CITRIN FINANCIAL AND INSURANCE, INC.THE CITY OF SOUTH MIAMI
REQUEST FOR PROPOSAL
INSURANCE BROKERAGE SERVICES
�.
CHARLES CITRIN
JULY 8, 201 1
CITRIN FINANCIAL AND INSURANCE, INC.
300 71ST STREET SUITE 300
MIAMI BEACH, FL 33141-3075
(305) 861 -0999
FAx: (305) 861 -0032
RFP # SM- 2011 -08 -HR
CITY CLERK OFFICE
SOUTH MIAMI CITY HALL
6130 SUNSET DRIVE
SOUTH MIAMI, FL 33143
TABLE OF CONTENTS
I. LETTER OF INTEREST 1
II, PROPOSER'S QUALIFICATION STATEMENT
2
1. QUALIFICATIONS AND EXPERIENCE
12
2. RESUME OF PROPOSER
14
3. LIST OF ENTITIES WITH CONTRACTUAL RELATIONSHIP
16
4. DISCLOSURES
17
5. EXAMPLES OF WORK PERFORMED BY PROPOSER
17
REFERENCES REQUIRED FOR RFP
19
6. RESUMES OF STAFF PERFORMING THE WORK
20
III. NON-COLLUSION AFFIDAVIT AND OTHER NOTARIZED FORMS 32
IV, SWORN STATEMENT ON PUBLIC ENTITY CRIMES 40
V. COST PROPOSAL 42
VI, BUSINESS AND PROFESSIONAL LICENSES 43
VII, EXHIBITS
SAMPLE CALENDAR OF MEETINGS /SERVICES WITH A-... 47
CURRENT CLIENT
SAMPLE OF EMPLOYEE BENEFIT SURVEY 49
SAMPLE OF BENEFITS GUIDE 50
SAMPLE OF A LEGISLATURE UPDATE 53
E/O INSURANCE 59
SAMPLE OF RENEWAL SPREADSHEET 62
Citrin Financial & Insurance, Inc.
300 71st Street, Suite 300
Miami Beach, FL 33141 -3038
Tel: 305.561.0999
Fax: 305.861.0032
July 8, 2011
Maria M. Menendez
South Miami City Clerk
South Miami City Hall
6130 Sunset Drive
South Miami, FL 33143
RE: LETTER OF INTEREST
REQUEST FOR PROPOSAL # SM- 2011 -08 -HR
INSURANCE BROKERAGE SERVICES
Dear Ms. Menendez:
Citrin Financial & Insurance, Inc, is pleased to respond to the Request for Proposal for Proposal for
Insurance Brokerage Services for the City of South Miami and encloses an original unbound proposal, ten (10)
additional copies and one (1) digital CD copy of the proposal. In responding, Citrin Financial & Insurance, Inc., its
principals and employees commit to provide the City of South Miami and its employees the highest quality and
ethical service, if chosen as their insurance agent. We agree to perform the required work with in the City's specified
timeline (please see an example of a proposed timeline in the application). We are presently the insurance agent for
the Cities of Opa- Locka, Sweetwater, and North Bay Village.
Charles A. Citrin, President of Citrin Financial & Insurance, Inc. will be authorized to make representation
for the firm. His phone number is 305 -861 -0999 and his email address ischascitrin(cilaol, corm.
We thank the City for the potential opportunity to serve it and its employees. Should the City have any
questions regarding the enclosed Written Submittals please contact either Charles A. Citrin (Ext. 305) or Deborah
Citrin (Ext. 302) at 305/861 -0999.
Sincerely,
CITRIN FINANCIAL & INSURANCE, INC.
By:����
Charles A. Citrin, President
By:
Deborah Citrin, Executive Vice - President
Ci0n Financial & Insurance, Inc.
PROPOSER'S QUALIFICATION STATEMENT
PROPOSER shall furnish the following information. Failure to comply with this requirement
will render the Bid non- responsive and shall cause its rejection. Additional sheets shall be
attached by the Proposer as required.
PROPOSER'S Name and Principal Address:
Charles Citrin
Home Address: Work Address:
3724 Pine Tree Drive 300 71st Street Suite 300
Miami Beach, FL 33140 -3936 Miami Beach, FL 33141 -3075
Tel: (305) 672 -6088 Tel: (305) 861 -0999
Fax: (305) 861-0032
Contact's Person
Name and Title: Charles A. Citrin, President
PROPOSER'S
License Number: A047758
(Please attach certificate of competency ad /or state registration)
PROPOSER'S
Federal Identification Number: 650857342
1. Number of years your organization has been in business, in this type of work: 13
2. Names and titles of all officers, partners or individuals doing business under trade name:
The business is a: Sole Proprietorship., ❑ Partnership ❑ Corporation a{
LLP ❑ LLC ❑
3. Describe your experience and services related to health management. This would include
health risk assessment, wellness, health coaching, disease management, etc.
Citrin Financial and Insurance, Inc. has been involved in developing an employee benefits
guide, wellness fairs and employee satisfaction surveys for their clients. During the annual
benefits enrollment we help to arrange the various vendors (including the insurance carriers,
chiropractic, physical and occupational therapy, massage therapy, urgent care centers with
nursing personnel and a variety of other vendors for the employees). With her educational
background in Occupational Therapy, Deborah Citrin, brings an enormous knowledge of the
Citrin Financial & Insurance, lne. 2
medical profession, medical language and health care in general from the position of the
patient /client and the professional provider in order to resolve disputed claims, billing issues
and dealing with the providers and insurance carriers.
Charles Citrin has represented the Public Health Trust of Dade County and acts as City
Attorney for the City of Hialeah Gardens and General Counsel to the Hialeah Housing
Authority. In these roles he has been involved in the selection of employee benefits and the
negotiations with various vendors and agents. Mr. Citrin has had extensive discussions
regarding the present challenges facing municipalities to deliver employee benefits due to
declining tax basis and declining state support.
4. Describe an example of a City for whom you have coordinated or provided these services.
CFI has worked extensively with all of our city clients including the City of Opa Locka, the
City of North Bay Village and the City of Sweetwater during open enrollment and throughout
the years to manage their employee benefit programs and costs with the help of their respective
Human Resource departmental personnel.
5. Have you ever failed to complete work awarded to you. If so, when, where, and why?
I .l�
6. How will you maintain confidentiality of the City's records and data (include in your
discussion any security procedures for accessing, sending, and storing data that are
currently in place)?
CFI has in place locked file cabinets and offices where the client files are kept. Our computers
all have passwords in order to be accessed. We maintain the security of our files based on the
strict requirements from our brokers and insurance carriers. No one outside our office personnel
have access to our files.
7. Discuss your service approach and how you respond to City requests. Include what you
consider non - urgent/routine requests and urgent requests.
Nothing is more important than courteous and timely assistance to a plan participant with a
problem. Nothing.
CFI is committed to excellent customer service. Our escalated service issues process is as
follows: When an employee or administrator from the City of South Miami experiences a
Citrm I,inmreiai & lns-urmice, Inc. 3
service issue they should contact us by email or phone immediately. CFI researches and gathers
the appropriate documentation and information. CFI has developed excellent relationships with
many contacts at different insurance carriers and this enables us to expedite and resolve service
issues almost immediately. If the issue can not be solved immediately then we continue to
follow up daily until it has been resolved. CFI guarantees that no service /claims issues will ever
be referred back to the City.
8. How do you measure client satisfaction?
CFI measures client satisfaction on continued employment satisfaction and success comes in
resolving issues for clients that they are unable to resolve themselves. There might be a time
when it is impossible to resolve an issue and in that case we will give a detailed explanation of
why the solution was not possible. We will keep track of the problem areas for a client and then
make recommendations for future solutions to that problem.
9. Confirm that you serve as a consultant or broker, independently, and are not affiliated
with any insurance company, third party administrative agency or provider network.
We confirm that Citrin Financial and Insurance, Inc. serves independently as a consultant or
broker and is not affiliated with any insurance company, third party administrative agency or
provider network.
10. Describe your experience in provider network development, recruitment and negotiation,
and maintenance.
When a doctor is not in the plan, but is important to the client, we will work to get the insurance
company to add this health care provider to the network. We are not involved in recruitment,
negotiation and /or maintenance other than what was previously noted above.
11. Outline your ability to provide expertise and experience in the areas of health benefit plan
analysis and design.
CFI has been representing groups and individuals for 13 years and has developed individual and
customized benefit plans for all of its clients. Deborah Citrin is presently enrolled in the Health
Care Consultant class at The American College. This course work goes into great detail about the
Citrin Financial & Insurance, Inc. 4
new Patient Protection and Affordable Care Act and the new Healthcare Reform laws and
regulations, including the timeline from now through 2018 when these provisions take effect. An
understanding of the mandates of the new health care reform, the changes to the social programs,
the health care exchanges, the tax consequences of this new reform and the parts of the reform
that have been rescinded are all studied. This course and others have given her the latest updates
on the new Healthcare Reform which can then benefit the City of South Miami's employees.
12. Explain in detail the types of analyses you have conducted relative to benefits analysis and
design for a health plan with at least 100 employees.
On a yearly basis, CFI reviews the claims experience for all clients, looks at holes in the
coverage, and conducts a cost benefit analysis in regards to each client and the group's
participation in the health care plan. We will then put together a detailed summary for the year
and then meet with the Human Resource Director and the City Manager to discuss the current
benefits plan and make recommendations to the City.
13. Provide examples of communication materials developed and prepared by your
organization for use in City's health benefit communication campaigns.
CFI has worked with our client, the City of Opa Locka, to develop a survey to be given to the
employees to determine their level of satisfaction with the current benefit plan(see example).
We also help advertise the annual wellness fair during open enrollment for clients.
14. Are there any existing service provider relationships that may prevent you from acting
independently and providing objective advice or guidance? (Examples, overrides,
commission agreements, preferred contracts, pricing based on volume, etc.)
M
15. List any subcontractors who will provide services under this Contract and the services they
will provide. The foregoing list of subcontractor(s) may not be amended after award of the
contract without the prior written approval of the Contract Administrator, to be
designated by the City Manager, and whose approval shall not be unreasonably withheld.
NONE
Citrin Financial & Insurance, Inc. 5
16. List and describe all bankruptcy petitions (voluntary or involuntary) which have been filed
by or against the Proposer, its parent or subsidiaries or predecessor organizations during
the past five (5) years. Include in the description the disposition of each such petition.
NOT APPLICABLE
17. Provide specific examples of a significant savings in the cost of benefits to the client that
can be directly attributed to your past services.
CFI does represent the City of Opa Locka with 188 employees, the City of Sweetwater with 77
employees and the City of North Bay Village with 60 employees. Each City is a comparable plan
to the City of South Miami
Opa Locka 2010 Renewal- The renewal rates for the medical health insurance plan had an
increase in premiums of 12.76% for the HMO plan and 14.23% for the PPO plan. CFI requested
proposals from alternate insurance carriers and found a plan that had a lower deductible HMO
plan, lower prescription drug copays. The premium for this plan included both dental and vision
coverage. The employee HMO rate decreased from $472.69 (the renewal premium) to $401.61
(the premium with the new carrier), for.a savings of $71.08 /month/employee calculating to a
savings of $852.96 /year /employee.
Opa Locka 2009 Renewal- The renewal rates for the medical health insurance plan had an
increase in premiums of 20.78% for both the HMO and PPO plans. CFI found another carrier
that offered very similar plans for the HMO with only a 4% increase in premiums and a POS
plan with a decrease of 29.5% from the current premiums, a savings of $215.68 a month per
employee or $2,588.16 a year per employee.
Sweetwater 2010 Renewal- The renewal rates for the medical health insurance plan had an
increase in premiums of 18% for the HMO plan and 18.68% for the POS plan. The City decided
to stay with their current carrier and we were able to help the City contain costs by finding plans
that offer alternative plans that increased the deductibles slightly, but lowered the office visit
copays. The increase of premium was reduced to 9.55% for the HMO and 7.55% for the POS
plan.
Sweetwater 2009 Renewal- The original renewal rates on the current HMO plan increased the
yearly premiums over 6% per employee. Because this increase could create a financial hardship
Citrin Financial & lnsarnnce, Inc. 6
for the City and its employees we requested a modified HMO option that maintained the
premiums at equal to or slightly below the previous year's rates and features many improved
benefits. It lowered the doctor office copays and the in patient hospital admission copays.
Sweetwater 2008 Renewal- The renewal rates for the medical health insurance plan had an
increase in premiums of 2.8% for the HMO plan and 2.5% for the POS plan and the City decided
to remain with their current carrier. The alternatives offered lower premiums with severe
reduction in benefits or an increase higher than their renewal rates with the same current benefits.
