Laserfiche WebLink
r� <br />U <br />• <br />PROPOSAL FORM <br />CITY OF SUNNY ISLES BEACH <br />REQUEST FOR PROPOSAL #01 -11 -11 <br />GROUP HEALTH INSURANCE COVERAGE <br />We propose the following rate structure: Aetna HMO 15 <br />Group Health Insurance Program, consistent with the City specifications and details provided by <br />the bidder on attached sheets. <br />Cost per month, per employee: <br />_$237.60_ employee _$444.50_ employee plus child(ren) <br />$528.30 employee plus spouse—$694.00_ employee plus three or more <br />We propose the following for Prescription Drugs: <br />In Network, Generic $10 Brand Name $15 <br />Out of Network $30 In network Non - Formualy <br />PROPOSAL FORM <br />Business Name Brown & Brown, Inc. <br />Address 8000 Governors Sq. Blvd; #400 <br />r <br />Miami Lakes, Fl, 33016 <br />�r <br />t _ <br />Signature <br />Name & Title L ,�!(� ;c _ rir((: /ri Date <br />Phone # 305- 364 -7818 <br />Fax #305-822-5687 <br />Please provide the names and phone numbers of three references that use the Group Health <br />Insurance Plan that you have proposed. <br />Company Name Contact Person Phone. <br />• The City reserves the right to reject any and all bids. <br />-12- <br />Rfp No. 01 -I1 -01 Grp Health Ins. Bid Package <br />