Agenda 12/13/2011 Item #16E 512/13/2011 Item 16.E.5.
EXECUTIVE SUMMARY
Recommendation to approve the purchase of Group Health Reinsurance coverage for
calendar year 2012 in the amount of $638,387, a reduction of 7.7 %.
OBJECTIVE: To protect the Group Health Fund from catastrophic losses through the purchase of
group health reinsurance coverage.
CONSIDERATIONS: The Board of Commissioners through its Risk Management Department
administers a partially self- funded Group Health Insurance Program (the Plan) for its employees and
their eligible dependents. Group Health reinsurance coverage, also known as "Stop Loss ", is
purchased to protect the Plan against adverse loss experience. Two types of reinsurance coverage
are available. Specific excess insurance protects the plan if a covered member incurs claims cost in
excess of a "per member" deductible. Aggregate excess insurance provides coverage to the Plan if
total losses exceed an aggregate deductible for the Plan. Currently, the County purchases specific
excess insurance through Zurich Insurance Company with a specific deductible of $275,000 per
member. The specific excess coverage provides an unlimited maximum lifetime benefit per covered
member. Aggregate excess coverage is not purchased.
Willis, Inc., the County's benefits brokerage and actuarial firm, marketed the health reinsurance
program on behalf of the County. Proposals were sought from twelve carriers. Specific retention
levels (deductibles) ranging from $275,000 per claimant to $325,000 per claimant were sought. Four
carriers provided. proposals. Willis completed an actuarial evaluation of the proposals to determine
which proposal presents best value.
Willis recommends that the County select a proposal from Zurich Insurance with a specific deductible
of $325,000. Increasing the deductible will result in an estimated annual premium decrease of 7.7%
compared to the cost of the current program. Statistical simulations project this option presents the
lowest net cost when comparing the cost of coverage and the probability of an excess insurance
recovery. Willis suggests the following:
"The stochastic models and resulting analysis suggests the risk management needs of the CCG are
best met by renewing with Zurich and increasing the specific retention level from $275, 000 to
$325,000. The modeling suggests there is a 79% probability that the reduction in premium will not be
offset by higher losses. "
The proposal has no lifetime maximum benefit limit. Zurich carries a Best's "A" (Superior) rating.
Willis also analyzed the purchase of aggregate excess insurance. The cost of aggregate coverage is
$32,206 per year. However, based upon the terms of coverage, the actuary determined that there is a
99% probability that the aggregate deductible will never be met. Thus, the purchase of aggregate
reinsurance is not recommended. Staff concurs with these recommendations.
FISCAL IMPACT: The total estimated cost of group health reinsurance in calendar year 2012 is
$638,387 based upon an estimated average enrollment of 1,988 employees. There are sufficient
funds available in Fund 517 for this purchase.
Packet Page -3052-
12/13/2011 Item 16.E.5.
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this
item.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney's Office, requires
majority vote, and is legally sufficient for Board action. — CMG
RECOMMENDATION: That the Board approves the purchase of Group Health Reinsurance as
outlined in the Executive Summary and authorizes the County Manager or designee to sign the
documents necessary to commence coverage effective January 1, 2012.
PREPARED BY: Jeffrey A. Walker, CPCU, ARM, Director, Risk Management
Packet Page -3053-
12/13/2011 Item 16.E.5.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.5.
Item Summary: Recommendation to approve the purchase of Group Health Reinsurance
coverage for calendar year 2012 in the amount of $638,387, a reduction of 7.7 %.
Meeting Date: 12/13/2011
Prepared By
Name: WalkerJeff
Title: Director - Risk Management,Risk Management
11/14/2011 1:23:04 PM
Submitted by
Title: Director - Risk Management,Risk Management
Name: WalkerJeff
11/14/2011 1:23:06 PM
Approved By
Name: SmithKristen
Title: Administrative Secretary,Risk Management
Date: 11/14/20112:08:02 PM
Name: GreeneColleen
Title: Assistant County Attomey,County Attorney
Date: 11/23/2011 10:54:37 AM
Name: PriceLen
Title: Administrator - Administrative Services,
Date: 11/30/2011 11:10:12 AM
Name: GreeneColleen
Title: Assistant County Attorney,County Attorney
Date: 11/30/2011 12:15:32 PM
Name: GreenwaldRandy
Packet Page -3054-
Title: Management/Budget Analyst,Office of Management & B
Date: 11/30/20113:25:00 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 12/1/20119:48:56 AM
Name: FinnEd
Date: 12/1/2011 3:19:13 PM
Name: OchsLeo
Title: County Manager
Date: 12/2/20119:53:48 AM
Packet Page -3055-
12/13/2011 Item 16.E.5.
EO
N
W
N
O
.-1-
•1
m
CL
O
4-0
N
r
O
EO
N
W
N
O
.-1-
•1
m
m
U)
ca
0
U
a)
r
m
0
m
N
O
U O
`o Q
`m a)
D N
EL
C c0
cu
roN
Y d
oy
O C
0
m �-
� o
C
c 0T
111
m
m
CD
co
N
E
>
a, ->'
>�
T
aro
c
oa)
Y
O T
L VO
10 1%,
c cn o
ai
mx
c^-E co
m
a)
E
c_
ro
ro
=aa
a%
cD
CD 4'
—
�7
r
Em
a)
N=
o
=
c0
O
L..
a-0 r
O
U
p
Q
mC
-
O C
N
U c
'UN
o> C
c0 c
N O a
'O 5
a)
r a
a
a)
O.o V
O
NO
r
O0O
Od
a
co
E
NO
U
E
N N
ca
O
U O
ZE3
O
cM
N O
a) (D
N
roa
o
> m
°�
a
o
a
yro�
croiro
o —m
aro
>
ui
$c
o
c o
x
m
c o
o ro
E 3
N
m
c
>
c
o
LO
N o
ro
ro
T
Q N
Q
•C
ro N
>
U
'.j
p
L
L C
a) N
a)
ro 'C O
° a
cc
0 0 7
U Y
N
L a
m
cN
a)>,
rn
a
mrot°
oa
5 o
L o
Ud>
a)�
.0 o
m
o
co
3E
N o
.a)
�c
3
�cE
ycEa
��o
o�
a)
=
oc�
as
Y
m Ty
O
�E a)
a°
O
U
QO
O
U
7
;p
r
L
a C C
_ �
O
° L CD
a
O w
O
O
ro ro N
Er d
-2 O
N C
_N
i4
C
Ta)
Npro
N
rs0
E0
U)
ayi
O
N
�0y
-O
�>°,
°��
NN
Ny
�
E
E
E
S
ro
T CO
ro>
°° c
o 3
°
U
N a
0 t-
Em
y
C y-
7 p
O
°
co
aa)
33
°.cE
ma°i
Q.
