**REVISED** Administrative Policy Committee Meeting

**REVISED** ADMINISTRATIVE POLICY COMMITTEE MEETING AGENDA November 21, 2024 at 5:30 PM Kronenwetter Municipal Center - 1582 Kronenwetter Drive Board Room (Lower Level) 1. CALL MEETING TO ORDER A. Pledge of Allegiance B. Roll Call 2. ANNOUNCEMENT OF CLOSED SESSION 3. PUBLIC COMMENT Please be advised per State Statute Section 19.84(2), information will be received from the public. It is the policy of this Village that Public Comment will take no longer than 15 minutes with a three-minute time period, per person, with time extension per the Chief Presiding Officer’s discretion. Be further advised that there may be limited discussion on the information received, however, no action will be taken under public comments. 4. APPROVAL OF MINUTES C. Administrative Policy Committee Minutes October 17, 2024 5. OLD BUSINESS D. Discussion and Possible Action: Policy GEN-010-Public Comment - for citizens unable to attend Village Committees, Commissions & Boards E. Discussion and Possible Action: Revision of Ordinance 180-3; Village Board Meetings F. Discussion and Possible Action: Removal of Policy Gen-009 6. NEW BUSINESS G. Discussion & Possible Action: Updated Fee Schedule H. Renewal of Contract for Service - League of Wisconsin Municipalities Mutual Insurance Company 2025 Proposal I. Discussion & Possible Action: Hiring of Interim Administrator and/or Finance Director J. Discussion & Possible Action: Renewal of Police Officer Helth Insurance United Health Care 7. CLOSED SESSION Consideration of motion to convene into closed session pursuant to Wis. Stat. 19.85 (1)( c ) for consideration of employment, promotion, compensation or performance evaluation data of any public employee over which the governmental body has jurisdiction or exercises responsibility – to wit Review of Village Clerk and Village Treasurer Candidates. 8. RECONVENE OPEN SESSION Consideration of motion to reconvene into open session. 9. ACTION AFTER CLOSED SESSION 10. CONSIDERATION OF ITEMS FOR FUTURE AGENDA 11. NEXT MEETING: December 19,2024 12. ADJOURNMENT 1 NOTE: Requests from persons with disabilities who need assistance to participate in this meeting or hearing should be made at least 24 hours in advance to the Village Clerk’s office at (715) 693-4200 during business hours. Posted: 11/20/2024 Kronenwetter Municipal Center and www.kronenwetter.org Faxed: WAOW, WSAU, City Pages, Mosinee Times | Emailed: Wausau Daily Herald, WSAW, WAOW, Mosinee Times, Wausau Pilot and Review, City Pages 2  Section 4, ItemC. **REVISED** ADMINISTRATIVE POLICY COMMITTEE MEETING MINUTES October 17, 2024 at 5:30 PM Kronenwetter Municipal Center - 1582 Kronenwetter Drive Board Room (Lower Level) 1. CALL MEETING TO ORDER A. Pledge of Allegiance B. Roll Call PRESENT Kelly Coyle Chris Voll Mary Solheim Terry Lewis-Birkett ABSENT Jordyn Wadle-Leff 2. ANNOUNCEMENT OF CLOSED SESSION 3. PUBLIC COMMENT Please be advised per State Statute Section 19.84(2), information will be received from the public. It is the policy of this Village that Public Comment will take no longer than 15 minutes with a three-minute time period, per person, with time extension per the Chief Presiding Officer’s discretion. Be further advised that there may be limited discussion on the information received, however, no action will be taken under public comments. None 4. APPROVAL OF MINUTES C. August 15,2024 APC Minutes Motion by Coyle/Voll to approve APC minutes as presented. Motion carried 4:0 by voice vote. D. September 26, 2024, Special APC Minutes Motion by Voll/Solheim to approve APC minutes as presented. Motion carried 4:0 by voice vote. E. September 19,2024, APC Minutes Motion by Coyle/Lewis-Birkett to approve APC minutes as presented. Motion carried 4:0 by voice vote. 5. REPORTS AND DISCUSSIONS F. Treasurer’s Report No comments 6. NEW BUSINESS G. Discussion & Possible Action: Increase of the Right of Way Excavation Permits Fees Greg Ulman- Public Works Director discusses the need for the Village to update fee schedule for contracted work in the Village. Motion by Coyle/Lewis-Birkett recommend Village Board approve the recommend updated fee schedule for right of way excavation. Motion carried 4:0 by voice vote. H. Discussion & Possible Action: Budget Amendment # 9 3  Section 4, ItemC. Lisa Kerstner-Finance Director discusses moving funds from one line to another to cover Municipal Court fees these funds would not be coming from undesignated fund. Motion by Voll/Coyle to recommend Village Board approve budget amendment #9 as presented. Motion carried 4:0 by voice vote. I. Discussion & Possible Action: Possible Increase compensation for Municipal Court Judge APC directed Lisa Kerstner to include Municipal Court Judge in the list of positions for possible raise being presented to the Village Board. J. Discussion & Possible Action: Fire Department Surplus Auction Items Motion by Voll/Coyle to recommend Village Board approve the items presented by the Fire Department to list on surplus auction as presented. Motion carried 4:0 by voice vote. K. Discussion & Possible Action: Vestis Contract Motion by Voll/Coyle to recommend the Village Board approve the Vestis contract as presented. Motion carried 4:0 as presented. CLOSED SESSION Consideration of motion to convene into closed session pursuant to Wis. Stat. 19.85 (1)( c ) for consideration of employment, promotion, compensation or performance evaluation data of any public employee over which the governmental body has jurisdiction or exercises responsibility – to wit Administrator candidates. Motion by Voll/Coyle to convene into closed session. Motion carried 4:0 by roll call. RECONVENE OPEN SESSION Consideration of motion to reconvene into open session. ACTION AFTER CLOSED SESSION Continue reviews for Administrators. 7. OLD BUSINESS L. Discussion and Possible Action: Onboarding Process/Materials for Village Board and Committee Members APC directs staff to create policy for employee/trustee/committee members onboarding. M. Discussion and Possible Action: Policy GEN-010-Public Comment - for citizens unable to attend Village Committees, Commissions & Boards Delay action bring back to next month's meeting. N. Discussion and Possible Action: To review and select a firm to conduct the executive search for the Administrator position APC to review firms and bring back top three firms. 