Request for Proposal. Group Health Insurance Group Life Insurance

Transcription

1 Request for Proposal for Group Health Insurance Group Life Insurance Page 1 of 41

2 Housing Authority of the City of Fort Worth 300 South Beach Street Fort Worth, TX , ext Issue Date: October 16, 2006 Proposal Due Date: November 2, 2006 Page 2 of 41

3 REQUEST FOR PROPOSALS FOR Group Health and Group Life Insurance TABLE OF CONTENTS TABLE OF CONTENTS... 3 I. INVITATION TO SUBMIT PROPOSALS... 4 II. PROPOSAL REQUIREMENTS III. PROPOSAL PROCESS AND TIME REQUIREMENTS... 5 IV. GENERAL INFORMATION V. PROPOSAL QUALIFICATIONS... 7 VI. PLAN ADMINISTRATION... 7 VII. COMPENSATION... 7 VIII. EVALUATION PROCESS AND SELECTION CRITERIA IX. QUESTIONNAIRE X. MEDICAL AND LIFE HISTORY XI. PROPOSAL SUBMISSION FORM XII. REFERENCES XIII. DECLARATION OF COMPLIANCE Attachments: Certifications and Affidavits Instructions to Offerors (Form HUD-5369-B) Certifications and Representations of Offerors (Form HUD-5369-C) Page 3 of 41

4 XIV. CURRENT MEDICAL BENEFITS XV. CURRENT LIFE BENEFITS XVI. CENSUS DATA Page 4 of 41

5 GENERAL INFORMATION AND INSTRUCTIONS I. INVITATION TO SUBMIT PROPOSALS: The Fort Worth Housing Authority (FWHA) seeks proposals from insurance carriers to provide Group Health Insurance and/or Group Life Insurance for the employees of the FWHA. Please note, a respondent may submit a proposal for life only, health only or both. FWHA is interested in both fully insured and selffunded HMO, PPO and HSA plans. This Request for Proposal (RFP) contains specific submission requirements, general scope of service requirements, as well as terms, conditions, and other pertinent information necessary for submitting a proposal. Interested vendors may obtain the Request for Proposal package on: October 16, :00 AM and 4:00 PM Monday through Friday Purchasing Department 300 South Beach Street Fort Worth, TX To request a copy to be mailed or ed Henry Robinson Call , ext II. PROPOSAL REQUIREMENTS: The Housing Authority of the City of Fort Worth (FWHA) is requesting proposals for Group Health Insurance and Group Life Insurance. To be considered: five (5) bound copies and one (1) unbound copy of the proposal must be labeled and received by: Henry Robinson, Purchasing Manager Fort Worth Housing Authority 300 South Beach Street Fort Worth, TX by 2:00 PM on November 2, FWHA reserves the right to reject any or all proposals submitted and to re-solicit for proposals. Questions and inquires should be received in writing on or before October 25, 2006 at 4:00 PM (CST).to: Henry Robinson, Purchasing Manager Page 5 of 41

6 Fort Worth Housing Authority 300 South Beach Street Fort Worth, Texas Fax: Proposals may NOT be withdrawn for a period of ninety (90) days from the submission deadline date. Website: During the evaluation process, FWHA reserves the right, where it may serve FWHA s best interest, to request additional information or clarifications from carriers or to allow corrections of errors or omissions. At the discretion of FWHA, firms submitting proposals may be requested to make oral presentations as part of the evaluation process. All proposals submitted become the property of FWHA. Submission of a proposal indicates acceptance by the firm of the conditions contained in this request for proposals (RFPs), unless clearly stated and specifically noted in the proposal submitted and confirmed in the contract between FWHA and the firm selected. III. PROPOSAL PROCESS AND TIME REQUIREMENTS: A. Request for Proposals Issued October 16, :00 AM B. Deadline for Submitting Written Questions October 25, :00 PM Respondents may submit questions in writing to Attn: Henry Robinson, Purchasing Manager Fort Worth Housing Authority 300 South Beach Street Fort Worth, TX FAX to henry@ftwha.org Such written questions must be received by FWHA at the aforementioned address by 4:00 PM (CST) on October 25, C. Responses to written questions October 27, :00 PM An Addendum will be issued to reply to all written questions and will be distributed to all Respondents by FAX or no later than October 27, 2006, by 4:00 PM. In order to maintain a fair and impartial competitive process, FWHA can answer questions only in response to written questions received within the specified time frame. FWHA must avoid private communication with the prospective Respondents during the evaluation period. The written questions will be the only opportunity for Respondents to Page 6 of 41

