HomeMy WebLinkAboutmetlifeMetLife
Metropolitan Life Insurance Company
One Madison Avenue, New York, New York 10010-3690
Metropolitan Life Insurance Company ("MetLife"), a stock company, will pay the benefits specified in the
Exhibits of this policy subject to the terms and provisions of this policy. The Schedule of Exhibits lists
each Exhibit to this policy, to whom it applies and its effective date.
Policyholder: City of Miami
Group Polley No.:
EFFECTIVE DATE
This policy will take effect on January 1, 2005.
POLICY ANNIVERSARIES
Policy anniversaries will be January 1, 2006 and each subsequent January 1.
PREMIUM PAYMENTS
This policy is issued In return for the payment by the Policyholder of required Premiums. Premiums are
payable at the home office of MetLife or to its authorized agent. The first Premium is due on and must be
paid by this policy's effective date. Any later Premiums are due monthly in advance on the first day of
each Policy Month. These dates are the Premium Due Dates.
POLICY SITUS
This policy is issued for delivery in and governed by the laws of Florida,
Signed as of this policy's effective date at MetLife's home office in New York, New York.
OA-
Gwenn L. Carr
Vice President and Secretary
Signed by
Robert H. Benmosche
Chairman, President and Chief Executive Officer
(A MetLife licensed agent or resident agent as required by law.)
Date
GROUP DENTAL INSURANCE POLICY NON -DIVIDEND PAYING
GPNP99
Page 1
TABLE OF CONTENTS
Section Page
POLICY FACE PAGE
Effective Date 1
Policy Anniversaries 1
Premium Payments 1
Policy Situs 1
DEFINITIONS 3
SCHEDULE OF INSURANCE 4
ELIGIBILITY AND EFFECTIVE DATES OF INSURANCE 4
CONTRIBUTIONS 4
PREMIUM RATE(S) 4
Initial Rate(s)
Frequency of Premium Payment 4
Computation of Premium 4
Premiums for Changes in Insurance 4
Right to Change Premium Rates 5
GRACE PERIOD 6
END OF INSURANCE PROVIDED BY THIS POLICY 6
REINSTATEMENT 7
GENERAL PROVISIONS
Entire Contract 7
Policy Changes or Waivers 7
Incontestability: Statements Made by the Policyholder 7
Incontestability: Statements Made by Covered Persons 7
Certificates 8
Assignment 8
Data Needed 8
Misstatement of Age 8
Non -Dividend Paying a
Conformity with Law a
SCHEDULE OF EXHIBITS SCHIEXHIBITS
EXHIBIT 1: Schedule of Premium Rates EXHIBITI
EXHIBIT 2: Certificate Forms EXHIBIT2
GPNP99 Page 2
DEFINITIONS
As used in this policy, the terms listed below will have the meanings defined below. When defined terms
are used in this policy, they will appear with initial capitalization. The plural use of a term defined in the
singular will share the same meaning.
Contribution means the amount the Policyholder may require the Employee to pay towards the total
Premium that MetLife charges for the insurance provided by this policy.
Contributory Insurance means insurance for which the Policyholder may require the Employee to pay at
least part of the Premium.
Covered Person means an Employee and/or a Dependent as set forth In the Exhibit which applies to the
Employee.
Dependent is defined in the Exhibit which applies to the Employee.
Employee is described in the Exhibit which applies to the Employee.
Employer means the Policyholder shown on page 1.
Noncontributory Insurance means insurance for which the Policyholder may not require the Employee to
pay any part of the Premium.
Policy Anniversary is defined on page 1.
Policy Month. The first Policy Month will begin on the effective date shown on page 1. Subsequent Policy
Months will begin on the same day of each subsequent calendar month.
Premium means the amount the Policyholder must pay to MetLife for all the insurance provided under this
policy.
Premium Due Date is defined on page 1.
Signed means any symbol or method executed or adopted by a person with the present intention to
authenticate a record, and which is on or transmitted by paper or electronic media, and which is consistent
with applicable law.
Written or Writing means a record which is on or transmitted by paper or electronic media, and which is
consistent with applicable law.