8. CONSIDERATION OF ITEMS FOR FUTURE AGENDA none. 9. NEXT MEETING: November 21, 2024 EnterTextHere 10. ADJOURNMENT Motion by Voll/Coyle to adjourn. Motion carried 4:0 by voice vote. NOTE: Requests from persons with disabilities who need assistance to participate in this meeting or hearing should be made at least 24 hours in advance to the Village Clerk’s office at (715) 693-4200 during business hours. Posted: 10/16/2024 Kronenwetter Municipal Center and www.kronenwetter.org Faxed: WAOW, WSAU, City Pages, Mosinee Times | Emailed: Wausau Daily Herald, WSAW, WAOW, Mosinee Times, Wausau Pilot and Review, City Pages EnterTextHere 4  Section 5, ItemD. POLICY ID: GEN-010 TITLE: Public Comment-for citizens unable to attend Village Committees, Commissions & Boards ORIGINAL REVISION APPROVED BY VILLAGE BOARD: DATE: EFFECTIVE DATE: Immediate _________________________ ____________ Village Clerk FLSA EXEMPT FLSA NON-EXEMPT APPLIES TO: REPRESENTED EMPLOYEES Non-REPRESENTED EMPLOYEES This policy applies to all Village of Kronenwetter employees in the categories checked in this section. Provisions within individual personal contracts or a collective bargaining agreement may supersede certain parts of this policy. Purpose – In recognition that a free government is only possible by having informed and involved citizens, the Village Board encourages public comment on any matter. The Village Board also understands that citizens may not be able to attend a public meeting. It adopts this policy to create a process to allow citizens to have their comments received by the Village when they cannot participate in a discussion. Policy – Any resident may submit a comment on any matter of concern to them by sending it to the Village Clerk’s Office either in writing or via email. The Village Clerk shall forward all such statements to Village Board or Committee members. The Village Clerk will forward any messages addressing a particular matter under consideration by any committee, commission, or board, to the designated clerk of that body dealing with that issue, who in turn shall have it read into the record of the next meeting during the public comment section. The clerks shall provide a copy of the submitted comments to each committee member. Nevertheless, all items submitted shall be copied to all members of the body and attached to the minutes of that meeting. Matters of concern that the writer designates as “public input,” “public comment,” or anything along those lines shall be of a length that someone can reasonably read in 3 minutes or less. On the day of the meeting, any comments submitted after 11 am may or may not, as circumstances allow, be included in the meeting of that day at the Village Clerk’s discretion. The clerk of the session shall process comments not included in the discussion of that day in the above manner at the next meeting of that body. In the event of input so numerous that reading them all would be impractical, the committee, commission, or board may accept the comments into the record without being read at the presiding officer’s discretion. Nevertheless, all items submitted shall be copied to all members of the body and attached to the minutes of that meeting. p. 1 of 1 This policy is not intended, and should not be construed, to limit or prevent an employee from exercising rights under the National Labor Relations Act. The Village of Kronenwetter retains the right to amend or change this policy at any time without prior notice. 5 Section 5, ItemF. 6  Section 6, ItemG. Report to APC Agenda Item: Discussion and Possible Action: Updated Fee Schedule Meeting Date: November 21, 2024 Referring Body: Committee Contact: Staff Contact: Greg Ulman Report Prepared by: Greg Ulman AGENDA ITEM: Discussion and Possible Action: Updated Fee Schedule OBJECTIVE(S): To have an up to date fee schedule for the Village HISTORY/BACKGROUND: The Village Board has instructed me to update the fee schedule by the November 25th board meeting. The proposed fee schedule has inputs from all Village staff within their respected departments. I looked at fee schedules from across the area and averaged out the fees to see where our current fees are at and updated the fees if adjustments would be needed. The black numbers are what we currently use for a fee structure, and what is proposed is in red. PROPOSAL: To have APC look at the fee schedule updates and give input if the committee would like to change anything. RECOMMENDED ACTION: Approve an updated fee schedule to present to the board on November 25th, 2024 1582 Kronenwetter Drive ▪ Mosinee, WI 54455 ▪ (715) 693-4200 ▪ Fax (715) 693-4202 ▪ www.kronenwetter.org 7  Section 6, ItemG. Village of Kronenwetter Fee Schedule Updated January 9, 2024 Zoning Fees Conditional Use Permit, Variance, and Zoning Fees: Board of Adjustments Variance, Appeal, or $300 350 Rehearing Conditional Use Permit Application - New $300 350 Conditional Use Permit Application - Renewal $150 200 Rezoning $250 300 Platting (including erosion control and stormwater review): Certified Survey Map (CSM) $200 + $25/lot Concept Plan $200 Preliminary Plats $500 + $25/lot Final Plats $200 + $10/lot Relocation of Boundary $40 + $5/lot Site Plan Fees (including erosion control and stormwater review): Minor Site Plan Amendment $150 Site Plans less than 5,000 SF of Building Area $500 Site Plans greater than 5,000 SF of Building Area $1,000 Zoning Request Letter $50/property Temporary Use Permit $25 50 Non Metallic Mine $1,500.00 Per year- New mine as of 01-01-2025 Residential Building Permit Fees (R1, R2, R4, SR, RR, Ag 1 and Ag 2) New Construction and Additions ($50 minimum) General Construction - Finished $0.12/sq. ft .15 General Construction - Unfinished $0.07/sq. ft .10 Plumbing $0.06/sq. ft + Min 75 .10 New Construction Lateral Pressure Test $26.25 30.00 Electrical $0.05/sq. ft + min 75 .10 HVAC $0.04/sq. ft + Min 75 .08 Yard Sheds $50 60 Garages: 550 sq. ft or less $75 100.00 Over 550 sq. ft $75 + $0.15/sq. ft over 550 sq. ft 100 +.20 Outbuildings (Agricultural): 1,000 sq. ft or less $75 100 1,000 to 2,500 sq. ft $100 150 Over 2,500 sq. ft $125 + $5/100 sq. ft over 2,500 sq. ft 200 +6 Decks $75 Plan Review $0.06/sq. ft .10 Building Permit Seal $40 50 Occupancy Escrow - One & Two Family $1,000 deposit Occupancy Escrow - Multi Family $2,000 deposit Erosion Control - One & Two Family $50 Erosion Control - Multi-Family $400 Address Number / Uniform House Number Sign $20 (additional $25 for UHNS if required) 30,40 Mobile Home Installation $100 Swimming Pools - Above Ground/Permanent $50 Swimming Pools - In Ground $100 Early Start, Foundation Only $100 Interior Renovations and Alterations ($50 minimum) 8 1 of 5  Section 6, ItemG. General Construction - Finished $0.07/sq. ft .10 Plumbing $0.06/sq. ft .10 Electrical $0.05/sq. ft .10 HVAC $0.04/sq. ft .08 Plan Review $0.10/sq. ft Decks $50 60 All Residential Roofing $40 (minimum does not apply) 50 Fences $25 (minimum does not apply) 40 Commercial and Industrial Building Permit Fees (B1,B2, B3, BP, M1 and M2) New Construction, Alterations and Additions ($100 minimum, $10,000 maximum) General Construction $0.10/sq. ft .15 Plumbing $0.03/sq. ft .05 Electrical $0.06/sq. ft .10 HVAC $0.03/sq. ft .05 Erosion Control $400 500 Occupancy Permit / Site Completion $2,000 or 2% of the project cost if greater, not to exceed $10,000 (100% returned) (not included in maximum) Address Number $20 30 Early Start, Foundation Only $250 Fences $100 125 Miscellaneous Building Permit Fees Re-inspection after violation $60 75 Razing - Accessory Building $40 50 Razing - Residential Building $50 65 Razing - Commercial/Industrial $100 150 Moving Building $40 and Insurance Certificate Signs $1.00/ sq. ft (one side counted only) ($40 min) 50 min Working without a Permit Double Fees * fee for standard size, depending on site characteristics price may be higher. Beer/Liquor/Cigarette License Fees Class A - Liquor $400 500 Class A - Fermented Malt Beverage $200 300 Class B - Fermented Malt Beverage $100 Class B - Liquor $300 400 Class C - Wine License $100 Temporary (Picnic) Class B - Fermented Malt Beverage $10 Temporary (Picnic) Class B - Wine $10 Reserve "Class B" Liquor License $10,000 Operator (Bartender) License - New (Expires in odd years) $35 50 Operator (Bartender) License - Renewal $35 50 Operator (Bartender) License - Provisional $15 Cigarette License $100 Sellers Fees Secondhand Goods: 9 2 of 5  Section 6, ItemG. (occasional residential “garage/yard sale” excluded) Pawnbrokers License (business) $100 150 Secondhand Article License "Flea Market" (Annual permit for seasonal or one-time event) $175 Secondhand Article (antique) Dealers License $35 50 Peddlers, Canvassers, Solicitors, and Transient: Merchants Investigation Fee $15 20 Surety Bond (Refundable) $500 Vending Machine (annual permit) $25 General Fees Mobile Home Park (maximum: 50 spaces) $100 Dog License: Male/Female (6 months+) $12 15 Neutered/Spayed (6 months+) $7 10 Service Dog Exempt Late Fees $5 10 Replacement Tags $1 5 Online Dog Licensing Convenience Fee $2.50 Animal Fancier $75 Dog Kennel Permit $75 100 Extra Tags $7/tag Dog Impoundment Fee actual cost Transport in Village (plus kennel cost) $20 Transport out of Village (plus kennel cost) $35 Assessment Letter: In water/sewer area $35 Not in water/sewer area $25 Returned Check Handling Charge $30 40 Attorney Fees actual cost Fireworks Users Permit $50 75 Block Party Permit (street closure plus cost of barrier delivery/pickup) $75 Noxious Weed Abatement $25+actual cost Fingerprinting $15 $20 Sign Inspection $25 Roadway Access Permit $100 + Materials Road Right-of-Way Excavation Permit $100 SEE ROW Sheet Culvert $400 Standard Size Culvert 100 + materials Village Maps: 12" x 18" and smaller $5 Anything greater than 12" x 18" $20 Water & Sewer Utility Missed Appointment Fee $20 Farmers Market Res: 0 Non Res: 50 Public Records Request Fee Schedule Estimates General Record/s $.15 per B&W page, $0.25 per color page Record Location Cost (Charged when total reaches $50 or more of clerical staff time) $50 + overages Electronic Media (email, PDF, DVD, flash drive, other electronic format) actual cost Data from Statewide Voter Registration System $25 + $5 for every 1,000 voters 10 3 of 5  Section 6, ItemG. Facsimile document $2/page Rental of Equipment actual rental cost Shipping/Mailing Fees actual cost Sewer Meter & Inspection Fees (Water Meter & Inspection fees are $25.00 for all meter sizes and determined by the WI PSC) Meter Size (inches) Meter/Inspection Fee 5/8 and 3/4 $728.00 1 $3,462.50 1 1/4 and 1 1/2 $6,925.00 2 $7,500.00 3 $20,775.00 4 $27,700.00 6 $34,625.00 Sewer Rates Base Charge Meter Size (inches) Minimum Fee per Quarter 5/8 and 3/4 $41.77 1 $208.84 1 1/2 $417.68 2 $626.53 2 (Compound) $1253.05 3 (Compound) $1253.05 Volume Charge $6.48 per 1,000 gallons of metered water Water/Sewer Utility Garden (Private) Well Permit 5-Year Private Well Operating Permit $0 Water/Sewer Utility Connection Charge (for unassessed properties) Designation Connection Charge Non-Sub dividable Residential User $7,314 Nonconforming User (Duplex) $9,116 Community Based Residential Facility $12,000 Agricultural Homestead User $7,314 Special User (Subdivision) $13,515 Municipal Center Community Room Rental Rates Rental Fee: Kronenwetter Resident $100 125 Non-resident $150 200 Non- Profit $0 Security Deposit (applies to ALL reservations) $200 11 4 of 5  Section 6, ItemG. Athletic Field Rental Security Deposit (applies to multiple use only) $50 Daily field rental $20 Tournament - Athletic Field Rental Security Deposit $50 100 Optional Items: Field (drag) Prep $200/field/day 250 Standard Portable Toilet $85 each/day 100 Handicap Portable Toilet $135 each/day 150 Hand Washing Station $75 each/day 90 Park Shelter Rental Norm Plaza; Gooding; Municipal Center; Seville Rental Fee: Kronenwetter Resident $40 Non-resident $60 80 Security Deposit $50 Sunset; Friendship (added amenities) Rental Fee: Kronenwetter Resident $50 Non-resident $70 100 Security Deposit $50 12 5 of 5 Section 6, ItemG. 13 Section 6, ItemG. 14 Section 6, ItemG. 15 Section 6, ItemG. 16 Section 6, ItemG. 17 Section 6, ItemG. 18 Section 6, ItemG. 19 Section 6, ItemG. 20 Section 6, ItemG. 21 Section 6, ItemG. 22 Section 6, ItemG. 23 Section 6, ItemG. 24 Section 6, ItemG. 25 Section 6, ItemG. 26 Section 6, ItemG. 27 Section 6, ItemG. 28 Section 6, ItemG. 29 Section 6, ItemG. 30 Section 6, ItemG. 31 Section 6, ItemG. 32 Section 6, ItemG. 33 Section 6, ItemG. 34 Section 6, ItemG. 35 Section 6, ItemG. 36 Section 6, ItemG. 37 Section 6, ItemG. 38 Section 6, ItemG. 39 Section 6, ItemG. 40 Section 6, ItemG. 41 Section 6, ItemG. 42 Section 6, ItemG. 43 Section 6, ItemG. 44 Section 6, ItemG. 45 Section 6, ItemG. 46 Section 6, ItemG. 47 Section 6, ItemG. 48 Section 6, ItemG. 49 Section 6, ItemG. 50 Section 6, ItemG. 51 Section 6, ItemG. 52 Section 6, ItemG. 53 Section 6, ItemG. 54 Section 6, ItemG. 55 Section 6, ItemG. 56 Section 6, ItemG. 57 Section 6, ItemG. 58 Section 6, ItemG. 59 Section 6, ItemG. 60 Section 6, ItemG. 61 Section 6, ItemG. 62 Section 6, ItemG. 63 Section 6, ItemH. 64 Section 6, ItemH. 65 Section 6, ItemH. 66 Section 6, ItemH. 67 Section 6, ItemH. 68 Section 6, ItemH. 69 Section 6, ItemH. 70 Section 6, ItemH. 71 Section 6, ItemH. 72 Section 6, ItemH. 73 Section 6, ItemH. 74 Section 6, ItemH. 75  Section 6, ItemJ. MN006-W300, 9800 Health Care Lane Minnetonka, MN 55343 Tel: 1-866-432-5992; Fax: 1-855-208-8348 October 18, 2024 Re: VILLAGE OF KRONENWETTER ANSAY & ASSOCIATES LLC Group number: 1573571 888 STATE HIGHWAY 153 STE 200 Current package: WI MC New 53 / WI053 MOSINEE, WI 54455 Renewal date: 01/01/2025 Dear Agent: Enclosed is a copy of the UnitedHealthcare renewal package for VILLAGE OF KRONENWETTER. We are excited to bring you the ability to renew your ACR Small Business in our Sales Automation Management (SAMx) Tool. • You can change plans, add products and update your employee enrollment in an abbreviated fashion. • Access SAMx by signing in to uhceservices.com with your One Healthcare ID, click on the Small Group Quoting & Renewals tab and select SAMx. Once you see your dashboard, you will see the list of renewals. • If you need assistance with uhceservices.com, please contact your Dedicated Client Service Manager, or call Client Services at 1-866-908-5940. You’ll be quickly on the path to controlling when your groups are renewed and an overall better service experience. If you have any questions about this material, please contact me at 1-866-432-5992. Thank you