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AG 17-1151 1 RETURN TO: ie etit Nsia4 19, // EXT: oisag 1 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM ORIGINATING DEPT./DIV: /1/2 ORIGINATING STAFF PERSON: ,l it1) Sittel (..tq EXT: r 53 c 3. DATE REQ. BY: D /0G /7D/ ? TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E ❑ PUBLIC WORKS CONTRACT %PROFESSIONAL SERVICE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE ❑ CONTRACT AMENDMENT (AG #): ❑ OTHER .G., RFB, RFP, RFQ) ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ MAINTENANCE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION ❑ INTERLOCAL PROJECT NAME: kte Q,L f 'A e C�{ZtQ I�'� - 0701g l-1e a lfh plays Buda? jc cbD r NAME OF CONTRACTOR: /-%G4.1 4 e.4'e 1 &e)ua f - 1-L-C. ADDRESS: /4S7 9 /09fit 72-Nb 13. FAcll G1 A 98011 TELEPHONE '125- 939 - 7 it 9'1 E -MAIL: rburforllla G4tf . User) FAX: VAS -9 9 -0089 SIGNATURE NAME: ,. G . r $S,4 TITLE PRgSirf EXHIBITS AND ATTACHMENTS: X SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS TERM: COMMENCEMENT DATE: 0 9 /0 / %Q/ i COMPLETION DATE: /2/3 //474/ �I TOTAL COMPENSATION $ /2, Q0. 06 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES WNO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES WINO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDE PURCHASING: PLEASE CHARGE TO: 0. DOCUMENT /CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED 5-04-1100 - SSd -Si 7- 30 - 9/0 ❑ PROJECT MANAGER ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ LAW -rpm -41s1 t 1. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 2. CONTRACT SIGNATURE ROUTING SENT TO VENDOR/CONTRACTOR DATE SENT: 0/10-7/Ad/ +l DATE REC'D: / 13/P4 l 7 ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE (Include dept. support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.) ❑ LAW DEPARTMENT SIGNATORY (MAYOR OR DIRECTOR) ❑ CITY CLERK ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED INITIAL / DAT GNED / AG# " /' // J`— DATE SENT: a7 -/4 ;OMMENTS: ` CAN w'IYI;IL {�yAYL� t �[ rp'T�dl�(�A�1 C�►a� • CITY OF "�...- Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 535 -7000 PROFESSIONAL SERVICES AGREEMENT FOR HEALTHCARE ACTUARY This Professional Services Agreement ( "Agreement ") is made between the City of Federal Way, a Washington municipal corporation ( "City"), and Healthcare Actuaries, LLC, a Washington limited liability company, ( "Contractor "). The City and Contractor (together "Parties ") are located and do business at the below addresses, which shall be valid for any notice required under this Agreement: HEALTHCARE ACTUARIES, LLC: Roger T. Burton, FSA, MAAA, FCA 16519 107th Place NE Bothell, WA 98011 425- 939 -7444 (telephone) 425- 939 -0089 (facsimile) rburton nhcact.com The Parties agree as follows: CITY OF FEDERAL WAY: Ade Ariwoola, Finance Director 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -2520 (telephone) (253) 835 -2509 (facsimile) ade .ariwoolanacityoffederalway.com 1. TERM. The term of this Agreement shall commence upon the effective date of this Agreement, which shall be the date of mutual execution, and shall continue until the completion of the Services specified in this Agreement, but in any event no later than December 31, 2017 ( "Term "). This Agreement may be extended for additional periods of time upon the mutual written agreement of the Parties. 2. SERVICES. The Contractor shall perform the services more specifically described in Exhibit A ( "Services "), attached hereto and incorporated by this reference, in a manner consistent with the accepted professional practices for other similar services within the Puget Sound region in effect at the time those services are performed, performed to the City's satisfaction, within the time period prescribed by the City and pursuant to the direction of the Mayor or his or her designee. The Contractor warrants that it has the requisite training, skill, and experience necessary to provide the Services and is appropriately accredited and licensed by all applicable agencies and governmental entities, including but not limited to obtaining a City of Federal Way business registration. Services shall begin immediately upon the effective date of this Agreement. Services shall be subject, at all times, to inspection by and approval of the City, but the making (or failure or delay in making) such inspection or approval shall not relieve Contractor of responsibility for performance of the Services in accordance with this Agreement, notwithstanding the City's knowledge of defective or non - complying performance, its substantiality or the ease of its discovery. 3. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days' written notice at its address set forth above. The City may terminate this Agreement immediately if the Contractor fails to maintain required insurance policies, breaches confidentiality, or materially violates Section 12 of this Agreement. Termination for such conduct may render the Contractor ineligible for City agreements in the future. 