Reduced to 65%
At age 70: Reduced to 45%
At age 75: Reduced to 30%
Additional Reductions Included in Policy
Spouse Life Benefit N/A Benefit Amount: $10,000
Guarantee Issue: $10,000
Dependent Child Life Benefit 14 days to 6 Months: $1,000
6 Months to Limiting Age: $10,000 14 days to Limiting Age: $5,000
Waiver of Premium Included Included
Portability Not Included Not Included
Conversion Included Included
PREMIUMS
Rate Guarantee Until 10/31/2025
Volume $200,000
Life Per $1,000 $0.310
AD&D Per $1,000 $0.020
Spouse & Dependent Rate (per unit)2 $1.420
Total Monthly Premium $68.84
Total Annual Premium $826.08
This proposal is intended only as a vehicle for information and comparison. The acceptance of your application and the final premium rates will be determined by each issuer of the insurance. The issuing
insurance company may make available brochures setting forth additional information which may be valuable to you in evaluating their products. The insurance carriers represented above may or may
not pay contingency fees (bonuses) to PDCM Insurance at no additional expense to the employer.
Waterloo Fiber
2023 Group Life and AD&D
We do not represent current benefit offerings. This proposal is intended only as a vehicle for information and comparison.
Current Proposal
Madison National Mutual of Omaha
Effective Date 11/1/2023
Class Definition(s)All Eligible Employees working 30 hours per week
(excluding Police and Fire employees)
All Active Elligible Employees
working 30 hours per week
LONG-TERM DISABILITY
Benefit Percentage 66.66%60%
Maximum Monthly Benefits $8,056 $6,000
Elimination Period 90 Days 90 Days
Benefit Duration 24 months
(Including the Elimination Period)RBD to SSNRA
Definition of Disability
Unable to perform at least one of the material duties of own
occupation and is unable to generate earnings in excess of
80% of pre-disability earnings due to injury or illness
Unable to perform at least one of the material duties of own
occupation and is unable to generate earnings in excess of
99% of pre-disability earnings due to injury or illness
Social Security Integration Full Family Fully Family
Pre-Existing Contion Limitation 3/12 3/12
Own Occupation Duration 24 months
(Including the Elimination Period)24 Months
PREMIUMS
Rate Guarantee Until 10/31/2025
Volume $19,166
LTD Per $100 of Coverage $0.220
Total Monthly Premium $42.17
Total Annual Premium $505.98
This proposal is intended only as a vehicle for information and comparison. The acceptance of your application and the final premium rates will be determined by each issuer of the
insurance. The issuing insurance company may make available brochures setting forth additional information which may be valuable to you in evaluating their products. The insurance
carriers represented above may or may not pay contingency fees (bonuses) to PDCM Insurance at no additional expense to the employer.
Waterloo Fiber
2023 Group Long-Term Disability
We do not represent current benefit offerings. This proposal is intended only as a vehicle for information and comparison.
PREMIUM ONLY PLAN (POP) AND ERISA WRAP DOCUMENTS
POP with POP with
POP 3rd Party HSA Advantage HSA WRAP
1st Year $150 $480 $150 $300
Renewal $100 $480 $100 $150
FLEXIBLE SPENDING ACCOUNTS
Administration Charges
Health and/or Dependent Care Flex Account Administration Charges ($200 Annual Minimum)
• First 10 Participants $9.00/participating employee/month
• Each Additional Participant $5.90/participating employee/month
Enrollment Charges
Online Enrollment or Excel Template
Paper Enrollments
Miscellaneous Charges
Standard Compliance Tests
Issue Paper Check (charged to employee’s account)
Stop Payment Fee on Reissued Checks (charged to employee)
Debit Card Fee (2 cards)
Reissue of Lost/Stolen Debit Card (charged to the employee's account)
Mobile App
Wire Deposit
Records Transfer to Successor TPA
Document Charges
Employer Initiated Plan Amendments
No Charge
$5 per Enrollment
Inc luded
$2
$30
Included
$10
Included
$30 plus sales tax
$1,500
$150 to $300/Amendment
Printing of Additional Summary Plan Descriptions $1/SPD with $10 Minimum
HEALTH SAVINGS ACCOUNTS
- First 50 Accounts $2.35/account
- Next 50 Accounts $1.75/account
- Each Additional Account $1.0 0/account
(Participants with a Limited Health FSA are not charged an HSA fee)
ACH Withdrawal/Electronic Statements/Online Access Included
No Load Mutual Fund Investment Options Included
Issue Paper Check (charged to employee’s account) $2.00 per check
Document Fee if deposits are made to custodians other than Healthcare Bank $40/month
Additional/Optional Services
Stop Payment $30
Return Items $5/item
Print Paper Statements $2/statement
Individual HSA Account Transfer to Alternate Custodian $50
WELFARE BENEFIT PLAN FEE SCHEDULE
Effective For Plan Years Beginning On or After July 1, 2020
WELFARE BENEFIT PLAN FEE SCHEDULE
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Effective For Plan Years Beginning On or After July 1, 2020
HEALTH REIMBURSEMENT ACCOUNTS
Administration Charges
- Standard Plan
- Extreme Plan
Enrollment Charges
Online Enrollment or Excel Template
Paper Enrollments
$5.25/covered employee/month
$8.70/covered employee/month
No Charge
$5 per Enrollment
Miscellaneous Charges
Records Transfer to Successor TPA $1,500
Document Charges
Employer Initiated Plan Amendments $150 to $300/Amendment
Printing of Additional Summary Plan Descriptions $1/SPD with $10 Minimum