Alternative Health Plans Sample Clauses

Alternative Health Plans. Nothing contained in this Agreement shall preclude the Participating Hospital from participating in or contracting with any other preferred provider organization, health maintenance organization, insurer or otherwise, whether before, during or subsequent to the term of this Agreement.
Sample 1
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Alternative Health Plans. In accordance with the provisions of federal law and the regulations there under, if applicable, the Employer shall make available the option of membership in qualified health maintenance organizations and/or other alternative health plans to employees and their eligible dependents who reside in the service area of qualified HMO’s and/or alternative health plans. If an employee elects to participate in an alternative health plan under this Section, the Employer(s) agree to pay the following percentage of the cost, and the employee who elects coverage under the plan shall pay the following percentage of the cost of the individual or dependent coverage, as the case may be. There shall be no annual limit on the contribution amount. Employer Employee Contribution Contribution Percentage Percentage Effective January 1, 2010 85% 15% Effective January 1, 2011 85% 15% Effective January 1, 2012 85% 15% Effective January 1, 2013 85% 15% The cost of providing individual and dependent health and dental insurance cov- erage under the alternative health plan shall be determined by December 15 of each year. The employee’s share of the cost shall be divided into twenty six (26) equal pay- ments and shall be deducted from the employee’s paycheck.
Sample 1
Alternative Health Plans. In accordance with the provisions of federal law and the regulations there under, if applicable, the Employer shall make available the option of membership in qualified health maintenance organizations and/or other alternative health plans to employees and their eligible dependents who reside in the service area of qualified HMO’s and/or alternative health plans. This option shall terminate effective December 31, 2019. If an employee elects to participate in an alternative health plan under this Section, the Employer(s) agree to pay the following percentage of the cost, and the employee who elects coverage under the plan shall pay the following percentage of the cost of the individual or dependent coverage, as the case may be. There shall be no annual limit on the contribution amount. Employer Contribution Percentage Employee Contribution Percentage Effective January 1, 2017 85% 15% Effective January 1, 2018 85% 15% Effective January 1, 2019 85% 15% The cost of providing individual and dependent health and dental insurance coverage under the alternative health plan shall be determined by December 15 of each year. The employee’s share of the cost shall be divided into twenty-six (26) equal payments and shall be deducted from the employee’s paycheck. Effective January 1, 2018: The annual deductible for medical services other than prescription drugs for each employee who has elected to participate in an alternative health plan under this Section is as follows: Deductible covered employee and for each covered dependent Maximum aggregated deductible per family Effective January 1, 2018 $250 $500 Effective January 1, 2019 $500 $1,000 The annual maximum out-of-pocket expenditure over and above the co-payments for medical services other than prescription drugs per employee or dependent shall be as follows: Maximum out-of-pocket expenditures per employee or dependent Maximum out-of-pocket expenditures per family Effective January 1, 2017 $1,700 $3,400 Effective January 1, 2018 $1,650 $3,300 Effective January 1, 2019 $1,650 $3,300 Co-Pays Primary Care Co-Pays Specialist Effective January 1, 2017 $25.00 $30.00 Effective January 1, 2018 $20.00 $25.00 Effective January 1, 2019 $20.00 $25.00
Sample 1
Alternative Health Plans. In accordance with the provisions of federal law and the regulations thereunder, if applicable, the Employer shall make available the option of membership in qualified health maintenance organizations and/or other alternative health plans to employees and their eligible dependents who reside in the service area of qualified HMO’s and/or alternative health plans. If an employee elects to participate in an alternative health plan under this Section, the Employer(s) agree to pay the following percentage of the cost, and the employee who elects coverage under the plan shall pay the following percentage of the cost of the individual or dependent coverage, as the case may be. There shall be no annual limit on the contribution amount. Employer Contribution Percentage Employee Contribution Percentage The cost of providing individual and dependent health and dental insurance coverage under the alternative health plan shall be determined by December 15 of each year. The employee’s share of the cost shall be divided into twenty-six (26) equal payments and shall be deducted from the employee’s paycheck.
Sample 1
Alternative Health Plans. The City and the Association agree to meet and confer regarding health plan alternatives if significant changes occur in the availability of optional health insurance plans.
Sample 1

Related to Alternative Health Plans

  • Health Plans A. The health plans offered and benefits provided by those plans shall be those recommended by the JLMBC, approved by the City Council, and administered by the Personnel Department in accordance with LAAC Section 4.