7 ask questions as to form and content. Please respect this policy and do not attempt to query FHWA personnel or members or its Board of Commissioners regarding this RFP except through written questions submitted in the manner and within the time frame indicated above. D. Due Date for Proposals November 2, :00 PM E. Anticipated Date of Award November 16, 2006 IV. GENERAL INFORMATION: Established in 1938, the Fort Worth Housing Authority was created by the City of Fort Worth in accordance with enabling legislation enacted through the State of Texas Housing Authorities Law. The Authority is a 'public body, corporate and politic' which is governed by a five member Board of Commissioners. The Department of Housing and Urban Development (HUD) provides guidelines, regulations and funding for the agency's operation. The mission of The Fort Worth Housing Authority is to provide decent, safe and affordable housing to low and moderate income families and individuals in Fort Worth and to create opportunities for our customers to achieve self-sufficiency. The Fort Worth Housing Authority (FWHA) owns, operates, and maintains approximately 1,200 low income public housing units within the City of Fort Worth. In addition, the FWHA provides rental assistance for approximately 4,700 residents through various Federally subsidized rental assistance programs. Therefore, it is desirable that the FWHA staff, of approximately 125 employees and their families, has access to quality health and life insurance at an affordable cost. It should also be understood that whereas it is the intent of the FWHA to provide access to health insurance, it is not a mandatory requirement for employees to participate with respect to themselves or dependent coverage. An award does not guarantee that all FWHA employees will enroll in any plan. The FWHA is interested in receiving fully insured and self-funded proposals for HMO s, PPO s, HSA s, plans. FWHA currently provides fully insured health insurance coverage to all full time employees 30 days after date of hire. Plan coverage year is from January 1 to December 31. Coverage History: January 2002 December 2003 Fully Insured PacifiCare HMO January 2004 December 2004 Fully Insured PacifiCare Dual Option: HMO or PPO January 2005 December 2005 Fully Insured Aetna Dual Option: HMO or PPO January 2006 December 2006 Fully Insured Aetna Triple Option: HMO, PPO or HSA 1. Proposals are required to provide a minimum 12-month rate guarantee, with a contract period of January 1, 2007 through December 31, Page 7 of 41

8 2. Since there are important considerations involved in selecting a carrier in addition to rates, the FWHA will not be required to accept the lowest bid. In addition to gross premium and retention charges, services rendered will also serve as a basis for award of the contract. 3. The Carrier must submit evidence of ability to service the group without undue requirements of the FWHA s employees. Each Carrier should list three (3) references that have terminated within the last year as well as three (3) references that are active groups and are approximately our size. (Forms Provided). 4. The FWHA reserves the right to reject any and all proposals and to accept any bid deemed advantageous to the FWHA. Any variance from these specifications must be stated in detail with complete reference to the bid specification provision from which the deviation is being made. 5. All proposals must be based on exact duplication of the existing plan benefits unless alternate benefits are requested. Any variance of benefits must be explained in writing and attached to the proposal for consideration. (Plan of current benefits attached.) 6. Proposals must be submitted for coverage on all eligible full-time regular employees and their dependents. 7. Actively at work and dependent confined requirements must be waived. 8. Please complete the appropriate enclosed bid forms that include: a. Proposal submission form including a Declaration of Compliance. b. Questionnaire c. References All proposals, including the current carrier, shall complete the proposal forms provided. All proposal forms submitted must be signed by an authorized official that has the authority to bind the bidder. FAILURE TO COMPLETE PROPOSAL FORMS MAY RESULT IN PROPOSAL BEING DISQUALIFIED. Page 8 of 41

