Page 3 - Canada Dry Bottling Renewal 2020

Canada Dry Bottling Company

Group Benefit Offerings

PHP – Gold HMO Exclusive (Mapped Renewal) – Option 1

$1400/$2800 per family deductible, 80/20% coinsurance to an embedded coinsurance
maximum of $1600/$3200, then to an overall out of pocket maximum of $8000/$16,000 per
family per calendar year, $25 PCP Office Visit Copay, $50 Specialist Copay, $5 AmWell Online
Visit, $60 Urgent Care Copay, and 80% after deductible for Emergency Room Copay, $20
Generic/$50 Preferred Brand Name/$80 Non Preferred Brand Name/20% Preferred and Non
Preferred Specialty Prescription Drug Copays (No Out of Network coverage) – Previous ECM
th
$2000/$4000, OOP: $6300/$12,600, $300 ER Copay and 4 tier of RX was $150)

PHP – Gold POS (Mapped Renewal) – Option 2
$1400/$2800 per family deductible, 80/20% coinsurance to an embedded coinsurance
maximum of $1600/$3200, then to an overall out of pocket maximum of $8000/$16,000 per
family per calendar year, $25 PCP Office Visit Copay, $50 Specialist Copay, $5 AmWell Online
Visit, $60 Urgent Care Copay, and 80% after deductible for Emergency Room Copay, $20
Generic/$50 Preferred Brand Name/$80 Non Preferred Brand Name/20% Preferred and Non
Preferred Specialty Prescription Drug Copays. Previous ECM $2000/$4000, OOP:
th
$6300/$12,600, $300 ER Copay and 4 tier of RX was $150)

PHP – Platinum PPO – Option 3

No deductible, 80/20% coinsurance to an out of pocket maximum of $1500/$3000 per
family per calendar year, $20 PCP Office Visit Copay $40 Specialist Copay, $5 AmWell Online
Visit, $50 Urgent Care Copay, and $150 Emergency Room Copay, $10 Generic/$40 Preferred
Brand Name/$80 Non Preferred Brand Name/$150 Specialty Prescription Drug Copays

MMA/Met Life - Dental

This plan covers 100% Preventative Services, 90% Basic Services and 60% Major Services.
Each person on the plan has $1000 of annual benefit running on a calendar year basis. June
1, 2021 anniversary

UNUM – Life Insurance

All full-time eligible employees receive 1 x salary to maximum $50,000 of term life and
accidental death and dismemberment.

UNUM – Long Term Disability

After a 90 day wait, benefits are payable at 60% of monthly earnings up to $10,000/month,
Payable to Age 65

UNUM – Voluntary Life Insurance
$50,000 Employee; $15,000 Spouse; $10,000 Child

UNUM policies rec’d a rate pass for 2020