HomeMy WebLinkAboutRes 16-40 Awarding the bid for Health Dental Vision Insurance to United Healthcare 2017TOWN OF WESTLAKE
RESOLUTION 16-40
A RESOLUTION QF THE TC?WN COUNCIL OF THE TOWN OF WESTLAKE, TEXAS,
APPROVING UNITED HEALTH CARE AS THE TtJWN'S HEALTH AND VISION
INSURANCE CARRIER AND APPROVING RENEWAL OF METLIFE AS THE
TOWN'S DENTAL INSURANCE CARRIER FOR T�IE 2017 CALENDAR YEAR.
WHEREAS, Town of Westlake desires to maintain a camprehensive health and dental
insurance benefits for its employees that is competitive to surrounding cities; and
WHEREAS, the leaders of the Town of Westlake desire to exercise exceptional levels of
stewardship with all financial resources; and,
WHEREAS, the Town Council finds that the passage of this Resolution is in the best
interest of the emplayees and citizens of the Town of Westlake.
NOW, THEREFORE, BE IT RESOLVED �Y THE TOWN COUNCIL OF THE TC?WN
4F WESTLAKE, TEXAS:
SECTION 1: That, all matters stated in the recitals hereinabove are faund to be true and
correct and are incorporated herein by reference as if copied in their entirety.
SECTION 2: That, the Westlake Town Council hereby approves United Health Care as
the Tawn's health and vision insurance carrier for a twelve (12) month period, beginning January
1, 2017, with an estimated annual employer cost of $472,393.
SECTION 3: That, the Westlake Town Council hereby approves the renewal of MetLife
as the Town's dental insurance carrier for a twelve (12) month period, beginning January l, 2017,
with an estimated annual employer cost of $28,333.
SECTION 4: If any portion of this resolution shall, for any reason, be declared invalid by
any court of competent jurisdiction, such invalidity shall not affect the remaining provisions hereof
and the Council hereby determines that it would have adopted this Resolution without the invalid
provisian.
Resolution 16-40
Page 1 of 2
SECTION 5: That this Resolution shall became effective from and after its date of
passage.
PASSED AND APPROVED ON THIS 14���; DAY NtJVEMBER, 2016.
ATTEST:
;�� /�
� d(„fi���+'� � Fe°' ���''n"��.�`
Laura`Wheat, Mayor
..► .i,
� _
� � '��I'�"��� .t��._� � i� _ .r
~ —
- • . �. � - - - ;, :���i �. ,•:
�x•;+,�• .,
. ll�f �!."'r.,�
�,.
APPROVE,,H AS TO ORM:
4�`�
�p
L. anton Lo y, n Attorney
\� ... �
�` . ;: . �
�.�' �k:
� ' ��� • . �
. �� � � '
� �W�- �
�
r�`���
Resolution 1b-40
Page 2 of 2
CERTIFICATE OF INTERESTED PARTIES FORM 1295
101`1
Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2016-135624
Lifetime Benefits Insurance, LLP
Grapevine,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 11/10/2016
being filed.
Town Of Westlake Date Acknowledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a
description of the services,goods,or other property to be provided under the contract.
Health Insurance RFP
Insurance Broker
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
Mundlin, Robert S Grapevine,TX United States X
Kidd,Connie N Grapevine,TX United States X
Clark,John W Grapevine,TX United States X
5 Check only if there is NO Interested Party. Q z,
6 AFFIDAVIT I swear,or affn,under alty aff/pe jury,that the above di ure is true and correct.
'aY'Av'.k KELLY EDWARDS
<.
Notary Public
a P
ox �r
*� *� STATE OF TEXAS r'
Notary ID 8 12408268-8 .�
Baa of `r My Comte.Exp.Febmary 3.2018
Atigoat e of auth&fZed,agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE r
Sworn to and subscribed before me,by the said this the day of Alcr
20-- ,to certify which,witness my hand and seal of office.
CA
-n l
ay3aL )6
Sic atur ' m cer administering oath Printed naof officer administering oath Title of officer administering tly
11 1
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1of1
Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2016-135624
Lifetime Benefits Insurance, LLP
Grapevine,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 11/10/2016
being filed.
Town Of Westlake Date Acknowledged:
11/17/2016
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a
description of the services,goods,or other property to be provided under the contract.
Health Insurance RFP
Insurance Broker
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I intermediary
Mundlin, Robert S Grapevine,TX United States X
Kidd,Connie N Grapevine,TX United States X
Clark,John W Grapevine,TX United States X
5 Check only if there is NO Interested Party. ❑
6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE
Sworn to and subscribed before me,by the said this the day of
20 ,to certify which,witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277
rw`
Town of Westlake Westlake Academy
Human Resources Department
FELONY CONVICTION NOTICE
State of Texas Legislative Senate Bill No. 1, Section 44.034, Notification of Criminal History,
Subsection (a), states "a person or business entity that enters into a contract with a school district
must give advance notice to the district if the person or an owner or operator of the business entity has
been convicted of a felony. The notice must include a general description of the conduct resulting in
the conviction of a felony.