��
�N
o r
m
a) °vm CL
°ro
CC'
o
o
o
Cl. E
c
.0
a)
ai°
�d"
o
ca
m
o
° >
>
Q
m
ca
CD
T
'y m
m
i °
o
E0cScZ
NO
�
'.
a
3
D�0N
.>
co
U
.2,070
U
m a)
> p c
C
ro
y a)
E
y . �y
)
Y ro y
•°
p
LJ 17
O L
c
C
E
L
c
co 0
o
p
N
�
p[ o c c
o E
dc�
-
Nm
C:
E0
ME
Z6 ^
C O
O
N
N
U
N
y
_
0
cc
ro n
O
`m
co
.
L
ro v
'm WD
L
TOO
U
oco
mm
>=N
O U
3c
°m
m
N
vQ
c°r°�
o
E
O
N
N c3
a E
ro E
°
O. p
c
C d
a)
a) U
cca
m
m aj
E m
Ln Ln
3 m
°3a
c
2Owca
C
Oao
o
a
�E
c
L) X
a�
c
c
c
o
o
¢
ac
°
a
n
° o
°
ca )
E
T
E
cc
co o
ao
?�
c
ao
a
3r O
a C(D
a)UO
N
2
C r N O
ONTO
N
`OO
E'- C
0ro
oc
O U
Nro
T N
E
u
O O
m�
ro U
ro
c
�° o
c
Q
m ay y
E E o
d°
E
ad
aro_
c
E c
y
c�
o
m y
L=
a
a)
:
w
o s
y N
m o E
N E a
o c`
._ a N
c
-9
o m
N L
m
N E
E E
L E
p
3 y
my
O
7 L ro
O.
E O ca E >
N
ca 0
U
m
0 CD
0 N.
C
C
O
3 ca ro
a
O p m
L C
O
(D
o"
N
O
U
°
•°
E
y
c
`
c a)
_7
m
m
ro `
c ro
I
aO ay �
r a)
CU
U
A
O a N
N
° U
°
U
p
C
m
N
ca
N
O
y �
N
E
U
o m
E 0)
lO
N U
U
C
a
PO
E c
°
Y
cca
E
?
a
(R
ro y
'O
m o
cr
N o r
E
p N
as
°
o
a N
O
6- to:
a= N
U
_
aa) 0
a) .-
3
C U O.§
y p
a�
c0
p Y
o f
aOj N
m
C co:
ca�3
d? 0 y
>, O
a 3
d O lca a
�Y
U)
« 7
N
>O
o
Ti
G W
Y 0
> o
o ro
U
O o E
T
n�
E� E c
o�
3°
c
f
�N
O y
laa p 0
(D a
"3'L..
O 'N
L
y c0 F
7
U L
N c
O
>
ro ....
O
N
L C�
p 7
a)
It T ci
7
E'
ro 0 a) N
c O U N
O. E
d N
C
r
N N
O
r-
m
°-�.
a
000
N a)
N C
dcroi
Oa
�m
00
�. =m�
¢o
�'�in
Q =_m0
NE
mac°)
mN
(L or
_
SQa
�1--f
uCD
c
C
c 0T
111
N
(D
co
L
M
O �
Y N
N .y
� m
0 —
`N
a�
'v. W
�N
cr
Q Q
C 'C --.IL
R
v
e"
cC))
Ill
Ul
N
a
S
Q
Q
d
Q
d
Q
N E
Q
Q
Q
Z
Z
Z
Z
Z
Z
Z
Z o
Z
Z
Z
a
Q
d
m
a
0)
a)
a)
O
m
a
0
Ci
0
d
0
0
0
C
0
p
N
N
co
N
N
N
N
N
N
N
N
N
N
N
N
0
N
N
N
N
N
N
J
J
J
J
J
J
J
J
J
J
J
a
0
a
0
a
0
a
0
a
0
a
0
a
0
a
0
a
0
a
0
a
0
N
U)
U)
0
U)
U)
U)
U)
U)
U)
U)
c
ca
U
0
E
Q
C
Z
T
a
�O
C
V7
O
T
c
5 _
cz
(D
N
C
y
Q ;O
E
N
..
LT-
Y
N
O
C LL
Q
L
O
O C
cz
N C
ca
O
U
C
U
E
d
ca
N
C3
c¢
Z
Q
Q
m
C7
2
g
O
Cn
co
(D
co
L
M
O �
Y N
N .y
� m
0 —
`N
a�
'v. W
�N
cr
Q Q
C 'C --.IL
R
v
e"
cC))
Ill
Ul
N
W
N
O
(D
3
O
m
N
m
�n
a
d
CC)_
Q
0
w
�m
c
�O
c=
y
o Z
m
m 2
a
�a ~
w
;o
�a
�2
e�
g
2
0
w
2
Ln
d
:1x d
N
W
N
O
O
■Ill
w
go
2
O
O
2
W
J
O
V
d
d
O
O
e
0
J
O
y
N
N
0
OP
a
a
j
C
0
N
h
a
Q
U
H
C
O
U
N
N �
N ~
OJ m
y
ro �
O
G �
vy m
n ° o
° � O
tit
h
c ro Z
ro
O O W
p C �
.5; CC
v
v Z
O Z
O ~
C
y
H
Q
O
Q
N
ti
(1)
CD
cu
a-
m
>
m
O CC
°ate
`N
c�
a�
2
G �
[ Oc
o�
v�
�CD
a
E3i
c 3
Kei
Q =Q
x
;VyQ
30�
:OEQ
€a
N
tN
non;
?
7ln
€u7
C
QEN
PCCZ
iz
�iZ
in iz�a
Co!Ln
9N
M
�W
Z }�
'�
(OD
�w
•
•
•
k�s;
j
�yp
4
Ip
-Q
10
X
(Q
Icd
Q
40
`60
Q 0
€a
tco
!p €�
{ Yb
0
""i 0:
;M'i
c
In
Ea y
gg
Z
ilAy
iD
z
M
•
Sao
�mA�
:oE�i
'^�, ci !OEOiQ 1f9rQ
:O,Q
a
€N
a,m
€Nilfl�$
In
z4i kH390 Z .21Z
'O €Zia
11�5N
'2 0
�,
^ Lo
INE
t�ico
0fN
ii
gpN
E
[
E
1
f
(g
Air
r0
a) C> ! i�lk03
Z € I
S C.> Q iN QtO;Q
w -o
ai
�NF
:co V)(
MP00
e
�
m
r{
c
pp
tQ m
t ;O
a' Epof
ZA6N
:tn;�
ai
sMSUf
C
in„
EE to
G� m
Ni 7E; N tZ iU
^
^
_~
6rk
k69.