9 V. PROPOSAL QUALIFICATIONS 1. All companies submitting proposals must be licensed by the State of Texas and be permitted to contract with the State or any of its subdivisions. Further, it is preferred that companies be recommended in the latest edition of Best s Life Insurance Reports with a general policyholder s rating of at least an A, or in the case of casualty companies have a rating of at least an A in the latest annual edition of Best s Key Rating Guide. VI. PLAN ADMINISTRATION 1. FWHA Responsibility: The FWHA will provide for payroll deductions of premium and advise the carrier of additions/deletions from the coverage. The FWHA will assist in the logistics of the enrollment process. 2. Selected Carriers Responsibility: The carrier will provide employee booklets outlining the benefits and instructions on filing a claim, identification cards, enrollment and orientation materials, and other appropriate communication materials deemed necessary by the FWHA. Selected carrier is liable for all claims incurred as of the effective date through the termination date. The carrier will provide the following quarterly claim reports: a. Summary of Paid Claims vs. Paid Premium b. And upon request of the FWHA, furnish a Summary of Claims in excess of $10,000, including diagnoses and prognosis for past 24 months; VII. COMPENSATION: FWHA wishes to contract directly with carrier and not through Broker/Agent of Record. Therefore, proposals shall be submitted NET of commissions. FWHA has retained the services of William Rusteberg, of Insurance Advisory Group, Inc., to assist the Housing Authority in the competitive proposal process. IAG is a fee based consulting firm and will receive no other remunerations from any vendor or any insurance company. VIII. EVALUATION PROCESS AND SELECTION CRITERIA: Proposals will be evaluated by a FWHA selection committee and William Rusteberg, Consultant of Record for the FWHA. The selection committee will present its recommendations to the FWHA Board of Commissioners who will make the final selection. Proposals will be evaluated using the Evaluation Criteria outlined below. After the initial scoring of proposals, those deemed by the selection committee to be within the competitive range will become the finalists and may be invited to make a formal presentation to the Section Committee. After the formal presentations, FWHA Selection Committee will enter into negotiations with the carrier elected the most highly qualified to provide the specified services. If negotiations prove unsuccessful, the next most qualified firm will be contacted. Page 9 of 41

10 FWHA reserves the right to accept or reject in part, or reject all proposals and to re-solicit new proposals. FWHA may also reject any proposals that are incomplete or non-responsive and any proposals that are submitted after the deadline. Page 10 of 41

11 EVALUATION CRITERIA The proposals will be evaluated using the following weighted criteria: MAXIMUM EVALUATIONS CRITERIA RATING (POINTS) Cost 30 Benefits 20 Ability to Service 20 Comprehensive Response to RFP 15 References 15 Total Initial Points 100 WITHDRAWAL OF PROPOSALS Proposals may NOT be withdrawn for ninety (90) days from the submission deadline date. MISTAKES IN PROPOSALS If a mistake in a proposal is suspected or alleged, the proposal may be corrected or withdrawn during any negotiations that are held. If negotiations are not held, of if best and final offers have been received, the Respondent may be permitted to correct a mistake in the proposal and the intended correct offer may be considered based on the conditions that follow: 1) The mistake and the intended correct offer are clearly evident on the face of the proposal. 2) The Respondent submits written evidence which clearly and convincingly demonstrates both the existing offer and such correction would not be contrary to the fair and equal treatment of other Respondents. Mistakes after award shall not be corrected unless the FWHA Executive Director makes a written determination that it would be disadvantageous to the FWHA not to allow the mistake to be corrected. The approval or disapproval of requests of this nature shall be in writing by the FWHA s Executive Director. CONFLICTS OF INTEREST: The Respondent warrants that to the best of his/her knowledge and belief and except as otherwise disclosed, he/she does not have any organizational conflict of interest. Conflict of interest is defined as a situation in which the nature of work under this contract and the Respondent s organizational, financial, contractual or other interests are such that: Page 11 of 41

