Page 4 - Eles Place Renewal 2020

ELE'S PLACE

DECEMBER 1, 2020 BCN MEDICAL RENEWAL

Mapped Plan
Current Mapped Renewal Alt # 1
Blue Care Network Blue Care Network Blue Care Network
HMO PCP Focus GOLD HMO PCP Focus GOLD HMO PCP Focus GOLD
$1500 $1500 $2500
17 employees
Member Member Member
Level Level Level
Rating Rating Rating

Est. Monthly Premium $10,764.87 $11,355.59 $11,067.40
Est. Annual Premium $129,178.44 $136,267.08 $132,808.80
Includes Taxes and Fees
Change in Premium 5.49% INCREASE 2.8% INCREASE
Benefits
Deductible
In network $1500/$3000 $1500/$3000 $2500/$5000
Out Network No Benefit No Benefit No Benefit

Prescription drug copay $4/$15/$40/$80/20%/20% $6/$25/$50/$80/20%/20% $4/$15/$40/$80/20%/20%

Office visit copay $20 PCP/$40 SPEC $20 PCP/$40 SPEC $30 PCP/$50 SPEC

Urgent care copay $50 $50 $50

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

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

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

Coinsurance Maximum $1500/$3000 $2500/$5000 $2000/$4000

Maximum copayment
In network $6600/$13,200 $8150/$16,300 $7350/$14,700
Out network No Benefit No Benefit No Benefit
2019 rates only increased 2.1% because group increased their deductible and moved to the PCP focus plan.
2018 rates increased 10%, 2017 rates increased 2.4%, 2016 rates increased 2.9%, 2015 CMI was going out of business, group enrolled with BCN.
2014 group moved to CMI and incurred a 12.1% increase instead of a 32.2%, if they had stayed with the BLUES, 2013 rates increased 6.9%.
If renewal had not been changed from Jan 2014 to Dec 2013, rates would have increased 29-33% with a comparable metal tier plan.
Jan 2013 rates DECREASED 2.3%, 2012 rates increased 9.7%

Prepared September 2020