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Home My Public Portal AboutExhibit MSD 70 - MetLife - LifeExhibit MSD 70 MetLifd Metropolitan Life Insurance Company 200 Park Avenue, New York, New York 101116 APPLICATION FOR GROUP INSURANCE The applicant named below is applying for a Group Policy to provide Insurance for the persons specified below. APPLICANT DATA 1. Full legal name of Applicant: Metropolitan St. Louis Sewer District (the "Policyholder) 2. Address: 2350 Market Street City St: Louie State JvlO Zip 63103 POLICY EFFECTIVE DATE The Group Policy's effective date will be February 1, 2011 subject to MetLife's acceptance of this application and the Applicant's payment of the Premium due on or before such date. POLICY SITUS The Group Policy will be issued for delivery In and governed by the laws of Missouri COVERAGE DATA Employees 1 Members Employees I Members Only and Dependents Life Insurance ❑ Accidental Death and Dismemberment Insurance ❑ wig PREMIUM DATA Premiums will be paid: ISI monthly ❑ quarterly ❑ annually 0 other: Attached is an advance payment of: $11,000,00 AGREEMENT The Applicant signing below agrees to accept the terms and provisions of the Group Policy, including its Exhibits, amendments and endorsements, if any. Fraud Warning. Any person who knowingly and with Intent to defraud any Insurance company or other person files an application for insurance or a statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudutent insurance act, which is a crime and subjects such person to criminal and civil penalties. c (Signature of Applicant's Authorized Representative) t: �1 • 4C9U/S .;.44V gnalure or}Ijrrtnass 'L.4lr (Signature of Ltcen Agent as requfr 461U Agenl or Reslde.ni by law) 0 (Print Name d Title of Ihorized Representative) kW1-011 Dale: %, Pa (Print Name of Witness) . p1 ��l`ssi�atet.t5car►s�fYla) o.) (Print ��ern1(��1�ili` � • �r1{ (state) APP-GP99 NWIF October 2, 2014 Chris Snell Gallagher Benefit Services, Inc. 12444 Powerscourt Drive, Suite 500 St. Louis, MO 63131 Re: Metropolitan St Louis Sewer District Renewal m 02/01/2015 MetLife® MetLife appreciates the opportunity to be a part of MSD's benefit program. This letter confirms their renewal for the 02/01/2015 plan year. Under the terms of your present rate guarantee, the rates currently in effect will continue for the next plan year beginning on 02/01/2015 and ending on 01/31/2016. In determining the rates for the plan year ahead, we have evaluated your plan experience, taking into account the credibility of the experience and the demographics of your group. Our objective in the renewal process is to identify rates that will maintain the overall financial stability of your benefit program. We have set the following rates for the coming year: I Coverage Current Rate/Fee Renewal Rate/Fee i ' Change in Rate/Fee (+/- %) Basic Life All Basic Life L $0.173 /1000 $0.173 /1000 0.0% Optional Life — I 0 TO 24 $0.074 /1000 $0.074 /1000 0.0% 25 TO 29 $0.077 1 $0.077 0.0% 30 TO 34 $0.102 $0.102 1 0.0% 35 TO 39 $0.130 $0.130 0.0% 40 TO 44 $0.154 $0.154 0.0% 45 TO 49 --�— $0.228 $0.228 0.0% 50 TO 54 $0.379 $0.379 0.0% 55 TO 59 $0.678 $0.678 0.0% 60 TO 64 $0.952 $0.952 0.0% 65 TO 69 $1.799 — $1.799 0.0% 70 + $2.915 $2.915 — 0.0% Dependent Life Dependent Life $2.2301EE $2.2301EE 0.0% Personal AD&D PAD&D Voluntary AD&D $0.031 /1000 $0.031 /1000 0.0% EE + FAMILY $0.050 /1000 $0.050 /1000 0.0% EE ONLY $0.030 $0.030 0.0% The rates shown above assume your existing plan design, contribution structure and group demographics remain the same. Please do not hesitate to contact me at 314-548-4073 if I may answer any questions or assist in any way. Once again, thank you for the privilege you have extended to us. You are the reason we are in business. We look forward to continuing our relationship in the months and years ahead. Sincerely, cluvit Julie Frame -Jones Account Executive MetLife INTERMEDIARY AND PRODUCER COMPENSATION NOTICE MetLife enters into arrangements concerning the sale, servicing and/or renewal of MetLife group insurance and certain other group -related products ("Products") with brokers, agents, consultants, third -party administrators, general agents, associations, and other parties that may participate in the sale, servicing and/or renewal of such Products (each an "Intermediary"). MetLife may pay your Intermediary compensation, which may include, among other things, base compensation, supplemental compensation and/or a service fee. MetLife may pay compensation for the sale, servicing and/or renewal of Products, or remit compensation to an Intermediary on your behalf. Your Intermediary may also be owned by, controlled by or affiliated with another person or party, which may also be an Intermediary and who may also perform marketing and/or