again for your business. We look forward to our continued relationship. Sincerely, Your Renewal Account Executive VILLAGE OF KRONENWETTER 1573571 01/01/2025  Section 6, ItemJ. MN006-W300, 9800 Health Care Lane Minnetonka, MN 55343 Tel: 1-866-432-5992; Fax: 1-855-208-8348 October 18, 2024 Re: VILLAGE OF KRONENWETTER VILLAGE OF KRONENWETTER Group number: 1573571 BOBBI BIRK-LABARGE Current package: WI MC New 53 / WI053 1582 KRONENWETTER DRIVE Renewal date: 01/01/2025 KRONENWETTER, WI 54455 Dear BOBBI BIRK-LABARGE: Thank you for allowing UnitedHealthcare to serve your health benefit plan needs for the policy year just ending. Now it’s time to begin making plans for the coming year. This packet contains your customized renewal package, which will allow you to determine which plan, or plans, best meet your business needs for the coming year. Your group health insurance coverage is coming up for renewal. Below are changes we’ll be making to the plan. • The cost share for Intensive Behavioral Therapy (IBT) and/or other outpatient services such as electro-convulsive therapy, transcranial magnetic stimulation, psychiatric testing, and medication assisted treatment may have changed. The most common IBT is Applied Behavior Analysis (ABA). • The term autism spectrum disorder means a condition marked by enduring problems communicating and interacting with others, along with restricted and repetitive behavior, interests, or activities, and as listed in the current edition of the International Classification of Diseases section on Mental and Behavioral Disorders or the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. • The mental health/substance-related and addictive disorders delegate (the delegate) administers benefits for mental health and substance-related and addictive disorders services. If the covered person needs assistance with coordination of care, locating a provider, and confirmation that services the covered person plans to receive are covered health care services, the covered person can contact the delegate. • The term intensive outpatient treatment has been changed to intensive outpatient program. • The exclusion section specific to mental health and substance-related and addictive disorders services has been removed. The following exclusions have been added as exclusions that apply to both medical and behavioral services: transitional, assisted, and independent living services, educational counseling, testing and support services, and vocational counseling, testing and support services. • Care Cash, a program designed to help members pay for cost sharing for certain services through a prefunded debit card, may be included in the plan. See the "Review" section of your renewal package to find out if Care Cash is included in your plan, may be included in the plan. • Benefits for voice modification therapy and/or voice lessons for gender dysphoria are subject to applicable speech therapy benefit limits as described under Habilitative Services and Rehabilitative Services - Outpatient Therapy. • Annual limits for presumptive and definitive drug testing are removed. • Covered Persons may not assign benefits under the policy to an out-of-network provider. When a determination is made to pay an out-of-network provider directly for services rendered, that payment is not: an assignment of benefits or any legal or equitable right to institute any proceeding related to benefits; or a waiver of the prohibition of assignment of benefits under the policy. Such payment will not preclude the assertation that any purported assignment of benefits under the policy is invalid or prohibited. Continued on other side VILLAGE OF KRONENWETTER 1573571 01/01/2025  Section 6, ItemJ. • The exclusion for health care services from out-of-network providers for non-emergent, sub-acute inpatient, or outpatient services at certain non-hospital facilities does not apply in the case of an emergency or when there is no network provider who is reasonably accessible or available to provide the covered health care service. • Administrative programs are included in the Are Incentives Available to You? section to accommodate for administrative actions. • The term unproven services may include services for medical and behavioral conditions. Determinations of unproven services based on well-designed randomized controlled trials or observational studies, include the following: well-designed systematic reviews (with or without meta-analyses) of multiple well-designed randomized controlled trial, individual well-designed randomized controlled trials, well-designed observational studies with one or more concurrent comparison group(s) including cohort studies, case-control studies, cross-sectional studies, and systematic reviews (with or without meta-analyses) of such studies. Medical and drug policies can be viewed on www.myuhc.com and liveandworkwell.com. • The term transitional living is also known as supportive housing, including recovery residences. • Virtual Behavioral Health Therapy and Coaching Rider will be removed. • Certain preventive care immunizations are covered under the pharmacy benefit. • Step therapy requirements can be satisfied through use of a pharmaceutical product or a prescription drug product. • Therapeutic equivalent requirements can be satisfied through use of a pharmaceutical product or a prescription drug product. • The variable copayment program under the outpatient prescription drug rider may include certain non-specialty and specialty prescription drug products. • Any cost-sharing changes, including whether the plan is a different metal level from the previous plan are described in the "REVIEW" section of your renewal package. New regulations and benefit plan design changes often require updates to our Certificate of Coverage (COC). The alternate benefit plan we are suggesting for your renewal is written on an updated COC. You may request to see the COC, and Schedule of Benefits for a complete explanation of your benefits. In addition, see our COC overview documents in the “Supporting Documentation” portion of this package. Soon, you will receive your Summary of Benefits and Coverage (SBC), if you haven’t already. Your employees may also access a copy on myuhc.com. The SBC provides information to help understand your renewal plan(s) and allows you to compare coverage options across different plans and products. For more information regarding the SBC, please visit uhc.com and search for “summary of benefits”. We’re looking forward to another year of serving you and your employees. Please take the time to review the enclosed materials and feel free to contact your broker, ANSAY & ASSOCIATES LLC, 715-693-4343, or call me at 1-866-432-5992 with any questions. Sincerely, Your Renewal Account Executive CC: ANSAY & ASSOCIATES LLC VILLAGE OF KRONENWETTER 1573571 01/01/2025  Section 6, ItemJ. Review The chart below shows an overview of your current plan, your renewal plan and the associated