CM-2024-234 - 9/13/2024Texas Legal,
1. Group Annual Renewal Information
Organization/Business Name: City of Round Rock
Date organization joined Texas Legal: 12/1/2000
Contact Name: TylerJarl
Address: 221 E Main
Round Rock, TX 78664
Agency Name: N/A
2. Enrollment and Plan Year Information
GROUP ANNUAL
RENEWAL AGREEMENT
Texas Legal Group Plan Number: 2000-103
Renewal Terms: 1/1/2025-12/31/2027
Office Phone: (512) 218-5490
Fax Number: (512) 218-5493
Email: tjarl@roundrocktexas.gov
Account Manager: Henry Pena Jr
Enrollment refers to the time frame an employee may enter the Plan. Many Groups elect to establish an open or rolling enrollment
while others establish a specific window of time when employees are only permitted to enroll. Plan Year refers to the beginning and
ending (renewal) of the consecutive 12 month period of membership. Groups have the option of establishing their Plan Year and
enrollment terms as they see fit.
Your organization's enrollment is currently: Your organization's Plan Year is currently:
January —December January —December
Employees may enroll anytime Benefits renew each January
3. Membership Dues/Premiums
Texas Legal membership dues/premiums billed directly to the organization as collected through payroll deduction or direct bile to
employee. Pursuant to the Certificate of Coverage, Texas Legal retains the right to increase premiums charges at plan renewa', not to
exceed 10% per year. Texas Legal will notify you through electronic or written communication at least thirty-one (31) days prior to any
change in premium rates. (Please select the desired ootfons below.l
PAYROLL RATES:
(X) SELECT Composite: $13.00
(X) PREFERRED Composite $18.00
4. Education and Membership Services
Texas Legal encourages Groups to schedule routine, if not annual, membership visits to ensure members are kept educated about the
Plan. Members may also stay connected to Texas Legal by subscribing to the monthly e-newsletter, frequently visiting the website and
other social media outlets for news and updates. Texas Legal organizes legal clinics, seminars, webinars and other membership events
and meetings all designed to help educate members on various legal issues and how they relate to the Texas Legal membership.
Please contact Texas Legal for more information.
S. Agreement
I am signing, on behalf of the above named organization/business to renew the Group's annual membership. I acknowledge no changes
have been made to our membership, unless indicated above, and agree to continue making the legal benefits available to employees
and affiliates of such organization under the agreed upon terms. Please return the completed form to Texas Legal at email address
dygnacio@texaslegal.org or fax to 512-327-0163.
Volunteers, Members, etc. Count: 238 Total if of Employees: 1,110
Name: Laurie Hadley Title: City Manager
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Signature:, J 1�, Date:
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