  • Health Plan An appropriately licensed entity that has entered into a contract with Subcontractor, either directly or indirectly, under which Subcontractor provides certain administrative services for Health Plan pursuant to the State Contract. For purposes of this Appendix, Health Plan refers to UnitedHealthcare Insurance Company.

  • Extended Health Plan An employee who makes an election under this provision must enrol in each and every of the benefit plans and shall not be entitled to except any of them.

  • Health and Welfare Plans (a) A copy of the master contracts with the carriers for the extended health care, dental and group life plans shall be sent to the President of the Union. (b) The Employer will consult the Union before developing any pamphlet explaining the highlights of the plans for distribution to employees. The cost of such a pamphlet shall be borne by the Employer.

  • Retiree Health Benefits 1. There is currently in effect a retiree health benefit program for retired members of LACERS under LAAC Division 4, Chapter 11. All covered employees who are members of LACERS, regardless of retirement tier, shall contribute to LACERS four percent (4%) of their pre-tax compensation earnable toward vested retiree health benefits as provided by this program. The retiree health benefit available under this program is a vested benefit for all covered employees who make this contribution, including employees enrolled in LACERS Tier 3. 2. With regard to LACERS Tier 1, as provided by LAAC Section 4.1111, the monthly Maximum Medical Plan Premium Subsidy, which represents the Kaiser 2-party non-Medicare Part A and Part B premium, is vested for all members who made the additional contributions authorized by LAAC Section 4.1003(c). 3. Additionally, with regard to Tier 1 members who made the additional contribution authorized by LAAC Section 4.1003(c), the maximum amount of the annual increase authorized in LAAC Section 4.1111(b) is a vested benefit that shall be granted by the LACERS Board. 4. With regard to LACERS Tier 3, the Implementing Ordinance shall provide that all Tier 3 members shall contribute to LACERS four percent (4%) of their pre-tax compensation earnable toward vested retiree health benefits, and shall amend LAAC Division 4, Chapter 11 to provide the same vested benefits to all Tier 3 members as currently are provided to Tier 1 members who make the same four percent (4%) contribution to LACERS under the retiree health benefit program. 5. The entitlement to retiree health benefits under this provision shall be subject to the rules under LAAC Division 4, Chapter 11 in effect as of the effective date of this provision, and the rules that shall be placed into LAAC Division 4, Chapters 10 and 11, with regard to Tier 3, by the Implementing Ordinance. 6. As further provided herein, the amount of employee contributions is subject to bargaining in future MOU negotiations. 7. The vesting schedule for the Maximum Medical Plan Premium Subsidy for employees enrolled in LACERS Tier 1 and LACERS Tier 3 shall be the same. 8. Employees whose Health Service Credit, as defined in LAAC Division 4, Chapter 11, is based on periods of part-time and less than full-time employment, shall receive full, rather than prorated, Health Service Credit for periods of service. The monthly retiree medical subsidy amount to which these employees are entitled shall be prorated based on the extent to which their service credit is prorated due to their less than full time status.

  • Medical Plans The Employer will maintain the current health (including vision) and dental insurance programs and practices. For Calendar Years 2022 — 2023, the Employer shall contribute 80% of the premium charge for PPO plans, 85% of premium for the EPO plan, 85% of premium for the IHM plan, 80% for the prescription drug plan and 50% for the dental plan.

