R-2021-238 - 9/9/2021RESOLUTION NO. R=2021=238
WHEREAS, the City of Round Rock (the "City") has duly advertised for proposals for
40
employee vision benefits commencing January 1, 20221P9 and
WHEREAS, Community Eye Care, LLC ("Community Eye Care") has submitted a proposal
to provide said services, and said proposal has been determined to be the most advantageous to the
City considering the price and other evaluation factors included i*n the request for proposals; and
WHEREAS, the City Council desIs
ires to accept the proposal of Community Eye Care and
authorize the Mayor to execute a Vision Services Agreement and other related documents required for
the implementation of said benefits, Now Therefore
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF ROUND ROCK,
TEXAS0
:
That the Proposal of Commun10 Is
ity Eye Care for provision of employee vision benefiitss hereby
accepted, as the proposal i*s determined to be the most advantageous to the City considering the price
40 and other evaluation factors included in the request for proposals.
That the Mayor is hereby authorized and directed to execute on behalf of the City the Vision
Services Agreement with Commiunty Eye Care and other related documents required for the
implementation of said benefits, a copy of such documents being attached hereto as Exhibit "A" and
incorporated herein for all purposes.
The City Council hereby finds and declares that written notice of the date, hour, place and
subject of the meeting at which this Resolution was adopted was posted and that such meeting was
40
open to the public as required by law at all times during which this Resolution and the subject matter
hereof were discussed, considered and formally acted upon, all as required by the Open Meetings Act,
Chapter 551, Texas Government Code, as amended.
011220212;00480317
RESOLVED this 9th day of September, 2021.
1A /0/
CRAIG M RGAN ayor
City of Round Roc , Texas
ATTEST:
J
a4
SARA L. WHITE, City Clerk
COMMUNITY EYE CARE, LLC
VISION SERVICES AGREEMENT
Employer: City of Round Rock
Address: 231 E. Main St., Ste. 100
City: Round Rock
Fax: 512-682-8766
State: TX Lie: 78664
E-mail: tjarl@roundrocktexas.gov
Primary Contact: Tyler Jarl, Benefits Manager
EXHIBIT
"A„
Telephone: 512-341-3143
1
Tax ID#: 74-6017485 Total Benefit Eligible Employees: 992 Effective Date: l/l/2022
This vision services agreement is made and entered into by and between Community Eye Care, LLC, a
vision benefits company with its principal office located in Charlotte, North Carolina (hereinafter referred
to as "CEC"), and City of Round Rock, a group located in Round Rock, Williamson County, Texas.
RESPONSIBILITIES OF CEC. For the duration of this agreement, CEC shall:
• Administer the routine vision benefit outlined in Schedule 1 (Benefit and Rates).
• Maintain an up-to-date database of member eligibility.
• Invoice City of Round Rock once per month, based on the most current eligibility file.
• Maintain an adequate network of credentialed providers.
• Credential participating providers in accordance with NCQA standards.
• Manage claims processing and claims payment in an accurate and timely manner.
• Manage member services related to the CEC vision plan.
RESPONSIBILITIES OF City of Round Rock. For the duration of this agreement, City of Round
Rock shall:
• Offer the CEC vision plan to its employees as a shared contribution benefit.
• Offer the CEC vision plan to its retirees as a retiree contribution benefit (no employer
contribution).
• Periodically transfer accurate enrollment data to CEC.
• Payroll deduct on behalf of CEC vision employee enrollees, and forward the deducted
amounts to CEC once per month.
• Direct bill on behalf of CEC vision retiree enrollees, and forward the collected amounts to
CEC once per month.
• Include CEC plan descriptions in all appropriate City of Round Rock communications to
employees and retirees (e.g., benefits guides, informational mailings, etc.). Certificate of
insurance will be available upon request.
BILLING. CEC will generate invoices by the 8th business day of each month. The invoices are made
available on CEC's Benefits Managers Portal, which can be accessed at www.cecvision.com on the Benefits
Managers page. CEC will send an email notification when the invoices are ready to be viewed online.
