Comprehensive Major Medical Insurance. A. The Employer will provide any employee with a comprehensive major medical plan which contains the following cost containment provisions.
(a) Out-patient surgery
(b) Mandatory Pre-admissions Testing
(c) Mandatory Second Opinion Surgery
(d) Ambulatory Surgery
(e) Inpatient Concurrent Review
(f) A prescription card
B. Coverage for the comprehensive major medical insurance program will contain the benefit provisions set forth at Appendix I. It will also include a full cost spousal surcharge for employees whose spouses are eligible for health coverage through their own employers. Additional information regarding this surcharge is set forth in the Employee Benefit Guide. Employee who are hired on or after November 20, 2017 are eligible to enroll in Core Plan or Essential Plan only. The plan will pay one hundred percent (100%) of all claims in excess of the annual deductible and coinsurance amount.
C. The comprehensive major medical insurance program coverage and exceptions shall be set forth in brochure and made available to all participants.
D. Upon the death of an active or retired employee, the spouse shall be provided such access to health insurance as required by law.
E. The plan will be administered by Anthem. A change in the third-party administration may occur at any time upon mutual agreement of the parties.
F. The Board and the Union agree that SBCSC will not exceed limits imposed by I.C. 20-26-17.
G. The Board and the Union agree that an open enrollment period will be offered annually and will provide an opportunity to change between plans offered, except that following the close of the 2017 enrollment period, participants in the Core or the Essential
H. Within 14 days after open enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for 2017, the Corporation’s contribution and the employee premium for each applicable plan and level of coverage. The Insurance Committee shall meet quarterly to review the premiums and to ensure there are no material errors in methodology and to monitor the services of Anthem.
I. The parties agree that the group health insurance plan will be changed to avoid the “Cadillac Tax” under the Affordable Care Act. The Board and the Union shall bargain such changes and will execute a Memorandum of Understanding prior to August 1, 2017 that is limited to this issue and does not re- open contract negotiations.
J. Within 14 days after opening enrollment ends, the Corporat...
Comprehensive Major Medical Insurance. 1. A summary of insurance specifications shall be added to the Appendix of this Agreement.
2. Changes to Medicaid and Prescription Drug Insurance are as follows: Emergency Room Co-Pay $150 Prescription Drug Co-Pay $5/$30/$50 Change effective November 1, 2017.
3. Payments Employee premium contribution shall be: Status I Twelve percent (12%) Status II Eighty percent (80%) paid by the Board Status III Not eligible for access to group plan.
Comprehensive Major Medical Insurance. A summary of insurance specifications shall be added to the Appendix of this Agreement. Changes to Medical and Prescription Drug Insurance are as follows: Prescription Drug Co-Pays: $5/$30/$50 Emergency Room Co-Pay: $150.00
Comprehensive Major Medical Insurance. All bargaining unit members who are eligible for medical coverage will be required to be enrolled in the PPO Program. For the 2016-2017 school year, the Board will pay eighty-four and one-half percent (84.5%) of the monthly individual or family premiums for the current comprehensive major medical insurance program (PPO) for full‐ time regular employees (regularly scheduled 5.4 or more hours per day). The Board will pay fifty percent (50%) of the monthly individual or family group health premiums for regular employees who are employed less than full‐time but at least half‐time (regularly scheduled between 3 and
Comprehensive Major Medical Insurance. A. The Employer will provide any eligible Employee with a comprehensive major medical plan which contains the following cost containment provisions
(a) Out-patient surgery
(b) Mandatory Pre-admissions Testing
(c) Mandatory Second Opinion Surgery
(d) Ambulatory Surgery
(e) Inpatient Concurrent Review
(f) A prescription card
B. Coverage for the comprehensive major medical insurance program will contain the benefit provisions set forth in the Appendix I, which will be updated upon ratification of the 2019 Professional Agreement between the Board and the NEA-SB. Appendix I also includes a full cost spousal surcharge for Employees whose spouses are eligible for health coverage through their own employer. Additional information regarding this surcharge is set forth in the Appendix I. Employees who are hired on or after November 20, 2017 are eligible to enroll in Core Plan or the Essential Plan only. The plan will pay one hundred percent (100%) of all eligible claims in excess of the annual deductible and coinsurance amount.
C. The comprehensive major medical insurance program coverage and exceptions shall be set forth in a brochure and made available to all participants.
D. Upon the death of an active or retired employee, the spouse shall be provided such access to health insurance as required by law.
E. The plan will be administered by Anthem. A change in the third-party administration may occur at any time upon mutual agreement of the parties.
F. The Employer and the Union agree that SBCSC will not exceed the limits imposed by IC 20-26-17. In accordance with the foregoing, the parties agree that the premiums set forth on Appendix I shall be updated upon ratification of the 2019 Professional Agreement between the Board and the NEA- SB. For any subsequent plan year, the employees’ premiums will be determined using the same methodology as used in the fourth quarter of 2019. Within thirty (30) business days after opening enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for the subsequent year, the Corporation’s contribution and the employee premium for each applicable plan and level of coverage. The Insurance Committee shall meet quarterly to review the premiums and to ensure there are no material errors in methodology and to monitor the services of Anthem.