administration services in connection with your Products and be paid compensation by MetLife. Base compensation, which may vary from case to case and may change if you renew your Products with MetLife, may be payable to your Intermediary as a percentage of premium or a fixed dollar amount. MetLife may also pay your Intermediary compensation that is based upon your Intermediary placing and/or retaining a certain volume of business (number of Products sold or dollar value of premium) with MetLife. In addition, supplemental compensation may be payable to your Intermediary. Under MetLife's current supplemental compensation plan, the amount payable as supplemental compensation may range from 0% to 8% of premium. The supplemental compensation percentage may be based on: (1) the number of Products sold through your Intermediary during a prior one-year period; (2) the amount of premium or fees with respect to Products sold through your Intermediary during a prior one-year period; (3) the persistency percentage of Products inforce through your Intermediary during a prior one-year period; (4) premium growth during a prior one-year period; (5) a fixed percentage of the premium for Products as set by MetLife. The supplemental compensation percentage will be set by MetLife prior to the beginning of each calendar year and it may not be changed until the following calendar year. As such, the supplemental compensation percentage may vary from year to year, but will not exceed 8% under the current supplemental compensation plan. The cost of supplemental compensation is not directly charged to the price of our Products except as an allocation of overhead expense, which is applied to all eligible group insurance products, whether or not supplemental compensation is paid in relation to a particular sale or renewal. As a result, your rates will not differ by whether or not your Intermediary receives supplemental compensation. If your Intermediary collects the premium from you in relation to your Products, your Intermediary may eam a return on such amounts. Additionally, MetLife may have a variety of other relationships with your Intermediary or its affiliates that involve the payment of compensation and benefits that may or may not be related to your relationship with MetLife (e.g., consulting or reinsurance arrangements). More information about the eligibility criteria, limitations, payment calculations and other terms and conditions under MetLife's base compensation and supplemental compensation plans can be found on MetLife's Web site at www.metlife.com/brokercompensation. Questions regarding Intermediary compensation can be directed to ask4met@metlifeservice.com, or if you would like to speak to someone about Intermediary compensation, please call (800) ASK 4MET. In addition to the compensation paid to an Intermediary, MetLife may also pay compensation to your MetLife sales representative. Compensation paid to your MetLife sales representative is for participating in the sale, servicing, and/or renewal of Products, and the compensation paid may vary based on a number of factors including the type of Product(s) and volume of business sold. If you are the person or entity to be charged under an insurance policy or annuity contract, you may request additional information about the compensation your MetLife sales representative expects to receive as a result of the sale or concerning compensation for any alternative quotes presented, by contacting your MetLife sales representative or calling (866) 796-1800. L0514374339[exp0615][AllStates] RESOLUTION NO. 3177 WHEREAS, Ordinance No. 13178 adopted December 9, 2010, authorized the Executive Director and Secretary -Treasurer on behalf of The Metropolitan St. Louis Sewer District to enter into a contract with MetLife Life Insurance Company, for the District's Employee Group Life and Accidental Death & Dismemberment Insurance, and WHEREAS, said contract will expire on January 31, 2015, and WHEREAS, the District desires to exercise the District's option to renew said contract for an additional one-year term, commencing on February 1, 2015, NOW, THEREFORE, BE IT ORDAINED BY THE BOARD OF TRUSTEES OF THE METROPOLITAN ST. LOUIS SEWER DISTRICT THAT, the Executive Director and Secretary -Treasurer are hereby authorized on behalf of The Metropolitan St. Louis Sewer District to exercise the District's option to renew for an additional one-year term commencing on February 1, 2015, the contract with MetLife Life Insurance Company, administer the District's Employee Group Life and Accidental Death & Dismemberment Insurance, said contract renewal shall be comprised of such terms and conditions as are approved by the office of the General Counsel of the District. The foregoing Resolution was adopted on November 13, 2014.