Sweetwater 2007 Renewal- The renewal rates for the medical health insurance plan had an
increase in premiums of 14.6% for both the HMO and POS plans and the City decided to remain
with their current carrier. We presented the City with alternatives that lowered the premium cost,
but increased the specialist office visit copay, ER copay, and prescription drug copay slightly.
The City decided to maintain their current level of benefits.
North Bay Village 2010 Renewal- The renewal rates for the medical health insurance plan had
an increase in premiums of 9% for both plans. CFI requested proposals from alternate insurance
carries but only received a quote from one other carrier that included higher office visit copays
and deductibles. We were able to negotiate with the current carrier to reduce the renewal rate
down to a 7% increase saving the City $162,804 in premiums.
North Bay Village 2009 Renewal- The renewal rates from their current medical health insurance
carrier had an increase in premiums of 1'1 %. We requested quotes from five (5) other carriers.
Three (3) of the carriers declined to quote for various reasons and one carrier requested more
information and individual health risk questionnaires. We presented a number of plan
alternatives with the current carrier. By choosing and adding an alternate plan with slightly
higher office visit copay, prescription drug copays and deductibles the City was able to keep the
premium cost for the new plan at the same level as the prior year and the employees had a choice
between two (2) plans (a dual option benefit).
North Bay Village 2008 Renewal- The renewal rates for the medical health insurance plan had
an increase in premiums of 65 percent. The City received decline to quotes from five (5) carriers.
The one alternative quote had a 76 -80% increase in premiums. We were able to offer the City a
number of plan options with their current carrier while by slightly changing the plan benefits
Citrin Financial & Insurance, Inc. 7
(actually eliminating the deductible and lowering the co pays) decreased the increase in premium
by 9 %.
North Bay Village 2007 Renewal- The renewal rates for the current medical health insurance
plan had an increase in premiums of 37 %. We were able to find one carrier (the others declined
to quote) with a plan that lowered the City's plan premium between 3 -8% over their current
plans premiums. These plans eliminated the outpatient hospital and advanced testing copay and
the savings to the City was be between $15,039.61 and $90,237.69 per year.
18. List any companies your are affiliated with or have contractual arrangement with
including insurance companies, third party administrators (claims or other
administrative /record keeping services), provider networks, HR or benefits software
vendors, etc.
Aetna, AFLAC, AMG, AvMed, BCBS, Ceridian Benefits Services, CIGNA, Colonial, Coventry,
Excelsior Benefits, Humana, Lincoln Financial, MetLife,Ohio National, Security Mutual, The
Standard, The Guardian, UnitedHealtheare/NHP, Crump and other life insurance companies.
19. Describe your firm's ability to assist with Benefits Administration issues.
CFI is knowledgeable about the various types of health plans and supplemental benefits plans
used to augment coverage for the employees. By finding the correct combination of alternative
plans we can meet needs of both the City and the employees in lowering their costs while
offering the best insurance coverage available. We always keep abreast of the industry and its
trends, both financial and legislative for the benefit of our clients. For example during the City of
Opa Locka's renewal we obtained quotes from an insurance carrier which included dental and
vision in its health insurance rates. By selecting that particular plan the City was able to reduce
its costs by eliminating its separate dental plan while offering the added benefit of vision care.
Another City selected a higher deductible plan and offered employer sponsored supplemental
benefits to eliminate the gaps in coverage.
20. What distinguishes your firm from other consulting firms and why should the City select
your firm for consulting needs?
Charles Citrin has over thirty eight (38) years of experience working with municipalities and a
commitment to SERVICE and SUPPORT. Service in the fact that we believe as the City of
Citrin Financial & Insurance, Inc. 8
South Miami's agent of record, the City and its employees are our prime responsibility. This is
especially true in trying financial times. As such we act as an active adjunct in support to the
City's Human Resources Department. CFI has the ability to adjust to the City's systems and
philosophy, while assisting you with our experience in other jurisdictions and the insurance
market in general.
21. What is the total number of employees that you have assigned, currently, to employees
benefits counseling?
Four.
22. What is your corporate mission, vision and values, as well as your organization's
philosophy towards providing benefits consulting services?
Citrin Financial and Insurance, Inc. is devoted to providing all of our clients with professional,
individualized and the most up to date information concerning employee health benefits. We
strive to find our clients the best employee benefit package available while being cognizant of all
of the financial pressures and limitations in today's corporate and government arenas. We keep
our clients up to date with the rapidly changing legislative environment by providing timely
emails, letters and phone calls concerning the new legislation. Our firm is dedicated to providing
SERVICE and SUPPORT to our clients. Service in the fact that we believe as the City of South
Miami's agent of record, the City and its employees are our prime responsibility as noted. This is
especially true in trying financial times. As such we act as an active adjunct in support to the
City's Human Resources Department. CFI has the ability to adjust to the City's systems and
philosophy, while assisting you with our experience in other jurisdictions and the insurance
market in general.
23. Discuss your firm's quality assurance policies and procedures. How do you measure
whether you are meeting these standards? What is the frequency of any such review?
We meet on a weekly basis to discuss employee benefit issues. We are constantly monitoring our
response time in both getting back to clients and to resolving service questions. While we are big
enough to handle clients such as the City of South Miami, we are not so big as to be bogged
down in unnecessary bureaucracy. Our job is quite simple; each employee is important and
deserves our help in getting the most out of their coverage.
Citin Financial & lnsarance, lac. 9
24. Detail your ability to monitor regulatory and legislative developments at both the state and
federal level and how this will benefit the City and be communicated to the City.
Citrin Financial and Insurance, Inc. is constantly getting circulars by way of email and regular
mail from our insurance carriers and professional associations. We are also signed into alerts
about the latest news from the federal and state governments and the Department of Labor, and
the Florida Department of Insurance. Charles Citrin monitors all court cases that are important in
the employee benefit area.
25. List all claims, arbitrations, administrative hearings and lawsuits brought by or against the
Proposer or its predecessor organizations(s) during the last (5) years. The list shall include
case name, case, arbitration or hearing identification number, name of the court or
tribunal, the name of the project over which the dispute arose; and a description of the
subject matter of the dispute.
NONE
26. Describe all proceeding concerning business related offenses in which the Proposer, its
principals or officers or predecessor organization(s) were defendants.
NONE
Citrin Financial & Insarmrce, lac. 10
27. Has the Proposer, its principals, officers or predecessor organization(s) been CONVICTED
of a Public Entity Crime, debarred or suspended from bidding by any government during the
last five (5) years? If so, provide details.
The PROPOSER acknowledges and understands that the information contained in response to
this Qualification Statement shall be relied upon by CITY in awarding the contract and such
information is warranted by PROPOSER to be true. The discovery of any omission or
misstatement that materially affects the PROPOSER'S qualifications to perform under the
contract shall cause the CITY to reject the Bid, and if after the award, to cancel and terminate
the award and /or contract.
VERIFICATION PURSUANT TO SECTION 92.525(2), FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing Response to
Qualification Statement and that the facts stated in it are true.
DATED this day of July . 2011.
CITRIN F1 A TN('
(P t Name f Pro os .r)
i
By
(Sign Your afne on Line Above)
Charles A. Citrin
(On Line Above, Print or Type Name of Person Signing)
FAILURE TO COMPLETE. SIGN. & RETURN THIS FORM MAY.DISOUALIFY YOUR RESPONSE
Insurance Brokerage Services RFP No. SiM- 2011 -09 -1 IR Page 19 of 25
QUALIFICATIONS AND EXPERIENCE
1. Citrin Financial's Understanding and Approach
Citrin Financial and Insurance, Inc. (CFI) understands the importance of attracting and
maintaining quality employees. Studies have shown a direct correlation between employee
benefits and employee satisfaction and retention. CFI is aware of the current budget constraints
faced by municipalities. Health care costs are increasing while budgets are decreasing.
Employers face tough decisions such as potentially decreasing benefits and laying off
employees. We will work diligently to help the City strike a balance between employer and
employee provided benefits in order to maintain and attract top talent. The City's greatest assets
are its employees and we understand how important it is for the City to provide quality benefits
at affordable rates.
CFI commits to preparing an Annual Stewardship Report, including complete accounting
of fees and/or commissions earned on the account, observations on relevant changes in the
insurance market, view on loss exposures, facing the City of South Miami, loss control activities
and insurance policy summaries. CFI will solicit and negotiate plan proposals and rate quotes
from existing and alternate insurance carriers for the City's annual renewals. CFI will provide
thorough analysis and recommendations for both cost - saving and benefit enhancement options,
to include scope of plan design changes (both new and nontraditional approaches), impact on
plan cost, value -added services, etc. CFI will conduct annual open enrollment benefits meetings
for all employees, including preparation and presentation of annual benefits plan status report.
Prepare Employee Benefit Guides detailing, but not limited to, the following: Pertinent provider
information, health plan benefits, dental plan overview, life insurance, qualifying events,
important phone numbers, etc.
CFI will maintain an active and ongoing relationship with the service providers /insurance
carriers to ensure smooth operation and delivery of benefits as well as facilitating prompt review
and resolution of plan and claims administration issues. CFI will make regularly scheduled visits
to the City to respond to questions, solve problems, hold periodic Wellness talks and assist with
benefit administration. CFI commits to provide a team of servicing representatives available to
Citrin Financial & Insurance, Inc. 12
the City on an ongoing basis. As well as provide plan design and financial management
performance updates throughout the plan year via detailed analysis, review, and evaluation of
costs, claims, and trends.
CFI also commits to assist with development and design of year -round informational
materials, payroll stuffers, employee meetings, Annual Wellness Fair, etc. to maximize
employees' knowledge and understanding of how to be the best consumer of the employee
benefits plan. CFI is knowledgeable on all Federal and State benefits laws (including but not
limited to: COBRA, HIPPA, FMLA, etc.) and serves as a resource to the City's Human
Resources staff. CFI will keep the City's Human Resources Department informed of changing
legislation and legal decisions affecting employee benefits and advise on and discuss methods to
comply with these changes.
CFI provides compliant COBRA administration services via third party, to include
responsibility for all COBRA notification obligations, premium collection, and provide
documentation/reporting of same. CFI will coordinate the provision of Section 125
Administration services via third parties; and any other duties critical to the proper formation of
the City's benefits package and its optimal operation and participation.
CFI understands the scope of the work the City is requesting and makes a firm
commitment to provide the aforementioned services. Charles A. Citrin, President, is authorized
to make representations on the behalf of Citrin Financial and Insurance, Inc.
Charles Cihin, resP ident
Charles Citrin
Home Address:
3724 Pine Tree Drive
Miami Beach, FL 33140 -3936
Tel: (305) 672 -6088
Work Address:
300 71" Street Suite 300
Miami Beach, FL 33141 -3075
Tel: (305) 861 -0999
Fax: (305) 861 -0032
Citrin Financial &Gasurance, Inc. 13
2. Resume of the Proposer who will work on City matters and a statement
identifying the individual who will attend meetings and have primary
responsibility for City matters and whether that individual represents other
municipalities.
Charles Citrin, Deborah Citrin, Carmen Dumas and Mariblanca Cartaya will be the account
management team for the City of South Miami.
Charles Citrin is President and Founder of Citrin Financial & Insurance, Inc. In addition to
his over sixteen (16) years of insurance experience, Citrin brings over thirty -eight (38) years of legal
experience to CFI. After graduating as a Root Tilden Scholar from New York University Law
School in 1972, and from the University of Miami in 1969 with a BBA in accounting with honors,
Citrin acted as Assistant County Attorney for Miami -Dade County, Counsel for the Public Health
Trust, Bond Counsel for many cities, counties and school boards, including Miami -Dade County,
Broward County, Dade County Housing Authority, Miami -Dade County School Board, et al. Citrin
also has served as financial advisor to the Cities of Miami and Sunrise, Florida, and has acted as
underwriter on numerous public financings. In all, Citrin has worked on well over $2 billion of
public financing. He currently acts as City Attorney for the City of Hialeah Gardens and General
Counsel to the Hialeah Housing Authority. In both of those roles he has been involved in the
selection of employee benefits and the negotiations with various vendors and agents. Citrin is also a
former Certified Public Accountant. Mr. Citrin will have the primary responsibility for City matters
and will attend meeting along with Deborah Citrin.
Deborah B. Citrin is a 1980 graduate of Florida International University with a degree in
Occupational Therapy. After a career in Occupational Therapy and raising three (3) children, she
joined Citrin Financial. She brings an enormous knowledge of the medical profession, the various
billing techniques used by providers (doctors, hospitals, clinics) and a working knowledge of
medical language. She has been most effective in resolving disputed claims. She brings both
intelligence and a soft and calming nature that allows her to be effective with insurance company
bureaucrats and reassuring to plan participants (i.e., your employees).