Please provide City of Round Rock billing contact information below.
Billing Contact: Tyler larl, Benefits Manager
Telephone: 512-341-3143
E-mail: tjarl@roundrocktexas.gov
Billing Address /if derent from company addressZ
QW.
State:
PERFORMANCE STANDARDS. CEC will administer the City of Round Rock vision plan in accordance
with industry standards. Should City of Round Rock identify any issues related to CEC's performance of
its duties, City of Round Rock will bring these to the attention of CEC, and CEC will take steps to resolve
the issues. Both CEC and City of Round Rock agree that deficiencies in service or other administrative
functions should be addressed promptly and that reasonable attempts should be made to achieve satisfactory
resolution within 60 days or less.
TERM. This agreement becomes effective on January 1, 2022 and will remain in effect for an initial term
of twelve (12) months. It will automatically renew on each anniversary date for a similar term until such
time as it is terminated in writing by City of Round Rock. In the absence of serious and persistent
perfonnance issues, this contract cannot be terminated at any time during a twelve (12) month benefit cycle.
However, if City of Round Rock wishes to terminate the CEC vision plan at the end of a twelve (12) month
benefit cycle, the group may do so by providing 30 days' prior written notice to CEC.
COMPLIANCE WITH LAWS. CEC and the City of Round Rock shall comply with all applicable federal
and state laws. In accordance with Chapter 2271, Texas Government Code, a governmental entity may not
enter into a contract with a company for goods and services unless the contract has written verification from
the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract.
The signatory executing this Agreement on behalf of CEC verifies that CEC does not boycott Israel and
will not boycott Israel during the term of this Agreement.
CEC: City of Round Rock:
By: �� _ . f� Vi �}1 i �� By:
Title: General Manager _ Title:
Date: Auaust 27.2021 Date:
Schedule 1—Benefit and Rates
The routine vision benefit offered by CEC to employees and retirees of City of Round Rock consists of:
One routine eye examination every 12 months ($10 co -pay)
A $225 allowance for eyewear every 12 months ($10 co -pay)
A contact lens fitting, re -fit or evaluation every 12 months ($10 co -pay)
The allowance can be applied to frames, spectacle lenses, contact lenses, special lens options,
or any combination. So long as the member selects eyewear having a retail price that's
less than or equal to the allowance, they incur no out-of-pocket expense for eyewear at the time
of service except for the eyewear co -pay. if the selected eyewear has a retail price that exceeds
$225, the member is responsible only for the balance (i.e., retail minus $225), plus the eyewear
co -pay. In addition, for the purchase of glasses (frames and/or lenses), members who exceed their
allowance are eligible at most CEC network providers for a 20% discount on the balance. For
the purchase of contact lenses, members who exceed their allowance are eligible at most CEC
providers for a 10% discount on the balance.
The monthly rates are as follows:
Employee Only $5.85
Employee + Spouse $9.95
Employee + Child(ren) $10.53
Employee + Family $15.62
The above rates are guaranteed for three years (36 months), starting with an effective date of
1 / 1 /2022.
The CEC vision plan will be offered to employees as a pre-tax benefit,
with payment handled through payroll deduction. Retirees will be direct billed by the City's
designated third -party billing administrator.
Services received from an out -of -network provider will be reimbursed as follows:
Exam: Up to $50 minus any applicable co -pay
Eyewear: Up to 85% of the allowance minus any applicable co -pay
Contact Lens Fitting, Re -Fit or Evaluation: Up to $48 minus any applicable co -pay
NOTES
♦ The CEC vision plan applies solely to routine eye examinations and the purchase of eyewear. The
following are not covered under the plan: a) medical eye care, b) surgical eye care, C) low vision
services, d) emergency eye care.
♦ Benefits may not be carried forward to a subsequent benefit period.
♦ Coordination of benefits is not permitted.
