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2022-174
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Last modified
10/13/2022 11:39:01 AM
Creation date
10/13/2022 11:34:24 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/13/2022
Control Number
2022-174
Agenda Item Number
12.D.1.
Entity Name
Lockton Companies, LLC
Subject
Agreement for Employee Benefits Consultant/Broker/Actuary Services
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Compensation Disclosure <br />Compensation Disclosure — Attachment Sheet 1 of 5 Sheet(s) <br />Lockton believes it is or may be entitled to receive the compensation listed below, from the insurance companies and/or other entities <br />listed below, attributable to the insurance and/or administrative service contracts placed with those insurers and/or other entities on <br />your behalf. <br />Client Name: <br />INDIAN RIVER COUNTY <br />Insurer or TPA: <br />Blue Cross and Blue Shield of FL Inc <br />Policy or Benefit Type: <br />Medical PPO <br />Plan Name: <br />Medical Premier Gold Plan <br />Policy / Contract Year: <br />Effective Date 10/1/2022 to Expiration Date 9/30/2026 <br />Base Commissions: <br />Medical Plan Rate - Net of commission <br />Additional <br />This insurer/TPA does have an Additional Compensation program in place that might apply to the placement of your <br />Compensation: <br />policy(ies) or administrative -services -only contract(s). Upon request, Lockton can provide you with a more detailed <br />description of the manner in which the Additional Compensation that Lockton may receive under such program would be <br />calculated. <br />Client Name: <br />INDIAN RIVER COUNTY <br />Insurer or TPA: <br />Blue Cross and Blue Shield of FL Inc <br />Policy or Benefit Type: <br />Medical PPO <br />Plan Name: <br />Medical Premier Silver Plan <br />Policy / Contract Year: <br />Effective Date 10/1/2022 to Expiration Date 9/30/2026 <br />Base Commissions: <br />Premier Silver Plan Rate - Net of commission <br />Additional <br />This insurer/TPA does have an Additional Compensation program in place that might apply to the placement of your <br />Compensation: <br />policy(ies) or administrative -services -only contract(s). Upon request, Lockton can provide you with a more detailed <br />description of the manner in which the Additional Compensation that Lockton may receive under such program would be <br />calculated. <br />Client Name: <br />INDIAN RIVER COUNTY <br />Insurer or TPA: <br />RxBenefits, Inc. <br />Policy or Benefit Type: <br />Prescription Drug (Carve -Out) <br />Plan Name: <br />PBM <br />Policy / Contract Year: <br />Effective Date 10/1/2022 to Expiration Date 9/30/2023 <br />Base Commissions: <br />PBM Rate - Net of commission <br />Additional <br />This insurer/TPA does not have an Additional Compensation program in place that might apply to the placement of your <br />Compensation: <br />policy(ies) or administrative -services -only contract(s). <br />Client Name: <br />INDIAN RIVER COUNTY <br />Insurer or TPA: <br />Optum <br />Policy or Benefit Type: <br />Stop Loss <br />Plan Name: <br />Stop Loss <br />Policy / Contract Year: <br />Effective Date 10/1/2022 to Expiration Date 9/30/2023 <br />Base Commissions: <br />Stop Loss Rate - Net of commission <br />Additional <br />This insurer/TPA does not have an Additional Compensation program in place that might apply to the placement of your <br />Compensation: <br />policy(ies) or administrative -services -only contract(s). <br />Client Name: <br />INDIAN RIVER COUNTY <br />Insurer or TPA: <br />Clarity Benefit Solutions <br />Policy or Benefit Type: <br />Administration Fees <br />Plan Name: <br />Retiree billing <br />Policy / Contract Year: <br />Effective Date 10/1/2021 to Expiration Date 10/1/2024 <br />Base Commissions: <br />$0.00 per Month <br />Additional <br />This insurer/TPA does not have an Additional Compensation program in place that might apply to the placement of your <br />Compensation: <br />policy(ies) or administrative -services -only contract(s). <br />L Copyright 2022 Lockton Companies, LLC. All rights reserved. The contents of this document are proprietary and confidential. <br />Unauthorized duplication of this document is prohibited. <br />LOGEiM Page 11 of 15 <br />
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