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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.