Page 6 - 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
BCBSM Simply Blue BCBSM Simply Blue PHP PPO Platinum # of employees BCBSM Simply Blue BCBSM Simply Blue PHP PPO Gold $1000 # of employees BCN HMO Platinum BCN HMO Platinum PHP PPO Platinum
PPO Platinum PPO Platinum $250 PPO Gold PPO Gold

4 employees Member Member Member 3 employees Member Member Member 23 employees Member Member Member
Snapshot as of 6/1/20 Level Level Level Level Level Level Level Level Level
1 COBRA NOT included Rating Rating Rating Rating Rating Rating Rating Rating Rating
Est. Monthly Premium $3,449.79 $3,749.73 $3,633.19 $2,304.91 $2,395.97 $2,843.56 $17,834.04 $19,078.34 $23,644.53
Est. Annual Premium $41,397.48 $44,996.76 $43,598.28 $27,658.92 $28,751.64 $34,122.72 $214,008.48 $228,940.08 $283,734.36
Includes Taxes and Fees
Change in premium 8.7% INCREASE 5.3% INCREASE 3.95% INCREASE 23.4% INCREASE 6.98% INCREASE 32.6% INCREASE
Benefits
Deductible
In network $250/$500 $250/$500 $250/$500 $1000/$2000 $1000/$2000 $1000/$2000 None None None
Out network $500/$1000 $500/$1000 $1500/$3000 $2000/$4000 $2000/$4000 $3500/$7000 No Benefit No Benefit $1000/$2000
Prescription Drug Copay $10/$40/$80/15%/25% $10/$40/$80/15%/25% $10/$40/$80/20%/20% $15/$50/50%/20%/25% $20/$60/50%/20%/25% $20/$50/$80/$150 $4/$15/$40/$80/20%/20% $4/$15/$40/$80/20%/20% $10/$40/$80/$150

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

Urgent Care Copay $60** $60** $50 $60 $60 $60 $35 $35 $50

Emergency Room Copay $150 $150 $150 $250 $250 $300 after deductible $150 $150 $150
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 N/A $2000/$4000 $3000/$6000 N/A $1000/$2000 $1000/$2000 N/A

Max. out of pocket
In network $6600/$13,200 $6600/$13,200 $2200/$4400 $6600/$13,200 $8150/$16,300 $5400/$10,800 $6600/$13,200 $6600/$13,200 $1500/$3000
Out network $13,200/$26,400 $13,200/$26,400 $4500/$9000 $13,200/$26,400 $16,300/$32,600 $7000/$14,000 No Benefit No Benefit $4000/$8000