SNOW JOE

*.*.** RENEWAL

HIGH MID BASE

Open Access Plus PPO Open Access Plus EPO HDHP H.S.A. EPO 2500/30% 15595915 15582521 15582503

Plan Type PPO EPO HDHP EPO

Drug Card Copays $15/35/75 after $100 Ded $15/35/75 after $100 Ded $15/35/75 after Ded No Referral No Referral No Referral

IN NETWORK

Deductible Ind/Fam $1,500/$3,000 $1,500/$3,000 $2,500/$5,D23000 Co-Insurance 20% 30% 50% copay after Ded.

Out-of-Pocket Max $4,000/$8,000 $6,350/$12,700 $7,000/$14,000 Office Co-Pay $20 $25 30% copay after Ded.

Specialist Co-Pay $40 $40 30% copay after Ded.

Lab Services/X-Ray 20% copay after Ded. 30% copay after Ded. 30% copay after Ded. MRIs, CATs, PETs 20% copay after Ded. 30% copay after Ded. 30% copay after Ded. Hospital In-Patient 20% copay after Ded. 30% copay after Ded. 30% copay after Ded. Hospital Out-Patient 20% copay after Ded. 30% copay after Ded. 30% copay after Ded. ER Copay $100 then pays 100% $100 then pays 100% 30% copay after Ded. Urgent Care $40 $40 30% copay after Ded.

Virtual Visits $20 $25 $55 myCIGNA

Lifetime MAX Unlimited Unlimited Unlimited

OUT NETWORK

Deductible Ind/Fam $1,550/3,100 N/A N/A

Co-Insurance 40% N/A N/A

Out-of-Pocket Max $6,000/$12,000 N/A N/A

UCR (usual customry reasonable)

80th N/A N/A

RATES

EMPLOYEE $218.47 $110.07 $5.19

EMPLOYEE/CHILDREN $598.52 $409.25 $226.09

EMPLOYEE/SPOUSE $728.87 $500.81 $280.09

FAMILY $938.87 $608.05 $287.92

Millennium Medicals Solutions Inc. medicalsolutionscorp.com 855-***-**** Garner offers year one savings of up to $56,119 while providing richer employee benefits

Base Plan Base Plan Base Plan

Plan

Office Copay (PCP/SPC) D&C $25 / $40 $20 / $40

Deductible $2,500 / $5,000 $1,500 / $3,000 $1,500 / $3,000 Coinsurance 30% 30% 20%

Out-of-Pocket $7,000 / $14,000 $6,350 / $12,700 $4,000 / $8,000 Employee Only Rate

Employee $430 $31 $461 $535 $21 $556 $643 $21

Employee + Spouse $905 $50 $955 $1,126 $32 $1,157 $1,354 $32 Employee + Children $751 $50 $801 $934 $32 $966 $1,124 $32 Employee + Family $1,313 $58 $1,371 $1,633 $38 $1,671 $1,964 $38 Proposed Base Plan $1,987,492

Garner Maximum Cost $78,778

Total $2,066,270

Minimum Savings -$21,321

Garner Program Cost and Savings

30%

$5,350 / $10,700

$500 / $1,000

PPO + $1,000 Garner H

with Ga

$0

$500 / $

20%

$3,000 / $

OAPIN Mid + $1,000 Garner HRA

with Garner

$0

OAPIN HSA + $1,500 Garner HRA

$5,500 / $11,000

$1,000 / $2,000

$0

30%

with Garner

Garner offers year one savings of up to $5

richer employee benefits

Base Plan Base Plan

Plan

Office Copay (PCP/SPC) D&C $25 / $40

Deductible $2,500 / $5,000 $1,500 / $3,000

Coinsurance 30% 30%

Out-of-Pocket $7,000 / $14,000 $6,350 / $12,70

Employee Only Rate

Employee $430 $31 $461 $535

Employee + Spouse $905 $50 $955 $1,126

Employee + Children $751 $50 $801 $934

Employee + Family $1,313 $58 $1,371 $1,633

Proposed Base Plan $1,987,492

Garner Maximum Cost $78,778

Total $2,066,270

Minimum Savings -$21,321

Garner Program Cost and Savings

OAPIN Mid +

OAPIN HSA + $1,500 Garner HRA

$5,500 / $11,000

$1,000 / $2,000

$0

30%

with Garner

Garner offers year one savings of up to $56,119 while providing richer employee benefits

Base Plan Base Plan Base Plan

Plan

Office Copay (PCP/SPC) D&C $25 / $40 $20 / $40

Deductible $2,500 / $5,000 $1,500 / $3,000 $1,500 / $3,000 Coinsurance 30% 30% 20%