Llr
yp 7i
{E?E!a [U!¢
`.L6
t(A]iN
EN fNi[O
It
N o
�t0
L1J
pp'%f
U 16
N 6QlN
�ii;
'9f Cii c €Z Z
iZ3a
lb911ti
N
f E ;Z
}E
[€
kw
�
>r.
�k
I
Xt
ID
i -Q QU {Q
lE:�[�
E
9O QNO
iND_
C
icrZ Z za�i Z
Lo
$N.Z}ai
"""k2
Z 6Z
'Z
.i69
N6%
'!9•
y
3
# 1{
fi
tea. e I
f
M,
ttt
I
%' E
E
31
I Ep
AN
j E
t
E
E (
i
E r '� }
e E
I
E`E cc
`m
oCL!
d (D
co
JiQ}Nim �Nw
E �
Oi�
Tf
E
Uc 3
0
N m c
X
y1iPUC
w
c a
0
0
C � #W
cc 7 O
IL E2 Z
N
0
OP
a
a
j
C
0
N
h
a
Q
U
H
C
O
U
N
N �
N ~
OJ m
y
ro �
O
G �
vy m
n ° o
° � O
tit
h
c ro Z
ro
O O W
p C �
.5; CC
v
v Z
O Z
O ~
C
y
H
Q
O
Q
N
ti
(1)
CD
cu
a-
m
>
m
O CC
°ate
`N
c�
a�
2
G �
[ Oc
o�
v�
�CD
a
E3i
c 3
Kei
ti
W
2
W
O
cs
.7
V
W
J
Q
U
C
E
0
CCi
a
c
0
a
y
a
3
ayi
m
'm
U
C
fp
y
G
O
N
U
C
N
N ti
O
Q
N
R1 �
c
A) ; m
U Rf h
y �
� ao
O �
h U
Z
4�
G 2
m
a >
� o W
h
0 o a
0
c a=
m m Z
10�O
a �=
c O
v Z
N
O
O
G
N
N
y
O
O
4
N
ti
3µr.
7�
m
�I
ad
o
u�
�N
aW
�N
SO
a--.IL
i�
n
u �
C
c �
tum
U1
ti
W
Z
W
'O
V
V
W
J
J
c
E
0
z
c
C
w
O
a
a�
c�a
m
N
N
3
U
e
0
m
m
O
W
m
c
4�
3 j
U o
4�
co Z
C6
O �
o W
c �
_y
O
Q �
�O
ti
0
Z
ti
00
N
CD
al
$Q
Y N
N .N
d m
Cc
Y
`N
crL �
4 �
'v. W
`N
a0
.c
c --.I
cc
v.
E
c
o �
C
rn
C31
W
2
§
b
�
0
0
�
�
§
q
$
�
u
$
g
/
%
§
\
§
% _
/
§
CU q
r [ G
7 *w$
camw
Af�§
ci�
\/u
/22{
o
(\%�
CU Ui
,ocCL
C)
Cc
\( \E
\ ca
\) 7
I
( \
�
2 w
2 /
\
\
\
co
>
/
�\
\�
kN
\�
@�
� {N
}O
cc
�
�
�
12/13/2011 Item 16.E.5.
COLLIER COUNTY GOVERNMENT
2012 Stop Loss Marketing
PROPOSAL QUALIFICATIONS AND CONTINGENCIES:
PPO Network(s): Community Health Partners, Other Network, First Health Network - CCN
Receipt, review and approval of updated monthly paid claims and 50% reports will be required.
Detailed clinical information, to include primary/secondary diagnosis. dates of inpatient hospital stays, current medical status and planned
course of treatment, is required for the following: RB78555013, 1638, 1282.. 2458. 2172.
Retiree coverage is included. Assumes Retiree's over age 65 are Medicare Primary.
Enhanced Transplant Coverage (ETC): Access to the Interlink, LifeTrac and Lifesource networks are included in this proposal. Patients
who have a transplant contract in place and are transplanted in a designated Centers of Excellence (COE) facility are eligible for the
Enhanced Transplant Coverage Program. Please note, not all facilities in a network are designated as a COE for every type of transplant. If
a plan participant chooses to have a transplant performed in an ETC facility, the Policyholder will share in the savings through a reduction
to the stop loss deductible of $10,000 for each individual transplanted.
The items fisted below are additional conditions specific to this group:
Specific Advance Funding included.
Claims administration performed by: Mieritain
Note_
This quote has been prepared based upon the information provided. In the event of inaccurate or incomplete date, we reserve the right to
modify this quote at final underwriting. Any misrepresentations or material differences in the data may void this quote andfbr any resulting
coverage retroactive to the Effective date.
MMONt, f CO'_r DMO`+S
Continuation of the orient plan of benefits including utilization review and medical case management —lea otherrume stated
Quote is valid fiire drtis from the proposer effective dare.
Assumes Alle ce milt be the Third Party Admitustrtor.
N intmum. participation requirement: 75% of eligible employees, 50": of esipble mepac ients.
The empiaver's agent is licensed im the state where the etmplaver is located_ The employer's agent does na have aat wnty to bond
or modify the terms ofthis quotation or the policy to be i==ced vathtna the prima approval of Mfmich Re. Stop Low.
Current plan document or employeebecklet received mithia 45 days of the proposed efftxave date_
Final census of emplwees and &-penis to be covered on the effective date received within 15 days of the effective date. The
rates and £actors will be recalculated and sub3ecr to change if the enrollment changes by hit°,: or mcae.
Asp_ Cmummury Health Partner PPO Netnxtrk
Quote m based on Prescupnm Ikua to be covered under a separate P-- cripn- thug Card. Program.
Policy will be issued in the state of FL
` Deposit Premtcm to be received with the slimed application and disdosme statement.
List of all claunazus who have prey ou 1r exhausted, their lifetime minumum acrd have been notified of their right to re -euntll. For
each im6nidual, please include any claim and diagnosis details asailab .
ike reerms ofAus offer are based ax tk =fenam uwn provided mid are teamow and subjeacy m c9 =W,- based on receWr torsi
rtwety rrfrbnfo &n.viag=
Snecifec Stop Lots Continreacie
The Claim D .elosraeNe ice on acy individual large c"; aim (employee ox dependent) in excess of f or expected w exeeed',i 50'*,* of
the zpecific deductible must be mined no more than 15 da}s prior to the propose& effects a date and recenedno lams than 15 days
after the proposed ef6ecove daze_ Please provide: din,.., -„ prognosis and total anx mt paid,'^_,_namr, held or unfunded during
each ems— . period_
" Documentation of mciriadval paid claims pair. in press of 50*4 of the deductible for the past 12 mro®th
Quote sab*-t to revzaee upon recewt and review of all detads of arry potentially laree or onvoing cairn c Chou=.