4. COMPENSATION. 4.1 Amount. In return for the Services, the City shall pay the Contractor a fixed fee of Twelve Thousand and no /100 ($12,000.00) as delineated in Exhibit A. The Contractor agrees that the flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for the Term. PROFESSIONAL SERVICES AGREEMENT 1 3/2017 CITY Federal Way CITY HALL 33325 Sth Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 :r.:tt•eityoft deraht-ay_corn 4.2 Method of Payment. Following the completion of all services and submission to the City the final 2018 Self - Funded Health Plans Budget Project Report, the Contractor shall submit an invoice. Payment shall be made after the Services have been performed and within thirty (30) days following receipt and approval by the appropriate City representative of the invoice. If the Services do not meet the requirements of this Agreement, the Contractor will correct or modify the work to comply with the Agreement. The City may withhold payment for such work until the work meets the requirements of the Agreement. 4.3 Non - Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment under this Agreement for any future fiscal period, the City will not be obligated to make payments for Services or amounts incurred after the end of the current fiscal period, and this Agreement will terminate upon the completion of all remaining Services for which funds are allocated. No penalty or expense shall accrue to the City in the event this provision applies. 5. INDEMNIFICATION. 5.1 Contractor Indemnification. The Contractor agrees to release, indemnify, defend, and hold the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers harmless from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, taxes, losses, fines, fees, penalties expenses, attorney's fees, costs, and /or litigation expenses to or by any and all persons or entities, including, without limitation, their respective agents, licensees, or representatives; arising from, resulting from, or in connection with this Agreement or the acts, errors or omissions of the Contractor in performance of this Agreement, except for that portion of the claims caused by the City's sole negligence. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, the Contractor's liability, including the duty and cost to defend, hereunder shall be only to the extent of the Contractor's negligence. Contractor shall ensure that each sub - contractor shall agree to defend and indemnify the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers to the extent and on the same terms and conditions as the Contractor pursuant to this paragraph. The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. 5.2 Industrial Insurance Act Waiver. It is specifically and expressly understood that the Contractor waives any immunity that may be granted to it under the Washington State industrial insurance act, Title 51 RCW, solely for the purposes of this indemnification. Contractor's indemnification shall not be limited in any way by any limitation on the amount of damages, compensation or benefits payable to or by any third party under workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties acknowledge that they have mutually negotiated this waiver. 5.3 City indemnification. The City agrees to release, indemnify, defend and hold the Contractor, its officers, directors, shareholders, partners, employees, agents, representatives, and sub - contractors harmless from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, losses, fines, fees, penalties expenses, attorney's fees, costs, and/or litigation expenses to or by any and all persons or entities, including without limitation, their respective agents, licensees, or representatives, arising from, resulting from or connected with this Agreement to the extent solely caused by the negligent acts, errors, or omissions of the City. 5.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement with respect to any event occurring prior to such expiration or termination. 6. INSURANCE. The Contractor agrees to carry insurance for liability which may arise from or in connection with the performance of the services or work by the Contractor, their agents, representatives, employees, or subcontractors for the duration of the Agreement and thereafter with respect to any event occurring prior to such expiration or termination as follows: PROFESSIONAI, SERVICES AGREEMENT 2 3/2017 �► CFederal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 mvvveltrnffederoiway. tom 6.1. Minimum Limits. The Contractor agrees to carry as a minimum, the following insurance, in such forms and with such carriers who have a rating that is satisfactory to the City: a. Workers' compensation and employer's liability insurance in amounts sufficient pursuant to the laws of the State of Washington. b. Professional liability insurance with limits no less than $1,000,000 per claim and $2,000,000 policy aggregate for damages sustained by reason of or in the course of operation under this Agreement, whether occurring by reason of acts, errors or omissions of the Contractor. 