12 1) Award of the contract may result in an unfair competitive advantage; or 2) The Respondent s objectivity in performing the contract work may be impaired. In the event the Respondent has an organizational conflict of interest as defined herein, the Respondent shall disclose such conflict of interest fully in the proposal submission. 3) The Respondent agrees that if after award he or she discovers an organizational conflict of interest to this contract, he or she shall make an immediate and full disclosure in writing to the Executive Director which shall include a description of the action which the Respondent has taken or intends to take to eliminate or neutralize the conflict. FWHA may, however, terminate the contract if it is in its best interest. 4) In the event the Respondent was aware of an organizational conflict of interest before the award of this contract and intentionally did not disclose the conflict to the Executive Director, FWHA may terminate the contract for default. 5) The provisions of this clause shall be included in all subcontracts and consulting agreements wherein the work to be performed is similar to the service provided by the Respondent. The Respondent shall include in such subcontracts and consulting agreements any necessary provisions to eliminate or neutralize conflicts of interest. 6) No member of or delegate to the U.S. Congress or FWHA Board of Commissioners shall be allowed to share any or part of this contract or to derive any benefit to arise there from. This provision shall be construed to extend to this contract if made with a corporation for its general benefit. 7) No member, officer, or employee of FWHA, no member of the governing body of the locality in which the project is situation, no member of the governing body in which the FWHA was activated, an no other public official of such locality or localities who exercises any functions or responsibilities with respect to the project, shall, during his or her tenure, or for one year thereafter, have any interest, direct or indirect, in this contract or the proceeds thereof. 8) FWHA reserves total discretion to determine the proper treatment of any conflict of interest disclosed under this provision. INCURRED COSTS IN PREPARING PROPOSALS: Respondents will be responsible for all costs incurred in preparing a response to this RFP. All material and documents submitted by Respondents will become the property of the FWHA and will not be returned. Brokerage firms selected for further negotiations, as well as Brokerage firms ultimately selected to enter into a contractual agreement with the FWHA, will be responsible for all costs incurred negotiations. AWARDS: A contract shall be awarded in accordance with the terms and conditions of this RFP to the Respondent whose proposal is most advantageous to FWHA considering price, technical and other factors as specified in this RFP. FWHA reserves the right to negotiate and award any element of this RFP, to reject any or all proposals or to waive any minor irregularities or technicalities in proposals received as in the best interest of FWHA. CONTRACT/AWARD: The Contract for Group Health Insurance and Group Life Insurance as requested in this RFP document will be subject to the approval of the FWHA Board of Commissioners. Page 12 of 41

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14 IX. QUESTIONNAIRE 1. Address of your company s home office. 2. Briefly describe your Company. (Date established, number of employees, number of insured) 3. What is your company s most current Best Rating? 4. Is your company licensed to do business in the State of Texas? 5. How many open complaints are on file against your company with the Texas Department of Insurance? 6. Is your company currently involved in any litigation as a defendant over any benefits or services being proposed in response to this RFP? If yes, please provide a brief description of each suit and the amount involved. 7. Where do you propose to pay claims for this account? 8. Does your company provide professional negotiation services for non-network providers? 9. Do you agree to a no-loss/no-gain takeover on all benefits for all employees (continuation of coverage to retirees, council or governing body) and dependents? Page 14 of 41

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16 10. What is your time frame for providing renewal rates to the Plan holder? 11. Do you have a toll-free telephone number for handling inquiries from staff and employees? If so, is there an additional charge? 12. Is the cost of providing employee booklets and identification cards included in the quoted rates? If no, what is the additional charge? 13. Will your company provide quarterly claim reports as specified in the plan administration qualifications? 14. Will your company provide on-site enrollment assistance? If yes, is there a charge? 15. Are the rates your company quoted guaranteed for 12 months? Page 16 of 41

17 X. MEDICAL & LIFE HISTORY Medical History and Claims Experience Carrier History: Carrier Plan Aetna HMO January 2001 December 2004 Carrier Pacific Care Plan HMO Premium Claims Jan July 2002 $ 230, ,955 Aug 2002-July 2003 $ 397,802 $364,780 Plan PPO Aug 2003-Dec 2003 Jan 2004-June 2004 $ 235,320 $ 97,168 Aug 2004 Dec 2004 Not Available Not Available 1/1/04-12/31/04 Rates E $ ES $ EC $ EF $ January 2005 December 2005 Carrier Aetna Plan HMO & PPO Premium Claims Subscribers Members Jan 2005 $ 41,814 $ 28, Feb 2005 $ 41,272 $ 31, Mar 2005 $ 43,766 $ 22, Apr 2005 $ 40,930 $ 19, May 2005 $ 39,130 $ 19, Jun 2005 $ 39,907 $ 33, Jul 2005 $ $ 94, Aug 2005 $ $ Sep 2005 $ $ Oct 2005 $ $ Nov 2005 $ 41,559 $ 18, Dec 2005 $ 38,855 $ 31, /1/05-12/31/05 Rates PPO HMO E $ $ ES $ $ Page 17 of 41

