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2008_08.21 CC Packet0 0 1 Q - { O -- �i) GIT �U AIL Notice is hereby given that a Special Meeting will commence at 7:00 PM by the governing body of the City of Kennedale, Texas, on the 2l day of August 2008 at 405 Municipal Drive, Kennedale Municipal Building, Kennedale, Texas at which time the following subjects will be discussed to wit: (SEE ATTACHED NOTICE) Dated this 18 day of August 2008. By: Bryan Lankhorst, Mayor I, the undersigned authority, do hereby certify that the above Notice of Meeting of the governing body of the City of Kennedale, Texas is a true and correct copy of said Notice and that I posted a true and correct copy of said Notice on the bulletin board of City Hall of said City in Kennedale, Texas, a place convenient and readily accessible to the general public at all times, and said Notice was posted on August 18, 2008 at 9:00 AM and remained so posted continuously for at least 72 hours preceding the scheduled time of said Meeting. Persons with disabilities who plan to attend this meeting and who may need auxiliary aids or services such as interpreters for persons who are deaf or hearing impaired, readers, large print, are requested to contact the City Secretaiy's Office at (8 17) 483 ®1296 five (5) work days prior to the meeting so that appropriate arrangements can be made. �� a "v -s' e 18 day of August 2008. Cxs G� By: Kathy Turner, TRMC City Secretary ary i or i q l 4051 unicipal Drive, Kennedak, Texas 76060 KENNEDALE CITY COVICH, SPECIAL MEETING — AUGUST 21,2008 405 MUNICIPAL DR. — KENNEDALE MUNICIPAL BLDG. COUNCIL CHAMBERS VAIIIIIJIM11 llo REGULARITEMS a. Public hearing to receive citizens comments on proposed tax rate of $0.722500 per $ 100 of taxable value. b. Review and consider approval to award bid for health/dental/vision/life and AD & D insurance. Date: August 18, 2008 Agenda Item No: I -a Subject: Public Hearing Originated by: Kathy Turner, City Secretary Summary: To receive citizens' comments regarding the proposed 2008 tax rate of $0.722500 per $100 of taxable value. Recommendation: Disposition by Council: The City of Kennedale will hold two public hearings on a proposal to increase total tax revenues from properties on the tax roll in the preceding tax year by 7.31 percent (percentage by which proposed tax rate exceeds lower of rollback tax rate or effective tax rate calculated under Chapter 26, Tax Code). Your individual taxes may increase at a greater or lesser rate, or even decrease, depending on the change in the taxable value of your property in relation to the change in taxable value of all other property and the tax rate that is adopted. The first public hearing will be held on Thursday, August 21, 2008 at 7:00 PM in the City Council Chambers, 405 Municipal Dr., Kennedale, TX 76060. The second public hearing will be held on Thursday, August 28, 2008 at 7:00 PM in the City Council Chambers, 405 Municipal Dr., Kennedale, TX 76060 The members of the governing body voted on the proposal to consider the tax increase as follows: FOR: Councilmember, Brian Johnson Councilmember, Jerry Miller Councilmember, David Green AGAINST: None PRESENT and not voting: Mayor, Bryan Lankhorst ABSENT: Mayor Pro -Tem, John Clark Councilmember, Kelly Turner The average taxable value of a residence homestead in the City of Kennedale last year was $140,970. Based on last year's tax rate of $0.722500 per $100 of taxable value, the amount of taxes imposed last year on the average home was $1,018.51 The average taxable value of a residence homestead in the City of Kennedale this year is $148,167. If the governing body adopts the effective tax rate for this year of $0.673255 per $100 of taxable value, the amount of taxes imposed this year on the average home would be $997.54 If the governing body adopts the proposed tax rate of $0.722500 per $100 of taxable value, the amount of taxes imposed this year on the average home would be $1,070.51 Members of the public are encouraged to attend the hearings and express their views. 2008 Property Tax Rates in City of Kennetlale2008. This notice concerns 2008 property tax rates for City of Kennedale 2008. It presents information about three tax rates. Last year's tax rate is the actual rate the taxing unit used to determine property taxes last year. This year's effective tax rate would impose the same total taxes as last year if you compare propertiestaxed in both years. This year's rollback tax rate is the highest tax rate the taxing unit can set before taxpayers can start tax rollback procedures. In each case these rates are found by dividing the total amount of taxes by the tax base (the total value of taxable property) with adjustments as required by state law. The rates are given per $100 of property value. Last year's tax rate: Last years operating taxes $ 2,492,653 Last years debt taxes $ 652,191 Last years total taxes $ 3,144,844 Last years tax base $ 435,272,526 