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June 1, 2015
<br />Dick Cook
<br />814 Hibiscus Way
<br />Placentia, CA 92870
<br />Re: City of Santa Ana #142337
<br />Renewal – 111116
<br />Dear Dick Cook,
<br />MetLife appreciates the opportunity to be a part of your benefit program. This letter confirms
<br />Your renewal for the 2016 plan year.
<br />In determining the rates for the coming plan year, we have evaluated your plan experience,
<br />taking into account the credibility of the experience and the demographics of your group, Our
<br />objective in the renewal process is to identify rates that will maintain the overall financial stability
<br />of your benefit program.
<br />We have set the following rates for the coming year:
<br />Coverage
<br />Current
<br />Renewal
<br />Change In
<br />Rate/Fee
<br />Rate/Fee
<br />Rate/Fee
<br />DHMO _
<br />Employee o $26.89 $26.89 +0.0%
<br />Employee +Family $45.98 +®Alo
<br />The lratipnt Protection and Affordable Cara Act ( "p»ACA ") includes a health insurance PndsstrJ fe: impoes a-
<br />aU
<br />health insurers, including dental and vision insurers. As with the prior year, this rep in included in the dental
<br />and/or vision rates above.
<br />The rates shown above assume your existing plan design, contribution structure and group
<br />demographics remain the same.
<br />Please do not hesitate to contact me at 949 - 471.2310 if I may answer any questions or assist in
<br />any way.
<br />Once again, thank you for the privilege you have extended to us, You are the reason we are in
<br />business. We look forward to continuing our relationship in the months and years ahead.
<br />Sincerely,
<br />Nick Sala
<br />Account Executive
<br />Request to Notify Alaska Residents of Impending Coverage andlor Premium Changes
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