Page 3 - Food Bank Council 2020 Renewal Booklet

Food Bank Council of Michigan

September 2020 Renewal Benefits

 BCN HMO PCP Focus Platinum $500/0%: $500 Single/$1,000
Family deductible, 0% Coinsurance, Annual Maximum OOP
$1,500 Single/$3,000 Family

 Delta Dental PPO 100/80/50/50 with Essential Health Benefits
(EHB): $25 Single/$75 Family Deductible applies to Class II
and III services; $1,000 per member Annual Maximum, $1,000
per child Lifetime Ortho Maximum

 EyeMed Vision: 12/12/12, $10/$10:
 Examination- once every 12 months
 Lenses or Contact Lenses- once every 12 months
 Frame- once every 12 months
 $175 Allowance

 SBAM Dearborn National Life/AD&D: 1 X basic Annual Salary,
Maximum of $100,000 (reduces by 35% at age 65)

 SBAM Dearborn National STD: 14/14/13, 66.67 % of weekly
earnings to a maximum of $1,000 per week

 SBAM Dearborn National LTD: 90 Day Elimination Period,
Monthly Benefit-60% of pre-disability earnings to a maximum
of $6,000 per month, SSNRA duration