Last years total tax rate 0.722500 /$100 This year's effective tax rate: 0.069570 /$100 Last years adjusted taxes $ 3,140,078 (after subtracting taxes on lost property) This years adjusted tax base $ 466,402,015 (after subtracting value of new property) = This years effective tax rate 0.673255 /$100 (Maxie un rate unless unit publishes notices and holds hearings) This year's rollback tax rate: Last years adjusted operating taxes (after $ 2,824,075 subtracting taxes on lost property and adjusting for any transferred function, tax increment financing, state criminal justice mandate, and /or enhanced indigent health care expenditures) This years adjusted tax base $ 466,402,015 This years effective operating rate 0.605502 /$100 x 1.08 = this years maximum operating rate 0.653942 /$100 +This years debt rate 0.153303 /$100 = This years total rollback rate 0.807245 /$100 Sales tax adjustment rate 0.069570 /$100 = Rollback tax rate 0.737675 /$100 Statement of Increase/Decrease If City of Kennedale2008 adopts a 2008 tax rate equal to the effective tax rate of $0.673255 per $100 of value, taxes would increase compared to2007 taxes by $98,257. Schedule A - Unencumbered Fund Balances The following estimated balances will be left in the units property tax accounts at the end of the fiscal year. These balances are not encumbered by a corresponding debt obligation. Type of Pr Tax Fund DEBT SERVICE Balance $41,000 Schedule B - 2008 Debt Service I J ill liql1i Jill 1 111111111 1,11�1111 11111111 11111 J �. Date: August 18, 2008 Agenda Item No: I -b Subject: Review and consider approval to award bid for health/dental /life /vision and ad &d insurance. Originated by: Kathy Turner, City Secretary Summary: Recommendation: Recommend Gaylon Thompson is appointed Insurance Agent of Record for the period of October 1, 2008 to December 31, 2009, and award bids as follows: Health: BCBS of Texas PPO Plan Number M -09a — Employee Cost $477.40 PPO Plan Number M -26A — Employee Cost $360.46 Health Savings Account — M114 -a — Employee Cost $366.41 Dental Insurance — Ameritas Group — Employee Cost $23.72 Vision — Ameritas Group — Employee Cost $7.16 Life Insurance & AD &D Insurance — Boston Mutual — Employee Cost $0.10/$0.02 • a C) Jo ° =z a� o ° o O O 00 O .1.1��� �� �� �� ���� � O ° CD N o O o O O O ° O ��(`�� ° O ° O °° O O °° o titi 0 o 0 r� 0 0 0 0 titi 0 0 0 0 titi�r 0 0 0 0 0 0 o o O O Q O T- -N 0 \O (n 64 Efl Efl LO _ 69- N N cum OV O m Y o 00 O O 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 \ 0 0 O r 00 0 M N N > O LO O O O LO O o O O O O O 00 00 00 0000 O O �p r z N Ln NL() 00000 ����� O rr O cc rr O O r O - �� - � - O O O O � O o ti 00 N o s 64 64 64 64 MNNlf' 0% L6 W O Qo z o 0 00 0 0 0 ��� 0 0 0 0 0 0 0 �� 0 0 �� 0 0 0 � 0 o 0 O 00000 O O 00 00 O cc O o 0 N CO LO I- 1` 00 r- ti r- r- LO I` I- LO LO CO LO ° O 69 64 (B LO 0 00 Q 0 0- O O CO 6 O m Y o o0 000 O o Q- (60 a -- o 0 0 Cl o 0 0 0 0 0 0 O O Cc)Nd"0) I'rr(D L) 0 0 L) + 00 O o o 00 \ O \\ O O \ O p OL6CN06 z 00N0 O �� O 0000 O �� O f� f�00 f� 0 O CIONN c 64 U:)- 69' 69 Ln O a z O \ \ \ \° \° \° \ 0 \ ° \ \ \ \° O ° M C o D O o 0 00000 0��00(0 0 0 0 0 0 O ti 0 O ti 0 00 D LO 0 0 00 I-- 0 ti 0 O M 0 cc (0(.0 0 0 O Cc) � o Ofl00 0 O 64 60 N 0 a 0 0 a oo > >,o o >, O �— 64 CO 69 O o V `0 00 o Q��O o o Q 0 0 0 0� 0 0 0 0 °�tiN m) 0 0 D O O M 0+0 0 0 L) O o o O O O O O f d Mo O D C) � 0 L o �0 00 0000 00 O ItMN 6 60, ���� � 69 LLO Ln 69 C O N L Q 0 0 O o U a) t d c 3 U) m v a) p p a) U) CD U U (6 C s ++ O L N Q Q a) 2 G _ x p 0) $ O m > • c y E to cn O V p U to N '� Q � N a) c •0 aa)i m 2) � ca a) >+ d p 0 a�i .N 0 � v � n3 U O °- E M Q x c O a) c V c �' c v co (/) N ±� L m ._ U cv N v-- O K v - O O ca 0 N S O. 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IN i_ Tom M iMe Market Business I " Group Name: CITY OF KEN6' EDALE PPO Group /Section (High Plan): 000009065 / 0003, 9003 PPO Group /Section (Low Plan): 000009065 / 0002, 9002 PAY - u0` Renewal Effective: 10/01/2008 Total Group Contracts: 66 Total PPO Contracts: 41 Total PPO Members: 62 Reg/Dist/Terr: 001 / 001 / 104 - - current i=iigh iarr afie s ' EO EC ES EF Total C14a $452.70 $706.55 %798.20 $965.94 $9,667.23 $15 Copay, 4$500/1500 In/$750/2250 Out Ded, 80 % to $2000 /6000 In /60% to $4000/12000 Out; 20/35/50 PDP SMIM Iw High Plan �te� Effective 10/01/2008 EO EC ES EF Total C14a $557.73 $870.47 _. $983.38 $1,190.04 $11,910.07 SMIM High Plan Contract Enrollment 12 1 2 2 Rate Change 23.2% a rt rretnnfi Law Plan Rates EO . EC ES EF Total <_ HSABa $361.75 .x}564.58 $637. $771.83 $9,907.0 $1250/2000 Ded, 100% to X51250/2000 In /70% to x;5250/10000 Out; Ric 100% after C.Y. Ded SMIM WtlSitliu.Plan'Rate EO EC ES EF Total Eflective 10/01/2008 HSA8a $468.47 $731.13 $825.98 $999.52 $12,830.70 SMIM Low Plan Contract Enrollment 20 2 0 2 Rate Change 29.5% Note: This rate change percentage is based on total monthly premium, Each tier's rate change may vary from the total change percentage. The above rates are projected to be effective for the 12 -month period beginning on the effective date of group coverage and are contingent upon the provisions shown below. Final rates may vary based on actual enrollment results. 