` Carrtiaaation o£the correct i3ai. -;�. `�+•+ rei„rew arrd Iwiedicat Case 3�faaaaememt Pcneramz.
Current Pended Claim Report up to 30 days prior to the proposed Effective Date.
Crtment Denied Claim Report up to 30 days prim to the proposed Effective Date.
List of al's pre- certificationinitiated in the past tfuee moa ffis as of the proposed effective date.
Case Management £ S— of an open Case &lama— fines, speci$caFn• noting any paruciparit who is an =patient at
the effective date.
Packet Page -3065 -
Page 10
12/13/2011 Item 16.E.5.
COLLIER COUNTY GOVERNMENT
2012 Stop Loss
GREENWOOD INTERNATIONAL (PAN AMERICAN)
Terms are subject to:
1) A signed and completed disclosure farm
2) Updated monthly paid claims and lives through the effective date.
3) Updated claims in excess of 520.000 including diagnosis and prognosis
4) Updated pended claims report
5) Updated pre -cent report
6) Anyone on a transplant list and any inidividual that has exceeded the prior lifetime maximum.
7) Assumes Allegiance as the TPA and First Health & Community Health Partners as the networks.
8) Rates are subject to change and lasers may be applied based on completion of medical review
TERMS:
The proposed coverage was underwritten for: Collier County Government (12)
The Pan American policy requires disclosure of all Disabled Persons to waive the actively at work or normal function provision
The Pan American contract wording contains Subrogation Clause_
CONDITIONS:
This is a tentative proposal based on information fumished in your request.
This proposal will be binding upon receipt of requested documentation, the first month's premium payment, and subject to final underwriting and approval by
Underwriters. Insured will provide Plan Document acceptable to Underwriters.
Annual projections are subject to revision based on the enrollment at inception. Rates and Factors can be recalculated if the demographics of the group
cause the specific rates to change by 10% or more_
Signed completed disclosure form submitted no earlier than 30 days prior to effective date.
EXCLUSIONS:
Underwriters shall not reimburse the Assured for
a. Charges payable under any other plan of insurance, including application of C.O.B in the Plan.
b_ Charges payable under any Workers Compensation or Occupational Disease Law.
c. Any payment of, or on account of, punitive or exemplary damages.
Any payments andtor expenses excluded by virtue of Items (a), (b), (c), and (d) above contributing to Items 4(a) and 4(b) of the Schedule,
being the amount {s) in excess of which Underwriters become liable hereunder.
OTHER CONDITIONS:
Quotation is subject to approval of the Third Party Administrator and PPO network by Pan American prior to the effective date.
1.) Subject to full details and diagnosis together with prognosis of all claims exceeding or which may exceed 50% of the proposed deductible. 2.) Quotation is
subject to pre - certification information for all individuals approved for 10 days or more of hospital confinement within 6months prior to the effective date. 3.)
Quotation is subject to receipt and review of paid claims and enrollment up to the effective date. 4.) Quotation is subject to updated information to the
effective date for all individuals in excess of the specific stop loss level. 5.) Quotation is subject to notification of all employees not actively at work on the
effective date. 6.) Quotation is subject to all claims in excess of 50% of the specific stop loss level incurred in the past twelve (12) months. Claim
infommationfor the past twelve (12) months is required including diagnosis and prognosis_ 7.)Terms are subject to updated paid claims through the effective
date; if outstanding claims cause more than a 7% increase to the current Year's average claims cost, an adjustment to the aggregate attachment point is
likely.
Packet Page -3066 -
Page 11
12/13/2011 Item 16.E.5.
COLLIER COUNTY GOVERNMENT
2012 Stop Loss Marketing
INTERNATIONAL ASSURANCE OF TN (AMERICAN FIDELITY)
WE ASSUMPTIONS
Enrollment in plans to remain near current.
Receipt and review of shock losses, experience, and enrollment for the months of August 2011 through November 2011.
lArs medical consultant has not completed review of known potential large claimants. Once the review is complete the rates
may change ancUlor lasers may be applied.
Receipt and review of the Employers Disclosure Statement completed within 30 days of the effective date.
Aggregate Accomodation is available. Please contact underwriter for quote.
Aggregate Terminal Liability Option (TLO) is available for any non-run-out contract. Please contact underwriter for quote. TLO is calculated
as a sum of each Aggregate Deductible Per Month for each month during the Contract Period, multiplied by 135%; or the Minimum
Aggregate Deductible multiplied by 135%, whichever is greater.
Medical Conversion is available for $0.63 per employee per month.
The Minimum Annual Specific Premium will be 75% of the Projected Annual Premium shown above.
Fees charged for the consulting or the placement of Excess Loss Insurance may not be added to premium rates on this proposal. Rates
charged on premium statements presented to the policy holder for payment must match rates exactly as shown on this proposal.
This offer is based on the attached Plan of Benefits using the following PPO Network(s):
CHP PPO
IAT reserves the right to adjust the rates and terms contained in this proposal upon:
1. receipt of any information, item, or material requested in this proposal, or
2. the event of non - compliance with any terms to which this proposal has been issued.
In the event there is a greater than 10 %. change in enrollment between the submitted initial enrollment data and the final enrollement data,
rates and factors may be recalculated.
Final Rates, Aggregate Factors, Minimum Aggregate Atlachement Point and any applicable Run-in Limit will be based on the greater of
the proposed rates, factors, etc., or the initial enrollment.
If medical information is requested for certain individuals:
1. a higher Specific Deductible andior different contract basis may be required. or
2. coverage may be denied on claims incurred by those individuals, depending on the information received.
This proposal is subject to:
1. the accuracy and validity of data submitted,
2. Receipt and approval of an application signed on or prior to the proposed effective date, and received by IAT within 16 days thereafter.
3. Documentation (on forms of, and prepared by the current TPA, carrier, etc.) of all data submitted for the evaluation of the proposed
insured.
4. Disclosure of locations of all covered participants.
S. Disclosure of the number of individuals eligible to participate under the Benefit Plan of Collier County Board of County Commissioners
(aka Collier Co. A minimum participation of 65% . of eligible employees is required.
Receipt and deposit by IAT of any check drawn in connection with this proposal does not constitute and acceptance of HaNlity. In the event
IAT disapproves the Apprication(s), IAT's sole obligation will be to refund the deposits)
Final Plan Document wording and terms must be approved by IAT, The Plan Document must contain the following provisions:
1. Subrogation
2. Coordination of Benefits
3. Exclusion of work-related illness and injuries
4. Exclusion of experimental procedures
y issue will follow the receipt and approval of outstanding items noted in the Confirmation of Coverage(Binder) Letter.
All premiums are due and payable on the first day of each month.
Packet Page -3067 -
Page 12
12/13/2011 Item 16.E.5.