♦ Existing employees and eligible dependents can enroll and/or make changes only during the company's
annual open enrollment period (unless a qualifying event occurs). New employees are permitted to enroll
mid -cycle during their new hire period (within 30 days after their hire date).
♦ Family coverage includes the employee or retiree, spouse and any children. Children must be under 26
years old.
♦ Vision benefit coverage will remain in effect for a minimum of twelve (12) months (or, with respect to
new employees who enroll mid -year, until the next renewal date). Covered members aren't permitted to
terminate coverage prior to the next open enrollment period unless: a) the employee is terminated from
employment, or b) the employee has undergone a qualifying event. At the time of open enrollment,
vision coverage will automatically renew unless voluntarily terminated by the employee.
♦ Enrollments are effective on the first of the month. Enrollments must be submitted by the 5th in order
to be included on that month's invoice. Any enrollment submitted after the 5th will be included on the
next month's invoice, and that member will become effective on the 1st day of the next month.
♦ Terminations are effective on the last day of the month. Terminations must be submitted by the 5th for
the member to be removed from that month's invoice. If submitted after the 5th, the member will still
be listed on that month's invoice, and the member's termination won't take effect until the last day of
that month.
♦ Agent of Record Change: If there is an Agent of Record for vision, and if that agent is terminated by
City of Round Rock, City of Round Rock should notify CEC at least 30 days prior to the termination
date. For a newly retained agent, CEC should be notified at least 30 days prior to the effective date.
♦ CEC vision plan members whose employment with City of Round Rock becomes terminated will be
given the option of continuing their vision coverage at the same rates that applied prior to termination of
employment. The administration of continued coverage will be entirely the responsibility of CEC. City
of Round Rock will retain no administrative or financial obligations whatsoever with respect to CEC
vision enrollees who are no longer employed by the group.
(CA companion Life
COMPANION LIFE INSURANCE COMPANY
P.O. Box 100102, Columbia, South Carolina 29202-3102
(803)735-1251
(A stock insurance company, herein called the "Company")
will pay benefits according to the terms and conditions of this policy
Policyholder: Policy Number: Effective Date:
City of Round Rock CL CEC 00194 January 1, 2022
Policy Anniversary Date: Place of Delivery:
0 I io I Texas
In consideration of the application made by the Policyholder, and receipt of any and all premiums when due, Companion Life
Insurance Company agrees to provide the coverage described herein subject to all provisions of this Policy and any amendments
added to this Policy.
The Company may change the premiums if such change is in accordance with the laws and the regulations of the state that the
Policy is issued.
This Policy shall renew each Policy Anniversary Date unless terminated in accordance with the Termination of Policy provision.
The Entire Contract provision of this Policy determines all rights and benefits of persons who are insured hereunder.
TEN DAY FREE LOOK
The Company urges the Policyholder to examine this Policy closely. If the Policyholder is not satisfied with it, the Policyholder
may send it back to the Company or its Administrator for any reason within 10 days after the date the Policyholder receives it.
If returned, the Policyholder's insurance will be canceled, and any premium paid will be refunded in full.
THIS IS NOT A POLICY OF WORKERS' COMPENSATION INSURANCE. THE EMPLOYER DOES NOT
BECOME A SUBSCRIBER TO THE WORKERS' COMPENSATION SYSTEM BY PURCHASING THIS POLICY,
AND IF THE EMPLOYER IS A NON -SUBSCRIBER, THE EMPLOYER LOSES THOSE BENEFITS WHICH
WOULD OTHERWISE ACCRUE UNDER THE WORKERS' COMPENSATION LAWS. THE EMPLOYER MUST
COMPLY WITH THE WORKERS' COMPENSATION LAW AS IT PERTAINS TO NON -SUBSCRIBERS AND THE
REQUIRED NOTIFICATIONS THAT MUST BE FILED AND POSTED.
In witness whereto, Companion Life Insurance Company has caused this Policy to be signed and shall take effect on the Effective
Date specified above.