Carmen M. Dumas acts as Office Manager and has been with Citrin Financial for twelve (12)
years. She is proficient in Microsoft Office, (Word /Outlook), WordPerfect, and QuickBooks
applications. She is bilingual (English and Spanish), and a 1977 graduate of Miami Senior High
Citrin Financial & Insurance, Inc. 14
School. She excels at organization skills, attention to detail and has a very effective problem solving
personality. In short, she's an excellent representative of Citrin Financial and the firm's clients. Prior
to her employment at Citrin Financial she was employed as a legal secretary for nineteen (19) years.
Mariblanca Cartava graduated High School in Havana, Cuba, in 1992. She has extensive
experience working with educational, non - profit and customer service entities. She brings the
following skills and attributes: She is results- oriented, hardworking and caring with excellent
interpersonal, verbal and written communication skills. She is attentive to detail with the ability to
handle multiple priorities in a fast paced setting. She is proficient with Microsoft Office (Word,
Excel, Power Point, Access, Publisher) Oracle, TRA Software, Dreamweaver CS3, QuickBooks,
Microsoft Money, Microsoft Works, Outlook Express. NC Health Services Information Systems:
HSIS & AS /400. Bilingual and Biliterate — English/Spanish.
Citrin Financial & Insurance, Inc. 15
3. List of any other entities with whom the Proposer has a contractual relationship
of other business affiliation.
CFI is the Agent of Record ( "AOR ") for the City of Opa -Locka (2005 - Present), City of
North Bay Village (2006 - Present), and the City of Sweetwater (2006 — Present). CFI handles South
Florida Water Management District's (2006- Present) Group Long Term Care as well as group
benefits for many other local businesses in the Miami Dade County area. CFI concentrates on
problem solving with our groups to help them obtain the right mix of employee /employer
contribution to maximize the benefits available to the most important asset of a business, its
employees. CFI works with most insurance carriers and has developed relationships with the carriers
to help expedite service issues as they arise. CFI also maintains relationships with the Human
Resource Department of each of our groups. CFI actively participates in the facilitation of
resolutions of problems and has a strong commitment to customer service. Our clients are our
priority.
Charles Citrin also brings over thirty -eight (38) years of legal experience to the insurance
business. Citrin has played many roles in the operation and representation of municipalities. He
currently acts as City Attorney for the City of Hialeah Gardens and General Counsel to the Hialeah
Housing Authority. In both of those roles he has been involved in the selection of employee benefits
and the negotiations with various vendors and agents. Each entity employs approximately one
hundred fifty (150) employees. In his role as counsel to the City of Hialeah Gardens and the Hialeah
Housing Authority, Citrin is intimately involved in the negotiations for various employee benefits,
including but not limited to, health, dental and supplemental benefits. In these roles Citrin is also
very familiar with union agreements. Citrin is also well versed in the present economic challenges
facing municipalities from his role both as City Attorney, Hialeah Housing Authority General
Counsel, and as the insurance agent for the Cities of North Bay Village, Opa- Locka, and
Sweetwater. Mr. Citrin has had extensive discussions regarding the present challenges facing
municipalities to deliver employee benefits due to declining tax basis and declining state support.
Citrin Financial & Insurance, Inc. 16
4. Disclosure of the following: (a) any relationships between proposer and any
commission member, spouse or family, etc.; (b) any relationship between the
Proposer and any business or entity owned by a Commission member or their
family or in which a Commission member or their family has or had an interest,
(c) any other information concerning any relationship between the Proposer and
any Commission member which the Proposer deems might be relevant to the
Commission's consideration; (d) such other governmental or quasi -
governmental entities which are represented by the Proposer, and the nature of
the representation; and (e) a "conflict list" if same is maintained by the Proposer.
NONE
5. Provide three (3) examples of work performed by the proposer that involved
services similar to those detailed herein and as to each, describe the scope of
work and explain why you believe it is similar to the work outlined in this RFP.
Prepare an Annual Stewardship Report, including complete accounting of fees and /or
commissions earned on the account, observations on relevant changes in the insurance market, view
on loss exposures facing the City of South Miami, loss control activities and insurance policy
summaries.
Solicit and negotiate plan proposals and rate quotes from existing and alternate insurance
carriers for the City's annual renewals.
Provide thorough analysis and recommendations for both cost - saving and benefit
enhancement options, to include scope of plan design changes (both new and nontraditional
approaches), impact on plan cost, value -added services, etc.
Conduct annual open enrollment benefits meetings for all employees, including preparation
and presentation of annual benefits plan status report.
Prepare Employee Benefit Guides detailing, but not limited to, the following: Pertinent
provider information, health plan benefits, dental plan overview, life insurance, qualifying events,
important phone numbers, etc.
Maintain an active and ongoing relationship with the service providers /insurance carriers to
ensure smooth operation and delivery of benefits as well as facilitating prompt review and resolution
of plan and claims administration issues.
Make regularly scheduled visits to the City to respond to questions, solve problems, hold
periodical Wellness talks and assist with benefit administration.
Provide a team of servicing representatives available to the City on an ongoing basis.
Citrin Financial & Insurance, Inc. 17
Provide plan design and financial management performance updates throughout the plan year
via detailed analysis, review, and evaluation of costs, claims, and trends.
Assist with development and design of year -round informational materials, payroll stuffers,
employee meetings, Annual Wellness Fair, etc. to maximize employees' knowledge and
understanding of how to be the best consumer of the employee benefits plan.
CFI will remain knowledgeable on all Federal and State benefits laws (including but not
limited to: COBRA, HIPPA, FMLA, etc.) and serve as a resource to the City's Human Resources
staff on same.
CFI will keep the City's Human Resources Department informed of changing legislation and
legal decisions affecting employee benefits and advise on and discuss methods to comply with these
changes.
Provide compliant COBRA administration services via third party, to include responsibility
for all COBRA notification obligations, premium collection, and provide documentation /reporting of
same.
Coordinate the provision of Section 125 Administration services via third party; and any
other duties critical to the proper formation of the City's benefits package and its optimal operation
and participation.
Citrin Financial & Insurance, Inc. is
References required:
The City of Hialeah Gardens
The City of Opa -Locka
The City of North Bay Village
The City of Sweetwater
City of Hialeah Gardens (Present — 2000)
Yioset De La Cruz 10001 N.W. 87`x' Ave.
Mayor Hialeah Gardens, FL 33016
Telephone: (305) 558 -4114
City of Opa -Locka (Present — 2005)
Kierra Ward 780 Fisherman Street
Acting Human Resources Director Opa- Locka, FL 33054
Telephone: (305) 953 -2815
The City of North Bay Village (Present — 2006)
Jenice Rosado 1666 Kennedy Causeway
Human Resources Suite 700
Telephone: (305) 756 -7171 North Bay Village, FL 33141
The City of Sweetwater (Present — 2006)
Joanna Rubio 500 SW 109 °i Ave
Human Resources Director Sweetwater, FL 33174 -1398
Telephone: (305) 221 -0411
Ciiriw Financial & Insurance, Inc. 19
6. Resumes of staff that will be performing the work.
CHARLES A. CITRIN
PROFESSIONAL HISTORY:
1998 to Present: Founder and President, Citrin Financial & Insurance, Inc.,
Miami Beach, Florida
2004 to Present: General Counsel to the Hialeah Housing Authority
2001 to Present: Citrin & Walker
2000 to Present: City Attorney, Hialeah Gardens, Florida
1996 to 1998 Associated Financial Consultants, Inc., Fort Lauderdale, Florida
1993 to 1996 Citrin & Blinderman, P.A., Miami, Florida
Law Practice
Practice centered on private /public finance and real estate
1989 to 1993; Charles A. Citrin, P.A., Miami, Florida
1996 to Present Law Practice
Practice centered on governmental contracts and public finance
City Attorney, City of Hialeah Gardens, Miami -Dade County,
Florida
1989 to 1993 Painewebber, Inc., Miami, Florida
Managing Consultant, Public Finance
Responsible for developing public finance business in Florida
1987 to 1989 Raymond James & Associates, Inc., Miami, Florida
First Vice President, Public Finance
• Initiated public finance effort in South Florida
1981 to 1987 Sparber, Shevin, Shapo & Heilbronner, P.A., Miami, Florida
Shareholder, Lawyer
• Managed bond counsel department
1978 to 1981 Fine, Jacobson, et al., P.A., Miami, Florida
Shareholder, Lawyer
• Concentrated on public /private financing
1975 to 1978
Assistant Dade County Attorney
Citrin Financial & Insurance, Inc. 20
PROFESSIONAL HIGHLIGHTS:
Successfully negotiated financing issues totaling over $2 billion, including numerous
development projects, trustee matters, public finance municipal bonds, tax
anticipation notes, tax - exempt commercial paper and securities
Underwriter for Miami -Dade and Broward Counties, the Miami -Dade County
Housing Finance Authority, the City of Miami Beach, the City of Miami Sports and
Exhibition Authority, the Miami -Dade County School Board, the Palm Beach County
School Board, the City of Davie and the City of Sarasota
Financial Advisor to the Cities of Miami and Sunrise
Bond Counsel for Miami -Dade and Broward Counties, the Cities of Miami, Hialeah
and Bay Harbor, the Miami -Dade County School Board, the Miami -Dade County
Housing Finance Authority, the Miami -Dade County Educational Authority and other
governmental entities
Underwriter's Counsel to, among others, Shearson Lehman Hutton, W.R. Hough,
Kidder Peabody, Smith Barney and Merrill Lynch
Assistant Miami -Dade County Attorney, 1975 to 1978
General Counsel to the Public Health Trust, 1976
Special Counsel to Florida Board of Examiners, 1978 and 1979
Special Counsel to Miami -Dade County in Florida Supreme Court Case, 1979
First Counsel to Miami -Dade County Industrial Development Authority, 1978
Chair, Florida Bar Committee on Housing and Community Development, 198 land
1982
Vice Chair of the Advisory Committee to the Finance and Tax Committee, Florida
House of Representatives, 1981
Official presenter for Florida State Committee on Infrastructure Financing, 1987
Authored "Industrial Revenue Bond Financing in Florida, The Present Situation ",
Florida Bar Journal, 1981; "Revival Seen For Small Issue Industrial Development
Bonds ", South Florida Business Journal, 1992
Drafted or co- authored the following legislation:
School Board tax anticipation notes, 1983
Documentary Surtax Bill of 1978
Cibin Financial &insurance, lnc. 21
Florida Industrial Development Statute, 1981
Community Redevelopment Statute, 1978
Original enabling legislation for tax increment financing in Miami -Dade
County, 1978
Florida Statutory Concept of "Slum and Blight" in the Industrial Development
Statute, 1978
EDUCATION:
New York University Law School, New York, NY
Juris Doctor, 1972
Root Tilden Scholar
University of Miami, Coral Gables, Florida
Bachelor of Business Administration, 1969
Cum Laude
Beta Alpha Psi (accounting honorary); Beta Gamma Sigma (business honorary); Phi
Kappa Phi (academic honorary)
LICENSES, CERTIFICATIONS, MEMBERSHIPS:
Florida Bar #146245
Certified Public Accountant (inactive status)
Series 7 Securities License, National Association of Securities Dealer (NASD)
License
Miami -Dade County Bar Association and Florida Bar Association
State of Florida Life, Health and Variable Annuities Insurance License
State of Florida Real Estate Sales License
COMMUNITY SERVICE:
Miami -Dade County School Board Superintendent's Scholarship Ball, Chair, 1989,
1990, 1991 and 1992
College Assistance Program, Inc., Board of Trustees, 1991 and 1992
Miami -Dade County Children's Service Council, 1994 and 1995
American Jewish Congress, Board of Directors, 1990, 1991 and 1992
Temple Beth Sholom, Chairman of the Board of Trustees, 2000, 2001 and 2002
Temple Beth Sholom, President, 1996, 1997, 1998 and 1999
Temple Beth Sholom, Vice President, 1994, 1995 and 1996; Board of Trustees, 1990
to present
Temple Beth Sholom, Chair, Fundraising Campaign, 1992 and 1993
Citrin Financial &insurance, Inc. 22
National Action Committee, Treasurer, 1988, 1989, 1990, 1991, 1992, 1993 and 1994
Greater Miami Chamber of Commerce, Chair, Committee to Defeat Proposition One
Greater Miami Book Fair, Board of Trustees, 1989
Greater Miami Jewish Federation, 1973 to present
Miami Beach Development Corporation, Board of Directors, 1987 and 1988
South Florida Conference of Soviet Jewry
City of Miami Beach Charter Review and Revision Board, 1991
Foundation Board - New World School of the Arts, 2002 to 2005
Advisory Board - Design and Architecture Senior High (DASH), 1999 to 2004
Miami Beach Chamber of Commerce - Board of Governor's, 2006 to present
Mt. Sinai Hospital Foundation Board, 2009 to present
Citrin Financial & Insurance, Inc. 23
300 71" Street
Suite 300
Miami Beach, FL 33141
305- 861 -0999 X 302
305- 861 -0032 — FAX
DeboraliC&citrinfinancial.com
Deborah Citrin
Objective To become the City of South Miami's Insurance Broker for all
employee benefits with our firm's exceptional service and support.