18 EC $ $ EF $ $ January 2006 December 2006 Carrier Aetna Plan HMO & PPO Premium Claims Subscribers Members Jan 2006 $ $ 75, Feb 2006 $ 50,778 $ 22, Mar 2006 $ 47,731 $ 22, April 2006 $ 50,210 $ 53, May 2006 $ 46,126 $ Jun 2006 $ 50,193 $ 253, Jul 2006 $ Aug 2006 Sep 2006 Oct 2006 Nov 2006 Dec /1/06-12/31/06 Rates PPO HMO HSA E $ $ $ ES $ $ $ EC $ $ $ EF $ $ $ Large Claims From To Amount Condition 01/01/ /31/2005 $ 43, Breast Cancer* 05/01/ /30/2006 $ 115,453 Breast Cancer* $ 40,187 Early onset of delivery** $ 26,795 Sinoatrial Node Dysfunction*** 07/01/ /30/2006 $ 92,656 Breast Cancer* $ 42,340 Early Onset of Delivery** $ 35,985 Sinoatrial Node Dysfunction*** 07/01/ /30/2006 $ 97,956 Vomiting $ 42,340 Squamous Blepharitis $ 35,555 Intestinal Infection $ 52,540 Coronary Atherosclerosis Page 18 of 41

19 * Breast Cancer same person ** Early Onset of Delivery same person *** Squamous Blpharitis same person Page 19 of 41

20 Life & ADD Prior to 2004 Carrier: Amount Fortis 1 1/2 x's Annual Salary Volume $ 5,431,694 Rates Life: $0.20 ADD: $0.03 January 2005 December 2006 Carrier: Lafayette Life Amount 1 1/2 x's Annual Salary Volume $ 5,365,450 Rates Life: $0.18 ADD: $0.02 Basic Waiting Period 1 st of month following 6 months employment Voluntary Waiting Period 1 st of month following 30 days employment Additional Life Insurance Guarantee Issue Amount $100,000 Page 20 of 41

21 XI. PROSPOSAL SUBMISSION FORMS PROPOSAL FORM Fully Insured The undersigned, as Respondent, does hereby declare that they have read the specifications for Group Medical, Life and AD&D for the FWHA employees, and with full knowledge of the requirements, does hereby agree to furnish the administrative services in full accordance with the specifications and requirements. The Respondent also agrees to duplicate present coverage and if not, will attach itemized detail of any differences. Medical Rates Monthly Employee Only Employee/Child(ren) Employee/Spouse Family Enclose with your Proposal, complete underwriter notes: Name of Respondent: Address: City, State, Zip: Telephone Number: Date: Signature: Title: Page 21 of 41

22 BASIC LIFE & AD&D PROPOSAL FORM - Life and AD&D per thousand Volume Quoted Life Rates AD&D Rates Volume Number of Employees ADDITIONAL LIFE Guarantee Issue Maximums: Employee Spouse Child(ren) AGE BANDED RATES Enclose with your Proposal, complete underwriter notes: Page 22 of 41

23 Name of Respondent: Address: City, State, Zip: Telephone Number: Date: Signature: Title: PROPOSAL FORM Self-Funded BASE QUOTE ON THE FOLLOWING SPECIFICATIONS: Specific Deductible $25,000 $35,000 $50,000 Contract for Specific & Aggregate: 12 / 12 Specific: Medical Aggregate: Medical & Rx Number of Employee Only Number of Employee & Dependents Total Number Specific Deductible $25,000 $35,000 $50,000 Specific Premium Total Employees $ $ $ Dependent Units $ $ $ Employee & Dependents $ $ $ Aggregate Premium $ $ $ Administration Claims Per Employee $ $ $ Claims Per Dependent $ $ $ Pre-Certification $ $ $ PPO Network $ $ $ Rx Program $ $ $ COBRA $ $ $ HIPAA $ $ $ Other $ $ $ Other $ $ $ Aggregate Factors Total Employees $ $ $ Dependent Units $ $ $ Employee & Dependents $ $ $ Page 23 of 41

