Page 3 - Muchmore Harrington Renewal Booklet 2020

MHSA

GROUP BENEFIT OFFERINGS

Physicians Health Plan – Mapped Platinum PPO Medical Plan

$750 Single, $1500 Family deductible followed by an 80/20 coinsurance to
an overall maximum out of pocket of $2700 Single, $5400 per family per
calendar year, $5 Copay for AmWell Online Visit, $20 PCP Office Visit
Copay, $40 Specialist Copay, $50 Urgent Care Copay, and $150 Emergency
Room Copay AFTER deductible, $20 Generic/$50 Preferred Brand
Name/$80 Non Preferred Brand Name/$150 Specialty Prescription Drugs
(Previous out of pocket maximum was $2500/$5000, 2 nd Tier of Rx was $40.)

Amwell Online copay is $0 until June 30, 2020

Delta Dental - Dental

This plan covers 100% of Preventative Services, 80% Basic Services and
50% Major Services. Each person on the plan has $1000 of annual benefit
running on a calendar year basis. $50/$150 per family deductible applies to
Basic and Major Services only.

No Rate Increase

Eye Med – Vision
This plan offers a $10 Eye Exam Copay, $10 Lenses/Frames Copay up to a
$160 allowance. Benefits and materials are payable once every 12 months.

No Increase - Rates guaranteed 9/1/20 – 9/1/24

Reliance Standard – Employer Paid Life

All full-time eligible employees receive a flat $100,000 of term life and
accidental death and dismemberment.

Reliance Standard - Employer Paid Long Term Disability

All full- time eligible employees receive 60% of monthly earnings up to
$10,000/month, Own Occupation, payable to Age 65 after a 90-day waiting
period.

Reliance Policies – received a rate pass until Sept 2021