Page 3 - S & S Die Company 2020 Renewal Presentation

S & S Die Company Renewal

November 2020

Current Renewal Alt # 1 Alt # 2 Alt # 3

BCN HMO Platinum BCN HMO Platinum BCN HMO PCP BCN HMO Gold BCBSM SB PPO
$500 $500 Focus Platinum $500 $500/20% $1000

36 employees
Member Member Member Member Member
Level Level Level Level Level
Rating Rating Rating Rating Rating

Est. Monthly Premium $38,587.85 $41,547.72 $38,215.07 $35,041.42 $39,648.10
Est. Annual Premium $463,054.20 $498,572.64 $458,580.84 $420,497.04 $475,777.20
Includes Taxes and Fees
Change in Premium 7.67% INCREASE SAVE .97% SAVE 9.2% 2.7% INCREASE
Benefits
Deductible
In network $500/$1000 $500/$1000 $500/$1000 $500/$1000 $1000/$2000
Out Network No Benefit No Benefit No Benefit No Benefit $2000/$4000

Prescription drug copay $4/$15/$40/$80/20%/20% $4/$15/$40/$80/20%/20% $4/$15/$40/$80/20%/20% $10/$30/$60/$80/20%/20% $20/$60/50%/20%/25%

Office visit copay $20 PCP/$30 Spec $20 PCP/$30 Spec $20 PCP/$30 Spec $30 PCP/$50 Spec $30 PCP/$50 SPEC

Urgent care copay $35 $35 $35 $35 $60

Emergency Room Copay $150 after deductible $150 after deductible $150 after deductible $250 after deductible $250

Hospitalization
In patient 100% after deductible 100% after deductible 100% after deductible 80% after deductible 80% after deductible
Out patient 100% after deductible 100% after deductible 100% after deductible 80% after deductible 80% after deductible

Lab & X-ray 100% after deductible 100% after deductible 100% after deductible 80% after deductible 80% after deductible

Ded. & Coinsurance Max. N/A N/A N/A $5000/$10,000 $3000/$6000

Maximum copayment
In network $1500/$3000 $1500/$3000 $1500/$3000 $8150/$16,300 $8150/$16,300
Out network No Benefit No Benefit No Benefit No Benefit $16,300/$32,600
2019 Changed to $500 Platinum BCN and saved 1.3% from renewal. 2018 moved from PHP to BCN Platinum and saved .56%
2017 Moved all employees to the HMO Exclusive (gave up the PPO Plan), Rates increased 3.9%, 2016 added Platinum HMO Exclusive Plan with a 4.2% savings.
6 members would be disrupted with their PCP if the BCN PCP Focus plan is chosen
Employee count is based on Sept 2020 invoice

Prepared August 2020