State of Louisiana DIVISION OF ADMINISTRATION



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State of Louisiana DIVISION OF ADMINISTRATION OFFICE OF STATE UNIFORM PAYROLL M. J. MIKE FOSTER, JR. MARK C. DRENNEN GOVERNOR COMMISSIONER OF ADMINISTRATION April 7, 2003 OFFICE OF STATE UNIFORM PAYROLL MEMORANDUM #2003-51 TO: FROM: SUBJECT: All ISIS HR Agencies Jena W. Cary Director Miscellaneous Insurance Products Removed from Payroll Deduction Payroll Deductions Authorized for Fiscal Year 2003-2004 In reviewing voluntary insurance products offered to state employees through payroll deduction, the Uniform Payroll Insurance Commission (UPIC) determined that any product offered which did not have a participation level of 100 employees paid through the ISIS HR Payroll System (ISIS HR) by December 31, 2002, would not be allowed to continue as a payroll deduction effective July 1, 2003. Applications submitted by payroll vendors for continued deduction authorization for Fiscal Year 2003-2004 have been approved. As a result of the participation level change and the annual OSUP review process of all current miscellaneous vendor applications, it has been determined that the following products will be removed from payroll deduction effective July 1, 2003: Vendor Deduction Code Wage Types Product Name American Family Life NT 29 3077/3477 Convalescent Care American Family Life NU 29 3078/3478 Medicare Supp American Heritage Life NR 31 3001/3401 Term Life American Public Life PB/NB 20 3050/3450, 3044/3444 Intensive Care American Public Life NR 30 3045/3445 Term Life American Public Life NS 31 3082/3482 Whole Life Colonial Life & Accident NS 77 3064/3464 Whole Life Conseco PB/NB 20 3021/3421, 3011/3411 Intensive Care Conseco NN 83 3015/3415 Intensive Care - C/V Conseco NZ 99 3019/3419 *Grandfather* Life Investors PD/ND 20 3075/3475, 3066/3466 Intensive Care Life Investors NS 83 3070/3470 Intensive Care - C/V Life Investors NR 30 3071/3471 Whole Life Life Investors NN 81 3068/3468 Accident - C/V New York Life NS 30 3085/3485 Term Life New York Life NM 22 3083/3483 Disability Professional NM 25 3092/3492 Cancer Professional PB/NB 21 3093/3493, 3089/3489 Hospital Indemnity Professional NS 30 3090/3490 Term Life Professional NT 32 3096/3496 Whole Life Protective Life NM 80 3030/3430 Cancer Protective Life NN 29 3102/3502 Disability Protective Life NP 31 3100/3500 Whole Life POST OFFICE BOX 94095 CLAIBORNE BUILDING BATON ROUGE, LA 70804-9095 (225) 342-0713 Fax (225) 342-1650 AN EQUAL OPPORTUNITY EMPLOYER

OFFICE OF STATE UNIFORM PAYROLL MEMORANDUM #2003-51 April 7, 2003 Page 2 Vendors have been notified that they are responsible for contacting employees with products being removed from payroll deduction. They will advise the employees on how premiums can be paid, e.g. bank draft or invoice, in order to keep their policies in force. Agencies will not receive a new SED-4 form to indicate the removal of these products. Agencies can run report ZP74 to determine which employees have these wage types, but may not be required to delimit them as the ISIS HR conversion to OGB s eenrollment may complete this task. Additional details will be forwarded in future OSUP memorandum. Vendors have also been advised to revise their SED-4 Payroll Deduction Authorization Form to include only those products approved effective July 1, 2003. Until these forms are approved, agencies must not accept