1. Enrollment of 66 or at least 75% of the eligible employees; with a sustained monthly enrollment of at least 75 %, but In any event, not less than 59. 2. The employer contributing at least 75% of the Employee Only cost. 3. No additional taxes will be imposed and no Increase in existing taxes until the next Anniversary Date. 4. Rates do not Include any future mandated benefit changes. 5. All employees must enroll in BCBSTX coverages, no other carrier allowed. G. Standard BCBSTX Managed Care programs with standard membership, eligibility, administration, claims processing and standard network. Standard Master Contract provisions and definitions apply. Any costs associated with special services or custom materials provided by BCBSTX will be supplemental billed separate and apartfrom the rates outlined on this confirmation page, 7. Annual open enrollment. 8. This proposal assumes the group contract will be issued In Texas. In addition to the benefits stated herein, benefits for covered persons who reside outside of Texas will conform to all Extraterritorial requirements of those states. 9. Insurance regulations require carriers to determine whether an employer is subject to Chapter 26, Texas insurance Code. 10. This proposal is made on the condition you are not a Small Employer as defined in Chapter 26. A proposal to a Small Employer would have to contain specific contractual elements and mandated insurance plans not contained in this proposal. Should it be determined you were a Small Employer, this proposal and any health insurance contract issued to you, shall be null and void. 11. Upon inquiry from employer groups, BCBSTX will provide information to the employer group regarding commissions and other compensation paid to the employer's broker /producer by BCBSTX in connection with the employer's policy or contract with BCBSTX. Texas Middle Market Business o Optional PPO Benefit plans Group Name: Group Number: CITY OF KENNEDALE Reg/Dist /Terr: 000009065 Effective Date: 001 / 001 /104 10/01/2000' M01a BC $15 Copay, $$250 Ded In /Out, 90%/70% Coins In /Out, $1000/$2000 $623.05 $972.42 $1098.56 $1329.43 Coins Stoploss In /Out, $15/$30/$45 PDP J MO2a t BC Copay, $$500 Ded In /Out, 90 %/70 1 /. Coins In /Out, $2 000/$400 0 Coins Stoploss In /Out, $ 15/$30/$45 PDP $557.70 )$870.45 $983.36 $1190.02 ? _ ` 0 3 M03a BC $15 Copay, $$500 Ded In /Out 80%/60% Coins In /Out, $2000/$4000 $554.18 $864.93 $977.13 $1182.48 �nt7 Coins Stoploss In /Out, $15/$30/$45 PDP 0 `1;z RA9 M04a BC $20 Copay, $500 Ded In /Out, 80%/60% Coins In /Out, $2500/$5000 Coins $523.70 $817.38 $923.39 $1117.45c� Stoploss In /Out, $20/$35/$50 PDP ?,`> M05a BC $20 Copay, $750 Ded In /Out, 80 76/60 Coins In /Out, $3000/$6000 Coins $510.63 $796.98 $900.36 $1089.58 Stoploss WOOL $15/$30/$45 PDP M06a BC $20 Copay, $1000 Ded In /Out, 100 7./70% Coins In /Out, $0/$8000 Coins $555.57 $867.12 $979.61 $1185.47 ��7 f Stoploss In /Out, $15/$30/$45 POP 4Ro - M07a BC $20 Copay, $1000 Ded In /Out, 8076/60 Coins In /Out, $2500/$5000 $508.61 $793.80 $896.79 $1085.25 1 �(?, (�-t Coins Stoploss In /Out, $15/$30/$45 PDP M08a BC $25 Copay, $1000 Ded In /Out, 90 %170% Coins In /Out, $3000/$6000 $523.27 $816.70 $922.65 $1116.55 Coins Stoploss In /Out, $15/$30/$45 PDP M09a BC $25 Copay, $1000 Ded In /Out, 80 U % Coins In /Out, $3000/$6000 $477.40 $745.12 $641715 $1018.66 Coins Stoploss In /Out, $20/$35/$50 PDP M10a BC $25 Copay, $1000 Ded In /Out, 75 %/50% Coins In /Out, $4000/$8000 $463.76 $723.83 $817.72 $989.58 Coins Stoploss In /Out, $20/$40/$60 PDP M11 a BC $30 Copay, $1000 Ded In /Out, 80 76/60% Coins In /Out, $4000/$8000 $472.41 $737.33 $832.96 $1008.01 Coins Stoploss In /Out, $20/$35/$50 PDP M12a BC Ded /Coins, $1000 Ded In /Out, 80 %/60% Coins In /Out, $3000/$6000 $435.27 $679.36 $767.48 $928.76 Coins Stoploss In /Out, $20/$35/$50 PDP M14a BC $20 Copay, $1500 Ded In /Out, 80 %/60% Coins In /Out, $3000/$6000 $472.24 $737.07 $83168 $1007.67 Coins Stoploss In /Out, $15/$30/$45 PDP M15a BC $25 Copay, $1500 Ded In /Out, 75 %/50% Coins In /Out, $3000/$6000 $457.79 $714.50 $807.19 $976.83 Coins Stoploss In /Out, $15/$40/$55 PDP M16a BC $30 Copay, $1500 Ded In /Out, 80 %/60% Coins In /Out, $3000/$6000 $457.85 $714.59 $807.28 $976.93 Coins Stoploss In /Out, $20/$35/$50 PDP M17a BC $30 Copay, $1500 Ded In /Out, 75 %/50 Coins In /Out, $4000/$8000 $436.93 $681.95 $770.40 $932.30 Coins Stoploss In /Out, $20/$40/$60 PDP M18a BC $20 Copay, $2000 Ded In /Out, 80 %/60 % Coins In /Out, $3000/$6000 $453.90 $708.42 $800.31 $968.50 Coins Stoploss In /Out, $15/$40/$55 PDP M19a BC $25 Copay, $2000 Ded In /Out, 75 %/50% Coins In /Out, $3000/$6000 $431.00 $67270 $759.95 $919.67 Coins Stoploss In /Out, $15/$40/$55 PDP M20a