Out-of-Pocket $7,000 / $14,000 $6,350 / $12,700 $4,000 / $8,000 Employee Only Rate

Employee $430 $31 $461 $535 $21 $556 $643 $21 $664 Employee + Spouse $905 $50 $955 $1,126 $32 $1,157 $1,354 $32 $1,386 Employee + Children $751 $50 $801 $934 $32 $966 $1,124 $32 $1,155 Employee + Family $1,313 $58 $1,371 $1,633 $38 $1,671 $1,964 $38 $2,002 Proposed Base Plan $1,987,492

Garner Maximum Cost $78,778

Total $2,066,270

Minimum Savings -$21,321

Maximum Savings -$56,119

Garner Program Cost and Savings

30%

$5,350 / $10,700

$500 / $1,000

PPO + $1,000 Garner HRA

with Garner

$0

$500 / $1,000

20%

$3,000 / $6,000

OAPIN Mid + $1,000 Garner HRA

with Garner

$0

OAPIN HSA + $1,500 Garner HRA

$5,500 / $11,000

$1,000 / $2,000

$0

30%

with Garner

s of up to $56,119 while providing

Base Plan Base Plan

$25 / $40 $20 / $40

$1,500 / $3,000 $1,500 / $3,000

30% 20%

$6,350 / $12,700 $4,000 / $8,000

$461 $535 $21 $556 $643 $21 $664

$955 $1,126 $32 $1,157 $1,354 $32 $1,386

$801 $934 $32 $966 $1,124 $32 $1,155

$1,371 $1,633 $38 $1,671 $1,964 $38 $2,002

30%

$5,350 / $10,700

$500 / $1,000

PPO + $1,000 Garner HRA

with Garner

$0

$500 / $1,000

20%

$3,000 / $6,000

OAPIN Mid + $1,000 Garner HRA

with Garner

$0

r HRA

,000

,000

ner

How Garner Works

We use more data and

new analytics to

identify top doctors

better than ever before

Our concierge team

makes it simple for

members to find the

best doctor for them

We reinforce

engagement with our

innovative engagement

incentives

Dr. Esther Chao

Non-Surgical Orthopedist

Megan C.

getgarner.com 6

The Garner Experience

getgarner.com 7

Use Garner’s

search tools

See the

recommended

Top Doctor

Unlock funds to pay

out-of-pocket

+

=

Your bill has been paid

MRI on 06/17/19

Your medical bill was $429.97

Garner paid -$429.97

Your bill after Garner $0

Garner administers a unique engagement-based HRA, enriching the plan for members who use Garner to find high quality care getgarner.com

Existing PCP

relationships

Emergency Room &

Urgent Care Visits

15

Garner’s flexible plan ensures there are no painful employee disruptions Garner covers…

Continuity of Care

Monthly Bi-weekly

Dental PPO 100/80/50 $1500 80th UCR Level

Individual $0.00 $0.00

Individual + Spouse/Partner $38.99 $18.00

Individual + Child(ren) $45.95 $21.21

Family $90.47 $41.76

Vision $10 Exams/12 Mo. & $25

Frames/lendses 12/24 Months;

$130 Allowance

Individual $0.00 $0.00

Individual + Spouse/Partner $8.53 $3.94

Individual + Child(ren) $7.51 $3.47

Family $16.04 $7.40

Vol Term Term Life Life $100K $25,000 GUARANTEED ISSUE 0% ACCIDENT &

DISMEMBERMENT $25,000

Guaranteed Issue $300K max; if above $100K+ Need Health Statement Group Voluntary Term Life

Insurance Employee Spouse

29 & Under $0.067 per $1,000 $0.067 per $1,000

30 - 34 $0.073 per $1,000 $0.073 per $1,000

35 - 39 $0.110 per $1,000 $0.110 per $1,000

40 - 44 $0.178 per $1,000 $0.178 per $1,000

45 - 49 $0.274 per $1,000 $0.274 per $1,000

50 - 54 $0.447 per $1,000 $0.447 per $1,000

55 - 59 $0.702 per $1,000 $0.702 per $1,000

60 - 64 $0.975 per $1,000 $0.975 per $1,000

65 - 69 $1.800 per $1,000 $1.800 per $1,000

70 & Over $2.967 per $1,000 $2.967 per $1,000

Note - All plans are subject to change.

Millennium Medicals Solutions Inc. medicalsolutionscorp.com 855-***-**** Summary of Dental Plan Benefits 2022

Summary of Vision Plan Benefits 2022

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