premiums. Metallic Level Plan Deductibles Out of Pocket Max Office Copays Single/Family Single/Family (PCP/Spec) Plan ID Network Non-Network Network Non-Network Network Network Name Current Medical Plans WI MC New 53 / WI053 Balanced 100 CX-EM / RX K62S 1 $2,000/$4,000 $5,000/$10,000 $2,500/$5,000 $10,000/$20,000 $5/$10 CHOICE PLUS Metallic Levels: = Platinum, = Gold, S = Silver, B = Bronze Renewal Medical Plans WI MC New 54 / WI054 Open Access w/Care EB-E2 / RX K62S 1 $2,000/$4,000 $5,000/$10,000 $2,500/$5,000 $10,000/$20,000 $5/$10 CHOICE PLUS Cash Metallic Levels: = Platinum, = Gold, S = Silver, B = Bronze • Important: If multiple policies are sold to one customer, we require the policy year or calendar year basis selection be the same for each sold policy. • If you choose to add or change an existing HRA plan, you must choose from the list of UnitedHealthcare HRA-eligible medical plans as shown to you by your broker or agent. If you have a Third Party Administrator for your HRA, please note that HRA plans administered by other insurers or TPAs must comply with UnitedHealthcare HRA design standards. • Premium rates and/or product forms included herein are subject to approval by regulators. If the rates or product forms offered herein are subsequently modified by regulators we will immediately advise you of the change in plan design and retroactively adjust premium in subsequent billings, in accordance with applicable law. • Starting with 2014 effective dates, all pharmacy plans include an ancillary charge (also known as a generic pharmacy program). This type of pharmacy program includes out of pocket expenses when a member fills a brand name or higher tier generic prescription but there is a chemically equivalent lower tier brand or generic available. • Current and renewal medical rates reflect the participant's age on the renewal date and may not be the same as the rates billed in the current billing. • SPECIALTY MEDICATION COST SHARE CHANGES: Upon renewal, most pharmacy plan designs have a separate higher cost share for Specialty Medications based on the Pharmacy Tiers. Those cost shares are reflected with an ‘S’ prior to the cost share amount. E.g. S$500. Your employees can also review their benefit summary and plan documents for these cost share changes to determine if they will be impacted. • Employer groups should consult with their benefits and/or tax counsel regarding any potential tax implications if they choose to offer a Health Reimbursement Arrangement (HRA) on a medical plan with Care Cash. • Medical plans with no mention of UHC Rewards Premium in the plan names above come with UHC Rewards Core. Neither UHC Rewards Premium nor UHC Rewards Core are available to groups in the state of HI, VT and specific plans in CO and CA. • Your renewal plan may include the Standard Select Pharmacy Network which could exclude certain pharmacies. Please contact your broker or your UnitedHealthcare representative for additional details. • This premium may include state and federal taxes and fees. 1 This medical plan is available with either calendar year or policy year deductibles and out of pocket maximums. 2 | VILLAGE OF KRONENWETTER 1573571 01/01/2025  Section 6, ItemJ. All of your current benefit design options are no longer available in a combined plan offering. We have included new Medical plan choices for the upcoming year, offering the same flexibility, choice, and affordability that you are enjoying today. Coinsurance Pharmacy Monthly Legal Entity / Med/Rx Ded (Spec; Enrolled HSA/HRA Medical Network Non-Network License Combined Non-Spec) Employees Contrib. Premium 100% 70% INS N $10/$40/$105/$250/S$500E 4 $5,117.21 100% 70% INS N $10/$40/$105/$250/S$500E 4 $5,571.22 Change from Current: 8.9% Renewal Assumptions: • The monthly cost noted above is based upon the coverage inforce at the time the renewal was calculated. Please refer to Appendix A included in this package. Actual billed premium as of your renewal date may differ from the amounts reflected in this package. • Information on alternate benefit plans is summarized for ease of review. It is not intended to be a statement of benefits, nor does it guarantee coverage. The Certificate of Coverage provides the legal description of coverage and is available for your review upon request. UHC Choice plans will cover only the employees within the defined UnitedHealthcare service area. The rates are based upon the employer's primary location. Other locations will require alternate plan designs and rates. • Renewal of your employer plan is contingent upon meeting UnitedHealthcare’s minimum participation requirements. • Plan design and corresponding premium rates offered herein represent a coverage option that is consistent with your current group size (based on most recent census or survey information) and closely matches your current coverage. Additional coverage options may be available to you. • Upon the renewal of your employer plan, the Certificate of Coverage or Summary Plan Description, and other documents, notices and communications regarding the plan(s) selected may be transmitted electronically to you (employer group) and the group employees. The employer group may withdraw their consent at any time or request a document in a paper or non- electronic form. • Please see the Glossary on inside back cover of this package for definitions of the above terms. VILLAGE OF KRONENWETTER 1573571 01/01/2025 | 3 Dental Renewal Section 6, ItemJ. Dental Benefit Summary Current Renewal Plan: P2375 1 / Type: DPPO Plan: P2375 1 / Type: DPPO Benefit In/Out Benefit In/Out Annual In/Out of Network $1,500 / $1,000 Annual In/Out of Network $1,500 / $1,000 Plan Maximums Plan Maximums Ortho Lifetime $1,500 / $1,000 Ortho Lifetime $1,500 / $1,000 Deductible Individual/Family $50 / $150 Deductible Individual/Family $50 / $150 Waiting Period Major Services NO WAIT Waiting Period Major Services NO WAIT Preventive 100% / 90% Preventive 100% / 90% Minor Restore 80% / 70% Minor Restore 80% / 70% Coinsurance Endo/Perio/Oral* 50% / 50% Coinsurance Endo/Perio/Oral* 50% / 50% Major Services 50% / 50% Major Services 50% / 50% Orthodontia 50% / 50% Orthodontia 50% / 50% Monthly Rates/Premiums Enrollment Rate Enrollment Rate Employee 2 $45.58 Employee 2 $45.58 Empl + Spouse 2 $91.15 Empl + Spouse 2 $91.15 Empl + Child 0 $91.99 Empl + Child 0 $91.99 Empl + Fam 1 $141.80 Empl + Fam 1 $141.80 Monthly Premium $415.26 Monthly Premium $415.26 Change in Rate: 0.0% • The rates displayed in this package will be effective through 12/31/2025. The rate guarantee is subject to change based upon changes to the policy and/or plan structure. * Please refer to your benefit summary or certificate of coverage for a more detailed view of the benefit coverage for services within these categories as some plans may have benefits that differ from what we are able to display here. 1 Ask about our Consumer Max Multiplier! This consumer driven benefit allows members to carry