BC $30 Copay, $2000 Ded In /Out, 75 %50% Coins In /Out, $4000/$8000 Coins $421.42 $657.75 $743.07 $899.23 Stoploss In /Out, $20/$40/$60 PDP M21 a BC Ded /Coins, $2000 Ded In /out,100 %/70% Coins In /Out, $0/$8000 Coins $482.98 $753.81 $851.59 $1030.55 Stoploss In /Out, 80 %/50 7o/50% after cal yr ded PDP Optional PPO rates above include the following: SMIM Please refer to the Renewal Rate Page for appropriate contingencies. On a Dual Option PPO, a group may not select one plan from the BlueChoice network and one plan from the BlueChoice Solutions network- they both must be from the same network. a Jul 11, 2008 U] Jul 11, 2008 Texas MoMe Market uss ness o ®pd o ad PPO Benef d plans Group Name: U T Y OF KENNEIDALE Reg/Dist/ err: 001 / 001 / 104 Group Number: 000009065 Effective hate: 10/01/2008 M22a BC $25 Copay, $2500 Ded In /Out, 80 %/60% Coins In /Out, $3000/$6000 $440.68 $687.80 $777.02 $940.31 Coins Stoploss In /Out, $10/$40/$60 POP M23a BC $25 Copay, $2500 Ded In /Out, 70 %/50% Coins In /Out, $3000/$6000 $416.43 $649.96 $734.26 $888.58 Coins Stoploss In /Out, $20/$40/$60 PDP M24a BC $30 Copay, $2500 Ded In /Out, 70 76/50% Coins In /Out, $4000/$8000 $401.66 $626.90 $708.21 $857.06 Coins Stoploss In /Out, $20/$40/$60 PDP M25a BC $30 Copay, $3000 Ded In /out,100 %/70% Coins In /Out, $0/$10000 Coins $442.65 $690.89 $780.51 $944.53 Stoploss In /Out, $10/$40/$60 PDP M26a �°" BC $40 Copay, $3000 Ded In /Out, 70 76/50% Coins In /Out, $5000/$10000 Coins Stoploss In /Out, $20/$40/$60 PDP $360.46 $562.60 $635.58 $769.15 M27a BC Ded /Coins, $3000 Ded In /Out, 80 %/60% Coins In /Out, $4000/$8000 $371.07 $579.17 $654.29 $791.79 Coins Stoploss In /Out, $20/$40/$60 PDP M28a BC $40 Copay, $4000 Ded In /Out, MUSH` Coins In /Out, $5000/$10000 $353.39 $551.56 $623.10 $754.05 Coins Stoploss In /Out, $20/$40/$60 PDP M29a BC $40 Copay, $4000 Ded In /Out, 50 7./50% Coins In /Out, $7500/$15000 $319.99 $499.44 $564.22 $682.80 Coins Stoploss In /Out, $20/$40/$60 PDP M30a BC $30 Copay, $5000 Ded In /Out, 100 % /70% Coins In /Out, $0/$10000 Coins $392.93 $613.27 $692.83 $838.43 Stoploss In /Out, $10/$40/$60 PDP M31 a BC $40 Copay, $5000 Ded In /Out, 80 7./60% Coins In /Out, $3500/$7000 $353.64 $551.97 $623.56 $754.61 Coins Stoploss In /Out, $20/$40/$60 PDP M32a BC $40 Copay, $5000 Ded In /Out, 70 1 /./50% Coins In /Out, $5000/$10000 $328.31 $512.43 $578.90 $700.56 Coins Stoploss In /Out, $20/$40/$60 PDP M33a BC $40 Copay, $7500 Ded In /Out, 75 %/50% Coins In /Out, $5000/$10000 $297.47 $464.29 $524.51 $634.74 Coins Stoploss In /Out, $20/$40/$60 PDP M34a BC $40 Copay, $10000 Ded In /Out, 75 %150% Coins In /Out, $5000/$10000 $284.21 $443.58 $501.12 $606.43 Coins Stoploss In /Out, $20/$40/$60 PDP M35a BC Ded /Coins, $1000 Ded In /Out,10W.06% Coins In /Out, $0/$8000 Coins $507.26 $791.73 $894.42 $1082.38 Stoploss In /Out, 80 %/50 %/50% after cal yr ded PDP M36a BC $30 Copay, $2000 Ded In /Out, 100 %80% Coins In /Out, $0/$8000 Coins $497.90 $777.10 $877.89 $1062.39 Stoploss In /Out, $20/$35/$50 PDP MB1 a BC $20 Copay, $$1000 Ded In /Out, MUM Coins In /Out, $3000/$6000 $444.32 $693.48 $783.43 $948.08 Coins Stoploss In /Out, $15/$40/$55 PDP Ma BC $30 Copay, $$2500 Ded In /Out, 80 0 /o/60% Coins In /Out, $4000/$8000 $377.63 $589.40 $665.85 $805.77 Coins Stopl in / put, $20/$40/$60 PDP MOt Sa BCS $15 Copay, $$250 Ded In /Out, 90 %/70% Coins In /Out, $1000/$2000 $589.45 $919,99 $1039.33 $1257.75 to Coins Stoploss In /Out, $15/$30/$45 PDP MO2Sa BCS $15 Copay, $$500 Ded In /Out, 90%00% Coins In /Out, $2000/$4000 $528.21 $824.42 $931.35 $1127.08 Coins Stoploss In /Out, $15/$30/$45 PDP M03Sa BCS $15 Copay, $$500 Ded In /Out, 80%/60% Coins In /Out, $2000/$4000 $524.89 $819.24 $925.50 $1120.01 Coins Stoploss In /Out, $15/$30/$45 PDP Optional PPO rates above include the following: SMIM Please refer to the Renewal Rate Page for appropriate contingencies. On a Dual Option PPO, a group may not select one plan from the BlueChoice network and one plan from the BlueCholce Solutions network - they both must be from the same network. U] Jul 11, 2008 Jul 11, 2008 Texas RAWffle Market Business o ©ptoona� PPP Benefit PNns Group Name: CITY OF BoENNEDALE Reg /Dish err: 001 / 001 / 104 Gr®up.Number: 000009065 Effective Dare: 10/01/2100' i - -- ---, _f M04Sa BCS $20 Copay, $500 Ded In /Out, 80%160% Coins In /Out, $2500/$5000 Coins $495.87 $773,94 $874.32 $1058.06 Stoploss In /Out, $20/$35/$50 PDP M055a BCS $20 Copay, $750 Ded In /Out, 80 76/60% Coins In /Out, $3000/$6000 Coins $484.09 $755.55 $853.56 $1032.93 Stoploss In /Out, $15/$30/$45 PDP M065a BCS $20 Copay, $1000 Ded In /Out,100 %/70% Coins In /Out, $0/$8000 Coins $526.21 $821.30 $927.83 $1122.82 Stoploss In /Out, $15/$30/$45 PDP M075a BC5 $20 Copay, $1000 Ded In /Out, 80 %/60% Coins In /Out, $2500/$5000 $482.20 $752.59 $850.21 $1028.88 Coins Stoploss In /Out, $15/$30/$45 PDP M085a BCS $25 Copay, $1000 Ded In /Out, 90 %/70% Coins In /Out, $3000/$6000 $495.94 $774.04 $874.45 $1058.22 Coins Stoploss In /Out, $15/$30/$45 PDP M095a BCS $25 Copay, $1000 Ded In /Out, 80 7./60 Coins In /Out, $3000/$6000 $452.49 $706.22 $797.81 $965.48 Coins Stoploss In /Out, $20/$35/$50 PDP M10Sa BCS $25 Copay, $1000 Ded In /Out, 75%/50% Coins In /Out, $4000/$8000 $439.17 $685.44 $774.34 $937.07 Coins Stoploss In /Out, $20/$40/$60 PDP M11Sa BCS $30 Copay, $1000 Ded In /Out, 80%/60% Coins In /Out, $4000/$8000 $447.80 $698.92 $789.55 $955.49 Coins Stoploss In /Out, $20/$35/$50 PDP M125a BCS Ded /Coins, $1000 Ded In /Out, 807./60% Coins In /Out, $3000/$6000 $412.99 $644.58 $728.18 $881.21 Coins Stoploss In /Out, $20/$35/$50 PDP M145a BCS $20 Copay, $1500 Ded In /Out, 80 %/60% Coins In /Out, $3000/$6000 $448.11 $699.40 $790.12 $956.16 Coins Stoploss In /Out, $15/$30/$45 PDP M15Sa BCS $25 Copay, $1500 Ded In /Out, 75 %/50% Coins In /Out, $3000/$6000 $433.98 $677.33 $765.18 $926.00 Coins Stoploss In /Out, $15/$40/$55 PDP M16Sa BCS $30 Copay, $1500 Ded In /Out, MUM Coins In /Out, $3000/$6000 $434.15 $677.61 $765.49 $926.36 Coins Stoploss In /Out, $20/$351$50 PDP M175a BCS $30 Copay, $1500 Ded In /Out, 75 %/50% Coins In /Out, $4000 /$8000 $414.01 $646.18 $729.99 $883.40 Coins Stoploss In /Out, $20/$40/$60 PDP M185a BCS $20 Copay, $2000 Ded In /Out, 80 %/60% Coins In /Out, $3000/$6000 $430.32 $671.63 $758.75 $918.19 Coins Stoploss In /Out, $15/$40/$55 PDP M195a BCS $25 Copay, $2000 Ded In /Out, 75 76/50% Coins In /Out, $3000/$6000 $408.87 $638.15 $720.91 $872.42 Coins Stoploss In /Out, $15/$40/$55 PDP M20Sa BCS $30 Copay, $2000 Ded In /Out, 75 %50% Coins In /Out, $4000/$8000 Coins $399.47 $623.50 $704.37 $852.40 Stoploss In /Out, $20/$40/$60 PDP M21 Sa BCS Ded /Coins, $2000 Ded In /Out, 100 Coins In /Out, $0/$8000 Coins $452.68 $706.54 $798.18 $965.92 Stoploss In /Out, 80 7.50 76/50% after cal yr ded PDP M22Sa BC5 $25 Copay, $2500 Ded In /Out, 80 7./60% Coins In /Out, $3000/$6000 $417.77 $652.06 $736.64 $891.45 Coins Stoploss In /Out, $10/$40/$60 PDP M23Sa BC5 $25 Copay, $2500 Ded In /Out, 70 %/50% Coins In /Out, $3000/$6000 $394.80 $616.20 $696.12 $842.41 Coins Stoploss In /Out, $201$40/$60 PDP M24Sa BCS $30 Copay, $2500 Ded In /Out, 70 76/50% Coins In /Out, $4000/$8000 $380.96 $594.59 $671.70 $812.87 Coins Stoploss In /Out, $20/$40/$60 PDP Optional PPO rates above include the following: SMIM Please refer to the Renewal Rate Page for appropriate contingencies. On a Dual Option PPO, a group may not select one plan from the BlueChoice network and one plan from the BlueChoice Solutions network - they both must be from the same network, Jul 11, 2008 Group Name: Group Number: Texas Middle Market BuMness - Optional PPO BenefK Plans CFj OF IKENNEDALE Peg /Dist /Terr: 001 / 011 ,/ 104 000009065 Effective Date: 10101/2001 ` - F C i_S Id ;� _i M25Sa BCS $30 Copay, $3000 Ded In /Out, 100%/70 Coins In /Out, $0/$10000 Coins $41262 $654.95 $739.91 $895.40 Stoploss In /Out, $10/$40/$60 POP M26Sa BCS $40 Copay, $3000 Ded In /Out, 70 %/50% Coins In /Out, $5000/$10000 $342.34 $534.32 $603.62 $730.47 Coins Stoploss in /Out, $20/$40/$60 PDP M27Sa BCS Ded /Coins, $3000 Ded In /Out, 80 9 Coins In /Out, $4000/$8000 $352.28 $549.84 $621.15 $751.69 Coins Stoploss In /Out, $20/$40/$60 PDP M285a BCS $40 Copay, $4000 Ded In /Out, 70%/50% Coins In /Out, $5000/$10000 $335.70 $523.97 $591.93 $716.33 Coins Stoploss In /Out, $20/$40/$60 PDP M295a BCS $40 Copay, $4000 Ded In /Out, 50 %/50% Coins In /Out, $7500/$15000 $304.40 $475.12 $536.74 $649.53 Coins Stoploss In /Out, $20/$40/$60 PDP M305a BCS $30 Copay, $5000 Ded In /Out,100 %/70% Coins In /Out, $0/$10000 Coins $373.02 $582.20 $657,74 $795.95 Stoploss In /Out, $10/$40/$60 PDP M31 5a BCS $40 Copay, $5000 Ded In /Out, 80 9 Coins In /Out, $3500/$7000 $335.95 $524.34 .$592.36 $716.84 Coins Stoploss In /Out, $20/$40/$60 PDP M325a BCS $40 Copay, $5000 Ded In /Out, 70 9 Coins In /Out, $5000/$10000 $312.21 $487.29 $550.49 $666.19 Coins Stoploss In /Out, $20/$40/$60 PDP M33Sa BCS $40 Copay, $7500 Ded In /Out, 75 %/50% Coins In /Out, $5000/$10000 $283.30 $442.17 $499.52 $604.49 Coins Stoploss In /Out, $20/$40/$60 PDP M345a BCS $40 Copay, $10000 Ded In /Out, 75 %/50% Coins In /Out, $5000/$10000 $270.66 $422.76 $477.60 $577.96 Coins Stoploss In /Out, $20/$40/$60 PDP M355a BCS Ded /Coins, $1000 Ded in /Out, 100 76/70% Coins In /Out, $0/$8000 Coins $475.45 $742.07 $838.33 $1014.50 Stoploss In /Out, 80 %50%/50% after cal yr ded PDP M36Sa BCS $30 Copay, $2000 Ded In /Out, 100%80% Coins in /Out, $0/$8000 Coins $471.69 $736.20 $831.68 $1006.46 Stoploss In /Out, $20/$35/$50 PDP MB1 Sa BCS $20 Copay, $$1000 Ded In /Out, 80 %/60% Coins In /Out, $3000/$6000 $421.34 $657.62 $742.92 $899.05 Coins Stoploss In /Out, $15/$40/$55 PDP MB2Sa BCS $30 Copay, $$2500 Ded In /Out, 80 U % Coins In /Out, $4000/$8000 $358.43 $559.42 $631.98 $764.81 Coins Stoploss In /Out, $20/$40/$60 PDP Optional PPO rates above include the following: SMIM Please refer to the Renewal Rate Page for