Page 7 - Tetra Renewal 2020
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The Tetra Corp: July 2020 Vision Analysis
Current Renewal Alternative
BCBSM BCBSM EyeMed
Blue VisionSM 12-12-12 Blue VisionSM 12-12-12 EyeMed 12-12-12
Plan Type PPO PPO Insight Network
Plan Year 2019 2020 2020
In-Network In-Network In-Network
Exam
Eye Exam - Copay $5 $5 $5
Benefit Period 1 exam every calendar year 1 exam every calendar year 1 exam every calendar year
Lenses and Frames
Copay $10 $10 $10
Allowance $130 $130 $130
Benefit Period 1 every calendar years 1 every calendar years 1 every calendar years
Contact Lenses
Copay $10 $10 $10
Allowance $130 $130 $130
Covered up to allowance every Covered up to allowance every Covered up to allowance every
Benefit Period calendar year calendar year calendar year
Effective Date 7/1/2019 7/1/2020 7/1/2020
Total Number of Employees 12 12 12
Monthly Total Vision Premium $113.11 $130.72 $154.93
Annual Total Vision Premium $1,357.32 $1,568.64 $1,859.16
Percentage Change From Current 15.57% 36.97%
Annual Dollar Change From Current $211.32 $501.84