6.2. No Limit of Liability. Contractor's maintenance of insurance as required by this Agreement shall not be construed to limit the liability of the Contractor to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. The Contractor's insurance coverage shall be primary insurance with respect to the City. Any insurance, self - insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with Contractor's insurance. 6.3. Additional Insured, Verification. The City shall be named as additional insured on all commercial general liability insurance policies. Concurrent with the execution of this Agreement, Contractor shall provide certificates of insurance for all commercial general liability policies attached hereto as Exhibit C and incorporated by this reference. At the City's request, Contractor shall furnish the City with copies of all insurance policies and with evidence of payment of premiums or fees of such policies. If Contractor's insurance policies are "claims made," Contractor shall be required to maintain tail coverage for a minimum period of three (3) years from the date this Agreement is terminated or upon project completion and acceptance by the City. 6.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement. 7. CONFIDENTIALITY. All information regarding the City obtained by Contractor in performance of this Agreement shall be considered confidential and subject to applicable laws. Breach of confidentiality by the Contractor may be grounds for immediate termination. All records submitted by the City to the Contractor will be safeguarded by the Contractor. The Contractor will fully cooperate with the City in identifying, assembling, and providing records in case of any public records request. 8. WORK PRODUCT. All originals and copies of work product, including plans, sketches, layouts, designs, design specifications, records, files, computer disks, magnetic media, or material that may be produced or modified by Contractor while performing the Services shall belong to the City upon delivery. The Contractor shall make such data, documents, and files available to the City and shall deliver all needed or contracted for work product upon the City's request. At the expiration or termination of this Agreement, all originals and copies of any such work product remaining in the possession of Contractor shall be delivered to the City. 9. BOOKS AND RECORDS. The Contractor agrees to maintain books, records, and documents which sufficiently and properly reflect all direct and indirect costs related to the performance of the Services specified in this Agreement, and maintain such accounting procedures and practices as may be deemed necessary by the City to assure proper accounting of all funds paid pursuant to this Agreement. These records shall be subject, at all reasonable times, to inspection, review, or audit by the City, its authorized representative, the State Auditor, or other governmental officials authorized by law to monitor this Agreement. 10. INDEPENDENT CONTRACTOR. The Parties intend that the Contractor shall be an independent contractor and that the Contractor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. The City shall be neither liable nor obligated to pay Contractor sick leave, vacation pay, or any other benefit of employment, nor to pay any social security or other tax that may arise as an incident of this Agreement. Contractor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the Services specified in this Agreement and shall utilize all protection necessary for that purpose. All work shall be done at Contractor's own risk, and Contractor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the Services. PROFESSIONAL SERVICES AGREEMENT - 3 - 3/2017 CIry of �. Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 no- cifyaf /ederalmlycorn The Contractor shall pay all income and other taxes due except as specifically provided in Section 4 of this Agreement. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may provide a secondary or incidental benefit to the Contractor, shall not be deemed to convert this Agreement to an employment contract. If the Contractor is a sole proprietorship or if this Agreement is with an individual, the Contractor agrees to notify the City and complete any required form if the Contractor retired under a State of Washington retirement system and agrees to indemnify any losses the City may sustain through the Contractor's failure to do so. 11. CONFLICT OF INTEREST. It is recognized that Contractor may or will be performing professional services during the Term for other entities or persons; however, such performance of other services shall not conflict with or interfere with Contractor's ability to perform the Services. Contractor agrees to resolve any such conflicts of interest in favor of the City. Contractor confirms that Contractor does not have a business interest or a close family relationship with any City officer or employee who was, is, or will be involved in the Contractor's selection, the negotiation, drafting, signing, administration of this Agreement, or the evaluation of the Contractor's performance. 12. EQUAL OPPORTUNITY EMPLOYER. In all services, programs, activities, hiring, and employment made possible by or resulting from this Agreement or any subcontract, there shall be no discrimination by Contractor or its subcontractors of any level, or any of those entities' employees, agents, subcontractors, or representatives against any person because of sex, age (except minimum age and retirement provisions), race, color, religion, creed, national origin, marital status, honorably discharged veteran or military status, sexual orientation including gender expression or identity, or the presence of any disability, including sensory, mental or physical handicaps, unless based upon a bona fide occupational qualification in relationship to hiring and employment. This requirement shall apply, but not be limited to the following: employment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. Contractor shall comply with and shall not violate any of the terms of Chapter 49.60 RCW, Title VI of the Civil Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973, 49 CFR Parts 21, 21.5, and 26, or any other applicable federal, state, or local law or regulation regarding non- discrimination. 13. GENERAL PROVISIONS. 13.1 Interpretation and Modification. This Agreement, together with any attached Exhibits, contains all of the agreements of the Parties with respect to any matter covered or mentioned in this Agreement and no prior statements or agreements, whether oral or written, shall be effective for any purpose. Should any language in any Exhibits to this Agreement conflict with any language in this Agreement, the terms of this Agreement shall prevail. The respective captions of the Sections of this Agreement are inserted for convenience of reference only and shall not be deemed to modify or otherwise affect any of the provisions of this Agreement. Any provision of this Agreement that is declared invalid, inoperative, null and void, or illegal shall in no way affect or invalidate any other provision hereof and such other provisions shall remain in full force and effect. Any act done by either Party prior to the effective date of the Agreement that is consistent with the authority of the Agreement and compliant with the terms of the Agreement, is hereby ratified as having been performed under the Agreement. No provision of this Agreement, including this provision, may be amended, waived, or modified except by written agreement signed by duly authorized representatives of the Parties. 13.2 Assignment and Beneficiaries. Neither the Contractor nor the City shall have the right to transfer or assign, in whole or in part, any or all of its obligations and rights hereunder without the prior written consent of the other Party. If the non - assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. Subject to the foregoing, the rights and obligations of the Parties shall inure to the benefit of and be binding upon their respective successors in interest, heirs and assigns. This Agreement is made and entered into for the sole protection and benefit of the Parties hereto. No other person or entity shall have any right of action or interest in this Agreement based on any provision set forth herein. PROFESSIONAL SERVICES AGREEMENT - 4 - 3/2017 CITY o Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 wiww cit yoflederalwa y corn 13.3 Compliance with Laws. The Contractor shall comply with and perform the Services in accordance with all applicable federal, state, local, and city laws including, without limitation, all City codes, ordinances, resolutions, regulations, rules, standards and policies, as now existing or hereafter amended, adopted, or made effective. If a violation of the City's Ethics Resolution No. 91 -54, as amended, occurs as a result of the formation or performance of this Agreement, this Agreement may be rendered null and void, at the City's option. 