appropriate contingencies. On a Dual Option PPO, a group may not select one plan from the BlueChoice network and one plan from the BlueChoice Solutions network - they both must be from the same network. Jul 11, 2000 Taxes Wc9 e Market Business o Opdonad CDHP Benefit Mans Group Name: CRY OF KEMNEDALF Reg /Dist/Terr: 001 / 001 / 104 Group Number: 0000 90GS Effective Date: 10/01/2000 lnll2Vfi _ L Y r LrX 9104a BC $500/$1000 HCA, $2000/4000 Ded, 80% to $2000 /40001n /60 %to $393.55 $614.24 $693.91 $839.74 $4000/8000 Out; 20/40/60 PDP 9501a BC $1000/$2000 HCA, $3500/7000 Ded, 90% to $3500/70001n/70 %to $363.27 $566.99 $640.53 $775.15 $7000/14000 Out; 20/40/60 PDP 920311a BC $750/$1500 HCA, $1500/3000 Ded, 80% to $1500/30001n/60 %to $378.00 $589.97 $666.51 $806.57 $3000/6000 Out; Rx 80% after C.Y. Ded 9502Ra BC $500/$1000 HCA, $5000/10000 Ded, 100% In/70% Out; Rx 100% after $267.98 $418.27 $472.52 $571.83 C.Y. Ded MD1a BC $500/$1000 HCA, $1000/2000 Ded, 80% to $3000 /60001n /60 %to $426.78 $666.11 $752.52 $910.66 $6000/12000 Out; 20/40/60 PDP MD2a BC $1000 /$2000 HCA, $2500/5000 Ded, 80% to $4000 /80001n /60 %to $371.85 $580.38 $655.66 $793.45 $8000/16000 Out, 20/40/60 PDP MD3a BC $1000/$2000 HCA, $3500/7000 Ded, 90% to $4000/8000 In/70 %to $361.28 $563.90 $637.05 $770.93 $8000/16000 Out; 20/40/60 PDP MD4a BC $1000/$2000 HCA, $5000/10000 Ded, 100 %1n /70% Out 20/40/60 PDP $299.92 $468.10 $528.82 $639.95 MHta BC Ded /Coins, $$2500/$5000 Ded In /Out, 100%/70 % Coins In /Out, $376.81 $588.11 $664.40 $804.02 $0/$5000 Coins Stoploss In /Out, 100% after cal yr ded PDP MI-12a BC Ded /Coins, $$3000/$6000 Ded In /Out, 100 % /70% Coins In /Out, $339.45 $529.81 $598.54 $724.33 $0/$6000 Coins Stoploss In /Out, 100% after cal yr ded PDP MH3a BC Ded /Coins, $$5000/$10000 Ded In /Out, 100%/70% Coins In /Out, $267.98 $418.27 $472.52 $571.83 $0/$10000 Coins Stoploss In /Out, 100% after cal yr ded PDP MI-14a BC Ded /Coins, $$1500/$3000 Ded In /Out, 80 7./60% Coins In /Out, $366.41 $571.87 $646.05 $781.82 $3000/$6000 Coins Stoploss In /Out, 80% after cal yr ded PDP MW1a BC $20 Copay, $$500 Ded In /Out, 80 %/60% Coini In /Out, $2500/$5000 $523.70 $817.38 $923.39 $1117.45 Coins Stoploss In /Out, $20/$35/$50 PDP MW2a BC $20 Copay, $$1000 Ded In /Out,10nnn Coins In /Out, $0/$8000 Coins $555.57 $867.12 $979.61 $1185.47 Stoploss in /Out, $15/$30/$45 PDP MW3a BC $20 Copay, $$1000 Ded In /Out, 80 %/60% Coins In /Out, $2500/$5000 $508.61 $793.80 $896.79 $1085.25 __ -Coins- Stoploss -In /Out,- $15/- $30 %$45 -PDP 9104BCSa BCS $500/$1000 HCA, $2000/4000 Ded, 80% to $2000 /40001n /60 %to $373.34 $582.71 $658.30 $796.63 $4000/8000 Out; 20/40/60 PDP 9203RBCSa BCS $750/$1500 HCA, $1500/3000 Ded, 80% to $1500 /30001n /60 %to $354.30 $552.98 $624.70 $755.99 $3000/6000 Out; Rx 80% after C.Y. Ded 9501BCSa BCS $1000/$2000 HCA, $3500/7000 Ded, 90% to $3500/70001n/70 %to $344.97 $538.43 $608.26 $736.09 $7000/14000 Out; 20/40/60 PDP 9502RBCSa BCS $500/$1000 HCA, $5000/10000 Ded, 100 %In /70 %Out; Rx 100% after $251.19 $392.04 $442.89 $535.97 C.Y. Ded MD1 Sa BCS $500/$1000 HCA, $1000/2000 Ded, 80% to $3000 /60001n/60 %to $404.50 $631.34 $713.23 $863.11 $6000/12000 Out; 20/40/60 PDP MD25a BCS $1000 /$2000 HCA, $2500/5000 Ded, 80% to $4000/80001n/60 %to $353.01 $550.98 $622.44 $753.25 $8000/16000 Out; 20/40/60 PDP Optional CDHP rates above include the following: SMIM Please refer to the Renewal Pate Page for appropriate contingencies. On a Dual Option PPO, a group may not select one plan from the BlueChoice network and one plan from the BlueChoice Solutions network o they both must be from the same network. Jut 11, 2008 Texas M iMe Market Business o Optional CD HP ° Benefit plans Group Name: CBTY OF KENNEDALE Reg/Dist6Terr: 001 / 001 /104 Group Number: 000009065 Effective Date: 10/01/2008 MD3Sa BCS $1000/$2000 HCA, $3500/7000 Ded, 90% to $4000 /80001nno%to $343.12 $535.54 $605.00 $732.14 $0 1 000/16000 Out, 20/40/60 PDP MD45a BCS $1000/$2000 HCA, $5000/10000 Ded, 100% In/70% Out, 20/40/60 PDP $285.58 $445.74 $503.56 $609.38 MI-115a BCS Ded /Coins, $$2500/$5000 Ded In /Out,100 %/70% Coins In /Out, $353.17 $551.24 $622.73 $753.59 $0/$5000 Coins Stoploss In /Out, 100% after cat yr ded PDP MH2Sa BCS Ded /Coins, $$3000/$6000 bed In /Out,100 %/70% Coins In /Out, $316.17 $496.59 $561.01 $678.90 $0/$6000 Coins Stoploss In /Out, 100% after cal yr ded PDP MH3Sa BCS Ded /Coins, $$5000/$10000 Ded In /Out, 1007./70% Coins In /Out, $251.19 $392.04 $442.89 $535.97 $0/$10000 Coins Stoploss In /Out, 100% after cat yr ded PDP MH4Sa BCS Ded /Coins, $$1500/$3000 Ded In /Out, 80%/60% Coins In /Out, $343.44 $536.01 $605.54 $732.79 $3000/$6000 Coins Stoploss In /Out, 80% after cat yr ded PDP MW1Sa BCS $20 Copay, $$500 Ded In /Out, 807o/60% Coins In /Out, $2500/$5000 $495.87 $773.94 $874.32 $1058.06 Coins Stoploss in /Out, $20/$35/$50 PDP MW2Sa BCS $20 Copay, $$1000 Ded In /Out,100 %/70% Coins in /Out, $0/$8000 Coins $526.21 $821.30 $927.83 $1122.82 