forward a portion of their unused annual dental maximum into an account for future use. Vision options Quote 1 Quote 2 Quote 3 Quote 4 Plan S1006 Plan S1008 Plan S1010 Plan S1012 Type VOLUNTARY Type VOLUNTARY Type 100% ER PAID/0% DEP Type 100% ER PAID/0% DEP PAID PAID Benefit Amount Benefit Amount Benefit Amount Benefit Amount Exam $10 Exam $10 Exam $10 Exam $10 In-Network Copay Materials $25 Materials $25 Materials $25 Materials $25 Frame $130 Frame $130 Frame $130 Frame $130 Allowances Contact Lens $105 Contact Lens $105 Contact Lens $105 Contact Lens $105 Exam 1 x per 12 mos Exam 1 x per 12 mos Exam 1 x per 12 mos Exam 1 x per 12 mos Frequencies Lenses 1 x per 12 mos Lenses 1 x per 12 mos Lenses 1 x per 12 mos Lenses 1 x per 12 mos Frame 1 x per 12 mos Frame 1 x per 24 mos Frame 1 x per 12 mos Frame 1 x per 24 mos Tiers Monthly Rate Tiers Monthly Rate Tiers Monthly Rate Tiers Monthly Rate Employee $7.67 Employee $7.14 Employee $6.75 Employee $6.28 Enrollment Rates Empl + Spouse $14.56 Empl + Spouse $13.54 Empl + Spouse $14.18 Empl + Spouse $13.19 Empl + Child $17.08 Empl + Child $15.88 Empl + Child $16.64 Empl + Child $15.47 Empl + Family $24.04 Empl + Family $22.36 Empl + Family $24.56 Empl + Family $22.84 Monthly Premium $77.91 $72.46 $76.31 $70.97 • Vision plans have a 24 month guarantee from contract issuance. Note that the rate guarantee is subject to change based upon changes to the policy and/or plan structure. • To complement the pediatric vision coverage included as an Essential Health Benefit in UnitedHealthcare medical plans, four vision options are included as part of this renewal package. Your Renewal Account Executive (RAE) or Renewal Account Consultant (RAC) is available to review your options to provide a consistent and comprehensive family vision experience. If you choose to offer an employer-paid plan, the Packaged Savings Program may apply. Packaged Savings may not be available in all states or for all group sizes. Basic Life AD&D options Enrollment Benefit Volume Rate per $1,000 Total Monthly Premium Life Insurance $0.12 $15.00 5 $25,000 $125,000 $17.50 AD&D Insurance $0.02 $2.50 • Basic Life/AD&D plans have a 24 month guarantee from contract issuance. Note that the rate guarantee is subject to change based upon changes to the policy and/or plan structure. • All coverage terminates at retirement. • If you choose to offer $25,000 or more in base life insurance, the Packaged Savings Program may apply. Packaged Savings may not be available in all states or for all group sizes. • The benefits will be reduced to 65% of original amount at age 65 and to 50% of the original amount at age 70. VILLAGE OF KRONENWETTER 1573571 01/01/2025 | 11  Section 6, ItemJ. Glossary Annual Plan Maximum – The maximum dollar amount that a HRA – Health Reimbursement Account. An account to which an Dental plan will pay toward the cost of care within a specific period, employer can make contributions that are not taxable to the usually a calendar year. employee, and which the employee can use to pay for certain covered medical expenses. Calendar Year Deductible – A deductible that is calculated based on a calendar year, beginning on January 1 and restarting the HSA – Health Savings Account. A trust or custodial account that is following January 1. established with a bank, insurance company, or other IRS approved trustee, to pay for certain covered medical expenses with employee Certification of Coverage – A written document provided to pre-tax or taxable contributions, and/or employer non-taxable members that sets forth the terms of the health plan. It explains contributions. among other things coverage, member cost share obligations, appeal rights, and important enrollment information. Med/Rx Ded Combined – a plan design in which pharmacy and medical expenses accumulate to the same deductible. Change from Current – The percentage change between the estimated renewal premium and the current premium, which may Metallic Levels – An identifier of the level of coverage provided include rate increases and subscriber changes. by an ACA-qualified plan based on the actuarial value, i.e. the percentage of health care costs that are covered by the plan. The COBRA – Consolidated Omnibus Budget Reconciliation Act of four levels of coverage are Bronze (60%), Silver (70%), Gold (80%), 1985. COBRA applies to employers who general employ 20 or more and Platinum (90%). full-time equivalent employees. It allows employees and dependents who no longer qualify under an employer approved group health plan Out-of-network – Employees and their covered dependents to continue insurance under the group benefit plan. receiving non-network services may have additional financial responsibility beyond any applicable plan deductible, coinsurance Coinsurance – The portion of covered costs that amount, and co-payment. This additional financial responsibility will UnitedHealthcare will pay after the deductible is met. There are not apply to any out-of-pocket maximum. separate amounts for in-network and out-of-network services. Out-of-pocket maximum – the maximum dollar amount that Contribution Level – Defines the level of contribution made by one pays for covered services in a year under the terms of the health the employer toward the premium for the plan. plan. Copay – The fixed dollar amount the member must pay directly to a PCP – A primary care physician is a doctor who is usually trained in provider at the time they receive certain services pediatrics, internal medicine, obstetrics/gynecology, family practice, Deductible – The amount of covered expenses that the insured or general medicine. (member) must pay before the insurance starts paying covered PPACA – Patient Protection and Affordable Care Act. Also known expenses, excluding copays, coinsurance, and non-covered as the “Affordable Care Act”. A law intended to increase access to expenses. health care for more Americans that included many changes Definition of Disability – Description of the level of disability impacting the commercial health insurance market, Medicare, and that is covered under the Short Term or Long Term Disability plan. Medicaid. Elimination Period – also known as the waiting period, defines Policy Year Deductible – A deductible that is calculated based the amount of time that must pass before the member is eligible to on a one year period starting with the effective date of the policy and collect benefits. restarting the follow year on that date. Flexible Spending Account (FSA) – A dedicated savings Pre-Ex Condition Limitation – The number of months after account to which employees contribute on a pre-tax basis. The coverage begins, that a disability from a pre-existing condition will be money is then used to get reimbursed for eligible health expenses. covered. Guaranteed Issue – The amount of life insurance available to the Subscriber – The person responsible for payment of premiums or member without having to provide Evidence of Insurability (EOI). whose employment is the basis of eligibility for membership in a plan. HIPAA – Health Insurance Portability and Accountability Act. This Transitional Relief – Certain states have allowed small law sets standards for the security and privacy of protected health employers to retain their Medical plans that do not include the information. In addition, the law makes it easier for individuals to provisions required under PPACA rules. change jobs without the risk of extended waiting periods due to pre- existing conditions.  