Experience 2004 — Present Citrin Financial & Insurance, Inc.
Miami Beach, FL
Executive Vice - President
Project manager for the employee benefit plans for the Cities of
Sweetwater, North Bay Village and Opa- Locka. Responsibilities
include determining the employee benefit plan needs of the
individual client, obtaining competitive quotes from various
insurance companies, education of the employees concerning the
plan options and hands on assistance during the enrollment
process. Assist clients with in -depth and tenacious problem
solving attention concerning claims issues throughout the year.
1981 -2003 Mt. Sinai Medical Center Miami Beach, FL
Miami Heart Institute Miami Beach, FL
Jim Hammond Therapy Miami Beach, FL
St. Francis Hospital Miami Beach, FL
Cedars Medical Center Miami, FL
Occupational Therapist — Contract, Staff and Supervisor Positions
• Evaluated and implemented treatment programs for adults and
children in a variety of treatment settings, including both in and out
patient programs.
• Developed a new Occupational Therapy evaluation for use with
psychiatric patients that improved direct client care.
Citrin Financial & Insurance, Inc. 24
• Supervised and taught Occupational Therapy students from local
universities.
• Presented in- service lectures to staff, students and other team
members.
As coordinator of the Stroke Club, arranged for monthly
speakers, lectures and health fairs.
Education 1980 Florida International University, Miami, FL
B. S. in Occupational Therapy
Professional Women In Insurance & Financial Services
Organization
Personal Married with three grown children, 26, 24 & 19 years old.
Interests include reading, gardening, theater, photography, Pilates, and
cooking.
Citrin Financial & Insurance, Inc. 25
Carmen M. Dumas
1650 NE 1 15" Street, Apt #402, Miami, FL 33181 -3100
Cell: (305) 608 -1183
EMPLOYMENT HISTORY
Organization Name(s):
Title:
Applicable Dates:
Responsibilities:
Citrin Financial & Insurance, Inc.
Citrin & Walker
Miami Beach, Florida
Administrative Assistant
February 1, 1999 to Present
Extensive and varied responsibilities, but primarily responsible for the efficient and smooth
operation of the office as it relates to the normal and usual proceedings of the office environment,
with the workload changing from day to day. Duties including bookkeeping, payroll and employer
related tasks, broker /dealer compliance, and general agent related tasks and communication, and
transcribing dictation and typing letters, internet research, ordering and obtaining insurance quotes,
opening files, processing insurance applications, client billing preparation, copying, scanning and
FAXing of documents, scheduling of meetings, answering phones, managing databases,
disseminating information (through email and internal memos), creating spreadsheets, generating
reports, ordering office equipment and supplies, and working with clients or customers.
Organization Name: Bedzow, Korn (no longer active)
Aventura, Florida
Title: Legal Secretary
Applicable Dates: May 1998 - January 1999
Responsibilities:
Secretary to Paul Lipton, Esquire and Associate Steve Friedman, Esquire. Responsibilities included
scheduling of appointments, depositions and court hearings (maintenance of calendar), transcribing
dictation, preparation of correspondence and court documents and general secretarial office duties.
Areas of law: Corporate, civil and family law litigation.
Organization Name:
Title:
Applicable Dates:
Responsibilities:
Lawrence H. Rogovin, PA
Aventura, Florida
Legal Secretary
May 1998 - January 1999
Citrin Financial & Insta-ance, lnc. 26
Secretary to solo practitioner with responsibilities including scheduling of appointments,
appointments, depositions and court hearings (maintenance of calendar), transcribing dictation,
preparation of correspondence and court documents and general secretarial office duties. Areas of
law: General civil and commercial litigation (contractual and transactional), corporate,
landlord /tenant, bankruptcy, probate, personal injury, family law and appellate practice. Practice
consists of mostly real estate (inclusive of commercial real estate related litigation), including
preparation of conveyance and related documents, title commitments and policies and light
bookkeeping duties.
Organization Name:
Title:
Applicable Dates:
Responsibilities:
Douglas D. Stratton, Esquire
Miami Beach, Florida
Legal Secretary
July 1984 - November 1986
Secretary to solo practitioner with responsibilities including scheduling of appointments,
appointments, depositions and court hearings (maintenance of calendar), transcribing dictation,
preparation of correspondence and court documents and general secretarial office duties. Areas of
law: General civil litigation, traffic court, probate, real estate, family and corporate law.
Bookkeeping and client billing duties.
Organization Name:
Title:
Applicable Dates:
Responsibilities:
Straley, Merrill & Pollack, P.A.
Keith J. Merrill, Esquire
Stephen J. Straley, Esquire
North Miami, Florida
Legal Secretary
June 1982 -June 1984
Primary secretary to Mr. Straley and secondary secretary to Mr. Merrill, with responsibilities
including maintaining collection files, preparation of correspondence, filings of liens and foreclosure
proceedings, transcribing dictation and general secretarial office duties. Areas of law: collections,
contractual and corporate law, civil litigation and real estate transactions.
Organization Name:
Title:
Applicable Dates:
Responsibilities:
Keith J. Merrill, Esquire
Miami, Florida
Legal Secretary
January 1979 -May 1981
General secretarial office duties such as answering telephones, typing, filing, maintaining calendar,
scheduling of court hearings, clients appointments and other meetings). Areas of law:
Condominium conversions, civil litigation and real estate transactions.
Citrin Financial & Insurance, Gvc. 27
Organization Name:
Title:
Applicable Dates:
Responsibilities:
Attorneys' Title Services (The Fund)
Dade Branch, Little River, Florida
Typist
January 1977 - December 1978
Verifying and typing chain of title, tax and name search information to be included in complete,
continuation or partial abstract of title orders and working in conjunction with various departments
(order, abstracting, photocopying and delivery).
Education:
Miami Senior High School — Class of 1977
Skills:
Bilingual (English/Spanish)
Proficient in WordPerfect for Windows, Microsoft Office Programs, Illustration Software
and Quickbooks
Detail oriented and organized
CMDResume2011
7/7/2011 1:56:37 I'M
Cit in Financial & Insurance, Inc. 28
MARIBLANCA CAR TA YA
1301 Salzedo Street, Coral Gables FL 33134
Phone: 786 - 423 -3845
E —Mail: mcartaya(&1ive.com
.......• ........................................... ...............................
Extensive experience working with educational, non -profit and customer service settings bringing the
following experience, skills, and attributes:
Results- oriented, hardworking and caring with excellent interpersonal, verbal and written communication
skills. Attentive to detail with the ability to handle multiple priorities in a fast paced setting. Experience with
Microsoft Office (Word, Excel, Power Point, Access, Publisher) Oracle, TRA Software, Dreamweaver CS3,
QuickBooks, Microsoft Money, Microsoft Works, Outlook Express. NC Health Services Information
Systems: HSIS & AS /400.
Fast and accurate typist. Bilingual and Biliterate — English/Spanish.
......................................................... ...............................
WORK EXPERIENCE
Citrin Financial & Insurance, Inc.
• Performed multifaceted general office support.
Florida School Services, Miami FL
• Performed multifaceted general office support.
Wake County Human Services -WIC, Raleigh, NC
Responsible for disseminating program information, scheduling in -take interview
and determining program eligibility.
• Works closet), as part of a team that provides customer service for program implementation.
• Provides administrative support as necessary.
El Pueblo, Inc., Raleigh, NC
AdiNnus1rative Assistaw
June 2011 — Present
April 2011 — Present
July 2010 — February 2011
April 2009 —July 2010
• Provided multifaceted administrative support to the Program Director.
• \lennbcr of the Grant Preparation Team.
• Oversaw and maintained all financial and budgetary aspects of the program.
• Worked closet), with staff in specific aspects of event implementation including registration, logistics and invoices.
• Census 2010 Coordinator.
• Translated documents into Spanish. ..
• Notarized documents Nvhen needed.
Knightdale YR Elementary School, Knightdale, North Carolina April 2007 — April 2009
Clerical Assistant
• Performed multifaceted general office support.
Citrin Financial & Insurance, Inc. 29
• Created and maintained the school Nvebsite.
• Before and After School Program Coordinator.
• Provided assistance as a translator for parent /teacher conferences and meetings.
Coral Gables Elementary School, Miami Florida
Secretary
• Provided confidential administrative support to the Principal and Assistant Principal.
• Kept monthly budget reports.
• FoRolved -up with purchase orders and kept accurate records.
• Provided Data Input as needed.
Developed and maintained excel spreadsheets and databases as needed.
Cuban Telephone Company, Havana Cuba
Executive Secviary (Commercial Deparb»ew)
Performed multifaceted general office support.
• Worked closely with the Commercial Department vice - President in following up on projects.
• Developed an excel spreadsheet and database of customers information.
• Kept monthly reports.
Computer Systems Design, Havana Cuba
Executive Secretary
Assisted the office director irn following up on projects and other requests.
• Performed multifaceted general office support.
• Kept monthly reports.
EDUCATION
High School Diploma, 1992
R.D.P. Argelina High School, Havana, Cuba
CENSAI Information Center, 1995
Sofhvare and Computer Courses, Havana, Cuba
WORKSHOPS AND IN- SERVICES
October 2004 —J a nuary 2007
January 2000 —January 2003
September 1994 — March 1999
Miami -Dade County Public School, Miami, Florida
Current Issues and Strategies I — October 2004
School Level Budget Reports — November 2004
Current Issues and Strategies II —January 2005
Developing Good Writing Skills (Intermediate) — January 2005
Computer Literacy — February 2005
Developing Good Writing Skills (Advanced) — February 2005
Citrin Financial & Insurance, Inc. 30
Web Based /Online Application — March 2005
Multicultural "Training —April 2005
Leadership Skills for Secretaries — April 2005
Office Filing — Apr] 2005
Beyond Spell Check — June 2005
Cl & S Reading (Part I) — August 2005
Philosophy Governing Laws and School Board Rules — December 2005
Communications —January 2006
Writing Skills III — March 2006
MSA Budget /Finance /Purchasing System Online Application — March 2006
Writing Skills IV — April 2006
Wake County Public School - North Carolina
Medication Administration: Training for School Designees —June 11, 2007
School Funds 2007 Updates and Year -End Close Out —June 21, 2007
Purchasing, Warehouse, & the Purchasing Card — July 23, 2007
Assisting Schools with Human Resources Forms, Reports & Procedures —July 23, 2007
Everything you wanted to know about Field'I'rips and MORE! —July 23, 2007
Oracle (Admin Inquiry) for School -Based Secretaries /Bookkeepers — August 21, 2007
Eastern Region Clerical Support Staff Training — August 22, 2007
Oracle Payroll Training 2007 -2008 — September 26, 2007
Tuition School Care Programs: Principal /Coordinator Guidebook Training — September 22, 2007
CPR, First Aid — October 11, 2007
Playground Equipment Safety — October 12, 2007
Compensation Services: Overview — February 25, 2008
Tuition School Care TRA Training- Review —June 12, 2008
Tuition School Care Guidebook Training - Review —June 12, 2008
Interpreter /Translator Training for Spanish /English WCPSS Employees — October 2008
REFERENCES UPON REQUEST
Citrin Financial & Insurance, lac. 31
NON - COLLUSION AFFIDAVIT
.Insurance Brokerage Services.
