Common use of Comprehensive Hospitalization Benefits Clause in Contracts

Comprehensive Hospitalization Benefits. The Board will provide hospitalization, medical, and major medical coverage for the staff as follows:‌ A. One hundred (100) per cent payment for single plan coverage. B. Ninety-five (95) per cent payment of premium for family plan coverage. C. Once a dependent child reaches their 24th birthday, the employee pays $150.00 per month for premium. Dependent child will retain coverage until they reach their 26th birthday (end of 25th year per contract cap).‌‌‌ D. There will be no pre-existing condition restriction for new teachers. E. Staff may have the option of electing health insurance coverage with a Board approved HMO carrier. If the rate charged for the HMO plan elected exceeds the rate set for the District's health insurance coverage provided under A and B above, the employee shall be responsible to pay the excess cost through monthly payroll deductions. F. The employee’s out of pocket expense for prescriptions is limited to $5.00 per generic prescription and $15.00 per name brand prescription.‌‌ This coverage is to include: Comprehensive PPO hospital benefits: Common semi-private room allowance (C.S.P.), (See letter A on page 60) under the family plan, and in- and out-patient diagnostic services, and pre-admission services and $250 deductible for each inpatient hospital admission to a maximum of $2,000 annually. Surgical benefits: Payment of all the usual and customary charges, and in- and out-patient diagnostic services. $2,000,000 maximum for hospitalization and doctor expenses: maximum employee out of pocket expense of $1,250; $250 calendar year deductible per person (maximum three deductibles per family per year); 100% co-insurance for hospital; 80% co-insurance for medical and surgical; dependents covered until they reach their 26th birthday under the family plan.‌ Non-PPO hospital benefits are reduced by 20% and a higher out of pocket expense will apply. All claims shall be subject to the right of reimbursement. If a teacher dies, the spouse will be provided family plan coverage with Xxxxxx’x health carrier, at no cost to the Board, for one year. Any change in health insurance carrier requires that the coverage remains equivalent. The Union will be consulted prior to bid acceptance to verify that coverage remains equivalent.

Comprehensive Hospitalization Benefits. The Board will provide hospitalization, medical, and major medical coverage for the staff as follows:‌follows: A. One hundred (100) Ninety-seven per cent (97%) payment for single plan HMO coverage. B. Ninety-five (95) two per cent (92%) payment of premium for HMO family insurance plan coverage. C. Once a dependent child reaches their 24th birthday, the employee pays $150.00 per month Ninety-five percent (95%) payment for premium. single plan PPO coverage. D. Ninety percent (90%) payment for family plan PPO coverage. E. Dependent child will retain coverage until they reach their 26th birthday (end of 25th year per contract cap).‌‌‌ D. There will be no pre-existing condition restriction for new teachers. E. Staff may have the option of electing health insurance coverage with a Board approved HMO carrier. If the rate charged for the HMO plan elected exceeds the rate set for the District's health insurance coverage provided under A and B above, the employee shall be responsible to pay the excess cost through monthly payroll deductionscap). F. The employee’s out of pocket expense for prescriptions is limited to $5.00 10.00 per generic prescription and $15.00 20.00 per name brand prescription.‌‌ prescription. This coverage is to include: Comprehensive PPO hospital benefits: Common semi-private room allowance (C.S.P.), (See letter A on page 60) under the family plan, and in- and out-patient diagnostic services, and pre-pre- admission services and $250 deductible per day for up to three (3) days for each inpatient hospital admission to a maximum of $2,000 annually1,500 annually for an individual covered under PPO. Surgical benefits: Payment Any emergency room visit by an individual covered under either plan, PPO and HMO, shall require a payment of all the usual and customary charges, and in- and out-patient diagnostic services$100 per visit. $2,000,000 maximum Maximum for hospitalization and doctor expenses: maximum employee out of pocket expense of $1,250; $250 calendar year deductible per person (maximum three deductibles per family per year); 100% co-insurance for hospital; 80% co-insurance for medical and surgical; dependents covered until they reach their 26th birthday under the family plan.‌ plan. Non-PPO hospital benefits are reduced by 20% and a higher out of pocket expense will apply. All claims shall be subject to the right of reimbursement. If a teacher dies, the spouse will be provided family plan coverage with Xxxxxx’x health carrier, at no cost to the Board, for one year. Any change in health insurance carrier requires that the coverage remains equivalent. The Union will be consulted prior to bid acceptance to verify that coverage remains equivalent. 12.5. Prior to June 30, 2015, a teacher retiring before age sixty-five (65) who is not eligible under the Xxxxxx Retirement Plan has the option until the age of sixty-five (65) of retaining health insurance under the Xxxxxx Group Plan, at no cost to the Board. Premiums shall be paid one (1) year in advance. 12.6. The Board will provide dental benefit coverage as follows: A. One hundred (100) per cent payment for single plan coverage. B. One hundred (100) percent payment for family plan coverage less $5 per month employee contribution. C. The terms of this coverage shall be as follows: Deductible (annually) $50 Maximum per year (annually) $1,500 Preventive (no deductible; part of maximum per year) 100% Primary (included in maximum per year) 80% Major (included in maximum per year; dental implants included) 50% Ortho Maximum (lifetime per family member) $1,500

