Page 6 - Tetra Renewal 2020
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The Tetra Corp: July 2020 Dental Analysis



                                                 Current                         Renewal
                                                 BCBSM                            BCBSM
                                     PPO Plus 100/80/50/50 $1000 SG PPO Plus 100/80/50/50 $1,000 SG
      Plan Type                                    PPO                              PPO
      Plan Year                                    2019                            2020
                                                In-Network                       In-Network
      Deductible
           Couple/Family                         $50/$75                          $50/$75
           Individual                              $25                              $25
      Class 1 - Preventitive                       0%                               0%
      Class 2 - Basic                              20%                              20%
      Class 3 - Major                              50%                              50%
      Class 4 - Orthodontic                        50%                              50%
      Orthodontic Lifetime Maximum                $1,000                           $1,000
      Annual Maximum                              $1,000                           $1,000
      Waiting Period
      Provider Network                        Blue Dental PPO                  Blue Dental PPO
      Effective Date                             7/1/2019                         7/1/2020
      Total Number of Employees                    12                               12
      Monthly Total Dental Premium               $947.90                          $967.03
      Annual Total Dental Premium               $11,374.80                       $11,604.36
      Percentage Change From Current                                               2.02%
      Annual Dollar Change From Current                                           $229.56




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