13.4 Enforcement. Time is of the essence of this Agreement and each and all of its provisions in which performance is a factor. Adherence to completion dates set forth in the description of the Services is essential to the Contractor's performance of this Agreement. Any notices required to be given by the Parties shall be delivered at the addresses set forth at the beginning of this Agreement. Any notices may be delivered personally to the addressee of the notice or may be deposited in the United States mail, postage prepaid, to the address set forth above. Any notice so posted in the United States mail shall be deemed received three (3) days after the date of mailing. Any remedies provided for under the terms of this Agreement are not intended to be exclusive, but shall be cumulative with all other remedies available to the City at law, in equity, or by statute. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. Failure or delay of the City to declare any breach or default immediately upon occurrence shall not waive such breach or default. Failure of the City to declare one breach or default does not act as a waiver of the City's right to declare another breach or default. This Agreement shall be made in, governed by, and interpreted in accordance with the laws of the State of Washington. If the Parties are unable to settle any dispute, difference or claim arising from this Agreement, the exclusive means of resolving that dispute, difference, or claim, shall be by filing suit under the venue, rules, and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative process. If the King County Superior Court does not have jurisdiction over such a suit, then suit may be filed in any other appropriate court in King County, Washington. Each party consents to the personal jurisdiction of the state and federal courts in King County, Washington and waives any objection that such courts are an inconvenient forum. If either Party brings any claim or lawsuit arising from this Agreement, each Party shall pay all its legal costs and attorney's fees and expenses incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; however, nothing in this paragraph shall be construed to limit the Parties' rights to indemnification under Section 5 of this Agreement. 13.5 Execution. Each individual executing this Agreement on behalf of the City and Contractor represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original and with the same effect as if all Parties hereto had signed the same document. All such counterparts shall be construed together and shall constitute one instrument, but in making proof hereof, it shall only be necessary to produce one such counterpart. The signature and acknowledgment pages from such counterparts may be assembled together to form a single instrument comprised of all pages of this Agreement and a complete set of all signature and acknowledgment pages. The date upon which the last of all of the Parties have executed a counterpart of this Agreement shall be the "date of mutual execution" hereof. [Signature page follows] PROFESSIONAL SERVICES AGREEMENT 5 - 3/2017 4CITY OF kIXA. Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 wwwvc,tyoftederon :ay<com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY RAL AY: Jim 1, : yor DATE: 1// 5//7 HEALTHCARE ACTUARIES, LLC By: SedVAC. Printed Name: Ro ,&4- T. Bolt-ran) Title: P/Le -SzD$r DATE: u L y 7 2617 STATE OF WASHINGTON ) ) ss. COUNTY OF SN ATTEST: St ie Courtney, CMC, APPROVED AS TO FORM: y Clerk J. Ryan Call, City Attorney On this day personally appeared before me e QT . 'T�; ; Q { 7 a� , to me known to be the -PCZ 0 r-ry of k- A->+ L-n.; c PN-12___ TuP.�12-1 S that executed the foregoing instrument, and acknowledged the said instrument to be the free and voluntary act and deed of said limited liability company, for the uses and purposes therein mentioned, and on oath stated that he /she was authorized to execute said instrument. GIVEN my hand and official ,,ss�1111&, 11 ` NOTARY 's col PUBLIC seal this -1 day of _ L` 2011 Notary's signature Notary's printed name ,S, ,n _ Notary Public in and for the State of Washington. My commission expires 0 S PROFESSIONAL SERVICES AGREEMENT - 6 3/2017 EXHIBIT A ealthcare /144 ctuaries n lechnologv to Provitic Cost- Effective Consulting June 16, 2017 Jean Stanley Human Resources Manager 33325 8th Avenue South Federal Way, Washington 98003 16519 107th Place NE 1 Bothell, WA 98011 t (425) 939 -7444 1 f (425) 939 -0089 w www.HealthcareActuaries.com Re: 2018 Renewal Report Engagement Letter Dear Jean, This letter outlines the fees, the project plan, and the information required to complete a 2018 renewal report (funding projection) for the City of Federal Way. Our preliminary report will be ready by August 15; please let us know if this meets your needs. Project and Deliverables The purpose of this project is to provide an annual review of the City of Federal Way's healthcare budget and to provide a renewal report for the 2018 plan year. With this report, we will include: • A projection of the healthcare budget for the 2018 plan year, including a composite per- employee rate • Tiered