Subsection (b) states "a school district may terminate a contract with a person or business entity if the
district determines that the person or business entity failed to give notice as required by Subsection (a)
or misrepresented the conduct resulting in the conviction. The district must compensate the person or
business entity for the services performed before the termination of contract."
THIS NOTICE IS NOT REQUIRED OF A PUBLICLY-HELD CORPORATION
I, the undersigned agent for the firm named below, certify that the information concerning notification
of felony has been reviewed by me and the following information furnished is true to the best of my
knowledge.
VENDOR'S NAME: Lifetime Benefits Insurance LLP
AUTHORIZED COMPANY OFFICIAL'S NAME (PRINTED) Robert S. Mundlin
Please check all that apply:
❑ My firm is publicly-held corporation, therefore, this reporting requirement is not applicable.
FR-My firm is neither owned nor operated by anyone who has been convicted of a felony:
My firm is owned or operated by the following individual(s)who has/have been convicted of a
felony:
Name:
Details of Conviction(s):
/11 Tli 10/31/2016
Contractor/I ` . pany icial Signature Date
3 Village Circle, Suite #202 • Westlake,Texas 76262
Metro: 817-490-5711 •Fax: 817-430-1812 •www.westlakeacademy.org
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B.23,84th Leg.,Regular Session. OFFICE USE ONLY
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received
has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the
vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity not later
than the 7th business day after the date the vendor becomes aware of facts that require the statement to be
filed. See Section 176.006(a-1),Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code.An
offense under this section is a misdemeanor.
1 Name of vendor who has a business relationship with local governmental entity.
a a
Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated
completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which
you became aware that the originally filed questionnaire was incomplete or inaccurate.)
Name of local government officer about whom the information is being disclosed.
Name of Officer
escn a each employment or other business relationship with the local government officer, ora tamily me-m-TiZe-r-07 the
officer,as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer.
Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form
CIQ as necessary.
A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income,
other than investment income,from the vendor?
Yes F-\7-1
No
B. Is the vendor receiving or likely to receive taxable income,other than investment income,from or at the direction
of the local government officer or a family member of the officer AND the taxable income is not received from the
local governmental entity?
Yes No
1 1_41
beannibeedch employinentai business telationship that the vendoi Mulled in Section 1 maintains with a cul Puldfivil 0i
other business entity with respect to which the local government officer serves as an officer or director, or holds an
ownership interest of one percent ormore.
006:
6
Check this box if the vendor has given the local government officer or a farrpily member of the officer one or more gifts
as described in Section 176.003(a)(2)(B),excluding gifts describgd in Section 176.003(a-1).
Irv_=
� c.�,
Signature of vendor doing business with the governmental;e�#ir' {�, 10!3112016
-I �
Town of Westlake Westlake Academy
Human Resources Department
NON-COLLUSION STATEMENT
The undersigned Proposer, by signing and executing this proposal, certifies and represents to
the Town of Westlake and Westlake Academy that Proposer has not offered, conferred or
agreed to confer any pecuniary benefit, as defined by Section 1.07 (a)(6) of the Texas Penal
Code, or any other thing of value, as consideration for the receipt of information or any special
treatment or advantage relating to this proposal; the Proposer also certifies and represents that
Proposer has not offered, conferred or agreed to confer any pecuniary benefit or other things of
value as consideration for the recipient's decision, opinion, recommendation, vote or other
exercise of discretion concerning this proposal; the Proposer certifies and represents that
Proposer has neither coerced nor attempted to influence the exercise of discretion by any
officer, trustee, agent or employee of the Town of Westlake and Westlake Academy concerning
this proposal on the basis of any consideration not authorized by law; the
Proposer also certifies and represents that Proposer has not received any information not
available to other proposers so as to give the undersigned a preferential advantage with
respect to this proposal; the Proposer further certifies and represents that Proposer has not
violated any state, federal or local law, regulation or ordinance relating to bribery, improper
influence, collusion or the like and that Proposer will not in the future, offer, confer, or agree to
confer any pecuniary benefit or other thing of value of any officer, trustee, agent or employee of
the Town of Westlake and Westlake Academy in return for the person having exercised the
person's official discretion, power or duty with respect to this proposal; the Proposer certifies
and represents that it has not now and will not in the future offer, confer, or agree to confer a
pecuniary benefit or other thing of value to any office, trustee, agent or employee of the Town
of Westlake and Westlake Academy in connection with information regarding this proposal, the
submission of this proposal, the award of this proposal or the performance, delivery or sale
pursuant to this proposal.
Firm Name: Lifetime Benefits Insurance LLP
Address: 400 N. Main St., Suite 103
City/State/Zip: Grapevine, TX 76051
Phone: 817-481-7133 Fax: 817-481-27-61
Name of Representative(s): Robert S. Mundlin F
Signature of Representative(s): (wl�_7
Date: 10/31/2016
3 Village Circle, Suite #202 ♦ Westlake,Texas 76262
Metro: 817-490-5711 ♦Fax: 817-430-1812 ♦www.westiakeacademy.org