STATE OF FLORIDA )
COUNTY OF MIAMI -DADE )
CHARLES A- CITRIN being first duly sworn, deposes and
states that:
(1) He /She /They is /are the PRESIDENT
(Owner, Partner, Officer, Representative or Agent)
Of CITRIN FINANCIAL & INSURANCE INC the PROPOSER that has submitted the
attached BID;
(2) He /She /They is /are fully informed with respect to the preparation and contents of the
attached BID and of all pertinent circumstances concerning such BID;
(3) Such BID is genuine and is not a collusive or sham BID;
(4) Neither the said PROPOSER nor any of its officers, partners, owners, agents,
representatives, employees or parties in interest, including this affiant, have in any way
colluded, conspired, connived or agreed, directly or indirectly, with any other PROPOSER,
firm, or person to submit a collusive or sham BID in connection with the Work for which
the attached BID has been submitted; or to refrain from PROPOSING in connection with
such Work; or have in any manner, directly or indirectly, sought by agreement or collusion,
or communication, or conference with any PROPOSER, firm, or person to fix any overhead,
profit, or cost elements of the BID or of any other PROPOSER, or to fix any overhead,
profit, or cost elements of the BID Price or the BID Price of any other PROPOSER, or to
secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage
against (Recipient), or any person interested in the proposed Work;
(5) The price or prices quoted in the attached BID are fair and proper and are not tainted by
any collusion, conspiracy, connivance, or unlawful agreement on the part of the PROPOSER
or any other of its agents, representatives, owners, employees or parties of interest,
including this affiant.
Signed, sealed and delivered in the presence of:
0
Subscribed and sworn to before me this
Signature
Charles A Citrin President
Print Name and Title
2011
L cAiel�EN �1 f3UM.AS 4 f � �. M 'OMMISSION # DD672695 Notary Public (Si nature)
EXPIRES August 19, 2011
153 rlondaRolart,Semce.xm My Commission Expires:
FAILURE TO COMPLETE SIGN. & RETURN THIS FORM MAY DISQUALIFY YOUR RESPONSE
Insurance Brokerage Services RFP No. SM- 2011 -09 -HR Page 20 of 25
SIGNATURE PAGE
Insurance Brokerage Services
The undersigned attests to his (her, their) authority to submit this Submittal and to bind the
firm(s) herein named to perform as per agreement. Further, by signature, the undersigned
attests to the following:
I. The Proposer is financially solvent and sufficiently experienced and competent to perform
all of the work required of the Proposer in the Contract;
2. The facts stated in the Proposer's response pursuant to Request for Proposal, instructions
to Proposer and Specifications are true and correct in all respects;
3. The Proposer has read and complied with, and submits its proposal agreeing to all of the
requirements, terms and conditions as set forth in the Request for Proposals.
4. The Proposer warrants all materials supplied by it are delivered to the CITY of South
Miami, Florida, free from any security interest, and other lien, and that the Proposer is a
lawful owner having the right to supply the same and will defend the conveyance to the
CITY of South Miami, Florida, against all persons claiming the whole or any part thereof.
5. Proposer understands that if a team is short listed and selected to make oral presentations
to the selection committee and /or CITY, only the team members who were involved in the
preparation of the written submissions may participate in the oral presentations. Any
changes to the team at the oral presentations may, at the sole discretion of the City, result
in that Proposer's Bid disqualification.
6. The undersigned certifies that if the firm is selected by the City the firm will negotiate in
good faith to establish a Contract.
7. Proposer understands that all information listed above may be verified by the City of South
Miami and Proposer authorizes all entities or persons listed above to answer any and all
questions. Proposer hereby indemnifies the City of South Miami and the persons and
entitles listed above and holds them harmless from any claim arising from such investigation
and verification process, including the dissemination of information pursuant thereto.
Submitted on this 1 day of July 2611
(If an indnifill partners q, , or non - incorporated organization)
CITRIN FINANCIAL
Witnes Company : rTPAT\I('P IN
Printed: ( y f J By:
Title:
AP
Fj i Print Name, Title: Charles A. Citrin
(If a corporation, affix seal) President
Company:
By:
Attested by Secretary Print Name, Title:
Incorporated under the laws of the State of Florida
FAILURE TO COMPLETE SIGN & RETURN THIS FORM MAY DISQUALIFY YOUR RESPONSE
Insurance Brokerage Services RFP No. SM- 2011 -09 -HR Page 21 of 25
CERTIFICATION OF AUTHORITY
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
Corporation or
X LLC
is not applicable to an individual
Brokerage
11 Partnership 11 LLP 11 Joint Venture
I HEREBY CERTIFY that a meeting of the Board of Directors, Partners, and /or Principals
(include DBA -Doing Business As, if applicable) of the following entity
CITRIN FINANCIAL & INSURANCE INC.
an organization existing under the laws of the State of Florida , was
held on July 20 11 and the following resolution was duly
passed and adopted:
"RESOLVED, that, Charles A. Citrin as President of the
organization, be and is hereby authorized to execute the Proposal dated, Q] day of
July 2011 , to the City of South Miami and this organization and that
my execution thereof, attested by a Notary Public of the State, shall be the official, act and deed
of this attestation"
I further certify that said resolution is now in full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the official seal of the
corporation this, 01 day of Jul y n , * 11
Print Name Charles A.
NOTARY PUBLIC:
SEAL �v; sip CARMEN "M DUMAS XXX Personally known to me, or
rc MY COMMISSION # DD672695 Personal identification:
FXPIRES August 19, 2011
tamjase -o�sa Prodaewolury;arv�co.nom NSA (Personally known)
~TMwT Type of Identification Produced
FAILURE TO COMPLETE SIGN & RETURN THIS FORM MAY DISQUALIFY YOUR RESPONSE
Insurance Brokerage Services RFP No, SM- 2011 -09 -HR Page 22 of 25
REFERENCES
Please list three (3) governmental agency, or comparable corporate client, contract
references for which you have done business within the past three (3) years:
Agency Name: City of Opa -Locka
Address: 780 Fisherman Street
City, State & Zip Code:
Contact's Name:
Telephone Number:
Agency Name:
Address:
City, State & Zip Code:
Contact's Name:
Telephone Number:
Agency Name:
Address:
City, State & Zip Code:
Contact's Name:
Telephone Number:
Opa- Locka, FL 33054
Kierra Ward
(305) 953 -2815
North Bay Village
1666 Kennedy Causeway
Suite 700
North Bay Village, FL 33141
Jenice Rosado
(305) 756 -7171
City of Sweetwater
500 S.W. 109 °i Avenue
Sweetwater, FL 33174
Joanna Rubio
(305) 221 -0411
Attach additional sheets if necessary.
FAILURE TO COMPLETE, SIGN, & RETURN THIS FORM MAY DISQUALIFY YOUR RESPONSE
Ci[rin Financial & Insurance, Inc. 35
RFP INFORMATION FORM
Insurance Brokerage Services
I certify that any and all information contained in this RFP is true;' and I further certify 'that this
RFP is made without prior understanding, agreement, or connections with any corporation,
firm or person submitting a RFP for the same materials, supplies, equipment, or services and is
in all respects fair and without collusion or fraud. I agree to abide by all terms and conditions of
the RFP, and if the Proposer is a legal entity, I certify that I am authorized to sign for the
Proposer. Please print the following and sign your name where indicated below:
Firm's Name: CITRIN FINANCIAL & INSURANCE, INC.
Principal Business Address: 300 71st Street, Suite 300
Miami Beach, FL 33141 -3075
Telephone: 305/861 -0999 Fax: 305/861 -0032
E -mail address: chascitrin
Name
Charles A. Citrin
Title: President
@ aol.Com
Signature of Citrin Financial & Tn urance, Inc.
Authorized P `f
Representative: & N
(� A /
FAILURE TO COMPLETE SIGN & RETURN THIS FORM MAY OISOUALIFY YOUR RESPONSE
Insurance Brokerage Services RFP No. SM- 2011 -09 -HR Page 24 of 25
NO CONFLICT OF INTEREST CERTIFICATION
Insurance Brokerage Services
The undersigned, as Bidder /Proposer, declares that the only persons interested in this RFP are
named herein; that no other person has any interest in this RFP or in the Contract to which
this RFP pertains; that this response is made without connection or arrangement with any
other person; and that this response is in every respect fair and made in good faith, without
collusion or fraud.
The Bidder /Proposer agrees that if this response /submission is accepted, to execute an
appropriate CITY document for the purpose of establishing a formal contractual relationship
between the Bidder /Proposer and the CITY, for the performance of all requirements to which
the response /submission pertains.
The Bidder /Proposer states that this response is based upon the documents identified by the
following number: Bid /RFP No. 9M- 2011 -09 —BR
The full -names and residences of persons and firms interested in the foregoing bid /proposal, as
principals, are as follows:
The Bidder /Proposer further certifies that this response /submission complies with Chapter 8(a)
of the Code of Ordinance, City of South Miami; Florida, that, to the best of its knowledge and
belief, no Commissioner, Mayor, or other officer or employee of the CITY has an interest
directly or indirectly in the profits or emoluments of the Contract, job, work or service to
which the response /submission pertains.
Signed, sealed and delivered in the presence of:
0
Subscribed and sworn before me this
CARMEN M DUMAS
MY COMMISSION N D0672695
EXPIRES August 19, 2011
NtJ1y'U .%
Signature
Charles A. Citrin, President
Print Name and Title
2011
My Commission Expires: (q u l f
FAILURE TO COMPLETE. SIGN. &RETURN THIS FORM MAY DISQUALIFY YOUR RESPONSE
Insurance Brokerage Services RFP No. SM- 2011 -09 -HR Page 25 of 25
CONE OF SILENCE AFFIDAVIT
Insurance Brokerage Services
The "Cone of Silence" specifically prohibits communication regarding RFP "S
(bids) or any solicitation with the City of South Miami staff except by written
means, with copy filed with the City Clerk. This takes effect upon
advertisement for Request for Proposal and terminates when the City Manager
makes his recommendation to the City Commission for the award. An
exception is made for oral communication during pre - proposal conferences. In
addition to any other penalties provided by law, violation of the Cone of Silence
shall render any proposal disqualified.
CITY OF SOUTH MIAMI DISCLOSURE AFFIDAVIT
Charles A. Citrin being first duly sworn, state: Florida
The full legal name and business address* of the person or entity contracting or transacting
business with the City of South Miami are:
CITRIN FINANCIAL & INSURANCE, INC.
300 71st Street, Suite 300
Miami Peach, FL 33141 -3075
If the contract or business transaction is with a corporation, the full legal name and business
address* shall be provided for each officer and director and each stockholder who holds
directly or indirectly five percent (5%) or more of the stock in the corporation. If the contract
or business transaction is with a partnership, the full legal name and business address* shall be
provided for each partner. If the contract or business transaction is with a trust, the full legal
name and address* shall be provided for each trustee and each beneficiary.. If the contract or
business transaction is with an LLP or LLC, the full legal name and address* shall be provided
for each member of the LLP or LLC. All such names and addresses are:
L�7/1
The full legal names and business address* of any other individual (other) than subcontractors,
material men, suppliers, laborers, or lenders who have, or will have, any interest (legal,
equitable, beneficial or otherwise) in the contract or business transaction with the City of
South Miami are:
N/A
Insurance Brokerage Services RFP No. SM -201 1 -09 -HR Page 26 of 25
Notary Public
Signed, sealed and delivered in the presence of:
By: i
Signature
Charles A. Citrin, President
Print Name and Title
Subscribed and sworn to before me this y f Jul '2011
bRwau•• CARMEN M DUMAS Notary ubhc (Sig ature)
�• _ h4Y COMMISSION # D0672695 ,
My Commission Expires: C'
-1....a "0' EXPIRES August 19, 2011
n +ti tipR0151- ._. �!oaNOtarySOrvlcorecom
FAILURE TO COMPLETE, SIGN, & RETURN THIS FORM MAY DISQUALIFY YOUR RESPONSE
Insurance Brokerage Services RFP No. SM- 2011 -09 -11R Page 27 of 25
SWORN STATEMENT UNDER SECTION 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR
OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS.
1. This sworn statement is submitted to the City of South Miami
[print name of public entity]
By Charles A. Citrin, President
[print individual's name and title]
for Citrin Financial & Insurance, Inc.
[print name of entity submitting sworn statement]
whose business address is 300 71 st Street, Suite 300, Miami Beach, FL 33141
and (if applicable) its Federal Employer Identification Number (FEIN) is 65- 0857342 (If the
entity has no FEIN, include the Social Security Number of the individual signing this sworn
statement:
2. I understand that a "public entity crime" as defined in Paragraph 287.133(I)(g), Florida Statutes,
means a violation of any state or federal law by a person with respect to and directly related to the
transaction of business with any business with any public entity or with an agency or political
subdivision of any other state or of the United States, including, but not limited to, any bid or
contract for goods or services to be provided to any public entity or an agency or political
subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery,
collusion, racketeering, conspiracy, or material misrepresentation.
3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida
Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an
adjudication of guilt, in any federal or state trial court of record relating to charges brought by
indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a
plea of guilty or nolo contendere.