Stoploss In /Out, $15/$30/$45 PDP MW3Sa BCS $20 Copay, $$1000 Ded In /Out, 80 0 /./60% Coins In /Out, $2500/$5000 $482.20 $752.59 $850.21 $1028.88 Coins Stoploss in /Out, $15/$30/$45 PDP * Optional CDHP rates above include the following: SMIM Please refer to the Renewal Rate Page for appropriate contingencies. On a Dual option PPO, a group may not select one plan from the BlueChoice network and one plan from the elueChoice Solutions network - they both must be from the same network. Jul 11, 2008 Texas Mock e Market Business o Tr ipG e Option NrINed Networks Group Name: 0TV Orr KESNNEDALE Reg/Dist err: 001 / 001 /104 Group Number: 0000090,5 Effective Date: /200UO lil��l � 1Nt�3Tg •> _ I vin! na _ ]�? i_I �` _ � k I i i�l €. _ _ _ _ MO%Ia BC $20 Copay, $$1000 Ded In /Out, 80 %/60 % Coins In /Out, $2500/$5000 $541.89 $845.77 $955.48 $1156.29 Coins Stoploss In /Out, $15/30/45 PDP M245a BCS $30 Copay, $$2500 Ded In /Out, 70 %/50% Coins In /Out, $4000/$8000 $380.96 $594.59 $671.70 $812.87 Coins Stoploss In /Out, $20/40/60 PDP MH1Sa BCS Ded /Coins, $$2500/5000 Ded In /Out, 100%/70 %Coins In /Out, $0/$5000 $353.17 $551.24 $622.73 $753.59 Coins Stoploss In /Out,100 % after cal yrdied PDP R .-11 MOM BC $15 Copay, $$250 Ded In /Out, 90 %/70% Coins In /Out, $10001$2000 $665.70 $1038.99 $1173.77 $1420.44 Coins Stoploss In /Out, $15/30/45 PDP M07Sa BCS $20 Copay, $$1000 Ded In /Out, 80 %/60% Coins In /Out, $2500/$5000 $482.20 $752.59 $850.21 $1028.88 Coins Stoploss In /Out, $15/30/45 PDP MH4Sa BCS Ded /Coins, $$1500/3000 Ded In /Out, 80 %/60 % Coins in /Out, $343.44 $536.01 $605.54 $732.79 $3000/$6000 Coins Stoploss In /Out, 80% after cat yr ded PDP Lam , M04Ta BC $20 Copay, $$500 Ded In /Out, 80 %/60% Coins In /Out, $2500/$5000 $558.81 $872.18 $985.30 $1192.36 Coins Stoploss in /Out, $20/35/50 PDP M16Sa BCS $30 Copay, $$1500 Ded In /Out, 80%/60% Coins In /Out, $3000/$6000 $434.15 $677.61 $765.49 $926.36 Coins Stoploss In /Out, $20/35/50 PDP MI-115a BCS Ded /Coins, $$2500/5000 Ded In /Out, 100 76/70% Coins In /Out, $0/$5000 $353.17 $551.24 $622.73 $753.59 Coins Stoploss In /Out, 100% after cat yr ded PDP M11Ta BC $30 Copay, $$1000 Ded In /Out, 80 7o/60% Coins In /Out, $4000/$8000 $503.31 $785.54 $887.44 $1073.94 Coins Stoploss In /Out, $20/35/50 PDP M215a BCS Ded /Coins, $$2000 Ded In /Out, 100 % /70% Coins In /Out, $0/$8000 Coins $452.68 $706.54 $798.18 $965.92 Stoploss In /Out, 80 %/509W50% after cat yr ded PDP MH1Sa BCS Ded /Coins, $$2500/5000 Ded In /Out, lonn0%coins In /Out, $0/$5000 $353.17 $551.24 $622.73 $753.59 Coins Stoploss in /Out, 1007'. after cal yr ded PDP ss MOM BC $15 Copay, $$250 Ded in /Out, 907J70% Coins in /Out, $1000 /$2000 $665.70 $1038.99 $1173.77 $1420.44 Coins Stoploss In /Out, $15/30/45 PDP M04Sa BCS $20 Copay, $$500 Ded In /Out, 80%/60% Coins In /Out, $2500/$5000 $495.87 $773.94 $874.32 $1058.06 Coins Stoploss In /Out, $20/35/50 PDP MH4Sa BCS Ded /Coins, $$1500/3000 Ded In /Out, 80 %/60% Coins In /Out, $343.44 $536.01 $605.54 $732.79 $3000/$6000 Coins Stoploss In /Out, 80% after cal yr ded PDP ` Optional PPO rates above include the following: SMIM Please refer to the Renewal Rate Page for appropriate contingencies. s jut 11, 2008 Group Name: Group Number: Te,Kas Midda e Market BNJshess ° Optbna W10 Benefit eons CMI OF i'ENNEDALE Reg /Dist err: 001 / 001 / 104 000009065 Effective Date: 10/01/20063 HMO $20/$20 PCP /Spec Copay, $500 per admission In- Hospital Copay, $75 ER $603.86 $942.45 $1064.71 $1288.46 29/PD10 Copay, PD10 $10/$25/$40 HMO $25/$25 PCP /Spec Copay, $750 per admission In- Hospital Copay, $75 $587.50 $916.94 $1035.88 $1253.57 31/PD11 ER Copay, PD11 $15/$30/$45 HMO $30/$30 PCP /Spec Copay, $1000 per admission In- Hospital Copay, $75 $568.81 $887.74 $1002.90 $1213.67 32/PD12 ER Copay,PD12 $20/$35/$50 HMO $10/$30 PCP /Spec Copay, $350 per admission In- Hospital Copay, $100 $623.34 $972.85 $1099.05 $1330.02 33/PD10 ER Copay, PD10 $10/$25/$40 HMO $15/$35 PCP /Spec Copay, $500 per admission In- Hospital Copay, $125 $600.88 $937.81 $1059.46 $1282.12 34/PD11 ER Copay, PD11 $15/$30/$45 HMO $20/$45 PCP /Spec Copay, $600 per admission in- Hospital Copay, $150 $589.99 $920.83 $1040.26 $1258.89 35/1`1311 ER Copay, PD11 $15/$30/$45 HMO $25/$45 PCP /Spec Copay, $1000 per admission In- Hospital Copay, $150 $560.89 $875.39 $988.95 $1196.78 36 /PD12 ER Copay,PD12 $20/$35/$50 HMO $30/$50 PCP /Spec Copay, $1250 per admission In- Hospital Copay, $150 $554.38 $865.22 $977.46 $1182.88 37/PD13 ER Copay, PD13 $20/$40/$60 HMO $35/$55 PCP /Spec Copay, $1250 per admission In- Hospital Copay, $150 $551.97 $861.50 $973.25 $1177.79 38/PD13 ER Copay, PD13 $20/$40/$60 HMO $40/$60 PCP /Spec Copay, $1500 per admission In- Hospital Copay, $150 $545.61 $851.55 $962.02 $1164.19 39/PD13 ER Copay, PD13 $20/$40/$60 Please refer to the Renewal Rate Page for appropriate contingencies. (' On a Dual Option PPO, a group may not select one plan from the BlueChoice network and one plan from the