Common use of Comprehensive Major Medical Insurance Clause in Contracts

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 Corporation will provide to the Insurance Committee the expected cost for group health care for 2016, the Corporation’s maximum liability 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.

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. forth. 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 Benefits Guide. Employee who are hired on or after November 20, 2017 are eligible to enroll in Core Plan or and 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 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 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 2017care, 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 Association 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- re-open contract negotiations. J. Within 14 days after opening enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for 2016, the Corporation’s maximum liability 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.

Comprehensive Major Medical Insurance. A. The Employer will provide any employee eligible employees 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 in Appendix I. I, which will be updated upon ratification of the 2019 Professional Agreement between the Board and the NEA-SB. It will also include includes a full cost spousal surcharge for employees whose spouses are eligible for health coverage through their own employersemployer. Additional information regarding this surcharge is set forth in the Employee Benefit Guide. Employee at 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 Board Employer and the Union agree that SBCSC will not exceed the limits imposed by I.C. 20-26-17. G. The . In accordance with the foregoing, the parties agree that the premiums set forth on Appendix I shall updated upon ratification of the 2019 Professional Agreement between the Board and the Union agree that 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. The Employer intends to offer an annual open enrollment period will be offered annually and will provide an opportunity for eligible Employees to change between plans offered, except that following the close of the 2017 enrollment period, participants in the Core or Essential Plans will not be permitted to select the Essential H. Buy Up Plan. Within 14 30 business days after open opening enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for 2017the subsequent year, the Corporation’s contribution 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 no later than five months prior to August 1, 2017 implementation of the “Cadillac Tax” that is limited to this issue and does not re- re-open contract negotiations. J. Within 14 days after opening enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for 2016, the Corporation’s maximum liability 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.

Comprehensive Major Medical Insurance. A. The Employer will provide any employee 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 at in the Appendix I. It I, which will be updated upon ratification of the 2019 Professional Agreement between the Board and the NEA-SB. Appendix I also include includes a full cost spousal surcharge for employees Employees whose spouses are eligible for health coverage through their own employersemployer. Additional information regarding this surcharge is set forth in the Employee Benefit Guide. Employee 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 Board Employer and the Union agree that SBCSC will not exceed the limits imposed by I.C. IC 20-26-17. G. The . In accordance with the foregoing, the parties agree that the premiums set forth on Appendix I shall be updated through discussion with the Insurance Committee and upon ratification of the 2021 Professional Agreement between 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. NEA-SB. Within 14 thirty (30) business days after open opening enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for 2017the 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. I. G. The parties agree that the group health insurance plan will be changed to avoid the “Cadillac Tax” under the Affordable Care Act. The Board Employer and the Union shall bargain such changes and will execute a Memorandum of Understanding no later than five months prior to August 1, 2017 implementation of the “Cadillac Tax” that is limited to this issue issue, and does not re- open reopen contract negotiations. J. Within 14 days after opening enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for 2016, the Corporation’s maximum liability 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.

Comprehensive Major Medical Insurance. A. The Employer will provide any employee eligible employees 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 in Appendix I. It will also include includes a full cost spousal surcharge for employees whose spouses are eligible for health coverage through their own employersemployer. 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. at 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. 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 Employer and the Union agree that SBCSC will not exceed the limits imposed by I.C. 20-26-17. G. The Board and . In accordance with the Union foregoing, the parties agree that the premiums set forth on Appendix I shall be in effect from January 1, 2016 through December 31, 2016. From January 1, 2017 through December 31, 2017, the employees’ premiums will be determined using the same methodology as used in the fourth quarter of 2015 to determined the premiums for 2016, based upon the expected cost of the medical plan and number of enrollees for 2016. The Employer intends to offer an annual open enrollment period will be offered annually and will provide an opportunity for eligible Employees 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 30 business days after open opening enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for 2017the subsequent year, the Corporation’s contribution 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 1December 31, 2017 that is limited to this issue and does not re- re-open contract negotiations. J. Within 14 days after opening enrollment ends, the Corporation will provide to the Insurance Committee the expected cost for group health care for 2016, the Corporation’s maximum liability 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.