Page 2 - Tetra Renewal 2020
P. 2

The Tetra Corporation



                         2020 Renewal Benefits











             BCBSM CB PPO Platinum $500:  $500 Single/$1,000 Family
             Deductible, 10% coinsurance to an Annual maximum of
             $500/$1,000, Annual Out of  Pocket  Maximum $6,600/$13,200



            BCBSM Blue Dental PPO Plus 100/80/50/50 with Pediatric Dental:
             Class I covered 100%, Class II covered 80%, Class  III covered
             50%, Class IV (Ortho) covered 50%.  $25 Single/$75 Family
             Deductible applies to Class II and Class III services, Annual
             Maximum $1000 per member per calendar year. Lifetime Ortho
             maximum of $1,000.



            BCBSM Blue Vision:  12/12/12, Eye Exam/Lenses/Frames every 12
             months.  $5 Eye Exam copay/$10 Materials copay, $130
             Allowance



            Principal Life/AD&D-Executives : Benefit Amount-$200,000



            Principal Life/AD&D-All other eligible: Benefit Amount-$100,000


            Principal Short-Term Disability: Elimination Period-8/8/12, Weekly
             Benefit-60% of pre-disability earnings up to $1,500



            Principal Long-Term Disability: Elimination Period-90 Days, Monthly
             Benefit-60% of pre-disability earnings up to $10,000



            Principal 401K
   1   2   3   4   5   6   7