COLLIER COUNTY GOVERNMENT
2012 Stop Loss Marketing
(FIDELITY SECURITY)
Terms and Conditions
UNDERWRITER NOTES: Aggregate quote is subject to receipt and evaluation of updated paid claims and enrollment through
September 2011.
The premium and maximum plan liability factors are based on the data submitted, plus other information furbished relevant to
underwriting the risk Any inaccuracy in the data or statistics submitted will necessitate additional cal culations. Variations will, of course,
affect results. We will not be bound by any typographical errors contained herein. Subject to the qualifications stated above, the
proposed terms are valid for an effective date of January 1, 2012 provided application and deposit premium are submitted before
January 15, 2012- Note that producing agent must hold a current and valid life, accident and health license_ Quote assumes that claims
will be administered by a faclity which has been approved by the underwriting agency.
CONTINGENCIES:
The Disclosure Statement and Signature Page must be up to date as of the Signature Date and be submitted no more than 45 days
prior to, or 15 days after, the effective date of coverage. The Stop Loss Insurance coverage will not be considered bound until we
receive and accept the final Disclosure Statement and Signature page. Our review of the Disclosure Statement will enable us to
determine if there are any known clam risks that will require higher deductibles, Le_, Lasers, or exclusion of coverage for certain
perms. In order to identify all possible claimants, information must be obtained from both the Claims Administrator as well as the UR
and Case Management vendors. Failure to provided complete and accurate information may impact the coverage provided under the
Stop Loss Policy.
Actively at Work / Actively at Life requirements will apply, subject to receipt, evaluation and acceptance of full and complete disclosure.
The Disclosure Statement, which is included with this proposal, must provide updated diagnosisiprognosis, case management notes
and paid and/or pending claim amounts on any previously disclosed person as well as for any new person that meets the following
conditions:
- Have paid or pending claims in excess of 500A of the Specific Deductible during the past 12 months-
- Have on -going serious medical conditions such as cancer, leukemia, severe cardiovascular disease, or major organ disorder (i.e.
on kidney dialysis), severe bums or trauma, neonatal disorders, brain or spine injuries, or potential organ transplant
- Are hospital confined.
- In particular, the above updated claim status information must be provided on the Disclosure Statement for all potential claimants
from the Large Claims report provided_ Note that prior to binding coverage, we will require potential claimants from the Large Claims
report provided. Note that, prior to binding coverage, we will require identification of those individuals. The following are acceptable: first
initial with last name or last 6 digits of SS#.
QUALIFICATIONS:
In accordance with the new Healthcare legislation, the Lifetime Maximum reimbursement will now be UNLIMITED on all of our Stop
Loss policies. Note however, that the maximum reimbursement limit for the POLICY PERIOD quoted in this proposal will either be
aligned with the current annual or lifetime maximum of the underlying self - funded Plan or it will be based on the reimbursement limit has
been requested by the Plan Sponsor.
This proposal is based on the information submitted. If it is determined that the information presented for the purposes of underwriting
evaluation is inaccurate and/or incomplete, then we reserve the right to re- evaluate and modify the terms prior to binding the risk.
In order for a claim to be considered for reimbursement under the Stop Loss policy, notification must be given to our Company when on
a covered person (1) the total claims equals or exceeds the lesser of 50% of the Specific Deductible or $25,000, OR (2) a catastrophic
diagnosis has been identified based on the ICD -9 listing included with this proposal. All claims submitted that meet these criteria will be
forwarded by our Comparry to our Medical Claims Settlement Specialists for possible audit review.. As an optional service, our Company
can also attempt to negotiate more cost effective charge levels, where appropriate, in full cooperation with the Claims Administrator or
TPA Note that in orderto achieve the best results, all claims meeting these criteria should be submitted to our Company priorto
payment by the Claims Administrator or TPA.
Packet Page -3068 -
Page 13
12/13/2011 Item 16.E.5.
COLLIER COUNTY GOVERNMENT
2012 Stop Loss Marketing
,AMWINS (FIDELITY SECURITY)
dr proposal is subject to our underwriting review and acceptance of the provisions, limitations and exclusions contained In the
Policyholder`s Summary Plan Document (SPD).
This proposal assumes that the Policyholder's Plan Document is in compliance with all federal legislation_ A copy of the Plan applicable
on the effective date must be received within 45 days of the effective date. No policy will be issued or claim paid until the Plan
Document has been reviewed and approved by underwriting. Any deviation from the plan upon which the sold quotation was based
may result in a change to the benefits, rates and/or factors.
Underwriting reserves the right to change the terms and/or conditions of coverage when the participation varies by more than 10%
and/or a new division is added and/or whenever plan or network changes occur_
Periodic open enrollments for any purpose other than for multiple plan selection or as defined by HiPAA will not be covered under the
Stop Loss policy.
The Stop Loss policy will not cover expenses resulting from organ transplants if such procedure (s) is considered experimental.
The Stop Loss policy will include an Advance Funding (Simultaneous Reimbursement) provision under the Specific Stop Loss
Insurance.
Quote is subject to 75% minimum participation requirement
Aggregate quote is subject to receipt and evaluation of updated paid claims and enrollment through September 2011
Network Access Fees are not a covered expense under Specific or Aggregate Stop Loss contracts_
Pre - Certification, Utilization Review and Large Case Management are required under the self-funded Plan. underwriting discounts have
been applied for these features. If it is determined that these managed care services are not in effect, then underwriting reserves the
right to withdraw the rate credit_ Our proposal is based on the assumption that these services will be provided by Community Health
'rtners.
Quote is based on the current schedule of benefits with utilization of the existing PPO network. Our proposal is based on the
assumption that the PPO network will be First Health Network, Community Health Partners - FL-
The proposed Third Party Administrator (Allegiance) will need to be formally approved by our Company and a TPA Questionnaire will
need to be completed.
This proposal assumes that Actives, and COBRA, including their eligible dependents will be covered under the Stop Loss policy.
Any member or dependent who declined coverage at their original enoliment date, i.e., a "late entrant!', will not be covered under the
Stop Loss pollcy at a later date, except if the late entrant is considered to be a "special enroliment" as defined by HIPAA, or there is a
pre - existing condition limitation in the self - funded Benefit Plan of at least 12 months (or the 18 months allowable by HIPAA)_
Other than state premium tax, proposed rates are exclusive of any state assessments which may apply. Expenses for taxes, fees and
surcharges that may be imposed on the self - funded Benefit Plan by Federal, State or local governments are not covered under either
the Specific or Aggregate coverages.
This proposal with the Stop Loss policy to be underwritten by the Fidelity Security Life Insurance Company, Kansas City, Missouri
Packet Page -3069 -
Page 14
O C%
di
4,1 P,
My to
04
bu
0
1p
4u
It 04
41
4,J w 0
O
V PA
4.