renewal rates for each group and plan for the City for 2018 • An estimate of the incurred claims liability (IBNR) for 2018 • An actuarial report on the above items in order to comply with all Washington State regulations regarding actuarial services for municipal health plans Schedule A suggested schedule for the renewal follows. The City and Healthcare Actuaries may adjust the schedule as necessary. Task Send information request to the City Responsible Healthcare Actuaries Due Date Completed Gather requested information City of Federal Way 7/21 Provide preliminary renewal Healthcare Actuaries 8/15 City to provide feedback City of Federal Way 8/21 Provide final renewal Healthcare Actuaries 8/28 Hen1t A ft Wet datin • Lft QYif.d V ?l dr'fifi;3 /AS • SYdi7Yegrc Benefits Pi ennini • fiekible Benefits Fees The fees for the 2018 renewal report are $12,000. Major revisions to the renewal are outside the scope of this project. We will bill for additional work at the following hourly rates: Lead Actuary $360 Actuary/Analyst $240 Information Required In order to complete the project, Healthcare Actuaries needs the following information. From the City, we need: 1. Current enrollment by family tier, plan, wellness status, and City paid spouse; split by actives and COBRA. 2. The 2017 rates and employee contributions. 3. Current budget information from the finance department, including reserve levels, if any. 4. Income statement through June 2017. 5. An estimate of the anticipated change (as either a headcount or a percentage change in headcount) in the City's benefits eligible workforce for 2018, 2019, and 2020. 6. A description of any plan changes that will be effective January 1, 2018. From R.L. Evans, we need: 1. Monthly paid claims and covered employees and dependents by month from July 2016 through June 2017, separately for medical and pharmacy. 2. A listing of large claims ( >$50,000) for plan years 2016 and 2017 year -to -date. 3. Monthly claim lag data separately for medical and Rx, for claims paid from July 2016 through June 2017, for all incurred months. 4. Administrative costs and other costs to build into the rates. Please supply the current rates and the rates for 2018, if known. 16519 107'" Place Northeast j Bothell, Washiingto % 9301.1. t (425) 939 -7444 ( f (425) 939 -0080 I w www.HealthcareActuaries.cotn If you have any questions or require clarification, please feel free to call us at (425) 939 -7444. Best regards, Roger T. Burton, FSA, MAAA, FCA c: Douglas Evans, R.L. Evans Company, Inc. 16519 107' Place Northeast 1 Eiotheli, Washington 98011 t (425) 939 -7444 1 f (425) 939 -0089 1 w www.HealthcareActuar es.corn AW °� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 06(20(2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CB Malaga Insurance Services LLC 9 WA License # 762661 1534 N Moorpark Rd., #316 Thousand Oaks CA 91360 CONTACT NAME Marie Meggs I PHONE FAX No INC. No Ext) (3].0). 796 -9056 05) 426 -8540 E -MAIL ADDRESS: mjrntgcbspeCialty cm NAIC # INSURE R($) AFFORDING COVERAGE INSURER A : Admiral Insurance Company 24856 INSURED Healthcare Actuaries LLC 16519 107th Place Northeast Bothell WA 98011 INSURER B: INSURER C S INSURER D : $ INSURER E : $ S INSURER F : CLAIMS -MADE f, -..l OCCUR • VISION NUMBER: vv r a_f v+v...v THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR -rypE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER ' -Port& EEFF JMMIDD/YYVY1 POUCY EXP (MMIDD/YYYY) LIMITS GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY j— j EACH OCCURRENCE S DAMAGE I U RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ S CLAIMS -MADE f, -..l OCCUR PERSONAL & ADV INJURY GENERAL AGGREGATE $ PRODUCTS - COMP/OF AGG $ GEN'L AGGREGATE LIMIT APPUES PER: —1 POLICY -1 JET F1 Loc $ AUTOMOBILE LUIB)UTY ANY AUTO All OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS AUTOS NON -OV NON-OWNED J (Ea idenED LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS UAB OCCUR CLAIMS -MADE 1 1 _ EACH OCCURRENCE S AGGREGATE $ $ DED 1 RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE IY / N (Mandatory (CLUDEO'i (Mandatory in NH} If yes, describe under DESCRIPTION OF OPERATIONS below N r A I WC STATU- OTH- I TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Professional Liability; Claims -made basis ("`" 11 E0000037862 -01 06/26/2017 06/26/2018 $3,000,000 Limit, each c aim $3.000,000 Limit, aggregate DESCRIPTION OF OPERATIONS / LOCATIONS f VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Location: 16519 107th Place Northeast, Bothell, WA 98011 Business Service: Solely in the performance of professional services as an Actuary for others for a fee. f.rcri l frf..n I I f_ In./ L■• City of Federal Way 33325 8th Avenue South Federal Way WA 98003 ∎. ... ____...._._ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTH RIZED R ESENTATNE 10V IL l c S. ACORD 25 (2010/05) f V 7yDD- . . The ACORD name and logo are register marks of ACORD J ACOR,D® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 07/06/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Lieu of such endorsement(s). PRODUCER INSURED R.L. Evans Company, Inc. 3535 Factoria Blvd SE, Ste 120 Bellevue, WA 98006 Healthcare Actuaries LLC 16519 107th Place NE Bothell, WA 98011 -4043 CONTACT NAME: Mardi E. Anderson Sodc . fac, NJ _ (a25)467- 5264 NExL(425)455.0501 E-MAIL ADDRESS: mardi erlevansco.COm INSURERS) AFFORDING COVERAGE .,, ,_. NAM /I INSURERA: Foremost Insurance INSURER B : INSURER C: INSURER D : INSURER E : INSURER F : E REVISION NUMBER: 5 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ,AODLSUBR POLICY EFF POLICY EXP ! LIMITS LTR • INS!): WVn POLICY NUMBER IMM /DD/YYYYI (MM/PONYYY! A x COMMERCIAL GENERAL LIABILITY Y PAS002025189 1//0812016 11/0812017 �. 'DAMAGE ...: CLAIMS -MADE X.: OCCUR - , . .._..... ........_... ._. ..... : j i ! GEN'L AGGREGATE LIMIT APPLIES PER: • POLICY PEO LOC . OTHER: EACH OCCURRENCE : S TO RENTED PREMISES (Ea ocwrrence) .i_S MED EXP (Any one person) S PERSONAL & ADV INJURY GENERAL AGGREGATE S . PRODUCTS 5 _.. S 2,000,000 _.2,.000,000_ _._.. 10,000_. 4 000 000 4,000,000.. AUTOMOBILE LIABILITY '—,1 ANY AUTO ...... OWNED '-.. { _ , ., O ..... { AUTOS NLY HIRED 1I __� AUTOS ONLY _. -..I i - SCHEDULED - AUTOS. NON- OWNED AUTOS ONLY _ COMBINED SINGLE LIMIT s (Ea acaden11 . . • BODILY INJURY (Per person) 5 ._ -. ... BODILY INJURY (Per acadenl) S PROPERTY DAMAGE S (Per. accident) . _. _.. .......... __.._.... UMBRELLA LIAB 1 EXCESS LIAB [ OCCUR E J CLAIMS -MADE EACH OCCURRENCE . S AGGREGATE - S l DED I RETENTIONS 'WORKERS COMPENSATION - . AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER /EXECUTIVE II (j OFFICER/MEMBER EXCLUDED? ! . N f A __._ ...) (Mandatory in NH) - If yes, describe under - DESCRIPTION OF OPERATIONS below - PER OTH- STATUTE ! • ER.__..:. E.L EACH ACCIDENT $ ..__. _.__.. -... E.L. DISEASE - EA EMPLOYEE S - E.L. DISEASE - POLICY LIMIT : S ...... . DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached W more space Is required) Certificate holder is Additional Insured per attached CG2010 0704 . CERTIFICATE HOLDER CANCELLATION City of Federal Way 33325 8th Ave S Federal Way, WA 98003 -6325 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTH1D REPRESS TATtVE (MEA) © 1988-2015 ACORD CORPORATION. All rights reserved, ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by MEA on July 06, 2017 at 12 :19PM BILL POLICY NUMBER TC PRODUCER NUMBER AC ACCOUNT NUMBER AUDIT D PAS 02025189 14135388 F004009939- 001 -00001 NONE BRANCH GR GRAND RAPIDS ENDORSEMENT EFF 06/28/2017 PRECISION PORTFOLIO SUPPLEMENTAL DECLARATIONS PRECISION AMERICA (CONTINUED) FOREMOST INSURANCE GROUP 5 POLICY COVERAGE PART(S) AND FORM OR ENDORSEMENT NUMBER FORM OR ENDORSEMENT NAME AND FORM OR ENDORSEMENT SUPPLEMENTAL INFORMATION LIABILITY CG2010 0704 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION NAME OF ADDITIONAL INSUREDS PERSON(S ) OR ORGANIZATIONIS) NAME 1 CITY OF FEDERAL NAY NAME 2 ADDRESS 1 33325 8TH AVE S ADDRESS 2 CITY FEDERAL WAY STATE WA ZIP 98003 -6325 LOCATIONIS) OF COVERED OPERATIONS 16519 107TH PL NE BOTHELL, WA COMMERCIAL GENERAL LIABILITY 955008 Ed 3-00 INSURED'S COPY 06/29/2017 PAGE 5 OF 5 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsementmodifes insurance provided underlheTollo✓vi�g: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name OfAdditional Insured Person(s) Or Organization(s): Location(s) OfCovered Operations In-formation requred incomplete this Schedule. ifnotshowh above, will be shown n the Declarations. A. Section 1I V1rho Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown n the Schedule, but any with respect to liab ility for 'b cd iy nju ry', property damage" or 'personal and advertising injury" caused, in whole or n part by: 1. Your ads cromssions; or 2. The ads or cm es ions of those acting on your behalf in the pe lance ofyour ongoing operations for the additional insured(s) at the bcation(s) desig- nated above. CG 20100704 B. VVGh respect tD the insurance afforded to these additional insureds, the folk,✓vng additional exclu- sions apply: This insurance does not apply to'bodily hj.nry"cr "p roperty d am ag e" occurring after: 1. All wort, ndudng materials, parts or equip- ment fumished in connection with such work, on the proj=ct (other than service, maintenance or repairs) to be performed by cr on behalf of the additional insured(s) at the iccation of the covered operations has been oompieted; or 2. That portion of 'your vcrk' out of which the inj.iry ordamage arises has been putto rTs Et— tended use by any person orcrgan¢ation other than another contractor or subcontractor en- gaged n performing operations for a prnchal as a partofthe same project Copyright ISO Properties, Inc., 2004 Page 1 oft ❑