SED-4 forms for deductions that are no longer approved with effective dates of July 1, 2003 or later. As a result of the analysis on the annual participation levels, some changes may also need to be made for deductions that are being withheld under an incorrect product code. Vendors will contact the agencies affected. Agencies may accept an SED-4 without an employee s signature if the SED-4 submitted by the vendor is correcting the product codes and/or amounts between products and there is no change in the total semi-monthly premium. These changes are allowed for employees participating in the flex plan since these are considered to be correcting an administrative error. Corrections to FBP deductions can only be made back to the beginning of the 2002-2003 plan year, if applicable. A list of authorized vendors (VC-01) for fiscal year 2003-2004 is attached. Also attached is a list of vendors, authorized products, and assigned codes, as well as, the names, addresses, and phone number of the vendor coordinator (VC-02) for your reference. For information on products authorized for payroll deduction, agencies can now refer employees to the following link on the OSUP website: http://www.doa.state.la.us/osup/misc_ins_prod_listing_july2003.htm. This website includes generic product definitions as well as the ability to search for information at the product or vendor level. Soon, there will be links added to web pages maintained by the vendors that will provide more details about the products offered to LA State Employees. These web pages should be printed by agencies for those employees who do not have access to the internet. Communication between agency personnel, vendor designated Coordinator and OSUP is critical for accurate and efficient processing of employee deductions for all parties involved. Timely resolution of deduction problems is mandatory. Agency personnel are responsible for assuring that both verbal and written correspondence from coordinators are acted upon in a timely manner. If you have any questions, please contact Angel Vernon at (225) 342-5344. JWC:ACV:kmb Attachments: VC-01, List of Authorized Vendors VC-02, List of Vendor Coordinator, Address and Product

VC-01 Rev 04/03 30004 FBP F/A+ American Family Life Assurance Co (AFLAC) 1932 Wynnton Rd Columbus, GA 31999-0002 Allyson Goodwin Idell (706) 317-6130 30013 FBP F/A Colonial Life & Accident 1200 Colonial Life Blvd W Columbia, SC 29210-7699 Belinda Maffei (800) 845-7330 ext 5631 30024 FBP D/B++ Guaranty Income Life 929 Government St Baton Rouge, LA 70802-6089 Sherry Ducote (225) 383-0355 ext 267 30047 FBP N/CD MSofA Dent-All Plan, Inc. PO Box 1418 Tomball, TX 77377-1418 Jeffrey A. Darin (800) 999-5842 30052 Non FBP N/ILOC Pre-Paid Legal Services 321 E Main St Ada, OK 74820-5694 Mark Riches (888) 264-4070 30064 FBP D/B+ Starmount Life Ins 7800 Office Park Blvd Baton Rouge, LA 70809-7603 Christie Duggan (225) 926-2888 ext 103 MISCELLANEOUS DEDUCTIONS ALPHA LISTING FISCAL YEAR 2003-2004 30006 FBP F/A+ American Heritage Life, a whollyowned subsidiary of the Allstate Corporation 1776 American Heritage Life Dr Jacksonville, FL 32224-6688 J. Craig Hensley (877) 417-2063 30014 FBP F/B u Conseco Health Ins, marketed through Southern Capitol 11825 N Pennsylvania St Carmel, IN 46032-4604 Gloria Tutt (225) 769-0500 30043 FBP F/A+ Life Investors Insurance, administered by Transamerica 4333 Edgewood Rd NE