GPNP99 Page 3
SCHEDULE OF INSURANCE
The Schedules of Insurance which apply under this policy are set forth in the Exhibits.
ELIGIBILITY AND EFFECTIVE DATES OF INSURANCE
The Eligibility and Effective Dates of Insurance provisions that apply under this policy are set forth in the
Exhibits.
CONTRIBUTIONS
The maximum amount that an Employee may be required to contribute to the cost of Contributory Insurance
will not exceed the Premium charged for the amounts of such insurance,
PREMIUM RATE(S)
Initial Rate(s)
The initial Premium rate(s) are shown In Exhibit 1.
Frequency of Premium Payment
Premiums for this policy will be paid as shown on page 1. MetLife and the Policyholder may agree that
payment be made in advance every 3, 6 or 12 months.
Computation of Premium
The Premium due on any Premium Due Date is determined by the total amount of insurance provided by
this policy on such Premium Due Date, multiplied by the appropriate Premium rate(s) which are then in
effect subject to any Premium adjustments, if applicable.
MetLife may use any reasonable method to compute Premiums due under this policy.
Premiums for Changes in insurance
For insurance that takes effect after the first day of a Policy Month, Premium will be charged from the first
day of the next Policy Month. However, if a policy amendment or evidence of good health is required for
such insurance, Premium will be charged as of the date such Insurance takes effect.
If this policy ends, or if insurance ends for a class of persons, Premium will be charged to the dale insurance
ends. If insurance ends for other reasons, Premium will be charged to the end of the Policy Month in which
insurance ends.
GPNP99 Page 4
PREMIUM RATES (Continued)
Right to Change Premium Rates
MetLife may change Premium rates for changes which materially affect the risk assumed for the insurance
provided by this policy, as follows;
1, when this policy is amended or endorsed;
2, when a class of eligible persons is added to or deleted from this policy for any reason including
corporate restructuring, acquisition, spin-off or similar situations;
3, when a Policyholder's subsidiary, affiliate, division, branch or other similar entity is added to or deleted
from this policy for any reason including corporate restructuring, acquisition, spin-off or similar
situations;
4. when there is a significant change in the geographic distribution of insured Employees;
5, when applicable law requires a change in:
a, the insurance provided by this policy: and/or
b, the class of persons eligible for insurance under this policy; or
6. when a Premium Due Date coincides with or next follows;
a. a change greater than 10% in the number of Covered Persons since the later of the policy
Effective Date and the last date Premium rates were changed; or
b. a change greater than 10% in the amount of insurance provided by this policy since the later of
the policy Effective Dale and the last date Premium rates were changed.
MetLife will notify the Policyholder, in Writing, at least 60 days before a Premium rate change.
In addition, MetLife may change Premium rates:
1. except as may be stated in Exhibit 1, on any date on or after the first Policy Anniversary; this will be
done no more frequently than every 12 months and only if MetLife notifies the Policyholder, in Writing,
at least 60 days before such change; and
2, on any other date agreed to by MetLife and the Policyholder.
The new Premium rates will apply only to Premiums due on or after the date the rate change takes effect.
GPNP99 Page 5
GRACE PERIOD
Each Premium due after the effective date of this policy may be paid up to 31 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 falls 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.
END OF INSURANCE PROVIDED BY THIS POLICY
The Policyholder can end this policy by giving 60 days advance Written notice to MetLife. The policy will end
on the later of:
1. the date stated In the notice; or
2. the date MetLife receives the notice.
MetLife can end this policy as follows:
1. on the date Premium is not paid when due, subject to the Grace Period provisions; or
2. on any Premium Due Date, by giving the Policyholder 90 days advance Written notice, if less than:
a. 75% of persons eligible under this policy are insured for Contributory Insurance;
b. 100% of persons eligible under this policy are insured for Noncontributory Insurance; or
c. 50 Employees are insured by this Policy;
3, on any Premium Due Date, by giving the Policyholder 90 days advance Written notice, if the
Policyholder fails to provide information on a timely basis or perform any obligations required by this
policy or any applicable law; or
GPNP89 Page 8
END OF INSURANCE PROVIDED BY THIS POLICY (Continued)
4. on any Policy Anniversary, except during a Rate Guarantee Period as may be provided in Exhibit 1, by
giving the Policyholder 90 days advance Written notice.
