Resolution No. 2013-091 (2)METLIFE
POLICY AMENDMENT
MARCH 3, 2015
MetLife
Metropolitan Life Insurance Company
200 Park Avenue, New York, New York 10166-0188
POLICY AMENDMENT
Group Policy No.: KM 06914646-G
Policyholder:
Effective Date:
City of Vernon
January 01, 2014
Metropolitan Life Insurance Company ("MetLife"), a stock company, issues this amendment to change the
following:
GRACE PERIOD
Each Premium due after the effective date of this policy may be paid up to 60 days after its Premium Due
Date. This period is the grace period. The insurance provided by this policy will stay in effect during this
period. MetLife will notify the Policyholder in Writing that, if the Premium is not paid by the end of the grace
period, this policy will end at the end of the last day of the grace period. If MetLife fails to give Written notice
to the Policyholder, this policy will continue in effect until the date such notice is given.
Policyholder's Intent to end this policy during the grace period. The Policyholder may notify MetLife in
Writing prior to the end of the grace period of its intent to end this policy before the end of the grace period. In
this case, this policy will end on the later of:
1. the date stated in the notice; or
2, the date MetLife receives the notice.
If the Policyholder replaces this policy with another group insurance policy but does not give MetLife notice of
intent to end this policy, the grace period provisions will apply.
Grace period extensions. MetLife may extend the grace period by giving Written notice to the Policyholder.
Such notice will state the date this policy will end if the Premium remains unpaid.
Premiums must be paid for a grace period, any extension of such period and any period insurance under this
policy was in effect for which Premium was not paid.
This amendment is to be attached to and made a part of the policy. This amendment is subject to the terms
and provisions of the policy.
To be completed by the Policyholder:
Signed at: VERNON CALIF013NIA Date: 03 jo 11901 5
(City) ( fate)
TEEESA MCALLISTER nTREcTnR OF MWAN EESOUCES
(Signature of Policyholder's Authorized Representative) (Pont Name and Tille_of Authorized Representative)
.(Signature of Witness)
PA99
C
(Print Name of Wtness)
Dental Insurance
All Active Full -Time Employees
RV 12/17/2014
To be completed by Metropolitan Life Insurance Company:
Signed at: Kansas. City. Missouri
(city) (State)
ignature of Authorized MetUfa Representative
PA99
Date,12/17/2014
Steven A. Kandarian
Chairman; President and Chief Executive Officer
Dental Insurance
All Active Full -Time Employees
RV 12/17/2014
INTERNAL COMMUNICATIONS FOR
METLIFE
POLICY AMENDMENT
MARCH 3, 2015
Juarez, Debbie
From: Rueda, Karina
Sent: Tuesday, March 03, 2015 5:59 PM
To: Juarez, Debbie
Subject: FW: MetLife Amendment
Attachments: 03032015155743.pdf
Karin Rueda
Hutnan Resources Analyst
City of Vernon
Human Resources Department
4305 Santa Fe Avenue
Vernon, CA 90058
T: (323) 583-8811 Ext 325
F: (323) 826-1439
www.cityofvemon.org
CONFIDENTIALITY NOTICE: This e-mail transmission, and any documents, files or previous a -mail messages attached to it may
contain confidential information that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to
the attended recipient, you are hereby notified that any disclosure, copying, distribution or use of any of the information contained in or
attached to this transmission is STRICTLY PROHIBITED. If you have received this transmission in error, please immediately notify the
sender. Please destroy the original transmission and its attachments without reading or saving in any manner.
From: McAllister, Teresa
Sent: Tuesday, March 03, 2015 4:58 PM
To: Rueda, Karina
Subject: FW: MetLife Amendment
FYI - teresa
CONFIDENTIALITY NOTICE: This e-mail transmission, and any documents, files or previous e-mail messages attached to it may contain confidential information
that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are hereby notified that any
disclosure, copying, distribution or use of any of the information contained in or attached to this transmission is STRICTLY PROHIBITED. If you have received this
transmission in error, please immediately notify the sender. Please destroy the original transmission and its attachments without reading or saving in any manner.
From: McAllister, Teresa
Sent: Tuesday, March 03, 2015 4:37 PM
To: Michel, Lisette
Subject: FW: MetLife Amendment
FYI - Teresa
CONFIDENTIALITY NOTICE: This e-mail transmission, mid any documents, files or previous e-mail messages attached to it may contain confidential information
that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are hereby notified that any
disclosure, copying, distribution or use of any of the information contained in or attached to this transmission is s'rRIC'I'LY PROHIBITED. If you have received this
transmission in error, please immediately notify the sender. Please destroy the original transmission and its attachments without reading or saving in any manner.
From: Muro, Eva
Sent: Monday, February 09, 2015 9:45 AM
To: Rueda, Karina
Cc- McAlister, Teresa; Moussa, Zaynah; Patel, Hema
Subject: FW: MetLife Amendment
Karina,
We have no recommended revisions to the amendment; the amendment is approved as to form. The
amendment does not require Council approval and Teresa is authorized to execute the amendment.
Please let us know if you have any questions.
Thank you.
Eva Muro
Legal Secretary I City of Vernon
4305 Santa Fe Avenue I Vernon, CA 90058
Phone: (323) 583-8811 ext. 273
CONFIDENTIALITY NOTICE: This e-mail transmission, and any documents, files or previous e-mail messages attached to it may contain confidential
information that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are
hereby notified that any disclosure, copying, distribution or use of any of the information contained in or attached to this transmission is STRICTLY
PROHIBITED. If you have received this transmission in error, please immediately notify the sender. Please destroy the original transmission and its
attachments without reading or saving in any manner.
From: Rueda, Karina
Sent: Wednesday, February 04, 2015 3:43 PM
To: Patel, Hema
Cc: Muro, Eva; McAllister, Teresa
Subject: MetLife Amendment
Hi Hema,
Please review the attached amendment to our MetLife Agreement. The original agreement was approved on October
15, 2013, by Resolution 2013-91.
The amendment to the agreement extends the grace period for payments from 30 days to 60 days and the change is at
no cost to the City.
Will the amendment require Council approval or does Teresa have the authority to execute the amendment?
Thank you,
Karin Rueda
Human Resources Analyst
City of Vernon
Human Resources Department
4305 Santa Fe Avenue
Vernon, CA 90058
T: (323) 583-8811 Ext 325
F:(323) 826-1439
www.cityofvemon.org
CONFIDENTIALITY NOTICE: This e-mail transmission, and any documents, files or previous e-mail messages attached to it may
contain confidential information that is legally privileged. If you are not the intended recipient, or a person responsible for delivering it to
the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of any of the information contained in or
attached to this transmission is STRICTLY PROHIBITED. If you have received this transmission in error, please immediately notify the
sender. Please destroy the original transmission and its attachments without reading or saving in any manner.