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Adr CITY OF SUNNY ISLES BEACH
<br /> Ancillary Plans (Basic Life and AD&D Voluntary Life, STD & LTD)
<br /> As of November,2013,there were 189 employees enrolled in the Basic Life and AD&D Plan. During the period
<br /> of March—November,2013,total premium paid was$20,446 and total claims paid was$30,000 or a Loss Ratio
<br /> of 146.7%. In a 24 month period ending November, 2013,total premium paid was$49,539 and total claims paid
<br /> was$117,000 or a Loss Ratio of 236.2%.
<br /> As of November, 2013,there were 189 employees enrolled in the LTD Plan. During the period of March—
<br /> November, 2013,total premium paid was$35,616 and total claims paid was$29,582 or a Loss Ratio of 83.1%. In
<br /> a 24 month period ending November,2013,total premium paid was$81,758 and total claims paid was$58,403
<br /> or a Loss Ratio of 71.4%.
<br /> As of November, 2013,there were 94 employees enrolled in the STD Plan. During the period of March—
<br /> November,2013,total premium paid was$16,513 and total claims paid was$15,014 or a Loss Ratio of 90.9%. In
<br /> a 24 month period ending November,2013,total premium paid was$41,930 and total claims paid was$44,543
<br /> or a Loss Ratio of106.2%.
<br /> As of November, 2013,there were 79 employees enrolled in the Voluntary Life Plan. During the period of March
<br /> —November,2013,total premium paid was$21,983 with No claims paid. In a 24 month period ending
<br /> November,2013,total premium paid was$52,750 with No claims paid.
<br /> Health Care Reform
<br /> Employer Mandate—
<br /> The Employer Mandate provision requires Large Employers, classified as 100 or more Full-time Equivalents
<br /> (FTEs),comply with the following or be subject to penalties:
<br /> • Offer a Minimum Value Plan, defined as having a 60%Actuarial Value,to Full-time Employees
<br /> • Offer a Affordable Plan, Employee Annual Contributions cannot exceed 9.5%of Employees Box 1 W-2
<br /> Income,to Full-time Employees
<br /> • Offer Minimum Essential Benefits to 95%of Full-time Employees
<br /> o Minimum Essential Benefits will be determined on a State Level
<br /> Under the Employer Mandate, Employers are required to consider all employees who average 30 or more hours
<br /> per weeks Full-time for Health Plan purposes. Safe Harbor Provisions have been released in order to assist in
<br /> calculating the hours of an Employee to determine his/her Full-time status.
<br /> Provisions Still Required
<br /> The delay in the Employer Mandate requirement does not affect the insurance market reforms. This means that
<br /> the following requirements have been implemented in 2014 with penalties of up to$100 per person per day for
<br /> non-compliance. These requirements apply to all plans except as noted:
<br /> • Waiting Periods cannot exceed 90 days from the date the Employee becomes eligible for coverage
<br /> • Health Plans can no longer include a Pre-Existing Condition limitations
<br /> • Health Plan Out-of-Pocket Maximums cannot exceed$6,350 for an Individual and$12,700 for a Family
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