This policy will end on the date an which the last certificate in effect under this policy ends.
If this policy ends, all Premiums due must be paid. If MetLife accepts Premium after the date this policy
ends, such acceptance will not act to reinstate the policy. MetLife will refund any unearned Premium.
REINSTATEMENT
The Policyholder may request to reinstate this policy within one year from the date it ended. The request
must be in Writing and it must provide MelLife with information that MetLife requires to consider such
request. If MetLife approves the request, the policy will be reinstated on the date stated in Writing by
MetLife.
GENERAL PROVISIONS
Entire Contract. The entire contract is made up of the following:
1. this policy, including its Exhibits;
2. the Policyholder's application; and
3. the amendments and endorsements to this policy, if any.
Policy Changes or Waivers. The terms and provisions of this policy may be changed, at any time, without
the consent of the Covered Persons or anyone else with a beneficial interest In it. MetLife will issue
amendments or endorsements to effect such changes. MetLife will only make changes that are consistent
with applicable law. An amendment or endorsement will not affect the insurance provided under certificates
issued before the effective date of the change, unless retroactivity is consistent with applicable law.
An officer of MetLife must approve in Writing any change or waiver of the terms and provisions of this policy.
A sales representative, or other MetLife employee, who is not an officer of MetLife does not have MetLife's
authority to approve such changes or waivers. A change or waiver will be evidenced by an amendment
Signed by an officer of MetLife and the Policyholder or an endorsement Signed by an officer of MetLife. A
copy of the amendment or endorsement will be provided to the Policyholder for attachment to this policy.
Incontestability: Statements Made by the Policyholder. Any statement made by the Policyholder will be
considered a representation and not a warranty. MetLife will not use such statement to avoid Insurance,
reduce benefits or defend a daim unless it is contained in a Written application. MetLife will not use such
statement to contest life insurance after It has been in force for 2 years from its effective date, or date of last
reinstatement, unless the statement is fraudulent.
Incontestabllity: Statements Made by Covered Persons. Any statement made by a Covered Person will
be considered a representation and not a warranty. MetLife will not use such statement to avoid insurance,
reduce benefits or defend a claim unless the following requirements are met:
1. the statement is in a Written application or enrollment form;
2, the Covered Person has Signed the application or enrollment form; and
3. a copy of the application or enrollment form has been given to the Covered Person or his beneficiary.
MetLife will not use a Covered Person's statements which relate to insurability to contest life insurance after
it has been in force for 2 years during his life, unless the statement is fraudulent. In addition, MetLife will not
use such statements to contest an increase or benefit addition to such insurance after the increase or
benefit has been in force for 2 years during his life, unless the statement is fraudulent.
GPNP99 Page 7
GENERAL PROVISIONS (Continued)
Certificates. MetLife will issue Individual certificates to the Policyholder for delivery to each Covered
Person, as appropriate. Such certificate will describe the Covered Person's benefits and rights under this
policy. "Certificate" includes any of MetLife's insurance riders, notices or other attachments to the
certificate.
Assignment. The rights and benefits under this policy are not assignable prior to a claim for benefits,
except as required by law or as permitted by MetLife.
Data Needed. The Policyholder will provide MetLife with all the data needed to compute Premiums and
carry out the terms of this policy, Metl ife may examine such data at any reasonable time. If MetLife or the
Policyholder make a clerical error in keeping the data, the Premium and/or benefits will be adjusted
according to the correct data. An error will not end insurance validly in effect, nor will it continue insurance
validly ended.
Misstatement of Age. if a Covered Person's age is misstated, the correct age will be used to determine if
insurance is in effect and, as appropriate, adjust the Premium and/or benefits.
Non -Dividend Paying. This policy does not pay dividends.
Conformity with Law. If the terms and provisions of this policy do not conform to any applicable law, this
policy shall be Interpreted to so conform.
GPNP99 Page 8