Comprehensive Hospitalization Benefits. The Board will provide hospitalization, medical, and major medical coverage for the staff as follows:‌follows: A. One hundred (100) per cent payment for single plan coverage. B. Ninety-five (95) four per cent (94%) payment of premium for PPO family insurance plan coveragecoverage or HMO family insurance plan coverage for the 2011-2012 school year, Ninety-three per cent (93%) payment of premium for PPO family insurance plan coverage or HMO family insurance plan coverage for the 2012-2013 school year and Ninety-two per cent (92%) payment of premium for PPO family insurance plan coverage or HMO family insurance plan coverage for the 2013-2014 school year. C. Once a dependent child reaches their 24th birthday, the employee pays $150.00 per month for premium. Dependent child will retain coverage until they reach their 26th birthday (end of 25th year per contract cap).‌‌‌cap). D. There will be no pre-existing condition restriction for new teachers. E. Staff may have the option of electing health insurance coverage with a Board approved HMO carrier. If the rate charged for the HMO plan elected exceeds the rate set for the District's health insurance coverage provided under A and B above, the employee shall be responsible to pay the excess cost through monthly payroll deductions. F. The employee’s out of pocket expense for prescriptions is limited to $5.00 10.00 per generic prescription and $15.00 20.00 per name brand prescription.‌‌ prescription. This coverage is to include: Comprehensive PPO hospital benefits: Common semi-private room allowance (C.S.P.), (See letter A on page 60) under the family plan, and in- and out-patient diagnostic services, and pre-admission services and $250 deductible per day for up to three (3) days for each inpatient hospital admission to a maximum of $2,000 annually1,500 annually for an individual covered under PPO. Any emergency room visit by an individual covered under either plan, PPO and HMO, shall require a payment of $100 per visit. Surgical benefits: Payment of all the usual and customary charges, and in- and out-patient diagnostic services. $2,000,000 maximum Maximum for hospitalization and doctor expenses: maximum employee out of pocket expense of $1,250; $250 calendar year deductible per person (maximum three deductibles per family per year); 100% co-insurance for hospital; 80% co-insurance for medical and surgical; dependents covered until they reach their 26th birthday under the family plan.‌ plan. Non-PPO hospital benefits are reduced by 20% and a higher out of pocket expense will apply. All claims shall be subject to the right of reimbursement. If a teacher dies, the spouse will be provided family plan coverage with Xxxxxx’x health carrier, at no cost to the Board, for one year. Any change in health insurance carrier requires that the coverage remains equivalent. The Union will be consulted prior to bid acceptance to verify that coverage remains equivalent.