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The Tetra Corporation: June 2020 Medical Analysis



                                                            Current                    Renewal                    Option 1                   Option 2                   Option 3
                                                             BCBSM                      BCBSM                      BCBSM                      BCBSM                Blue Care Network

                                                       CB Platinum $500           CB Platinum $500             CB Gold $1500               SB Gold $500            Platinum $500 0%
                 Plan Type                                     PPO                        PPO                        PPO                        PPO                        HMO
                 Plan Year                                    2019                        2020                       2020                       2020                       2020
                                                            In-Network                 In-Network                 In-Network                 In-Network                 In-Network
                 Deductible
                      Individual                              $500                        $500                      $1500                       $500                       $500
                      Couple/Family                           $1,000                     $1000                      $3000                      $1000                      $1000
                 Coinsurance                                   10%                        10%                        20%                        20%                         0%
                 Coinsurance Max
                      Individual                              $500                        $500                      $4500                      $4500                   Not Applicable
                      Couple/Family                           $1,000                     $1000                      $9000                      $9000                   Not Applicable
                 Annual Out of Pocket Max
                      Individual                              $6,600                     $6600                      $8150                      $8150                      $1500
                      Couple/Family                          $13,200                     $13200                     $16300                     $16300                     $3000
                 Physician Copays
                      Preventive Care                     Covered 100%                 No Charge                  No Charge                  No Charge                   No Charge
                      Office Visit                             $20                        $20                        $30                        $30                         $20
                      Specialty Office Visit                   $20                        $20                        $30                        $50                         $30
                      Virtual Visits                           $20                        $20                        $30                        $30                         $20
                 Hospital Services
                      Urgent Care                              $60                        $60                        $60                        $60                         $35
                      Emergency Room                          $150                        $150                       $250                       $250             $150 Copay after deductible
                      Inpatient Hospital                10% after deductible       10% after deductible       20% after deductible       20% after deductible        0% after deductible
                      Outpatient Hospital               10% after deductible       10% after deductible       20% after deductible       20% after deductible        0% after deductible
                 Diagnostic Services
                      Imaging/CT/PET/MRI                10% after deductible       10% after deductible       20% after deductible       20% after deductible    $150 Copay after deductible
                      Labs                              10% after deductible       10% after deductible       20% after deductible       20% after deductible            No Charge
                      X-Rays                            10% after deductible       10% after deductible       20% after deductible       20% after deductible        0% after deductible
                 Mental Health                                 $20                 10% after deductible       20% after deductible       20% after deductible               $20
                 Chiropractic                                  $20                        $20                        $30                        $30                         $30
                 Prescription Drugs
                      Generic                                   $5                         $5                        $10                        $20                       $4/$15
                      Preferred Brand                          $40                        $40                        $40                        $60                         $40
                      Non-Preferred Brand                      $80                        $80                        $80                 $80 or 50% $100 max                $80
                      Preferred Specialty                      $40                        $40                        $40                    20%/$200 max               20%/$200 max
                      Non-Preferred Specialty                  $80                        $80                        $80                    25%/$300 max               20%/$300 max
                 Effective Date                             7/1/2019                    7/1/2020                   7/1/2020                   7/1/2020                   7/1/2020
                 Total Number of Employees                      12                         12                         12                         12                         12
                 Monthly Total Medical Premium             $14,903.55                  $15,892.19                 $13,126.01                 $12,537.59                 $12,777.24
                 Annual Total Medical Premium              $178,842.60                $190,706.28                $157,512.12                $150,451.08                $153,326.88
                 Percentage Change From Current                                          6.63%                     -11.93%                    -15.88%                     -14.27%
                 Annual Dollar Change From Current                                     $11,863.68                ($21,330.48)                ($28,391.52)               ($25,515.72)





                                                                              Illustrative purposes only. Rates are subject to DIFS and carrier approval.
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