Page 4 - ECIC 2020 Renewal

EARLY CHILDHOOD INVESTMENT CORPORATION
SEPTEMBER 1, 2020 RENEWAL
PRESENTED BY: GREGORY D. BROGAN

Current Renewal Current Mapped Renewal Alt # 1 Current Renewal Alt # 1 Alt # 2
BCBSM Simply Blue BCBSM Simply Blue BCBSM Simply Blue BCBSM Simply Blue BCBSM Simply Blue
# of employees # of employees BCN HMO Platinum BCN HMO Platinum BCN HMO Gold BCN HMO Gold
PPO Platinum PPO Platinum PPO Gold PPO Gold PPO Gold

4 employees/1 COBRA Member Member 3 employees Member Member Member 23 employees Member Member Member Member
Snapshot as of 6/1/20 Level Level Level Level Level Level Level Level Level
Rating Rating Rating Rating Rating Rating Rating Rating Rating
Est. Monthly Premium $5,645.94 $6,045.12 $2,304.91 $2,395.97 $2,257.85 $17,834.04 $19,078.34 $16,317.95 $16,103.12
Est. Annual Premium $67,751.28 $72,541.44 $27,658.92 $28,751.64 $27,094.20 $214,008.48 $228,940.08 $195,815.40 $193,237.44
Includes Taxes and Fees
Change in premium 7.07% INCREASE 3.95% INCREASE SAVE 2% 6.98% INCREASE SAVE 8.5% SAVE 9.7%
Benefits
Deductible
In network $250/$500 $250/$500 $1000/$2000 $1000/$2000 $2000/$4000 None None $500/$1000 $1000/$2000
Out network $500/$1000 $500/$1000 $2000/$4000 $2000/$4000 $4000/$8000 No Benefit No Benefit No Benefit No Benefit
Prescription Drug Copay $10/$40/$80/15%/25% $10/$40/$80/15%/25% $15/$50/50%/20%/25% $20/$60/50%/20%/25% $15/$50/50%/20%/25% $4/$15/$40/$80/20%/20% $4/$15/$40/$80/20%/20% $10/$30/$60/$80/20%/20% $10/$30/$60/$80/20%/20%

Office visit copay $20 PCP/$40 SPEC** $20 PCP/$40 SPEC** $20 PCP/$40 SPEC** $30 PCP/$50 SPEC** $30 PCP/$50 SPEC** $25 PCP/$35 SPEC $25 PCP/$35 SPEC $30 PCP/$50 SPEC $20 PCP/$40 SPEC

Urgent Care Copay $60** $60** $60 $60 $60 $35 $35 $35 $50
Emergency Room Copay $150 $150 $250 $250 $150 $150 $150 $250 after deductible $250 after deductible

Hospitalization
In patient 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible
Out patient 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible
Lab & X-ray 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible

Embedded Coinsurance Max. $1000/$2000 $1000/$2000 $2000/$4000 $3000/$6000 N/A $1000/$2000 $1000/$2000 $5000/$10,000 $3500/$7000
Max. out of pocket
In network $6600/$13,200 $6600/$13,200 $6600/$13,200 $8150/$16,300 $7350/$14,700 $6600/$13,200 $6600/$13,200 $8150/$16,300 $8150/$16,300
Out network $13,200/$26,400 $13,200/$26,400 $13,200/$26,400 $16,300/$32,600 $14,700/$29,400 No Benefit No Benefit No Benefit No Benefit
2019 Changed to BLUE and offered three options: SB Platinum $250 saved .73%, SB Gold $1000 saved 13.5% and HMO Platinum saved 14.6%.
2018 rates increased 2.4%, 2017 rates decreased 9.7%, 2016 rates increased 6.9%, 2015 rates increased .65%, 2014 rates increased 8.4%, 2013 rates increased 10.7%,
2012 moved to PHP's PPO and increased rates 5%, 2011 rates increased 9.4% (tweaked copays), 2010 rates DECREASED 2.8%, 2009 saved 16.8% by increasing some copays,
2008 rates increased 7.8%, 2007 Saved 13.9% when moved to CB 3 plan eff. 1/10/08.
**BCBSM Simply Blue plans apply deductible and coinsurance to office services. Services include diagnostic (including complex), therapeutic and surgery. An office visit copay still applies to the exam.

Prepared June 2020