0 &U
r, � R
0
ri
o ci vu
ti
tu
u
o
00
aj w
I"
11
ru
I
ti
O
—u
basin ��2 .5
.2 P, p
bfj
Ed g
0
0, cw
Ou
*Awr,
41
o w
bp,
q4 0 m
IS
.-G m 19 tg
g
2
cz
NJ
—A.
W
cu
CF)
1n
6
pl'
P,
.6 di
m Ell 4-1
46.1
u �4
o .13
14
9:14
P�l
0
4u
oul 0- 51�
Od
cc Ja
P4
CC-
21,
P4
cg
t� 4.
� u
4.4
6 4.
4
O
O
tu
0
as
Cc'
bfj
4u
t)fj tr
o
Cc>
0,
0
4",
bf,.
o
=M
S. R
u
cu
ad
to
04
5,2
24
om
pq
44
ovi
ml,
'.. t2
0
4
F3
2 -Cc
u
0.
CI 2
40,
0 cu
rp
qu
Im
U
EA
*6
4o ip w
W
O
Lk
zx
QJ Au
40.
c4
T3 ;s
O
V
v lu
C)
-..%.
--X
CD
m
tig
�D
ol
0
u
0
H
'O-g
o
o 6t
44
'o
ct
's
w
g
4) u
lu
IX)
Caw
cz
O j0 p
qj
0 L
5 o
-14U
Up
lu.
o
E�A
4r �a SFr
bfF
t3
tb
di
Ll
6- p
--.I
N)
CD
02
0
pu
O
0 P
t9j.
v Cc;,
40
0
0
4j
tz
LEI
cr
Cl
65
1 10
JS
OR
as m
40,
o ;An
4u
10 'a
to
0
u 0 ad
R
to
bij
0 z
40,
4d
0
u
ad
O cv
y GU di
4-1
CA)
Ri O 4
CY)
�n
6
w
Li
CS
t;4
fu
04 U
44 OL
EL
bfj
J4
op
%luj
C3
i�
0 104
79
oz,
.0 El
20
2
44
Q4
O
iu
IS
m RA
O
CD
O
a,4 t � u A 0 -, u - 41
.2 -a
OWJ u
10 T,
;lu, 'ul '8
tv. lo,
s , — 2
rC 1.0 01
Cr a,
cc
U 0 4A
iii IW
4-4
CQ
w u 0 *0
g
0 61
-to
bli
lu Cti L
Rg
cz
0-0
SO.
ygy
40
Gi bk
CA)
CY)
In
Cn
K3
0
..k
CD
CY)
m
cyl
40
C3
44
cn
1-0
-0 Qb
k6
U 0?
2d
di En
t6
m
0
AM
-Mu
8 b
8"
Au
ZE m
.20
.9
�o u
K3
0
..k
CD
CY)
m
cyl
12/13/2011 Item 16.E.5.
Collier County Government November 10, 2011
2012 Medical Stop Loss Marketing Report
Introduction
Each year Willis assists the Collier County Government (CCG) in obtaining quotes, analyzing the responses and
placing stop loss protection for the medical and pharmacy plans offered to the employees of the Collier County
Government and its constitutional affiliates.
Willis seeks stop loss coverage for both specific and aggregate coverage on behalf of the CCG. Specific stop loss
provides reimbursement of medical and pharmacy claims for an employee, spouse or dependent whose claims
exceed a specified deductible in any one year. The current retention level is $275,000.
Aggregate stop loss protects the CCG in the event that total claims for covered individuals exceed a predetermined
amount in any one year. The CCG does not currently purchase aggregate stop loss as past analysis of the terms
has shown that purchasing this coverage in conjunction with specific stop loss would offer little real protection and
represented a poor value.
While CCG had a large number of claimants with total dollars exceeding the specific stop loss in 2007 and 2008,
large claims activity slowed in 2009 and 2010 and so far in 2011, there have not been any claims that have reached
the $275,000 mark.
Marketing Summary and Recommendation
Willis worked to secure terms for the specific medical stop loss program from the current carrier Zurich. In addition, a
request for proposal document was prepared, approved by the CCG and distributed to select carriers. Quotations
were requested for specific retention levels of $275,000 (the current level), $300,000 and $325,000. The terms were
also requested for aggregate stop coverage based on 125% of the expected cost for 2012. Specific terms were
requested on a 12/24 basis which means the coverage operates on an incurred versus a paid basis. This is
consistent with past practice.
Specific and aggregate quotations were requested from the following carriers:
b Greenwood International (quoted)
b Symetra (declined)
b ING (declined)
b Sun Life (declined)
b Optum (declined)
b Beacon Risk (declined)
b Zurich (incumbent)
b Amwins (quoted)
b GlenCaim (declined)
b HM Life (declined)
b Munich Re (quoted)
b International Assurance of Tennessee (quoted)
All these carriers are rated A or better by A.M. Best. Carriers that declined to quote did so because of fears over the
demographics of the population, the relationship of current rates to their manual rates and CCG requirements over
how confidential health information is used and retained. AmWins was the only carrier to offer an aggregate quote.
To aid the CCG in making a selection of what carrier offers the best terms as well as what type of program to
purchase, Wills completed three separate analyses. The purpose of each is summarized below:
Willis
Packet Page -3078-
Page 1
12/13/2011 Item 16.E.5.
Collier County Government November 10, 2011
2012 Medical Stop Loss Marketing Report
1. A standard spread sheet analysis which shows what each carrier quoted and who offered the most
competitive terms at the stated retention levels as well as whether aggregate terms were offered.
2. A stochastic forecast model which used detailed claims data to forecast the expected number of claims at
each retention level to assist the CCG in selecting the most appropriate retention level.
3. A loss probability study which provides data to assist the CCG in determining whether it is appropriate to
purchase aggregate stop loss coverage given the terms quoted.
The stochastic models and resulting analysis suggests the risk management needs of the CCG are best met by
renewing with Zurich and increasing the specific retention level from $275,000 to $325,000. The modeling suggests
there is a 79% probability that the reduction in premium will not be offset by higher losses.
However, the current reserve status of the health fund although adequate does not have the same level of surplus it
did two years ago. Although the draw down was planned, any decision to assume additional risk must be carefully
considered. The reward of lower premiums for taking on signally more risk is approximately $140,000. Not a lot of
money for the additional risk assumed or as a percentage of the total cost of the program.
Further, although the advocacy health plan model implemented by the CCG in 2009 should have a continued
mitigating impact on the frequency of large claims in 2012, the affected claims are in the range of $100,000 to
$200,000. The claims at the $275,000 retention level are highly random catastrophic events and therefore not
generally affected by the new plan. Therefore, Willis believes that fiscal prudence suggests the retention level should
be maintained at $275,000 for 2012. The following analysis provides the detail of the market process and the
analysis that Willis performed on behalf of the CCG.