Signed for by the Company
7_:� , �1' i___
John Wilbur
President
GROUP VISION INSURANCE POLICY
OPTIONALLY RENEWABLE AS
DESCRIBED WITHIN
For service or questions about this Policy, please address any inquiries to CEC Vision 4944 Parkway Plaza Blvd, call 1-800-
736-7872 or via website www.companionlife.com
CL-V I S-1000-P-TX I (02,:20)
CEC Vision
SECTION I - TABLE OF CONTENTS
SECTION
TableofContants......................... ..........................................................................................]
ScheduleofBenefit.............................................................................................................. . .2
Prvmiums.. .............................................................................................................................3
QenerMPrOVi$ions....................... ................ ............................... .,......................... ................. a
CL-VIS-1000-P-TX 2 (02i20)
CEC Vision
SECTION 2 - SCHEDULE OF BENEFITS
The Schedule of Benefits for this Policy as listed below is shown in the Certificate.
The Schedule of Benefits will control the:
1) benefit amounts and maximum limits;
2) eligibility and Effective Date requirements; and
3) other schedule amounts and limits.
CL-VIS-1000-P-TX 3 (01-20)
CEC Vision
SECTION 3 - PREMIUMS
Monthly Premium Rates
The first premium is due and payable on the Policy Effective Date. Subject to this Policy's grace period provision, all premiums
after the first premium must be paid when or before they are due.
Grace Period
After the first premium is paid, the Company will allow the Policyholder no less than a 31-day grace period for the payment of
all premiums. During this grace period, this Policy will stay in force. If the premium due is not paid by the end of the grace
period, this Policy will terminate on the last day of the grace period. If the Policyholder gives the Company written advance
notice of an earlier cancellation date, this Policy will terminate on the earlier date. Premium is due for each day this Policy is in
force. The Policyholder is liable for the premium due for coverage through the grace period.
Premium Payments
Premium payments are due and payable in full to a place designated by the Company, or with respect to the initial premium
payment, premium payments may be made to an authorized agent of the Company.
If any insurance is added, increased, or becomes effective after this Policy is in force, the premium charges will begin on:
1) the day the coverage is effective, if it is also the first day of a Policy month; or
2) the first day of the next Policy month.
For insurance which is terminated, premium charges will stop as of the first day of the next Policy month.
Premiums may be calculated by any other method which both the Company and the Policyholder agree to in writing.
Premium Chances
We have the right to change the premium We charge. If We plan to make a change, We will send a notice to the Policyholder's
last address on record at least 60 days before the date of change.
CL-V IS-1000-P-TX 4 (02120)
GEC Vision
SECTION 4 -GENERAL PROVISIONS
Entire Contract
The contract between the parties consists of:
I ) this Policy;
2) the application of the Policyholder, which is made a part of this Policy when issued;
3) the Certificate;
4) any endorsements, amendments, or riders; and
5) the enrollment forms, if any, of each Insured.
All statements made by the Policyholder and Insured shall be deemed representations and not warranties, and no statement made
by the Policyholder or an Insured shall void the insurance or be used in defense to a claim hereunder unless a copy of the
instrument containing such statement is , signed by the Insured or the Policyholder, and has been furnished to the Policyholder
or Insured. If the Insured dies or becomes incapacitated, such statement will be provided to the Insured's beneficiary, if any.
Chanae in This Policy
The Company reserves the right to make changes in this Policy. The Company will give the Policyholder 31 days' advance
written notice of any change other than a change of premiums. No agent has authority to change or waive any part of this Policy.
To be valid, any change or waiver must be in writing on company letterhead and/or email, approved by one of Our officers: (1)
the President; (2) a Vice President; or (3) the Secretary. The approval must be endorsed on or attached to this Policy.
Clerical Error
Clerical errors or delays in keeping records for this Policy:
1) will not deny insurance which would otherwise have been granted;
2) will not continue insurance which otherwise would have ceased; and
3) may call for an adjustment of premium or benefits to correct the error.
