nr~nER ra~~ ,~~=~~~ar
AF'F='~0'JAL OFD HEALTH IhdSURAhdCE RENEWAL
l,! I TH E h1~'I_L7YEE BENEF 11" AI~t~I I N I S1"RATaRS
C)n this d~-~y the :7th d~-~y of LJCt OI]er, x.3'37 ~_tpon motion made by
Commissioner L_et ~ sec_onded by Commis:~i~:~ne~^ Lac_I~ey, i;he Ca~_~r~t
~_tnanimo~asly approved by a vote of 4-~-~, the Health Ins~_trar~ce
renewal with Employee F~enefit Administrators and a~_~thorize
Co~_tnty ,7~_~dge i;o siyn statue.

COMMISSIONERS' COURT AGENDA REQUEST
PLEASE FURNISH ONE ORIGINAL AND FIVE COPIES OF THIS REQUEST AND DOCUMENTS
TO BE REVIEWED BY THE COURT.
MADE BY:
Barbara Nemec
OFFICE:
Treasurer
MEETING DATE: oc t 2 7, 19 9 7 TIME PREFERRED: A' M
SUBJECT: (PLEASE BE SPECIFIC)
CONSIDER AND DISCUSS HEALTH INSURANCE RENEWAL WITH EMPLOYEE
BENEFIT ADMINISTRATORS.
EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON)
ESTIMATED LENGTH OF PRESENTATION: 5 min .
IF PERSONNEL MATTER -NAME OF EMPLOYEE:
NAME OF PERSON ADDRESSING THE COURT: Bryan Finley
Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5,
Chapter 551 and 552, Government Code, is as follows:
Meeting scheduled for Mondays:
THIS REQUEST RECEIVED BY:
THIS REQUEST RECEIVED ON:
5:00 P.M. previous Monday.

All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has
been prepared for the Court's formal consideration and action at time of Court Meetings. Your cooperation will
be appreciated and contribute towards you request being addressed at the earliest opportunity. See Agenda
Request Rules Adopted by Commissioners' Court.
OCT 2B '9? 03~~IPM
E~PLC~YEE B~~rr A~,=~~~o~s, 3=c.
(il[~NBSD 7'HtAD PARTY AbllllNlSi'ftATO~
October 2D, 1997
TOs Barbara Nemec
Treasurer
KERB C4UNTX
Re: Renewal rates for your group medi,aal plan
effective November 1, 1997
r.l
We wi17. present a formal renewal quote to yvu on ~vednesday,
October 22, 1997 for your presentation to the Court.
Sincerely,
Dฎnnis L. SurkY~dlder
b800P~Teo$1nd,#t?S-Wet Sm.'t'x 782t3 (2t~738-tM4-(Zt0~738-t4488uc

