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Capps Insurance Agency Recommendations for the City of Paris <br />Option 1 <br />Fully-Insured Medical, Dental, Life, Vision & LTD <br />With Voluntary Long Term Care Option <br />Medical <br />Humana <br />$414.25 <br />lZate <br />$61.00 <br />$150.00 <br />$240.00 <br />Dental <br />Humana <br />18.19 <br />16.90 <br />22.76 <br />4031 <br />Life <br />Ft. Dearborn <br />.101,000 <br />2.70 <br />AD&D <br />Ft. Dearbom <br />.03/$1,000 <br />.45 <br />Dependent <br />Life <br />Ft. Dearbom <br />Retiree Life <br />Ft. Dearborn <br />' <br />Vision <br />Guardian <br />7.25 <br />5.20 <br />4.96 <br />12.45 <br />LTD * <br />Mutual of <br />Omaha <br />7.16 * <br />Total <br />$450 <br />$83.10 <br />$17746- <br />$292.76 <br />i Optional Long Rates vary as to age & are medically <br />Ternt Care Unum $7.85 undenvritten <br />FULLYINSURED RATES ARE FIRM <br />• Medical Plan -$500 deductible, 80/50 coinsurance; $2,000 OOP; 10/25/45/25% RX <br />• Dental Plan -$50 deductible (waived on Preventative); 100/80/50 coinsurance; $1,000 annual max; Ortho not <br />quoted, but available. • <br />• Life -$15,000 active employees, $5,000 retired employees; (See Reduction features & Buy-Up rates for <br />Voluntary Life in Proposal) <br />• AD&D -$15,000 active employees, $0 retired employees <br />• Vision - Plan B; 12/12/24 (Exam every12 months, Lenses every 12 months, Frames every 24 months) <br />• Long Term Disability - Per specifications, rates vary with payroll. <br />CAPPS AGENCY CAN ASSUME CURRENT LTD PLAN WITH UNUM <br />