4. I understand that an "affiliate" as defined in Paragraph 287.133 (1)(a), Florida Statutes, means:
1. A predecessor or successor of a person convicted of a public entity crime; or
2. An entity under the control of any natural person who is active in the management of the entity
and who has been convicted of a public entity crime. The term "affiliate" includes those officers,
directors, executives, partners, shareholders, employees, members, and agents who are active in
the management of an affiliate. The ownership by one person of shares constituting a controlling
interest in another person, or a pooling of equipment or income among persons when not for fair
market value under an arm's length agreement, shall be a prima facie case that one person
controls another person. A person who knowingly enters into a joint venture with a person who
has been convicted of a public entity crime in Florida during the preceding 36 months shall be
considered an affiliate.
Eli]
5. I understand that a "person" as defined in Paragraph 287.133(I)(e), Florida Statutes means any
natural person or entity organized under the laws of any state or of the United States with the legal
power to enter into a binding contract and which bids or applies to bid on contracts for the provision
of goods or services let by a public entity, or which otherwise transacts or applies to transact
business with a public entity. The term "person" includes those officers, directors, executives,
partners, shareholders, employees; members, and agents who are active in management of an entity.
6. Based on information and belief, the statement which I have marked below is true in relation to the
entity submitting this sworn statement. [indicate which statement applies.]
X Neither the entity submitting this sworn statement, nor any officers, directors, executives,
partners, shareholders, employees; members, or agents who are active in the management of the
entity, nor any affiliate of the entity has been charged with and convicted of a public entity
crime subsequent to July 1, 1989.
— The entity submitting this sworn statement, or one or more of its officers, directors, executives,
partners, shareholders, employees, members or agents who are active in management of the
entity, or an affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989.
— The entity submitting this sworn statement, or one or more of its officers, directors, executives,
partners, shareholders, employees, members, or agents who are active in the management of the
entity, or an affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July I, 1989. However, there has been a subsequent proceeding before a Hearing
Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered
by the hearing Officer determined that it was not in the public interest to place the entity
submitting this sworn statement on the convicted vendor list lattach a copy of the final order]
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE
PUBLIC ENTITY IDENTIFIED IN PARAGRAPH I (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY
AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT
IS FILED. 1 ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO
ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION
287.017, FLORIDA STATUTES FOR CATEGORY TWO O ANY CHANGE IN THE INFORMATION
CONTAINED IN THIS FORM. 71 11 n n
signature]
Sworn to and subscribed before me this _day of July ___, 2011
Personally known XXXX
OR Produced identification N/A Notary Public -State of Florida _
at Large
N/A My commission expires
(Type of Identification)
1 �.�
rtn d typ or sta ipea"Co tinlissioned name of Notary Public)
L;3"MY COMMISSIGtJ -t, DDb "72895
-EXPIRES August 1 J. 2011= 3 m.. -. rmdluNOlaryaerv;ceAVn:, _.
41
BUSINESS AND PROFESSIONAL LICENSES
A0477:58
Citrin Financial & Insurance, Inc 43
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
DEBORAH BOWERS CITRIN
License Number EIW26
IS LICENSED TO TRANSACT THE FOLLOWING CLASSES OF INSURANCE.
! Life. Health & Var Annuity
3
RESIDENT
LICENSE
This I. icensee must have an aclrve appoinuneni with the insurer or employor for which products or services ale be:nq
marketed See reverse for additional rngwremenis.
Cin-in Financial & Insurance, Inc. 44
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Citrin Financial & Insurance, lac. 45
THIS IS NOT A BILL - 00. NOT PAY
FIRST -CLASS
U.S. POSTAGE
PAID'
MIAMI, FL
PERMIT NO. 231
404527 -4 RENEWAL
BUSINESS NAME I LOCATION RECEIPT NO. 4#22164-4
CITRIN FINANCIAL & INSURANCE INC
300 71 ST 300
33141 MIAMI BEACH
'OWNER
CITRIN FINANCIAL & INSURANCE.INC .
%Soo, Type of Business
TMENT /HOLDING CO I
DO NOT FORWARD
PAYMEMft"WEn
WAMWAOECOUnry TAI(
cauecTon;
09/23/2010
60060000457
000270.00
SEE OTHER SIDE
CITRIN FINANCIAL & INSURANCE INC
CHARLES A CITRIN PRES
300 71 ST 300
MIAMI BEACH FL 33141
IIII1131111ttIIIII.IIIIIIIIIII I II„Ii„IIIIIIII11'1 1'167,111
Cin-in Financial & Insurance, Inc. 46
Throughout CFI's term as AOR we will actively manage the City's account and assist with
service issues on an ongoing basis. CFI maintains relationships with insurance carriers to
ensure expedited service when client service issues arise. CFI provides an account
management team to assist with questions, solve problems, and assist with benefits
administration who will respond in a timely manner. CFI will also visit the City on an as
needed basis to hold periodic employee meetings and address any issues, concerns or just
to update employees on benefit information. CFI will maintain records of the plans,
financial and claims experience as provided by the insurance carriers, and provide progress
reports to the City to continually evaluate the effectiveness of plans. CFI will be
responsible for maintaining the confidentiality of the City's records which CANNOT be
sold, shared or otherwise disclosed to other companies or individuals without prior written
permission.
This timeline is for illustrative purposes and is subject to change to meet the City's needs:
JULY *Assuming the contract is awarded
Meet with the City to discuss existing benefits plan and identify potential
gaps /overlaps and make recommendations as necessary.
Contact existing insurance carrier and complete required change of agent paper
work.
Enroll in any online services that the current insurance carrier maintains.
Request and review historical claims experience, demographic data trends and plans
performance from existing carrier.
Supply the City with informational material /payroll stuffers.
Review City processes and procedures and make recommendations with regard to
compliance issues, HIPPA, FMLA, etc.
Provide plan design and financial management performance updates.
Conduct employee survey to gauge satisfaction.
If requested, help to develop annual employee benefit statements.
Supply the City with informational material /payroll stuffers.
Meet with City to discuss results from employee satisfaction survey.
Supply the City with informational material /payroll stuffers.
AUGUST
Solicit and negotiate plan proposals and rate quotes from existing and alternate
carriers for annual renewals.
Perform all necessary professional services related to bid requests and negotiating
the best bid from vendor submittals.
Provide analysis and summary of plan proposals and rates from existing and
alternate carriers for annual renewals.
Meet with City to discuss CFI recommendation and City's selection.
Supply the City with informational material /payroll stuffers.
Preparation and finalization of Open Enrollment materials including the Employee
Benefits Guide.
Schedule an employee meeting to discuss legislature and legal decision changing
the insurance marketplace.
Citrin Financial & Insurance, btc. 47
Available to meet with Staff through out the planning of Open Enrollment as
needed.
Supply the City with informational material /payroll stuffers.
SEPTEMBER
Provide plan design and financial management performance updates.
Coordinate with insurance carrier representative for their presence at Open
Enrollment.
Coordinate and Participate in Open Enrollment.
Coordinate and Participate in Annual Wellness Fair.
Coordinate COBRA administration services via third party.
Coordinate provision of Section 125 administration services via third party.
Supply the City with informational material /payroll staffers.
OCTOBER
Review City processes and procedures and make recommendations with regard to
compliance issues, HLPPA, FMLA, etc.
Meet with City to review and discuss Open Enrollment and follow up on any
outstanding issues.
Supply the City with informational material /payroll stuffers.
NOVEMBER
Conduct employee survey to gauge satisfaction.
Supply the City with informational material /payroll stuffers.
DECEMBER
Provide plan design and financial management performance updates.
Meet with City to discuss results from employee satisfaction survey.
Supply the City with informational material /payroll stuffers.
JANUARY
Submit Annual Stewardship Report.
Meet with City if needed.
Supply the City with informational material /payroll stuffers.
FEBRUARY
Conduct an employee meeting to discuss legislature and legal decisions changing
the insurance marketplace.
Supply the City with informational material /payroll stuffers.
MARCH -JUNE
Request and review historical claims experience, demographic data trends and plans
performance from existing carrier.
Meet with the City to discuss existing benefits plan and identify potential
gaps /overlaps and make recommendations as necessary.
Supply the City with informational material /payroll stuffers.
Citrin Financial & Insurance, Inc. 48
Opa OKO
ip�Kn °— 6G pN
EMPLOYEE BENEFITS SURVEY
Thank you for participating in our Employee Benefits Survey. This survey is designed to provide
you with the opportunity to tell us how you think we are doing in meeting your benefits needs as we
prepare for the next enrollment period. Please complete and submit to the Human Resources
Department by June 30, 2011.
Satisfaction with Benefits — How satisfied are you that: (Check one)
If you said that you were "dissatisfied" with any of the above, please tell us why you feel this way:
Importance of Benefits — please indicate the level of importance to you of each of the
following programs in the City's benefits package. (Check one)
Very
Important
Somewhat
Important
Not Very
Important
Very
Medical Plan
Satisfied
Satisfied
Neutral
Dissatisfied
Dissatisfied
The City provides you with
the type of benefits you
need?
You understand the City's
benefit options?
The City provides benefits
that compare favorably with
other companies in the
industry?
If you said that you were "dissatisfied" with any of the above, please tell us why you feel this way:
Importance of Benefits — please indicate the level of importance to you of each of the
following programs in the City's benefits package. (Check one)
Is there any ways in which the City could improve the benefits programs currently provided?
Name (OPTIONAL)
Citrin Financial & Insurance, Inc. 49
Very
Important
Important
Somewhat
Important
Not Very
Important
Not
Important at
all
Medical Plan
Dental Plan
Life Insurance
Retirement
Employee Assistance
Program (EAP)
Is there any ways in which the City could improve the benefits programs currently provided?
Name (OPTIONAL)
Citrin Financial & Insurance, Inc. 49
YOUR BENEFITS AT A GLANCE
Provider
Products/Service
Employee
Contributions
Contributions
Coventry Health
Health Insurance
All
100% for
50% for
Care of Florida
Employees
Employees
Dependents
Solstice Benefits
Dental Insurance
All
100% for
50% for
Employees
Employees
Dependents
Primary Plus
Vision Plan
All
100% for
NA
Employees
Employees
Security Mutual
Life Insurance
All
100% for
NA
Life Insurance
Employees
Employees
Standard Life
Life Insurance
Executive
100% for
NA
Insurance /AD &D
Pertinent
Employees
LifeSynch
Employee
All
100% for
As provided
Assistance
Employees
Employees
for employee
Program
and family
Miami Dade
Accidental Death
Certified Law
100% for
NA
County General
&
Enforcement
Pertinent
Services
Dismemberment
Personnel
Employees
Administration
AFLAC
Supplemental
All
Optional
Insurance
Employees
Colonial Life
Supplemental
All
Optional
Insurance
Employees
Conseco Life
Life Insurance
All
Optional
Employees
ANICO
Deferred
All
Optional
Compensation
Employees
ICMA
Deferred
All
Optional
Compensation
Employees
Pre -paid Legal
Legal Service Plan
All
Optional
Employees
Dade County
Banking and
All
Optional
Federal Credit
Financial Services
Employees
Union
Membership
AAA
Vehicle Protection
All
Optional
Membership
I
Employees
Cihin Financial & Insurance, Inc. 50
MEDICAL INSURANCE
COVENTRY HEALTH CARE OF FLORIDA
The City of Opa -locka offers full time employees the option of two medical plans with
Coventry Health Care of Florida. Aside from a toll free customer service number,
employees have access to online self - services to: search for network doctors, check claim
status, request ID cards, view benefit summaries and obtain educational information.
The chart below is provided for information and does not include complete details. A
Summary of Benefits will be provided during Open Enrollment or can be obtained from
Human Resources.
PLANFEATURES
HMO PLAN
EMPLOYEE CO -PAY
Office Visit
$15
Specialist Visit
$30
Annual Hospital Deductible (applies to all inpatient
$500
and outpatient services at hospitals.
Lifetime Maximum Benefit
Unlimited
Individual /Family
Emergency Services
$100
(waived if admitted)
Urgent Care
$30
Outpatient Surgery
After Hospital Deductible: $200
Ambulatory Surgery Center
$100
Outpatient Diagnostic Center
$50
In Physician Office
$0
In Hospital Surgery
$200 /day 1 -5 after deductible
Prescription Drug Coverage
$15/35/50/200/,
Retail (up to 30 days)
90 Day Supply
EMPLOYEE
G I-WEEKLY PAYROLL
DEDUCTIONS
Type of Plan
Employee
Employee /Spouse
Employee /Child(ren)
Family
Only
HMO
0
$90.02
$81.01
$188.03
PPO
$65.80
$311.64
$287.05
$581.19
Citrin Financial & Insurance, /nc 51
Short Term /Long Term Disability Coverage — This type of
AFLAC
insurance replaces your income if you become disabled from an
Colonial
accident or sickness. Benefits are available for up to 66% of
your income for off the job accidents /sickness and 33% of your
income for on the job accidents /sickness with a choice of
benefits period and elimination periods. Maternity benefits,
partial disability, worldwide coverage, waiver of premium are
included. Such benefits are offered through Colonial Life and
AFLAC.