Although Zurich would not offer an aggregate quote, we did assess what AmWins offered. As in past years,
aggregate would represent a poor value. The CCG would have less than a 5% probability of collecting on coverage
that costs $32,206 annually. Therefore, it does not make sense to go back to Zurich and request aggregate quotes
as a condition of being recommended as the carrier for the specific stop loss.
Quote Cost Analysis
The attached document labeled Collier County Government 2012 Stop Loss Marketing Analysis outlines what each
of the carriers quoted at each retention level and which carrier quoted the best terms at each retention level. The
analysis shows that Zurich has the best terms at all three attachment points.
The Zurich terms for the current retention level of $275,000 represent an increase of 12.5% or $86,597 annually from
the current coverage.
Although no increase is welcome, this proposed renewal is very favorable. Stop loss renewal increases typically
range between 25 to 40% due to two factors —the carriers' risk expectations based on a review of emerging high cost
claims /trigger diagnoses and what is called leveraged trend. Leveraging is what happens to the amount of claims
exceeding a specific level ($275,000 in the CCG's case) when claim costs are increasing.
For example, assume a claim of $300,000 occurred for an individual with a liver transplant. In this case, the CCG
would receive $25,000 back from the reinsurer. Now let's assume costs increase 5% (which is consistent with
medical CPI). Next year the same claim would cost $315,000. Under this scenario, the amount collected under the
reinsurance would be $40,000 instead of $25,000. This represents an increase of 60 %.
Willis
Packet Page -3079-
Page 2
12/13/2011 Item 16.E.5.
Collier County Government November 10, 2011
2012 Medical Stop Loss Marketing Report
In the CCG's case the modest increase was likely influenced by favorable large claims experience and the
implementation of the CIGNA network which will provide larger discounts for complex claims that might occur outside
of Collier County.
As in the past, all quotes were made assuming a 12/24 basis. This means coverage applies to all claims incurred in
2012 and paid by December 31, 2013, so there is no concern at the end of the year about getting claims paid so they
will be included against coverage.
Retention Level Analysis
Willis actuaries developed a Monte -Carlo simulation model using actual large claims in 2008 -2010 and the first 9
months of 2011 to forecast the large claims that are likely to occur in 2012. Note that the expected number of claims
for all quoted retention levels is higher than what CCG actually experienced in 2010. This is because the forecast is
based on several years' experience and 2010 was more favorable from a stop loss perspective than 2008 and 2009.
Refer to the attached document labeled Collier County Government — Specific Level Retention Support Analysis.
The first page shows the actual and expected number of claimants that exceed specific levels. It also shows the
expected cost of risk transfer. When the risk transfer number is negative the model is suggesting the likelihood that
the specific recoveries will exceed the premium paid. Generally a negative or smaller number suggests that specific
retention is likely to provide the best return.
This analysis suggests that the CCG is best served by increasing its retention level to $325,000 as the expected cost
of risk transfer is more than $57,000 lower than the expected cost of the current level.
Page two contains an analysis that shows the relative cost savings associated with increasing the specific level and
the number of high cost claimants that must occur to offset the savings. It further shows the relative probability that
the additional claims paid by the CCG by raising the retention level will not offset the savings realized by increasing
the retention level.
The premium reduction CCG will receive for raising its attachment point from $275,000 to $300,000 or $325,000 will
offset the additional retained claims from the higher deductible if the CCG incurs fewer than 3 claims exceeding the
$275,000 attachment point. To put this in perspective, there were 6 claims over this level in 2007 but only 2 in 2008,
2 in 2009, and 1 in 2010. In 2011, the CCG has not experienced any claims of this magnitude and none of the
existing claims are close to hitting the stop loss.
The stochastic models suggest the best choice for the CCG is to raise the retention level to $325,000. The analysis
indicates there is a 79% probability that the additional retained payments will not exceed the premium savings of
$140,034.
As for increasing the retention level to $300,000 there is only a 26% chance that the additional retained payments will
not offset the premium reduction if the retention level were increased to that level.
However, as noted earlier in this report, the reward for increasing the risk amount of risk the CCG assumes is about
$140,000 annually. Therefore, the gain in total cost of risk transfer is relatively small compared to the total cost of the
program. This as well as the reserve status of the medical plan suggests the current retention level be maintained for
2012.
Willis Page 3
Packet Page -3080-
12/13/2011 Item 16.E.5.
Collier County Government November 10, 2011
2012 Medical Stop Loss Marketing Report
Aggregate Stop Loss Analysis
Zurich did not provide a quote for aggregate stop loss. The only carrier that provided an aggregate quote was
AmWins. AmWins has offered to cap the total liability under the medical and pharmacy programs at a level equal to
$1,424 per month. The premium for this guarantee is estimated to be $32,206 for the two specific retention levels
($275,000 and $300,000) quoted.
Please see the chart labeled "Likelihood of Medical Claims (with RX) Cost Greater than Listed $ Per Employee Per
Month for CY 2010 - - Assuming 8% Trend."
This loss probability distribution shows the likelihood of claims falling within certain ranges. The high end of the
distribution is $1,445 per employee per month. AmWins' aggregate claims level is below this level, but above the
95th percentile value of $1,401. What this says is the probability model suggests that there is a 95% probability that
per employee claims will be less than $1,401.
Since the AmWins cap is $1,424, Willis does not believe that purchasing aggregate stop loss would be a good
investment.
Willis
Packet Page -3081-
Page 4
12/13/2011 Item 16.E.5.
�*, v► 40 fw #A rs► 44 rs► 40 M
A
v► d+ to a► aA -A 4* " *%
0
D
0
to
A, W W W W N N N N-p
O V M N O -4 N N O
p
? W W W W N N N N
O V M N O -C M N O
M
p
CD
ocno_v+Opon"p
tB
ocnornocno cno
A
0
CD
''*
A
=
_
C1
000000000 =«
0000000 00
�;
000000000
p
oa00oo o 0 0
�
00000OOOOO
_„
o0o00oo 0o
n
0
c
(D
CL
y
CD
=
M
r
CD
7�
<
a
--�
Cr
x
�D
CD
Cp
n
0
X
y
C
O
<
rt
�D
-69
l< l< l< 0) -4 v l< l< •<
�,
N
a Z X
CL
CD
CD cD CD oD rn ao CD CD CD
3 0
3
A
N
o
W wN =___
= c�D r.