24 Enclose with your Proposal, complete underwriter notes: Name of Respondent: Address: City, State, Zip: Telephone Number: Date: Signature: Title: Page 24 of 41

25 XII. REFERENCES REFERENCES Please provide the Policyholder with three references that have been insured with your company for at least three years. Company Name: Name of Bidder: Contact Person: Title: Address: City, State, Zip: Telephone Number: # of Employees: Company Name: Name of Bidder: Contact Person: Title: Address: City, State, Zip: Telephone Number: # of Employees: Company Name: Name of Bidder: Contact Person: Title: Address: City, State, Zip: Telephone Number: # of Employees: Page 25 of 41

26 TERMINATIONS Please provide the Policyholder with three references that have terminated with your company in the past year. Company Name: Name of Bidder: Contact Person: Title: Address: City, State, Zip: Telephone Number: # of Employees: Company Name: Name of Bidder: Contact Person: Title: Address: City, State, Zip: Telephone Number: # of Employees: Company Name: Name of Bidder: Contact Person: Title: Address: City, State, Zip: Telephone Number: # of Employees: Page 26 of 41

27 XIII. DECLARATION OF COMPLIANCE The undersigned does hereby declare that they have read the Request for Proposal on which they are submitting a proposal with full knowledge of the requirements, and does hereby agree to furnish all services in full accordance with the requirements outlined in the Request for Proposal. The proposer affirms that, to the best of their knowledge, the proposal has been arrived at independently and is submitted without collusion to obtain information or gain any favoritism that would in any way limit competition or give unfair advantage over other proposers. The undersigned hereby declares that they have the authority to represent the proposer in submitting this proposal at the unit prices and level of services herein after notice of proposal award. Company Name Address City, State, Zip Code Contact Person/Agent Area Code & Phone Number Authorized Signature Typed Name of Signatory Title of Signatory Date Page 27 of 41

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29 ATTACHMENTS: 1. Instructions to Offerors (Form HUD-5369-B) 2. Certifications and Representations of Offerors (Form HUD-5369-C) Page 29 of 41

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34 ATTACHMENTS EMPLOYEE CENSUS DATA 1. HMO CENSUS 2. PPO CENSUS 3. HIGH DEDUCTIBLE PPO CENSUS 4. MEDICAL INSURANCE WAIVED BY EMPLOYEE Page 34 of 41

35 HMO Census September 25, 2006 D/O/B SEX HMO STATUS OF COVERAGE TOTAL 11/15/41 M + Employee Only 1 08/28/51 M + Employee Only 1 09/07/51 M + Employee Only 1 02/08/57 M + Employee Only 1 08/28/69 M + Employee Only 1 06/07/58 M ** Employee Only 1 05/13/53 M + Employee Only 1 08/05/42 M + Employee Only 1 02/10/52 M + Employee Only 1 = 9 08/25/66 F + Employee Only 1 01/31/53 F + Employee Only 1 10/18/59 F + Employee Only 1 06/06/80 F + Employee Only 1 09/16/48 F + Employee Only 1 07/25/70 F + Employee Only 1 10/06/72 F + Employee Only 1 10/31/81 F + Employee Only 1 04/03/42 F + Employee Only 1 10/25/42 F + Employee Only 1 02/05/47 F + Employee Only 1 07/02/65 F + Employee Only 1 10/10/57 F + Employee Only 1 07/22/45 F + Employee Only 1 11/23/56 F + Employee Only 1 Page 35 of 41

36 04/02/62 F + Employee Only 1 = 16 08/09/48 M ** Employee + Children 1 08/04/64 M ** Employee + Children 1 08/21/68 M + Employee + Children 1 11/02/53 M + Employee + Children 1 = 4 HMO Census September 25, 2006 D/O/B SEX HMO STATUS OF COVERAGE TOTAL 01/07/65 F + Employee + Children 1 04/09/62 F + Employee + Children 1 09/11/66 F + Employee + Children 1 07/20/80 F + Employee + Children 1 06/17/45 F + Employee + Children 1 07/11/70 F + Employee + Children 1 = 6 04/24/60 M + Employee + Spouse 1 11/13/47 M + Employee + Spouse 1 = 2 05/01/56 M + Employee + Family 1 07/21/57 M + Employee + Family 1 12/27/51 M + Employee + Family 1 10/08/69 M + Employee + Family 1 = 4 11/03/67 F + Employee + Family 1 09/15/72 F + Employee + Family 1 04/29/66 F + Employee + Family 1 12/20/70 F + Employee + Family 1 01/15/53 F + Employee + Family 1 = 5 Page 36 of 41