  • Requiring Health Benefits for Covered Employees Contractor agrees to comply fully with and be bound by all of the provisions of the Health Care Accountability Ordinance (HCAO), as set forth in San Francisco Administrative Code Chapter 12Q, including the remedies provided, and implementing regulations, as the same may be amended from time to time. The provisions of section 12Q.5.1 of Chapter 12Q are incorporated by reference and made a part of this Agreement as though fully set forth herein. The text of the HCAO is available on the web at xxx.xxxxx.xxx/xxxx. Capitalized terms used in this Section and not defined in this Agreement shall have the meanings assigned to such terms in Chapter 12Q. a. For each Covered Employee, Contractor shall provide the appropriate health benefit set forth in Section 12Q.3 of the HCAO. If Contractor chooses to offer the health plan option, such health plan shall meet the minimum standards set forth by the San Francisco Health Commission. b. Notwithstanding the above, if the Contractor is a small business as defined in Section 12Q.3(e) of the HCAO, it shall have no obligation to comply with part (a) above. c. Contractor’s failure to comply with the HCAO shall constitute a material breach of this agreement. City shall notify Contractor if such a breach has occurred. If, within 30 days after receiving City’s written notice of a breach of this Agreement for violating the HCAO, Contractor fails to cure such breach or, if such breach cannot reasonably be cured within such period of 30 days, Contractor fails to commence efforts to cure within such period, or thereafter fails diligently to pursue such cure to completion, City shall have the right to pursue the remedies set forth in 12Q.5.1 and 12Q.5(f)(1-6). Each of these remedies shall be exercisable individually or in combination with any other rights or remedies available to City. d. Any Subcontract entered into by Contractor shall require the Subcontractor to comply with the requirements of the HCAO and shall contain contractual obligations substantially the same as those set forth in this Section. Contractor shall notify City’s Office of Contract Administration when it enters into such a Subcontract and shall certify to the Office of Contract Administration that it has notified the Subcontractor of the obligations under the HCAO and has imposed the requirements of the HCAO on Subcontractor through the Subcontract. Each Contractor shall be responsible for its Subcontractors’ compliance with this Chapter. If a Subcontractor fails to comply, the City may pursue the remedies set forth in this Section against Contractor based on the Subcontractor’s failure to comply, provided that City has first provided Contractor with notice and an opportunity to obtain a cure of the violation. e. Contractor shall not discharge, reduce in compensation, or otherwise discriminate against any employee for notifying City with regard to Contractor’s noncompliance or anticipated noncompliance with the requirements of the HCAO, for opposing any practice proscribed by the HCAO, for participating in proceedings related to the HCAO, or for seeking to assert or enforce any rights under the HCAO by any lawful means. f. Contractor represents and warrants that it is not an entity that was set up, or is being used, for the purpose of evading the intent of the HCAO. g. Contractor shall maintain employee and payroll records in compliance with the California Labor Code and Industrial Welfare Commission orders, including the number of hours each employee has worked on the City Contract. h. Contractor shall keep itself informed of the current requirements of the HCAO. i. Contractor shall provide reports to the City in accordance with any reporting standards promulgated by the City under the HCAO, including reports on Subcontractors and Subtenants, as applicable. j. Contractor shall provide City with access to records pertaining to compliance with HCAO after receiving a written request from City to do so and being provided at least ten business days to respond. k. Contractor shall allow City to inspect Contractor’s job sites and have access to Contractor’s employees in order to monitor and determine compliance with HCAO. l. City may conduct random audits of Contractor to ascertain its compliance with HCAO. Contractor agrees to cooperate with City when it conducts such audits. m. If Contractor is exempt from the HCAO when this Agreement is executed because its amount is less than $25,000 ($50,000 for nonprofits), but Contractor later enters into an agreement or agreements that cause Contractor’s aggregate amount of all agreements with City to reach $75,000, all the agreements shall be thereafter subject to the HCAO. This obligation arises on the effective date of the agreement that causes the cumulative amount of agreements between Contractor and the City to be equal to or greater than $75,000 in the fiscal year.