3
cn cn Cn 4 .t, - Cn Cn in 3
m A -, CD
(D
lD
a
CD CD N CAD CD CLAD
N 01
CD CD CD CD CD CD
N t�
n
0
3 3 3 *oq �ruq.9333 SCAM
E N N W •0
9
N00>
rh
E' E C' C C CD X
3 3 Ow3 3 0 0
W M Co
O M A
0
OODOCoo
° c
3
y
N 4 V < =_w A
OD NO CD A CAD
CA M M
O
A y
O O CL
0
y
<
M sv
y
O O Okk i# ,Zj
N o n Z D
<< <WWA <GG�M
°CD CA
F-r-rD-
-r3 =
oC'� 3 c
awZDmDrrD
CCC C C C
y
rnmm mmm3 0
a0�
0
M <
0
�*�t tw�)�* ate M
CCC - M-4CCC�,�
mmmC)OD0mmmFD co
M
n
0
w
0
X
N
X
tQ
CD
Packet Page -3082-
m o m(D 3 m 36
cc
W Q S -a -0
CD
O
=r
N CD
CD CC CD
Q S
"a' 0 3 o O
c W
0-i-0 O
M Cn
0X
CD
=
rt C 0 W
�<
.7
ei
_
C = CD
Q° (Sp W "O
0
a
C]• _ CD
CD (Q =;
CL S -0*
y
tr
0 CD
D CL
3
CD
CD C CD c
�. 3 (D n.
oa. - -
'
m
O (D 0 n N
�. O (D '-
CD
3
CD
c0i
(ov�E:
00 �' 0 n+ N
0
CD
W CD
Cn
3 ma *�
CL
a
CD W y. 0
_
�fD
pi < N 0 c
M
W
a�S m �
3x� aa
v'
o = 3 CD CD
y
0
°1 CL --. a. CL
3
m
y r+: (D
C
W
(D 0
^. (n = 0
S
CD0 .« C7
(p
S
CD CD
m
_ = 3 W
.. . O_
CD
W = S - Q
Cr - CD W -.
Q
Q.
(D Q =
.-n
3 CD � W
Cr
O
CL
S N C N.
CD
(D
CD
W - < CD 77,
-0
�• (D 7 O W
= Q
C
pi
y
Co CD "a EF y
y
6 7 O CD C
�S3
CD N -.Cc CL
CD
-a
N 0 W " l<
B
CL
NO•CDN �
CD
3
c CL
C
�° CD
v
�'v c<i
=r 3 a W `<
(D y CD W CCD
(ten
y _
a CD (D
0
W CD CA
0.
?
7
S
^1
(O
12/13/2011 Item 16.E.5.
W W W N N N N� W W W W N N N N O CrD -p W
C7f N O V Cif N O S V CJf N O V C11 N O < Cp �
O C77 O CJf O Cif O tlf O tJf O Cif O Cif O Cp o
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 (D 0 0 0 0 0 0 0 0 a O O <,
(D p -0 CD
D �N D
CD a
N' CD _N
A W W W W N N y� .p W W W W N N N CD 0 CD (D (D y.
O V 0 N O -i O a O V CH N O -i Cif N< O < CL -+ a'
O Cif O Cif O Cif O O CJf O Cil O VI O Cif Cp S 3 CD y
0000000 0 0 0 0 0 ER 0 0 0 0 0 0 0 0 y y
0000000 CT1 00000000 Co M. Q Ca N
O CD 0 O
CD CD (71
O
O
O n O
*t *k -69 Efl *k *k *k p 3
«<�«<c7 <<< -4 0«<�;� Ci
D D D o D D D M D D D N y D D D
CCCOCCCa C C C -9-1 00 C C C (D
mmmWmmmCD
(D En nM�v
� mmm
y y
rrr DrDrD rNa' D D D y N -Of
D0 DDD1 0 DD
rrr rrr,.. 'a
C C C CCC(D CCC CCC �*� @
mrnm mmmc� mmm mmm *< 0
c '
v v
000 Q. 000 -� p (nZ Q
O O O A O = 0 0 O A b) Q. CAD C
rt'W► CCDD rt
Cr Q = ci Cr
(D (o n h (D
.m
x
y �
CD
Z .0•.
CD CD
>< rL
0CD 0 0 000- - -00p f7 DZ
M y W 'Oy C
C
CT
� .W► y � CD
Cl)
CT -0 0
CD tQ y (D
� ^ n
M n
«<CD «< «Gw §<< a� C �_ - c
DDD�DDD DDD�o DDD •a 00 0
rrr rrr rrr rrrpD� �0 =r of
CCC CCC CCC CCC y CD 0.M y Cr
mrnm MMM MMM MMMW A
y-%0MW
< O Cl) C Q. (� #
M -a 0 Q W D
C�D CD >t .�
2.
C7 CD CD (QD C)
� y
Packet Page -3083-
O
(D
O
C
0
O
<
CD
7
CD
rt
M
0
r
M
ID
f•f
N
(D
O
C
V
10
O
9
au
H
E
CD
L
IM
M
k
so
0
z
C
3
Cr
CD
o_
(n
CD
0
n
N
CD
N
0)
tsi
N
4
(11
O
O
O
v
CD
CL
C
n
Cr
CD
Probability
0 0 0 0 0 0
0 00 0 0 0 0
N
w
cn
rn
CO
c0
O
i
N
W
Packet Page -3084-
12/13/2011 Item 16.E.5.
0
M
0
.0
0
a
a
rr
Z
3
a
cD
0
N
0
n
n
_F
3�
N
m
N
4
Cn
O
O
O
M
x
fu
0
Z
C
3
a'
<D
1
N
^(D
0
�h
0
0
LU
3
Efl
fA
O
O
ffl
N
N
Cn
W
fig
N
00
� o
M
3 �
a:
N
CO
O O
CD
M
C �\
Cl)
L
w
W
CD
fA
W
4
00
0
ffl
cn
12/13/2011 Item 16.E.5.
Probability of $PEPY > Value Listed
W 4 U7 O -4 O O O
O O O O O O o O O O O
\° \o \° \° \ \° \ \° \o
0 0 0 0 0 0 0 0 0 0 0
Packet Page -3085-
5F
M
0
0
CL
0
CD
n�
n
F
�N
O N
XN X
on
N y
D rt
N �
N
C �
D
O rt
CO 0)
'r
�D rt
CL c.
49
cD
M
3
a
O
�D
CD
0
3
0
0
rt
3
X
D
CD
0
CD
Q
ffl
M
_
cn
o
M
a
W
/7�1
11�
it
CO
w
w
co
-„
m0
.3
3
-j
CD
CD
r..
64 O
m�
C'
01
d
Packet Page -3085-
5F
M
0
0
CL
0
CD
n�
n
F
�N
O N
XN X
on
N y
D rt
N �
N
C �
D
O rt
CO 0)
'r
�D rt
CL c.
49
cD
M
3
a
O
�D
CD
0
3
0
0
rt