ANNUAL DENTAL RENEWAL INFORMATION (2)Public, Hospital and Labor Union Sectors
October 22, 2013
City of Clearwater
Human Resources
Mr. Allen DelPrete, Manager
100 South Myrtle Ave; First Floor
Clearwater, Florida 33756
Dear Mr. DelPrete:
As a valued client of Humana Specialty Benefits, we would like to thank you for allowing Humana the opportunity
to provide the dental and vision benefits portion of the benefits package for City of Clearwater. Our goal is to
ensure that your employees and team members experience the highest quality service and benefits.
Humana is pleased to provide City of Clearwater with a 1 (one) year rate pass for your dental renewal; effective
1/01/2014. This renewal includes continuation of the dental current benefits. Confirmation of the dental renewal
rates and rate guarantees are as follows:
Dental Benefit Period: 1/01/2014, Rates Guaranteed through 12/31/2014
Dental Plan- CS-150
Current Monthly Premiums
Dental Plan —PPO
Current Monthly Premiums
Employee
$17.52
Employee
$39.30
Employee + One
$32.62
Employee + One
$79.66
Employee + Family
$42.46
Employee + Family
$117.44
Dental Plan- Advantage -AVF1
Current Monthly Premiums
Employee
$26.40
Employee + One
$49.18
Employee + Family
$64.02
Lastly, as part of our renewal process, please complete the acknowledgement below and return/fax a copy to me as
soon as possible. This will complete our documentation of the renewal process. Should you have any questions
regarding the renewal rates or benefits, please feel free to contact me at 813 - 287 -6136 or 813 -503 -3963.
Sincerely,
Nanaee MircganeEfi
Account Executive
Renewal Acknowledgement: We hereby acknowledge that we have received and reviewed the renewal listed
within this notification and agree with the terms of the renewal.
See Attached Signature Page W(3
Signed
Print Name
Date
Karole Mingarelli, Account Executive - Public Sector
4030 W. Boy Scout Blvd, Ste. 1000 1 Tampa, FL 33607 1 813.287.6136 jfax 813.465.7526
Countersigned:
— ctekyn<<c os
George N. Cretekos
Mayor
Approved as to form:
1
Leslie K. Doug. &des
Assistant City A ey
CITY OF CLEARWATER, FLORIDA
Attest:
William B. Horne II
City Manager
_ Attu
Rosemarie CaII
City Clerk