Section 6, ItemJ. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. UnitedHealthcare dental coverage underwritten by UnitedHealthcare Insurance Company, located in Hartford, Connecticut, or its affiliates, or UnitedHealthcare of Kentucky. Administrative services provided by Dental Benefit Providers, Inc., Dental Benefit Administrative Services (CA only), United HealthCare Services, Inc. or their affiliates. Plans sold in Texas use policy form number DPOL.06.TX and DPOL.12.TX (Rev. 9/ 16) and associated COC form numbers DCOC.CER.06 and DCERT.IND.12.TX. Plans sold in Virginia use policy form number DPOL.06.VA with associated COC form number DCOC.CER.06.VA and policy form number DPOL.12.VA with associated COC form number DCOC.CER.12.VA. Benefits for the UnitedHealthcare dental Select Managed Care plans are provided by or through the following UnitedHealth Group companies: Nevada Pacific Dental, National Pacific Dental, Inc., Dental Benefit Providers of Illinois, Inc., and UnitedHealthcare of Georgia. Plans sold in Texas use contract form number DHMO.CNT.11.TX and associated EOC form number DHMO.EOC.11.TX. The Select DHMO plan is underwritten by Dominion Dental Services, Inc. Dominion is licensed as a Limited Health Care Services HMO in Virginia, Pennsylvania and a Dental Plan Organization in Maryland and Delaware. In CA, benefits for the UnitedHealthcare Dental Select Managed Care/Direct Compensation plans are offered by Dental Benefit Providers of California, Inc. UnitedHealthcare Dental is affiliated with UnitedHealthcare. UnitedHealthcare vision coverage provided by or through UnitedHealthcare Insurance Company, located in Hartford, Connecticut, or its affiliates. Administrative services provided by Spectera, Inc., United HealthCare Services, Inc. or their affiliates. Plans sold in Texas use policy form number VPOL.06.TX or VPOL.13.TX and associated COC form number VCOC.INT.06.TX or VCOC.CER.13.TX. Plans sold in Virginia use policy form number VPOL.06.VA or VPOL.13.VA and associated COC form number VCOC.INT.06.VA or VCOC.CER.13.VA. UnitedHealthcare Life and Disability products are provided by UnitedHealthcare Insurance Company, and certain products in California by Unimerica Life Insurance Company. Life and Disability products are provided on policy forms LASD-POL (05/03) et al. and UHCLD-POL 2/ 2008 et al., in Texas on forms LASD-POL-TX(05/03) and UHCLD-POL 2/2008-TX, and in Virginia on LASD-POL(05/03) and UHCLD-POL 2/ 2008. UnitedHealthcare Insurance Company is located in Hartford, CT, and Unimerica Life Insurance Company is located in Milwaukee, WI. The policies have exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. Some products are not available in all states. UnitedHealthcare EDGE® plans are only available in states that have implemented the 2007 and 2011 Certificates of Coverage and have the UnitedHealth Premium® designation program. UnitedHealth Wellness® is a collection of programs and services offered to UnitedHealthcare enrollees to help them stay healthy. It is not an insurance product but is offered to existing enrollees of certain products underwritten or provided by UnitedHealthcare Insurance Company or its affiliates to encourage their participation in wellness programs. Health care professional availability for certain services may be dependent on licensure, scope of practice restrictions or other requirements in the state. Some UnitedHealth Wellness programs and services may not be available in all states or for all group sizes. The UnitedHealthcare Health Savings Account (HSA) high deductible health plan (HDHP) is designed to comply with IRS requirements so eligible enrollees may open a Health Savings Account with the bank of their choice or through Optum Bank, Member of FDIC. “UnitedHealthcare HSA” refers generally to the UnitedHealthcare HSA product, which includes a HDHP, although at times “UnitedHealthcare HSA” may refer only and specifically to the UnitedHealthcare Health Savings Account, provided in conjunction with Optum Bank and not to the associated HDHP. UnitedHealthcare's Health Reimbursement Account, or HRA, combines the flexibility of a medical benefit plan with an employer-funded reimbursement account © 2024 United HealthCare Services, Inc. 34 | VILLAGE OF KRONENWETTER 1573571 01/01/2025  Section 6, ItemJ. Glossary Annual Plan Maximum – The maximum dollar amount that a HRA – Health Reimbursement Account. An account to which an Dental plan will pay toward the cost of care within a specific period, employer can make contributions that are not taxable to the usually a calendar year. employee, and which the employee can use to pay for certain covered medical expenses. Calendar Year Deductible – A deductible that is calculated based on a calendar year, beginning on January 1 and restarting the HSA – Health Savings Account. A trust or custodial account that is following January 1. established with a bank, insurance company, or other IRS approved trustee, to pay for certain covered medical expenses with employee Certification of Coverage – A written document provided to pre-tax or taxable contributions, and/or employer non-taxable members that sets forth the terms of the health plan. It explains contributions. among other things coverage, member cost share obligations, appeal rights, and important enrollment information. Med/Rx Ded Combined – a plan design in which pharmacy and medical expenses accumulate to the same deductible. Change from Current – The percentage change between the estimated renewal premium and the current premium, which may Metallic Levels – An identifier of the level of coverage provided include rate increases and subscriber changes. by an ACA-qualified plan based on the actuarial value, i.e. the percentage of health care costs that are covered by the plan. The COBRA – Consolidated Omnibus Budget Reconciliation Act of four levels of coverage are Bronze (60%), Silver (70%), Gold (80%), 1985. COBRA applies to employers who general employ 20 or more and Platinum (90%). full-time equivalent employees. It allows employees and dependents who no longer qualify under an employer approved group health plan Out-of-network – Employees and their covered dependents to continue insurance under the group benefit plan. receiving non-network services may have additional financial responsibility beyond any applicable plan deductible, coinsurance Coinsurance – The portion of covered costs that amount, and