G. The parties agree that the group health insurance plan will be changed to avoid the “Cadillac Tax” under the Affordable Care Act. The Employer ...
Comprehensive Major Medical Insurance. A summary of insurance specifications is set forth at Appendix G of this Agreement. Changes to Medical and Prescription Drug Insurance are as follows: Retail Prescription Drug Co-Pays: $10/$30/$60 Home Delivery Prescription Drug Co-Pays: $20/$60/$120 Out of Pocket – increase as follows: Out of Pocket: Single Family 2023-2024 $1,200 $2,400 2024-2025 $1,500 $3,000 2025-2026 $1,800 $3,600 Out of Pocket: Single Family 2023-2024 $2,400 $4,800 2024-2025 $3,000 $6,000 2025-2026 $3,600 $7,200 Co-Pay – changes set forth in Appendix G Co-Insurance – Deductibles: Single Family 2023-2024 $400 $800 2024-2025 $500 $1,000 2025-2026 $600 $1,200 Deductibles: Single Family 2023-2024 $800 $1,600 2024-2025 $1,000 $2,000 2025-2026 $1,200 $2,400
Comprehensive Major Medical Insurance. A. The Employer will provide any employee with a comprehensive major medical plan which contains the following cost containment provisions
(a) Out-patient surgery
(b) Mandatory Pre-admissions Testing
(c) Mandatory Second Opinion Surgery
(d) Ambulatory Surgery
(e) Inpatient Concurrent Review
(f) A prescription card
B. Coverage for the comprehensive major medical insurance program will contain the benefit provisions set forth in Appendix I. The plan will pay one hundred percent (100%) of all claims in excess of the annual deductible and coinsurance amount.
C. The comprehensive major medical insurance program coverage and exceptions shall be set forth in a brochure and made available to all participants.
Comprehensive Major Medical Insurance. A. The Employer will provide any eligible Employee with a comprehensive major medical plan which contains the following cost containment provisions
(a) Out-patient surgery
(b) Mandatory Pre-admissions Testing
(c) Mandatory Second Opinion Surgery
(d) Ambulatory Surgery
(e) Inpatient Concurrent Review
(f) A prescription card
B. Coverage for the comprehensive major medical insurance program will contain the benefit provisions set forth in the Appendix I which also includes a full cost spousal surcharge for Employees whose spouses are eligible for health coverage through their own employer. Additional information regarding this surcharge is set forth in the Appendix I. Employees who are hired on or after November 20, 2017 are eligible to enroll in Core Plan or the Essential Plan only. The plan will pay one hundred percent (100%) of all eligible claims in excess of the annual deductible and coinsurance amount.
C. The comprehensive major medical insurance program coverage and exceptions shall be set forth in a brochure and made available to all participants.
Comprehensive Major Medical Insurance. 1. A summary of insurance specifications is set forth at Appendix G of this Agreement.
2. Payments Employee premium contribution shall be: Status I Twelve percent (12%) Status II Eighty percent (80%) paid by the Board Status III Not eligible for access to group plan.
Comprehensive Major Medical Insurance. A. The Employer will provide any employee with a comprehensive major medical plan which contains the following cost containment provisions
(a) Out-patient surgery
(b) Mandatory Pre-admissions Testing
(c) Mandatory Second Opinion Surgery
(d) Ambulatory Surgery
(e) Inpatient Concurrent Review
(f) A prescription card
B. Coverage for the comprehensive major medical insurance program will contain the benefit provisions set forth. The plan will pay one hundred percent (100%) of all claims in excess of the annual deductible and coinsurance amount.
C. The comprehensive major medical insurance program coverage and exceptions shall be set forth in a brochure and made available to all participants.
D. Upon the death of an active or retired employee, the spouse shall be provided such access to health insurance as required by law.
E. The plan will be administered by Anthem. A change in the third-party administration may occur at any time upon mutual agreement of the parties.
F. The Employer and the Union agreed that before October of 2012, negotiations for the 2012-13 Collective Bargaining Agreement concerning this Paragraph F will result in plan changes which allows SBCSC to comply with I.C. 20-26-17, and that such plan changes which will result in SBCSC’s contribution to insurance premiums being reduced so that the contribution amount will be no less than 105% and no more than 107% of the state contribution amount. In accordance with the foregoing, the parties agree that the premiums set forth shall be in effect from October 1, 2012 through December 31, 2012. From January 1, 2013 through December 31, 2013, the employees’ premiums will be determined using the same methodology as used in the fourth quarter of 2012, based upon the expected cost of the medical plan and number of enrollees for 2013. Within 14 days after opening enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for 2013, the Corporation’s maximum liability (106% of the state’s cost for similar enrollment) and the employee premium for each applicable plan and level of coverage. The Insurance Committee shall meet quarterly to review the premiums and to ensure there are no material errors in methodology and to monitor the services of Anthem.