Cedar Rapides, IA 52499-0002 Marilyn Brinkhuis (225) 925-9829 30048 Non FBP F/A++ New York Life Insurance 51 Madison Ave New York, NY 10010-1655 Stephen Goldsmith (800) 695-1272 ext 200 30053 FBP F/A Professional Insurance, underwriter for GE Financial Assurance PO Box 80637 Lincoln, NE 68501-0637 Carolyn Santiago (800) 451-2513 ext 2297 30008 FBP F/B++ American Public Life PO Box 925 Jackson, MS 39205-0925 Doug Johnson (800) 256-8606 ext 218 30023 FBP D/NR-5 Guaranty Assurance Co 11969 Bricksome Ave Ste A Baton Rouge, LA 70816-2337 Delina Schexnayder (225) 291-3172 30046 Non FBP F/A Loyal American Life PO Box 559004 Austin, TX 78755-9004 Warren Benoit (800) 443-5694 10048 Non FBP -/- Office of Group Benefits (American General) 5825 Florida Blvd Baton Rouge, LA 70806-4248 Ray Harrison (225) 925-3739 30054 Non FBP F/A+ Protective Life Ins PO Box 12687 Birmingham, AL 35202-6687 Debra Lawson (800) 866-9933 ext 3561 XXXXX = ISIS HR Vendor Code for the specific company FBP/Non FBP = Indicates whether company has products participating in the Flexible Benefits Plan x1/x2 = x1= D-domestic insurance, F-foreign insurance, or N-non insurance x2= Insurance Vendors - A.M. Best current rating- A+, A, B+, B, etc. Or Non-insurance vendors - CD-Certificate of Deposit or ILOC-Irrevocable letter of credit Home address of company Name and phone number of designated Coordinator NOTE: Codes assigned EACH AUTHORIZED PRODUCT are listed on form VC-02 (04/03)

VC-02 VENDOR COORDINATOR, ADDRESS, PRODUCTS, Best/FBP Page 1 of 2 (04/03) OSUP Memo #2003-51 (Fiscal Year 2003-2004) Vendor No. Vendor Best Rating/FBP Indicator Coordinator Address/Phone Product Code Product Description Product Code Product Description (Agency Personnel Use Only) 30004 American Family Life Assurance Co (AFLAC) F/A+ / FBP Allyson Goodwin Idell 1932 Wynnton Rd PA/NA 25 Cancer PB/NB 20 Intensive Care Columbus, GA 31999-0002 PC/NC 21 Hospital Indemnity NV 81 Accident/Disability (706) 317-6130 NS 38 Term Life (706) 660-7539 (FAX) aidell@aflac.com 30006 American Heritage Life, a wholly-owned subsidiary of the Allstate Corporation PA/NA 25 Cancer NN 27 Accident NP 22 Disability Income - N/S NS 32 Universal Life Customer Service number for Employees (800) 992-3522 F/A+ / FBP J. Craig Hensley 2400 Veterans Blvd Ste 235 Kenner, LA 70062 (877) 417-2063 (504) 466-1441 (FAX) craig.hensley@ahlcorp.com Customer Service number for Employees (800) 521-3535 30008 American Public Life F/B++ / FBP Doug Johnson PA/NA 25 Cancer NM 27 Accident PO Box 925 Jackson, MS 39205-0925 PD/ND 23 Denta-Care I PE/NE 15 Denta-Care II (800) 256-8606 ext 218 (601) 932-9011 (FAX) djohnson@ampublic.com Customer Service number for Employees (800) 256-8606 30013 Colonial Life & Accident F/A / FBP Belinda Maffei PA/NA 63 Cancer PB/NB 78 Intensive Care Attn: Mail Stop SC216 PO Box 1365 NM 60 Accident/Disability PD/ND 76 Hospital Indemnity Columbia, SC 29202-1365 NR 69 Universal Life (800) 845-7330 ext 5631 (803) 213-3010 (FAX) BTMaffei@UNUM.com 30014 Conseco Health Ins, marketed through Southern Capitol PA/NA 25 Cancer NM 80 Cancer-C/V PC/NC 27 Accident NP 81 Accident-C/V PD/ND 16 HeartCare NR 82 HeartCare-C/V NS 84 Hospital Indemnity-C/V - N/S Customer Service number for Employees (800) 325-4368 F/B u / FBP Gloria Tutt PO Box 83360 Baton Rouge, LA 70884-3360 (225) 769-0500 (225) 769-0160 (FAX) gloriatutt@southerncapitol.net Customer Service number for