Cancer Insurance — This plan provides coverage that helps
AFLAC
you pay some of the direct and indirect- costs related to cancer
Colonial
diagnosis and treatment, including, bone marrow transplants,
travel expenses, surgical procedures and supportive or
protective -care drugs.
Critical Illness - Coverage provides employees with a lump-
AFLAC
sum benefit from $5,000 and up for diagnosis of heart attack,
Colonial
stroke, major organ transplant, renal failure, cancer, paralysis,
coma, blindness, Occupational HIV, or Occupational Hepatitis.
Universal :Life — A cash -value life insurance product with
Colonial
'
flexible premiums and an adjustable beefit. Also provides for
Long Term Care Rider.
Term Life - An individual > term life insurance product that
Colonial
offers 10 year, 20 year or 30 year level premium and death
benefits.
Accident Indemnity This plan covers benefits ;for emergency
AFLAC
treatment, follow up treatment, hospitalization, physical therapy
and more.
Hospital Protection Plan - Besides hospitalization, this plan
AFLAC
covers diagnostic exams, surgeries and ambulance.
Medical Bridge Policy — Provides protection to supplement the
Colonial
medical plan and minimize out of pocket cost in the event of
hospitalization.
Deferred Compensation — Pre -tax retirement savings to
ICMA
supplemental other retirement plan offered by the City
ANICO
Cilrin Financial & insurance, Inc. 52
April 29, 2010
To All of Our Very Important Clients:
We want to share with you news about the Health Reform Package that was passed by
both the House and Senate and Ilion signed into law by President Obama on March 30, 2010.
The new law has thousands of pages and hundreds of provisions and before all of the provisions
can be put into place there will be some new laws and regulations to be developed. But we
wanted to pass on to you some of the major highlights of the new law and the time frames
involved. Attached is the review that was developed by Humana, one of the insurance companies
that we represent.
We will continue to keep you updated as more news comes available. And as always,
please feel free to contact our firm with any questions you may have on this matter.
Citrin Financial & Insurance, Inc.
300 71st Street, Suite 300
Miami Beach, FL 33141-3038
To[: 305 - 861 -0999 X 302
Fax: 305 - 861 -0032
Email: deborab@citrinfinancial.cona
Cirrin Financial & /nsw-ance, lac. 53
v
Changes that affect
your business and
the employees who
depend on you.
GCA0890HN 4110
1441oRFANT the; noo,ment srl wtnedInl de ,l; rr i y r r - or ft . 1. rt
relorm his, Irur..Nor ( .. pt roc.. rr !lot rh by fluivie,i ... ..... I I NJTI i, Lµ
I 'I'd Ador r r pi. n rtl i'le uInffi L i... r I s_ A r r 11 1 ..calm r.
mrhot" in Icp 11 if nn felt ,ndnul hoe lh ncvr,I•w n .1, ,U ?ffr . .,snip .
the health refoun package is made up of two pans a bill Ihat passed the Senote on I limuf as I.vr
passed the I lour on March 21, and was signed Into law by the I'rPSdmIan March 23, and a
second p i d a e of IegishCion the Nooses reconohatioh b i l l , whit l makes dhanges t o t he original
law. passed both chambers on March 2S, and was signed by the Pfd xicni of i March 311.
Many of the provrsioni in the law will not lake effect for s iv ml years. AI Iho conies(, provtsfons
that affocl employer- sponsomd health plans will lake effect srx months Irom the date of
enactment - in late Sepierulfw fven then, Ihosc cady provisions will not IINot plans until Ihey
renew for the next plan year
I he health reform law has thousands of pagRS and hundreds of provisions. Sr, rt , ntpnrlant In
remember that before many of those provisfnns are put In place, adrhtinnol lava and rego1,4101 6
will flood to he drvolopi'd, that could he a Icngthy prcress
Pere are some hohII Ili f s of the r najor provisions.
Starting in 2014, everyone must have coverage or pay a penalty, vvho II will he enfurcod
by the Intamal Revenue Sc Nice I he pennliios call be phased in over lone.
• In 2014, an individual without Muranec must pay whuhawer umnuni is grc.nor
$4i or I percent of income
• list 2016 and beyond, That penalty rises to $695 or 2 it percent of income, wberea r
is greater (the 8695 is if born )016 onj.
• families will pay hall the penalty for children, with if dap of $2,065 per IdmfPy.
• there will he exemptions to this requuemenL ,u[,h as in ones (if finoncial hardship
and other limned cdcnmstances.
Subsidres In buy insurance in new stale exchange.% vill he available in fie form of to ardns
and cost - sharing assslance for people above Medicaid ohgfhill y but below 400 percent of
due federal poverty level. Medf-aid elrgibilily will he incre:regd to 1 35 percent of the federal
Poverty level.
HUMANA
Ciain Financial & Insurance, lac. 54
rH t',' « ! _rail v ,r =i,u •..
Slarting in 2014, employers don't have to offer their rmployees health inwmnc, coverage, but
moq of them will I more than 50 employees will pay an ssessmenI J they don't, or if they offer
coverage that iSn t affordable. full -limo and part -line employees an, Included when determining
whether an employer Iras 50 employees (basin on current full -tune employee equivalency rules).
• Fmployee, will) 50 or more employees that do not offer 'minimum "sonnet coverage" w,
pay $2,000 for each employee over the fast 30 employees if one of their employees gets a
lax subsidy to tiny Insurance under an exchange_
• Imployers with 50 or employees that rho offer muunn n, FS.Enlidl onverage but have
of Ioosl one full-rune employcc mcciwng subsidimd coverage under an exchange will pay
whichever is II S3,000 for each employee receiving a premium credit or 52,000 tot each
f l6Gme employee
Employers trust provide 'fine choice" vouchers to Para) rrs wish mcnnms helow iloo percent of
the federal poverty level if the employee's contribution to coverage is between 8 per and 3 8
percent of income and the employee chooses to purchase coverage in the uxchangc- No penalties
will he imposed on employers with rasp(':( to employee., who rccerve these voudrea.
• beginning in 2011, employers will be required to disclose the value of health cam hour rf is
on an employees annual w -2.
• 6nployea will be required to notify employees:
- About the availability of the exchange - [of new employers, it the nee of Nunn,
for current employees, by March 1, 2013,
- Ihoy may Iru eligible for a subsidy under the exchange if fhe vniployar's ronninunnn
to the plan is less Ihan Go percent nt of total allowed (I of the hcnefiK;
- It the employee purchases coverage in the exchange, hr or the will lose the em loyov,
Coverage conbibulion-
lieginnmq in 2010, small businesses wlh frwrr (half 2S amployras and average waoas of V',
than 850,000 get a lax credit for their contributions to buying health insurance for employees.
Tha, tax credit starts al lip to 35 percent and mcmaevs to So percent in 2014 when the exchange
is operational. A full lax CMA11 may be available to small businesses with fewer than 10 employms
and average wages of less than $25,000.
Under the new law, amployervemployees have the right to keep file coverage they had as of
March 23, 2010 and arc exempt train many refnrru -These group health plans om considrri'd
"grandfalhered plans."
Citrin Financial & /nsui-ance, hie. 55
• Federal rate review. fhe Department of Heallh and I uman Services (1II IS) will
establish a process for federal review of fully insured premium Fall, mrreasrs.
• Internet portaf. By luly I, an Intemel portal will he created for consume¢ and small
busnesses to shop for health Insurance.
• High -risk pool. 85 billion has been appropriated to (mate d Ienq)vdry high -ask insurance
pool to help adults with pre - existing (ondltlons get coverage if they have bens uninznnul for
SIX nrnnthS, . the program will be effective through 201 i,
• Reinsurance for early retirees. A wrnporary reinsurance progrern will be established too
employers providing coverage to early Felt(('('s over age 55 who are not elaloblc for Medimn.
lhn federal government will provide $5 billion to fund the program. Paniopating carpfioyois
or insurers will be reimbursed RO percent of retlmu claims between f 15,000 and $90,000.
The pngmm will be effective through 2013-
Effective for new plans or plans renewed six months after the enactment date
unless otherwise noted (includes "grandfathered plans'):
• Lifetime and annual limits. Plans ro. y not impose lifetime noes on the dull.v value of
essential benelits Amoral lirnits will be restrie led (to be determined by I II I))
-
• Rescissions. No rescmions ane permuted, except in casm of fraud or intentional
misrepresentation.
• Coverage for adult children. Children may stay on Ih it parents' pokers until ('loo 2d if
coverage isn't available through (heir work, regnrclless of their marital status. Any e=mployer
contribution toward the premium is a tax - deductible business expense for the Bmpino I and
not taxable income for the mcreber.
• Pre - existing conditions. Plans mdy no longer impure pre - existing I ondlhun uxdusions lot
children under 19.
Effective for new plans or plans renewed six months after the enactment date
(does not include "giandfathered plans"):
• Preventive services. New polices most cover the lull cost of preventive care > ieconunended
by the U S. Preventive setwces Task force,, recommended imnunwalionz, preventive lore for
infants, children and adolescents, and additional preventive care for women.
• Appeals. New minimum requirements for internal and exlcrnal darns appeaK processes
• Patient protections. flans that require or ptovrde fora pnmary care provider (PC P)
designation must allow each nternher to designate any in network I'( .I; or pedialncian for
children, accepting new parents. flans may no loaner regwre an authonnron or rel ,mil to an
Ob -Gyp Prior authorvalinn or increased Lost shanng for emergency services os dlxr prolnhaen.
• Nondiscrimination rules. Nondisoiminaron rules that apply to self- lunded hedlth plans doe
expanded to group bully inSLIn d health plan% . flans cannot hose in employ((', ergrfnlily or
(ontinued eligibility on hourly or annual silary.
l Financial & Insurance, Inc. 56
• Medical loss ratio (MLR). An inAUer must publicly mpor on is MLR and spend it low Bo
percent of small it rot premiums on medical services or provide rebate payments to enrollee:.
• Spending accounts. Health savings accounts (HSAs) and flexible spending durum, 0 SA,)
may no longer be used to purchase over the- cotinter drugs unless pre,( iIwd by If doctor.
Inrreases tax for nonclualifFed 16A withdrawals from 10 percent to )0 percent, and for Archer
MSA withdrawals from I S percent to M percent.
• HHS studies. 1111% is regu ied to study the group health plan markets to compare employei
characteristics and deter!nine whether the new insurance market reforms are likely to cause
adverse selection in the lame group market or to encourage small and midsize employers to
self -unwe. HHS and the Department of I abnr rmml also collect information on self- tunded
likes These studies eould lead In drJdihonal employer repolhng requirements.
• Uniform explanation of coverage. Within 12 months of the laws enactment, 1116, w
Consultation with the Notional Assoaallon of Insurance [ ommissroners, will develop uniform
standards and definitions for summaries of benefits and coverage explanations- Within 24
months of enactment, group health plans must provide ensolloes and opplemits with coverge
documents that meet these standards
• Comparative effectiveness fee. A new fee is imposed on group health plans to brad
comparative effectiveness research I$1 per participant through 201 3. $2 poi pancripant
through 2019).
• FSA contributions. Conlr! but!on%toflexible spendingaanunts ,are Ironed to >2,Si10 a year.
Me federal definition of a small employer is definer) as an employer with 1 -100 employees. titatr%
can modify the dotinition to I -50 employees until January 1, 701 G
• Pre - existing conditions. Group heath liken can no longer impose pre - existing r on!1!non
nxctrsion%for any person of any age.
• Annual limits. Annual limits on essential health benefits arc prohibited
• Guaranteed issue. Health insurers must accept every employer who apphr%for fnver!gr
• Rating restrictions. Rating restrktion%go into effect for new fully !nwred small group plan,
Insurancv czxnpanies cannot hale pretniu!ns oil heahh stoles, darn% rxprr iron•
Of gender- Premiums can only vary fly:
Age (no more than 1 J )
-. Geography
Family size
Iobazcu use (no more loan 1.5.1)
• Merged markets. Slates are allowed to merge the iIIdIVldnal and small group markets.
• Clinical trials. C overage of rourne parent care costs I% mandated for partiapauon!n approved
clinical trials (does not apply to granclfalhered plans)
• Exchanges. slate health imurance exchanges arc tip and iunt!inq for small buvecssrs
and individuals to buy insurance.