BEST LIFE ASSURANCE COMPANY
OF CALIFORNIA
~, ~•
.- ~~~
0
~~,:~ ~~
Mr. Dennis Burkholder
Employee Benefit Administrators, Inc.
6800 Park Ten Blvd., Suite 175 West
San Antonio, Texas 78213
Re: KERR COUNTY
Dear Dennis:
BH-2805 BL-2771
The renewal date for the above referenced group is November 1, 1997. Our Specific
and Aggregate Excess Risk renewal offer based on 224 employees and 44 dependent
units is as follows:
	Current	Renewal
I Specific Level:	$ 25,000 *	$ 25,000 *
' Contract	15/12	Paid
Employee Rate	$ 32.65	$ 32.65
Dep. Unit Rate	$ 43.20	$ 43.20
Aggregate:			
Contract	15112		Paid
Employee Factor	$ 164.85	$	164.85
Dep. Unit Factor	$ 238.47	$	238.47
j Agg. Premium	$ 2.64	$	2.64
Accum. Mo. Accom./Mo./EE	$ .67	$	.67
" A separate $60,000 Specific Deductible will continue on Sylvia Rogers (only
$25,000 will be applied to the Aggregate.)
Life Rate (per $1,000) $ .29 $ .29
AD&D Rate (per $1,000) $ .05 $ .05
The Life/AD8~D renewal based on the current schedule. The Life/AD&D volume is
$2,219,000 with 224 employees participating.
Commissions for the above rates are set at:
Life/AD8~D 15D/o~~ific 10% and Aggregate 10%.
~~,, ~ Jl
_ P.O. BOX 19721 • IRVINE, CA 92 623-9 72 1 •2505 McCABE WAY • IRVINE 92614
(714) 253-4080 • FAX (7 i 4) 222-1004
~ BEST LIFE ASSURANCE COMPANY OF CALIFORNIA
P.O. BOX 19721
!RVlNE, CA 92713-9721
RENEWAL ACCEPTANCE FORM
Renewal Period From 11- 01- 9 7 To 11- 01- 9 8
Renewal Action For KERR COUNTY
Third Party Administrator EMPLOYEE BENEFIT ADMINISTRATORS
Life Rate • 29 /Per $1,000 AD&D Rate • 05 /Per $1,000 Dep. Life Rate N A /Per Dependent Unit
SPECIFIC EXCESS RISK: CONVERSION OPTION:
Contract Incurred i~ Included
J Incurred & Paid :~' Excluded
'~ Incurred in 12 Months, Paid in 15 Months
'~~' Paid
Attachment Point $
Employee Rate $ 32.65
Dependent Rate $ 43.20
(Additional)
AGGREGATE EXCESS RISK':
Contract x Paid Basis ~ Incurred and Paid
Monthly Loss Fund Factor $ 164.85 Per Employee $ 238.47 Per Dependent Unit
Expenses Covered ~ Medical ~.' Dental Vision ~Rx Plan -Other
Aggregate Premium $ Annual $ 2 • 64 Mo. Per Employee
Term. Liability Factor $ Per Employee $ N/A Per Dependent Unit
Accum. Mo. Agg. Option $ Annual $ • 67 Mo. Per Employee
=NOTE: The Minimum Annual Attachment Point will be based upon the enrollment of the first Policy Month for each Policy Year.
Witness (Agent or Designated TPA)Ttle
Witness Signature/Date
(Revised 1/95)
The renewal action is accepted as shown.
• CLIE NT Kerr County Renewal Effective 11/1/97
PLAN "A" $x'00.00 Deductible
Life/AD&D
__ _~_~4 per $10 0 0
( ~~Q,QQg Per Employee )
Dependent Life Premium
(Available)
Specific Premium
Aggregate Premium
Accommodation Fee
Claims Adjudication Fee
~~~~~~ Fee-Hippa/Cobra
Dental, Aggregate
(If applicable)
Total Fixed Costs
Self-Funding Premium
(Attachment Factor)
TOTAL PREMIUM
OPTIONAL BENEFITS PREMIUM
RX CARD BENEFIT (Included)
DENTAL BENEFIT
~ ~,
EO	EC	ES	EF
3.40	3,40	3,40	3.40
32,65	75.85	75.85	75.85
2.64	2.64	2.64	2.64
.67	.67	.67	.67
11.00	11.00	11.00	11.00
1.00	1.00	1.00	1.00
			
			
51.36	94.56	94,56	94,56
177.00	261.00	333.00	408.00
228.36	355.56	427.56	502.56
TOTAL MONTHLY PREMIUM 228.36 355.5b 427.56 502.56.
WITH OPTIONAL BENEFITS
(If applicable to group)
Group Census Info Month7,y Self-Fundinq Annual Self-Fundin
Retirees 756.00 9,072.00
E O 1 7 7 E S _1~__-
$ 44,490.00 $ 533,880.00
EC 26 EF 8
Life Or~J,y 3 MONTHLY BILLING FEE 25.00
Retirees EONS 1 TOTAL MONTHLY PREMIUM 58, 548.88
No. on Alternate Plan
Alternate Plan Premium
.. ~ K r Co to y
PREMIUM COST ANALYSIS
MAJOR MEDICAL PLAN
Life/AD&D Premiums
$ 2,210,.000 Volume
at ,34 per $1000
Dependent Life
$ X Units
SPECIFIC PREMIUM
172 Single @ $ 32.65
46 Family @ $ 75.85
AGGREGATE P12EMIUNI
218 Emp . @ $ 2.64
ACCOMMODATION FEE
218 Emp . @ $ . 67
CLAIMS ADJUDICATION FEES
225 Emp . @ $ 11.00
225 COBRA @ $ 1.00
F; Hippa
BROKERAGE FEES
Emp. @ $
UTILIZATION REVIEW FEES
Emp. @ $
RX CARD FEES
Emp. @ $
BILLING & ADMINISTRATIVE FEE
TOTAL FIXED COSTS
= 5,615.80
= 3,489.10
SELF-FUNDING RESERVES
172 Employee Only @ 177.00
12 Employee/Spouse @ ~~3_.nn
2h Employee/Children @ 261.00
~ Employee/Family @ 408.00
6 Retiree only @ 93.00
1 Retiree and Spouse 198.00
TOTAL MONTHLY PREMIUM COST
ANNUAL COST OF PLAN (Monthly X 12)
Fixed Costs 159,634.56
Self-Funding _542,952.00
702,586.56
751.40
n/a
9,104.90
575.52
146.06
2,700.00
n/a
n/a
n/a
25.00
13,302.88
45,246.00
58,548.88
Order No. 25085
Approval of Health
Insurance Renewal
with Employee Benefit
Administrators
October 27, 1997
Vol V Page 454