Page 15 - 2015 BRP Benefits Guide
P. 15
2015 Annual Enrollment
Speciic Injuries or Treatments (continued)
Laceration $50 - $400
Surgery (Arthroscopic/Abdominal or Thoracic) $250/$1,000
Surgical Repair of Ligaments/Tendons, Knee Cartilage, Rotator $450
Cuff
Ruptured Disc $600
Accidental Death & Dismemberment (AD&D)
Employee $75,000
Spouse $25,000
Child $12,500
Reasonable Modiications to Home or Vehicle in the Case of $2,500
Catastrophic Loss
$50 Annual Wellness Benefit
This beneit is payable for you as well as any covered dependents ($50
each year). Covered conditions include but are not limited to blood test
for triglycerides, bone marrow testing, breast ultrasound, chest x-ray,
colonoscopy, EKG, fasting blood glucose test, lexible sigmoidoscopy,
mammography, pap smear, PSA, serum cholesterol HDL/LDL, and a stress
test.
Bi-Weekly Employee Premiums
Employee Only $7.31
Employee + Spouse $11.19
Employee + Child(ren) $12.08
Employee + Family $16.99
15
Speciic Injuries or Treatments (continued)
Laceration $50 - $400
Surgery (Arthroscopic/Abdominal or Thoracic) $250/$1,000
Surgical Repair of Ligaments/Tendons, Knee Cartilage, Rotator $450
Cuff
Ruptured Disc $600
Accidental Death & Dismemberment (AD&D)
Employee $75,000
Spouse $25,000
Child $12,500
Reasonable Modiications to Home or Vehicle in the Case of $2,500
Catastrophic Loss
$50 Annual Wellness Benefit
This beneit is payable for you as well as any covered dependents ($50
each year). Covered conditions include but are not limited to blood test
for triglycerides, bone marrow testing, breast ultrasound, chest x-ray,
colonoscopy, EKG, fasting blood glucose test, lexible sigmoidoscopy,
mammography, pap smear, PSA, serum cholesterol HDL/LDL, and a stress
test.
Bi-Weekly Employee Premiums
Employee Only $7.31
Employee + Spouse $11.19
Employee + Child(ren) $12.08
Employee + Family $16.99
15