BlueChoice Solutions network- they both must be from the same network. I Jul 11, 2008 Texas Noddle Warket Business: Optional Dental Benefit plans Group Name: MY OF KENNEDALE Reg/Dist/Terr: 001 / 001 /104 Group Number: 000009005 Effective Date: 90/06/200 D101 Value $25/$75 Ded, 100% /80 % /0 % to $750 Annual Max, No Ortho 8.99 26.65 19.33 41.75 D201 Value $50/$150 Ded, 1001'J80 % /50 %to $1000 Annual Max, No Ortho 20.59 45.98 44.99 77.23 D202 Value $50/$150 Ded, 1007./809 to $1500 Annual Max, No Ortho 22.21 49.64 48.59 83.44 D301 Value $50/$150 Ded, 100 % /80 %/50% to $1500 Annual Max, 50% Ortho 24.87 59.41 54.50 98.33 to $1000 Max D302 Value $50/$150 Ded, 100 7./80 %/50% to $1500 Annual Max, 50% Ortho 25.13 62.96 55.02 103.25 to $1500 Max D401 Deluxe $50/$150 Ded, 100%/80 to $1,500 Annual Max, 50% Ortho 28.89 69.39 62.54 113.91 to $1500 Max D402 Deluxe $50/$150 Ded, 100 7./80 7./50% to $2000 Annual Max, 50% Ortho 30.10 72.16 65.05 118.45 to $1500 Max D403 Deluxe $50/$150 Ded, 100%/80`/`/50% to $2000 Annual Max, 50% Ortho 30.36 75.61 65.68 123.05 to $2000 Max D411 Deluxe $50/$150 Ded, 100 7.180 %/50% to $1000 Annual Max, No Ortho 24.18 54.33 52.34 90.44 D421 Deluxe $50/$150 Ded, 110076/80%50% to $1000 Annual Max, 50% Ortho 24.39 58.98 52.78 96.59 to $1000 Max Note: Dual Option Dental is allowed with the following combinations: D101 and any other plan D201 and D401 (or D402, or D403, or D421) D202 and D401 (or D402, or D403, or D421) Requirements: Group Name, Group Number, Reg/Distfrerr, and Effective Date to be the same as the renewing Health plan. All benefit plans above to be shown to all groups with the exception of groups with less than 10 contracts. Groups with less than 10 contracts should only be shown plans D101, D201, and D202. Rates are to be pulled from a table based upon the zip code of the group's home address, which is found in BIueSTAR. I Jul 11, 2006 Taxis WMddh Plarket udness MOP Re- nevial -HM0 Ponion Group Name: CKif of Kennadale Group Numbers: 09065 Renewal Effective Date: 10/1 /20011 Rate Effective Date: 10/1/200; Reg /®ist/Terr: 001/001/104 Total Group Contracts: Total HMO Contracts: 25 Total HMO Contracts: Total HMO Members: 25 Total HMO Members: Current Plan Rates EO EC Plan 26 S 479.49 $ 749.00 Contract Enrollment 16 1 Renewal Plan Rates EO EC 549.94 $ 1,029.62 $ 14,536.00 ES EF Total Plan 26 $ 63 0 8 .6 0 0 997.67 $ 1,132.12 1,371.45 $ 19,3 Rate Change 33.2% Note: This rate change percentage is based on total monthly premium. Each tier rate change may vary from the total change percentage. Rates are contingent upon: 1. Enrollment of 25 or at least 75% of the eligible employees; with a sustained monthly enrollment of at least 75 %, but in any event, not less than 24. 2. A twelve month period from the renewal effective date. 3. The employer contributing at least 75% of the Employee Only cost. 4. No additional taxes will be imposed and no increase in existing taxes until the next Renewal Effective Date. 5. Rates do not include any future mandated benefit changes. 6. All employees must enroll in BCBSTX coverages; no other carrier allowed. 7. Standard BCBSTX Managed Care programs with standard membership, eligibility, administration, claims processing and standard network. Standard Master Contract provisions and definitions apply. Any costs associated with special services or custom materials provided by BCBSTX will be supplemental billed separate and apart from the rates outlined on this confirmation page. g. Annual open enrollment. 9. This proposal assumes the group contract will be issued in Texas. In addition to the benefits stated herein, benefits for covered persons who reside outside of Texas will conform to all Extraterritorial requirements of those states. 10. Insurance regulations require carriers to determine whether an employer is subject to Chapter 26, Texas Insurance Code. 11. This proposal is made on the condition you are not a Small Employer as defined in Chapter 26. A proposal to a Small Employer would have to contain specific contractual elements and mandated insurance plans not contained in this proposal. Should it be determined you were a Small Employer, this proposal and any health insurance contract issued to you, shall be null and void. 12. Upon inquiry from employer groups, BCBSTX will provide information to the employer group regarding commissions and other compensation paid to the employer's broker /producer by BCBSTX in connection with the employer's policy or contract with BCBSTX. BlueCross and BlueShield of Texas reserves the right to change premium rates upon sixty (60) days prior written notice when a substantial change occurs in the number or composition of subscribers covered. A substantial change will be deemed to have occurred when the number of subscribers covered changes by 10% or moreover a thirty (30) day period or 25% or moreover a ninety (90) day period. Rates do not include any future mandated benefit changes.