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<br />· (510) 795-0103 <br /> ... <br /> C Administrators (FAX) 795-0858 <br /> (800) 533-0 I 13 <br /> 3340 Walnut Avenue <br />11-IE Suite 290 <br />LIPMAN Fremont <br />COMPANY, INe. California <br /> 94538 <br /> THE CITY OF REDWOOD CITY <br /> Claims Administration Services <br /> for Approximately 500 Employees <br /> Effective October 1, 1996 <br /> ONE-TIME SET-UP FEE: Cost of Printing Summary Plan Descriptions <br /> ($3,000.00 Set-Up Fee Waived) <br /> ON-GOING MONTHLY FEES: $4.50 Per Employee Dental Participant <br /> This rate is guaranteed for the first two contract years. Services can be contracted for a <br /> period of five years with the possibility of annual rate increases at the beginning of the <br /> third contract year and guaranteed not to exceed $6.00 per employee through the fifth <br /> contract year. <br /> RATE BASIS: <br /> These rates are based on the following information and are subject to modification in <br /> the event of significant changes: <br /> 1. Approximately 500 Self-Funded Employee Dental Participants. <br /> 2. There will be coordination of benefits with other group plans. <br /> 3. The administration fee covers and includes all routine postage, all claims review and <br /> payment functions, printing and all other administrative functions. <br /> 4. Our services will include the preparation of the Summary Plan Description. Printing <br /> of the SPD, changes and upgrades will be made at the cost of the client. <br /> COBRA <br /> Flexible Benefits <br /> Self-Insured Vison <br /> Self-Insured Dental <br /> Self-Insured Medical <br /> Self- Insured Prescriptions <br /> "T" <br />