37 ** denotes New Employees PPO Census September 25, 2006 D/O/B SEX PPO STATUS OF COVERAGE TOTAL 06/05/53 M ** Employee Only /16/49 M + Employee Only /14/58 M + Employee Only /27/69 M + Employee Only /23/57 M ** Employee Only /08/72 M + Employee Only /23/79 M + Employee Only /18/81 M + Employee Only /12/72 M ** Employee Only 1.00 = /09/45 F + Employee Only /14/84 F ** Employee Only /08/55 F ** Employee Only /08/51 F + Employee Only /14/51 F + Employee Only /18/60 F + Employee Only /04/55 F ** Employee Only /06/54 F + Employee Only /10/67 F + Employee Only 1.00 Page 37 of 41

38 07/27/51 F + Employee Only /26/65 F ** Employee Only /21/60 F ** Employee Only /23/72 F + Employee Only /03/46 F + Employee Only /27/72 F + Employee Only /28/46 F + Employee Only /21/44 F + Employee Only /13/82 F + Employee Only /11/43 F + Employee Only 1.00 = /27/70 M + Employee + Children /05/49 M + Employee + Children 1.00 = /20/64 F + Employee + Children /30/54 F + Employee + Children /08/54 F + Employee + Children /26/54 F + Employee + Children /06/81 F + Employee + Children /20/77 F ** Employee + Children /10/79 F + Employee + Children 1.00 = 7.00 PPO Census September 25, 2006 D/O/B SEX PPO STATUS OF COVERAGE TOTAL 09/05/49 M ** Employee + Spouse /10/46 M + Employee + Spouse /28/61 M ** Employee + Spouse 1.00 = /31/72 F ** Employee + Spouse 1.00 = /16/63 M + Employee + Family /10/66 M + Employee + Family /11/68 M + Employee + Family /27/60 M + Employee + Family /29/59 M + Employee + Family /26/68 M + Employee + Family /10/56 M ** Employee + Family 1.00 = /18/68 F + Employee + Family 1.00 Page 38 of 41

39 12/01/75 F ** Employee + Family 1.00 = 2.00 ** denotes New Employees High Deductible PPO Census September 25, 2006 D/O/B SEX H/D PPO STATUS OF COVERAGE TOTAL 06/11/67 F + Employee Only /22/52 F + Employee Only 1.00 = 2.00 Page 39 of 41

40 EMPLOYEES WAIVING MEDICAL COVERAGE September 25, 2006 D/O/B SEX New Emp STATUS OF COVERAGE TOTAL 12/13/43 M Waived Medical Coverage /27/64 M ** Waived Medical Coverage /26/46 M Waived Medical Coverage /30/56 M Waived Medical Coverage /02/72 M Waived Medical Coverage 1.00 Page 40 of 41

41 08/23/82 M Waived Medical Coverage /24/62 M Waived Medical Coverage /04/57 M ** Waived Medical Coverage /31/73 M ** Waived Medical Coverage /18/76 M ** Waived Medical Coverage /26/44 M Waived Medical Coverage /06/61 M Waived Medical Coverage /12/67 M ** Waived Medical Coverage 1.00 = /13/56 F Waived Medical Coverage /16/53 F Waived Medical Coverage /14/74 F Waived Medical Coverage /25/65 F Waived Medical Coverage /23/72 F Waived Medical Coverage /05/81 F Waived Medical Coverage /24/54 F Waived Medical Coverage /28/60 F Waived Medical Coverage /22/66 F Waived Medical Coverage /26/76 F ** Waived Medical Coverage /28/77 F Waived Medical Coverage /08/47 F Waived Medical Coverage /13/63 F Waived Medical Coverage /12/44 F ** Waived Medical Coverage /10/59 F Waived Medical Coverage /15/53 F Waived Medical Coverage 1.00 = Total = 127 Regular Full-Time Employees *Added new employees in red ink Page 41 of 41