  • HEALTH AND WELFARE PLAN 9.01 The Employer shall make available the following or similar benefits as mutually agreed between the Employer and the Union to eligible regular full-time employees (as defined below). The cost of the benefits under Sections 9.07, 9.08, 9.09, 9.10, 9.11, 9.12 and 9.13 below shall be paid one hundred percent (100%) by the Employer. An eligible full-time employee shall be one who has three (3) consecutive months current employment at the effective date of the Plan. Benefits for full-time employees who are laid off will be maintained by the Employer for one half (½) of the employee's recall period as specified in Section 14.04 on the following basis: - B.C. Medical Services Plan (M.S.P.) - Group Life Insurance - Hearing aid, eyeglasses and prescription drug coverage A regular full-time employee who does not have three (3) months' current consecutive full-time service at the effective date of the Plan, or a new employee, shall be eligible the day following the date their current consecutive full-time service reaches three (3) months. 9.02 A regular full-time employee reduced to part-time shall continue to be eligible to participate in the Plan. Full-time employees reducing to below thirty-two (32) hours per week shall receive proportionate Weekly Indemnity benefits. Employees shall return completed enrollment forms as soon as possible. The Employer will only offer benefits after first eligibility test is met. If refused at that time by the employee, further testing is not required. If an employee later wants coverage, it is his or her responsibility to make application to the Employer. If he or she is eligible for coverage, the same rules regarding late enrollment as apply to full- time staff may be imposed. 9.03 The Employer shall also make available the benefits to employees (except students) who work an average of thirty-two (32) hours per week for a period of three (3) consecutive months. Such employees shall receive the same benefits as set out for full-time employees in this Section of the Agreement. 9.04 For the purposes of entitlement and disentitlement, the conditions set out below will apply: A. Employees who average thirty-two (32) hours per week for a three (3) month period will be eligible for all benefits under Section 9 on the first of the month following meeting this requirement. Eligibility verifications will be done each month ending on the last Saturday of the month on a 4, 4, 5 basis, i.e.: if an employee had averaged thirty-two (32) hours per week in the three (3) months prior to April 25, he/she would become eligible for the benefit package on May 1. B. If an employee fails to meet the eligibility test, he/she will continue to be eligible for three (3) months. At that time he/she will be tested again and, if eligible, will continue receiving benefits. If not eligible, will cease receiving benefits. Thereafter at the end of each month, the employee's eligibility will be tested and, as soon as he/she becomes eligible again, benefits will be reinstated. 9.05 The Employer shall also make available: - Medical Services Plan (M.S.P.) - Extended Health Benefit (E.H.B.) - Hearing Aid, Eyeglass, Prescription Drug Plan (H.E.P.) to employees (except students) who work an average of twenty-four (24) hours per week for a period of three (3) consecutive months. For the purposes of entitlement and disentitlement, the hours' tests set out above will apply, but will be based on twenty-four (24) hours instead of thirty-two (32) hours per week. New employees who are covered by the B.C. Medical Services Plan at the date of their employment can elect to maintain their continuity of coverage to be paid as defined above. 9.06 Enrollment of group benefits shall be compulsory at the option of the Employer. The Employer, at his option, may require all enrollment cards to be signed within three (3) months from the date that regular full-time employment commenced. If, under exceptional circumstances, an employee does not sign an enrollment card within three (3) months of employment, he or she may be allowed a further month of grace at the option of the Employer. A period of grace longer than one (1) month may be allowed by the Employer; but, in such cases, a medical examination at the employee's own expense shall be compulsory and a three (3) month penalty period may be imposed.

  • Medical Plan ‌ Eligible employees and dependants shall be covered by the British Columbia Medical Services Plan or carrier approved by the British Columbia Medical Services Commission. The Employer shall pay one hundred percent (100%) of the premium. An eligible employee who wishes to have coverage for other than dependants may do so provided the Medical Plan is agreeable and the extra premium is paid by the employee through payroll deduction. Membership shall be a condition of employment for eligible employees who shall be enrolled for coverage following the completion of three (3) months’ employment or upon the initial date of employment for those employees with portable service as outlined in Article 14.12.

  • Retiree Health Insurance Retired members of the Department receiving, or to receive City of Lincoln monthly pension checks, may participate in the group comprehensive health care plan for active City employees, provided that each retiree so desiring will execute the required forms in a timely fashion, and further provided that each retiree will be required to pay the full monthly cost at the current rates subject to any rate increases which may occur from time to time. Such payment will be made by payroll deduction from pension checks, or by direct payment in the case of an early retiree.

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