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Aetna Life Insurance Company
LIFE INSURANCE PROGRAM REVIEW
FOR
City of Sanford
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Prepared by: Group Insurance Department
Date: June 14, 2004
151 Farmington Avenue Robert Rosevear
Hartford, CT 06156
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Xiketna: Group Insurance, RT42
Aetna Life Insurance Company
June 15, 2004
City of Sanford
Attention: Joyce Riggins -McCoy
300 N. Park Avenue
Sanford, FL 32771
RE: Group Insurance Policy — 813265
We have completed a review of your benefit plan in order to determine the appropriate funding
level for the October 1, 2004 to October 1, 2005 policy period.
The experience results under your prospectively rated Term Life, Supplemental Life, Retiree Life,
Accidental Death & Dismemberment and Supplemental Accidental Death & Dismemberment
coverages have been favorable and therefore we will continue the existing rates for the 2004
policy period.
Your current rates will continue effective October 1, 2004 and will remain in effect, while the
policy remains in force and in the absence of any plan revisions, change in participation, or other
material change in the conditions under which your plan operates until the next policy
anniversary.
Please contact Deborah Trager in our Orlando office if you have any questions or require any
additional information on the contents of this package.
Sincerely,
IZpbert Rosevear
Robert Rosevear
Underwriting Analyst
Aetna Life Insurance Company
10/1/04 - 10/1/05 Life Evaluation
Program Description
Plan Demographics & Rates (Active census as of 5104)
Aetna Life Insurance Company
City of Sanford
PH No. 813265
Total Active Lives:
All active full -time employees
533
Total Employee volume:
$21,128,000
Average Volume per employee:
up if $500 or above
$39,640
Funding arrangement:
Prospective
Plan Rate:
Basic Term Life
$0.225/$1,000
deemed by the employer
Retiree Life
$2.73/$1,000
Accelerated Death Benefit
Supp. Life
$0.28/$1,000
payment option, $100,000 maximum
AD &D
$0.035/$1,000
Su pp. AD &D
$0.045/$1,000
Term Life Plan Design
Eligibility:
All active full -time employees
Benefit:
Class I : 1X annual rate of basic earnings
rounded down if under $500 and rounded
up if $500 or above
Class II : City Officials: 1 X annual rate of
basic earnings rounded to the next $1,000
Class III Retirees existing and future as
deemed by the employer
Disability Provision:
Premium Waiver 60
Accelerated Death Benefit
Terminal illness period - 12 months. 50%
payment option, $100,000 maximum
Age Reduction Rule:
Reduced to 65% at age 65; 40% at age 70
and 25% at age 75.
Retirement Rule:
$3,000
same as life
All active full time employees
Increments of $10,000 to a $100,000
maximum
Premium Waiver 60
Provision: Terminal illness period — 12 months. 50%
ad Death Benefit: payment option, $100,000 maximum
Benefit Exhibit 06/15/04
Pagel
/05 Life
Heduced to 65% at age 65, 40% at age
and 25% at age 75.
Same as Supplemental Life
Benefit Exhibit 06/15/04
Paget