co-payment. This additional financial responsibility will UnitedHealthcare will pay after the deductible is met. There are not apply to any out-of-pocket maximum. separate amounts for in-network and out-of-network services. Out-of-pocket maximum – the maximum dollar amount that Contribution Level – Defines the level of contribution made by one pays for covered services in a year under the terms of the health the employer toward the premium for the plan. plan. Copay – The fixed dollar amount the member must pay directly to a PCP – A primary care physician is a doctor who is usually trained in provider at the time they receive certain services pediatrics, internal medicine, obstetrics/gynecology, family practice, Deductible – The amount of covered expenses that the insured or general medicine. (member) must pay before the insurance starts paying covered PPACA – Patient Protection and Affordable Care Act. Also known expenses, excluding copays, coinsurance, and non-covered as the “Affordable Care Act”. A law intended to increase access to expenses. health care for more Americans that included many changes Definition of Disability – Description of the level of disability impacting the commercial health insurance market, Medicare, and that is covered under the Short Term or Long Term Disability plan. Medicaid. Elimination Period – also known as the waiting period, defines Policy Year Deductible – A deductible that is calculated based the amount of time that must pass before the member is eligible to on a one year period starting with the effective date of the policy and collect benefits. restarting the follow year on that date. Flexible Spending Account (FSA) – A dedicated savings Pre-Ex Condition Limitation – The number of months after account to which employees contribute on a pre-tax basis. The coverage begins, that a disability from a pre-existing condition will be money is then used to get reimbursed for eligible health expenses. covered. Guaranteed Issue – The amount of life insurance available to the Subscriber – The person responsible for payment of premiums or member without having to provide Evidence of Insurability (EOI). whose employment is the basis of eligibility for membership in a plan. HIPAA – Health Insurance Portability and Accountability Act. This Transitional Relief – Certain states have allowed small law sets standards for the security and privacy of protected health employers to retain their Medical plans that do not include the information. In addition, the law makes it easier for individuals to provisions required under PPACA rules. change jobs without the risk of extended waiting periods due to pre- existing conditions.  Section 6, ItemJ. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. UnitedHealthcare dental coverage underwritten by UnitedHealthcare Insurance Company, located in Hartford, Connecticut, or its affiliates, or UnitedHealthcare of Kentucky. Administrative services provided by Dental Benefit Providers, Inc., Dental Benefit Administrative Services (CA only), United HealthCare Services, Inc. or their affiliates. Plans sold in Texas use policy form number DPOL.06.TX and DPOL.12.TX (Rev. 9/ 16) and associated COC form numbers DCOC.CER.06 and DCERT.IND.12.TX. Plans sold in Virginia use policy form number DPOL.06.VA with associated COC form number DCOC.CER.06.VA and policy form number DPOL.12.VA with associated COC form number DCOC.CER.12.VA. Benefits for the UnitedHealthcare dental Select Managed Care plans are provided by or through the following UnitedHealth Group companies: Nevada Pacific Dental, National Pacific Dental, Inc., Dental Benefit Providers of Illinois, Inc., and UnitedHealthcare of Georgia. Plans sold in Texas use contract form number DHMO.CNT.11.TX and associated EOC form number DHMO.EOC.11.TX. The Select DHMO plan is underwritten by Dominion Dental Services, Inc. Dominion is licensed as a Limited Health Care Services HMO in Virginia, Pennsylvania and a Dental Plan Organization in Maryland and Delaware. In CA, benefits for the UnitedHealthcare Dental Select Managed Care/Direct Compensation plans are offered by Dental Benefit Providers of California, Inc. UnitedHealthcare Dental is affiliated with UnitedHealthcare. UnitedHealthcare vision coverage provided by or through UnitedHealthcare Insurance Company, located in Hartford, Connecticut, or its affiliates. Administrative services provided by Spectera, Inc., United HealthCare Services, Inc. or their affiliates. Plans sold in Texas use policy form number VPOL.06.TX or VPOL.13.TX and associated COC form number VCOC.INT.06.TX or VCOC.CER.13.TX. Plans sold in Virginia use policy form number VPOL.06.VA or VPOL.13.VA and associated COC form number VCOC.INT.06.VA or VCOC.CER.13.VA. UnitedHealthcare Life and Disability products are provided by UnitedHealthcare Insurance Company, and certain products in California by Unimerica Life Insurance Company. Life and Disability products are provided on policy forms LASD-POL (05/03) et al. and UHCLD-POL 2/ 2008 et al., in Texas on forms LASD-POL-TX(05/03) and UHCLD-POL 2/2008-TX, and in Virginia on LASD-POL(05/03) and UHCLD-POL 2/ 2008. UnitedHealthcare Insurance Company is located in Hartford, CT, and Unimerica Life Insurance Company is located in Milwaukee, WI. The policies have exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. Some products are not available in all states. UnitedHealthcare EDGE® plans are only available in states that have implemented the 2007 and 2011 Certificates of Coverage and have the UnitedHealth Premium® designation program. UnitedHealth Wellness® is a collection of programs and services offered to UnitedHealthcare enrollees to help them stay healthy. It is not an insurance product but is offered to existing enrollees of certain products underwritten or provided by UnitedHealthcare Insurance Company or its affiliates to encourage their participation in wellness programs. Health care professional availability for certain services may be dependent on licensure, scope of practice restrictions or other requirements in the state. Some UnitedHealth Wellness programs and services may not be available in all states or for all group sizes. The UnitedHealthcare Health Savings Account (HSA) high deductible health plan (HDHP) is designed to comply with IRS requirements so eligible enrollees may open a Health Savings Account with the bank of their choice or through Optum Bank, Member of FDIC. “UnitedHealthcare HSA” refers generally to the UnitedHealthcare HSA product, which includes a HDHP, although at times “UnitedHealthcare HSA” may refer only and specifically to the UnitedHealthcare Health Savings Account, provided in conjunction with Optum Bank and not to the associated HDHP. UnitedHealthcare's Health Reimbursement Account, or HRA, combines the flexibility of a medical benefit plan with an employer-funded reimbursement account © 2024 United HealthCare Services, Inc. 34 | VILLAGE OF KRONENWETTER 1573571 01/01/2025