• Essential benefits. I sse of bene.f t plan is crealnf, which mandates the level of hencfns that must
he includerl in plans offered in the e- 0),inge, as well as in the ndrudual and small group morkefe
omsir e, the exchange. Deduclibles limited to 11 00(r for indr ,duds and 14,000 for I)rmlies m till
small group market (soli funded plans and gr)ndfalhrrnd plans are exempt hom ton rltnncrnenti-
• Cost - sharing limits. Cost sharing unposed under group health plans o II n,ied to uumnl
health savings ac(iirint amounts (does not apply to gmnrllalhered plans).
• Waiting periods. Wailing periods cannot exceed 90 days.
Cirrin Financial & Insurance, Inc. 57
• Wellness. Expands health plan wellness I tic Orr ives up k, 30 percent of total coverage Cost, (up
to 50 percent with 1116 approval.
• Reinsurance. A lernporarry relnsruance prograrn will bn pslabhshed for the Indlmdual nhdrket
and funded by individual and group health plan msessnents ($25 billion m X014 -201(t)
• Taxes. A new exnse, tax Boos Into effect for high - value, "C aclillar', h?dlth plans 40 pelcent
(9r amounts over $ 10,200 for mclmlduals and $27,500 for lonely plans, paid by Insuence
companies dnd plan administrators.
• Part D donut hole. Provides a $250 rebate for Part D enrollees who enter the "(lentil hole"
coverage yap (2010 only), Beginning in 2011, Ihere will be a S0 per amt brand dscamn on
drugs in the gap. Mor trz will pay less for generic drugs In the gap as well 93 percont in
2011, which phass down l025 percent by 20211. lbe (Joni[ hole is eliminated by 21120.
• Retiree drug subsidy. Beglnninq In 201,9, employers may no longer deduct the retilcI, dluq
subsldy when offering qualified coverage under M2dicam Part D.
• Medicaid. Beginninq in 2014, states are requited to provide pmmwnr assistance and wrap-
around benefits to any Medicaid beneficiary who is odored employer-sponsorod rovorage,
II n c cost- effective [o do vo.
• Medii the loahonal Association of Insurance Culnnnss¢mm� wll <_« Sete new nhexfel pl, -ins for
I>rnelil packages C and E Thal irxlude nominal cost shannrl. 1 he new modals will to av,00 n)[15.
• Administrative simplification. The law a6o requires 1116 to adopt d smgle set of operatmq
rules for electronic transactions to create uniformity teq -, health clomu or equ'metent encounter
information, nhgibility and clalrm stalus, enrollment and dlscruollnienl, premlmn pdymmfits,
anti referral certification and authon�auoN. �Imup health plans will have to cenlfy compliance
with these standards.
• CLASS Act Creates a new government -run voluntary lonq -lean cart° a ruuhnce program
(CLASS Program). Employers must automatically enroll employees and faahtate payroll
deductions. tarn eus may choose not to participate.
• Starting July 1, 2010, impose a 10 percent lax on Ianning ruw,:,s
• Beginning 1112011, the phannacculical indnslly will pay annual Industry tee% . the fee will be
phased in and will hold steady at $2.8 billion a year after 2019.
• Beginning in 2013, mdnufachncu of ineclicdl devices will pay 12. 3 percent cxase tax on sales
of rnpolcal devices.
• Be9inning In 2013, the Medicare payroll tax rate will increase by 0.9 percent for individuals
who make more than $200,000 and couples that make more than $250,000.
• A new i.R percent tax will be added on income from Interest dividends, rename•;, royalties
and rents for Ihnse at the saint Income threshold.
• Begmnmg In 2014, a non - deductible premium tax will be Imposed on invm -ls 08 often in 2014.
$ I I.3 billion In 2015 and 2016, $13 9 billion in 2017 and $14 3 bdhon In 2018 Ater that, it will
inoease in an amount proportional to otmrah premium glowthl.
Cid1n Financial & lnsarance, Inc. 58
The Ohio National Life Insurance Company
Agenls' and Registered Representa ti ve's Errors & Omission Insurance
CERTIFICATE OF INSURANCE
OR
Marsh Consumer -
e service of Seabuty & Smith, Inc.
P.O. Box 14458
F
Des Moines, IA 50306 -3458
lArSt. `U
Charles A Citrin
Ste 300
300 71st St
_Miami U IIFI 4M141 -M075_
CARR/E /t
Continental Casually Company, one of the CNA companies
PO/.lCY 1]TU:
Claims A -Sale anJ Reported —Policy--
1'O/ IC1' Nt/it9LiL•' /Z:
7.Sfi90636R --
C /iRTI /• %G1777sr(IAM'k
CNA9605
P011CYPF.R /OD:
--
April I, 2010 in April 1, 2011 - -"-
LGt4l7S OF L /A13 1,
$2,000,000 Lath Wrmrgfid Act -- " - - -- - - -- "
.$2,000,000 In life Aggregate
DEDUC77BUYS,
$500 Per claim on'1'he Ohio National Life Insurance Company
products
$1,500 Per claim on Life products outside'rhe Ohio National Life
Insurance Company
PKIOR f1C7S COI4iR'1G7i:
The earliest date of continuous life agent's E &O. Securines prior acts
date is the dale of contract with ONESCO unless Prior Acts coverage is
. --
purchased for Securities transactions prior to contracting with ONESCO,
C0 1TRAOE
Life Agent plus Financial Products: The sale and/or servicing of fife,
accident & health, disability, employee benefit plans, pensiorJprofit
El7ccrive Dnrc.- 04101/2010
sharing plans, fixed annuities, variable life, variable. annuities, and
mulual funds with lire SEC. The sale and /or servicing of approved
securities in your capacity as a registered representative of ONESCO. A
Per Claim limit of $1,000,000 and Aggregate of $ 1,000,000, with a
deductible of-$5,000, is included for Outside RIA activities that have
been disclosed in—writing to ONESCO.
You most hnrcacurrcnrnpJwm (nrenl uVfr /he Ohro A'nbunal G @Insurance Conrpanyas an hra ace . %cn(/Regisnvcd
Ryvr rranvcund hvrx pnrd..prannnnlb. .... hs,, uses under dlcE&O Program Prurrinnus consrdered'Yul[y ennrcti ".rod
du '-fi" no pnnnnrm rs rclumcd lurrnyrcason. 7hc puhg• cxpnxlion dart for nn /rrsvred w/1 he 411POI1 ar 1h, dale the hrancJ:.
nppwnrnrnnarb the abmelrsi'd syonsurmg.,noq is larm/nnted, uhrchaer rs whr Co rotagc e,prmvded nd ct ro lifemrnu,
cond t.... and c.chrsiuns ofrhe polio•. Iron rtgencv or corpora non is Ao, shouu as an in,+ar.. d abor,'.vc age rc prmided Ilrr nc,
acema,00"or.heronlynrrh"s'erto those I'll"h-es minnng In the.... ronnl acrvccsrn,,ded by nc, nmred msurrd
en( and ohxh are cnsered I'll Fit flcY ngrnt under the Agents o/ 0hro Nadeau! Life Ins rrmrce Company Poh,
NOTE' This rs ro fx considercJlhe hrgldrthts nllbe insucmre •alihrde<! It is not ntended reowerprel the actual mmragr or conhw(
oftlm pnbry nor is II /rya Induce. unre., ill, our unde,wndoig uf1ho cen.gepronidn{
Pkase retain this doannent in a safe place for your future reference and E &O compliance requireincim
ISSUE DATE: 04/01/2010
"99 4Z4 --
Joan F. O'Sullivan
Marsh Affinity Group Services,
a service of Seabury & Smith, Inc.
R,,i,,d A -1 -111
Citrnl Financial & Insurance, Inc. 59
,'M f
— - -- - --
CERTIFICATE OF INSURANCE
NOTICE: THIS INSURANCE PROVIDES COVERAGE FOR INSURANCE AGENT'S ERRORS AND OMISSIONS ON A CLAIMS -MADE AND
REPORTED BASIS AND, SUBJECT 1'0 THE PROVISIONS OF THE POLICY, APPLIES ONLY 1'0 ANY CLAIM FIRST MADE AGAINST AN
INSURED AND REPORTED TO THE INSURER IN ACCORDANCE WITH CLAIMS NOTIFICATION, NO COVERAGE EMS I S FOR CLAIMS
FIRST MADE AFTER THE CND OF HIE POLICY PERIOD UNLESS, AND TO THE EXTENT THAT, TI 1E EXTENDED REPORTING PERIOD
APPLIES. DEFENSE COSTS REDUCE THE LIMIT OF LIABILITY AND ARE SUBJECT TO THE RETENTION, PLEASE REVIEW THE
POLICY CAREFULLY AND DISCUSS THE COVERAGE WITH YOUR INSURANCE AGENT OR BROKER.
THIS CERTIFICATE OF INSURANCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND. OR ALT ER THE COVERAGE
AFFORDED BY THE INSURANCE POLICY.
NAMED INSURED: PRODUCER:
CITRIN. DEBORAH B LOUIS MARINACCIO
300 71ST ST SUITE 300 NAPA BENEFIT SERVICES
9024 TOWN CENTER PARKWAY
MIAMI BEACH, FL 33141 LAKEWOOD RANCH, FL 34202
COMPANY AFFORDING COVERAGE: SCOTTSDALE INSURANCE CO
COVERAGE: THIS IS TO CERTIFY THAT THE INSURED LISTED ABOVE IS COVERED UNDER THE POLICY OF INSURANCE LISTED
BELOW, FOR THE CERTIFICATE PERIOD INDICATED. THE INSURANCE AFFORDED BY THE POLICY DESCRIBED HEREIN IS
SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICY.
Policy Number
Corlificate Period
Limits of Liability: Each Claim
Limits of Liability: Aggregate
FNS0002654
311/2011
311/2012
$1,000,000
$1.000.000
RETENTION 1 DEDUCTIBLE:
Life, Accident. and Health
$1,000
Medicare Advantage and Medicare Supplemental
$1,000
Disability Income Insurance (if purchased)
$1,000
Indexed Annuities /Fixed Annuities (if purchased)
51.000
Variable Annuities (if purchased)
55,000
Mutual Funds (if purchased)
_
$5.000
NOTICE OF CLAIMS:
SPECIALpROVISIQN.S:
NAPA Bonefit Services
9024 Town Center Parkway
Lakewood Ranch FL 34202
Named Insureds Endorsements allaclred al Cedificale Inceplion
DATE 2/248011
BY
dulhnrized Reprnsenlahvo
The Company affording coverage hereby certifies that the Named Insured named herein is insured under the Policy referenced
above. The limits of liability, premium and effective date of coverage applicable to such Nanled Insured are as specified above.
This certificate of insurance is not the contract of insurance. It is merely evidence of insurance provided under the Master Policy.
All claims are paid according to [he term of the Master Policy. A COPY of such policy and any endorsements Iherelo is available at
www,napa- bene0is.org /co. This is an individual agent's E &O policy. In the case a business name appears on this certificate,
coverage is extended from the individual insured to the corporation named but only for the covered acts of the individual insured.
Applicant must notify the Company within 10 days of any material change in the nature of Applicant's business (including, without
limitation. any changes with fines, complaints or claims, changes in income earnings, or file kind of products said or services
provided), Keep this document in a safe place- It is evidence of your insurance coverage.
OD-in Financial & hisarance, hic. 60
CITY OF SOUTH MIAMI RFP # SM- 2011 -09 -HR
WORKER'S COMPENSATION INSURANCE:
Citrin Financial & Insurance, Inc., is not required by Florida state
law to have Workers' Compensation Insurance but we will get
coverage when required.
EMPLOYER'S LIABILITY:
Citrin Financial & Insurance, Inc., does not presently have this
insurance but we will get coverage when required.
COMPREHENSIVE GENERAL LIABILITY:
Citrin Financial & Insurance, Inc., does not presently have this
insurance but we will get coverage when required.
BUSINESS VEHICULAR LIABILITY:
Citrin Financial & Insurance, Inc., currently has approximately
$300,000 in coverage per occurrence for our vehicles, but will
purchase more insurance coverage when required.
PROFESSIONAL LIABILITY:
Citrin Financial & Insurance, Inc., currently has E & O coverage for
both Charles A. Citrin and Deborah B. Citrin with minimum limits
of $1 000,000. Please see the copies of the policies.
Citrin Financial & Insurance, Inc. 61
Dedllrllrle Ir
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PCP Office Via
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Via
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PCP Referral
Prier Arrllrorirdlra
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SAMPLE RENEWAL SPREADSHEET
Citrin Financial & Insurance, Inc. City of Opa -Locka 2010 Medical HMO Benefits Renewal
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Citrin Financial & Insurance, Inc. 62
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