Certificates
The Company will supply individual Certificates for each Insured. The Certificate will describe:
1) the insurance benefits;
2) to whom benefits will be paid;
3) any limitations of this Policy; and
4) all other essential features of this Policy.
If more than one Certificate is issued under this Policy to an Insured, only the last one issued will be in effect.
If requested, the Certificates will be provided electronically at no additional cost.
Misstatement of Aee
If the date of birth or age of any Individual Insured has been misstated, an adjustment of premium will be of an amount that the
premium paid would have purchased at the correct date of birth or age.
Lezal Action
No legal action can be brought against Us until at least 60 days after the Insured sends Us the required proof of loss. No such action
may be brought against Us after three years after proof of loss is required.
Conformity with State Laws
If any provision of this Policy is contrary to the law of the jurisdiction in which it is delivered, such provision is hereby amended
to conform to that law. If any change to state or federal law affects the Company's liability under this Policy, the Company may
change this Policy, the premiums or both.
Such change:
1) wi Il be effective as of the date of change to the state or federal law; and
2) will not be made until the Company gives the Policyholder 31 days' notice.
Incontestability
The validity of this Policy cannot be contested after two years from its date of issue, except for nonpayment of premiums. After
coverage for an Insured Individual has been in force for two years, the Company cannot: (a) void the coverage; or (b) deny a
claim for loss that starts after the two-year period, because of statements in the application unless they were fraudulent
misstatements.
CL-VIS- 1000-P-TX (02.20)
CEC Vision
Nothing herein should be construed to prevent the Company from denying any claim on the basis that an individual was not
eligible for coverage.
Not in Lieu of Workers' Compensation
This Policy is not in lieu of and does not affect any requirement for coverage by workers' compensation insurance.
Termination of Policy
The Company may terminate this Policy for the following reasons by giving the Policyholder 31 days written notice:
1) the Policyholder fails to furnish any information which the Company may reasonably require;
2) the Policyholder fails to perform any of his other obligations pertaining to this Policy; or
3) less than 100% of the persons eligible for non-contributory coverage are insured.
This Policy will terminate, subject to the grace period, if any premium is not paid when due.
Termination of this Policy under any conditions will not prejudice any payable claim which occurs while this Policy is in force.
The Policyholder or the Company may terminate this Policy by giving the other party at least 3 I days prior written notice.
Terminations may take effect on an earlier date when both the Policyholder and the Company agree.
Data to be Furnished
The Policyholder, or any other person designated by the Policyholder, will give the Company all information the Company needs
regarding matters pertaining to the insurance. At any reasonable time while this Policy is in force and for 12 months after that,
the Company may inspect any of the Policyholder's documents, books, or records which may affect the insurance or premiums
of this Policy.
The Policyholder will, upon Our request, give Us:
I ) the names of all persons initially eligible for coverage;
2) the names of all additional persons who become eligible for coverage;
3) the names of all persons whose insurance is to be changed;
4) the names of all persons whose eligibility or insurance is terminated; and
5) any data necessary to administer the insurance provided by this Policy.
If the Policyholder gives the Company any incorrect information, the relevant facts will be determined to establish if insurance
is in effect.
No person will be deprived of insurance to which he is otherwise entitled or have insurance to which he is not entitled because
of any misstatement of fact by the Policyholder. Any required adjustment may be made in premiums or benefits.
Right to Audit
The Company reserves the right to audit the Policyholder's billing records and premium accounting practices. If the Company
discovers:
1) an underpayment of premium by the Policyholder, the Policyholder will be obligated to remit the underpayment amount
in a timely manner; or
2) an overpayment of premium, the Company will return any overpayment amount in a timely manner for the previous
two-year period.
Time Period
All periods begin and end at 12:01 A.M., standard time, at the Policyholder's address.
Addition of New Employees
New Employees may be added to this Policy when they become eligible for coverage.
CL-V IS-1000-P-TX [3 (02.20)
CEC Vision