Employees (800) 541-2254 30023 Guaranty Assurance Co D/NR-5 / FBP Delina Schexnayder PA/NA 23 DINA Pref Dental PO Box 40017 Baton Rouge, LA 70835-0017 (225) 291-3172 (225) 292-3075 (FAX) dschexna@bellsouth.net Customer Service number for Employees (800) 376-3462 30024 Guaranty Income Life D/B++ / FBP Sherry Ducote PA/NA 23 Q-Dent Dental Plan NM 32 Universal Life PO Box 2231 Baton Rouge, LA 70821-2231 (225) 383-0355 ext 267 (225) 343-0047 (FAX) Sherry@gilico.com 30043 Life Investors Insurance, administered by Transamerica PA/NA 25 Cancer NM 80 Cancer-C/V - N/S NT 27 Accident PC/NC 16 Heart NP 82 Heart-C/V - N/S Products followed by N/S = Product has active participants but is no longer solicited/sold Customer Service number for Employees (225) 383-0355 F/A+ / FBP Marilyn Brinkhuis 1136 E Riveroaks Dr Baton Rouge, LA 70815-4156 (225) 925-9829 (225) 927-5655 (FAX) 1Marilyn@cox.net Customer Service number for Employees (225) 925-1393

VC-02 VENDOR COORDINATOR, ADDRESS, PRODUCTS, Best/FBP Page 2 of 2 (04/03) OSUP Memo #2003-51 (Fiscal Year 2003-2004) Vendor No. Vendor Best Rating/FBP Indicator Coordinator Address/Phone Product Code Product Description Product Code Product Description (Agency Personnel Use Only) 30046 Loyal American Life F/A / Non FBP Warren Benoit NM 32 Universal Life NP 34 Whole Life - N/S PO Box 640488 Kenner, LA 70064-0488 (800) 443-5694 (504) 443-6004 (FAX) w_benoit@bellsouth.net Customer Service number for Employees (800) 633-6752 30047 MSofA Dent-All Plan, Inc. N/CD / FBP Jeffrey A. Darin PA/NA 23 Dental/Eye/Chiropractic/Vitamin /Hearing Aid/24-hr Nurse Hotline PO Box 1418 Tomball, TX 77377-1418 (800) 999-5842 (281) 351-2786 (FAX) jdarin@dent-allplan.com Customer Service number for Employees (800) 999-5842 30048 New York Life Insurance F/A++ / Non FBP Stephen Goldsmith NN 31 Whole Life NP 32 Universal Life PO Box 500 Minneapolis, MN 55440-0500 (800) 695-1272 ext 200 (952) 884-2477 (FAX) stephen_c_goldsmith@newyorklife.com Customer Service number for Employees (800) 695-1272 ext 407 10048 Office of Group Benefits (American General) -/- / Non FBP Ray Harrison NM 50 Universal Life - N/S PO Box 44036 Baton Rouge, LA 70804-4036 (225) 925-3739 (225) 925-4860 (FAX) rharrison@ogb.state.la.us Customer Service number for Employees (800) 247-8837 30052 Pre-Paid Legal Services N/ILOC / Non FBP Mark Riches NM 99 Pre-Paid Legal 4660 Mirandy Rd Cookeville, TN 38506-8655 (888) 264-4070 (931) 537-2270 (FAX) mriches@citlink.net 30053 Professional Insurance, underwriter for GE Financial Assurance NN 27 Disability Income Customer Service number for Employees (800) 654-7757 F/A / FBP Carolyn Santiago 100 Bright Meadow Blvd Enfield, CT 06082-1981 (800) 451-2513 ext 2297 (860) 737-1040 (FAX) Carolyn.santiago@ge.com Customer Service number for Employees (800) 289-1122 ext 3006 30054 Protective Life Ins F/A+ / Non FBP Debra Lawson NR 30 Term Life NS 32 Universal Life PO Box 12687 Birmingham, AL 35202-6687 (800) 866-9933 ext 3561 (205) 868-3402 (FAX) debra.lawson@protective.com Customer Service number for Employees (800) 866-9933 30064 Starmount Life Ins D/B+ / FBP Christie Duggan PA/NA 17 Preferred Dental PO Box 14389 Baton Rouge, LA 70898-4389 (225) 926-2888 ext 103 (225) 926-6292 (FAX) christied@starmountlife.com Customer Service number for Employees (888) 729-5433 ext 2013 Products followed by N/S = Product has active participants but is no longer solicited/sold