Employees’ Health Insurance Program. 1. The Board of Education will provide family major medical health insurance coverage and/or individual major medical health insurance coverage through Blue Cross Blue Shield plan as selected by each teacher. The Board will pay 78% and the individual teacher will pay 22% of the total premium cost. Each teacher who participates in the District’s health insurance program will be covered under a drug plan that includes copays of $10 for Tier 1 prescription drugs, $25 for Tier 2 prescriptions drugs, and $40 for Tier 3 prescription drugs. The annual Major Medical deductible shall be $150 per person with an aggregate annual family coverage maximum deductible of $450. The annual maximum Major Medical out of pocket costs after the deductible will be $600 per person with an aggregate annual family out of pocket cost of $1800. Once the Major Medical out of pocket maximum has been reached, there will be no Major Medical co-pay for that individual. The Major Medical deductibles and out of pocket maximums are based on covered health plan expenses the amounts of which are the usual, customary, and reasonable amount, or actual expenses, whichever is less. The foregoing coverage will be provided for by the Board irrespective of other medical insurance carried by the individual or the spouse or domestic partner of the individual. The District warrants and represents that the major medical and prescription coverage provide to the ITA members pursuant to this Section A will be equivalent to the coverages that were in effect for the ITA members on June 30, 2017 under the Blue Cross /Blue Shield Plan provided through the Cooperative, unless and until the parties negotiate otherwise. The District shall have the prerogative to control the means by which the health insurance coverage set forth in this section is provided to teachers, provided that such coverage provides benefits that are at least equivalent to the benefits that were in effect for such teachers on June 20, 2017. The District shall establish a regular schedule of meetings, to which ITA leadership will be invited, to review the performance of the District’s health insurance plan.
Employees’ Health Insurance Program. The Board of Education will provide family coverage and/or individual coverage as selected by each teacher under the Central New York Regionwide Plan (Blue Cross/Blue Shield/Major Medical) presently in effect. This plan will provide coverage at least equivalent to the Statewide Plan in effect in the 1981 calendar year. Effective July 1, 2006, the Board will pay 78% and the individual teacher will pay 22% of the total premium cost. Each teacher who participates in the District’s health insurance program will pay $5 for generic prescription drugs and $10 for brand name prescription drugs. Major Medical coverage will include an annual deductible of $100 per person with an aggregate annual family coverage maximum deductible of $300 with no individual contributing more than $100 toward the annual aggregate family maximum. For each covered person, the annual maximum Major Medical out- of-pocket cost, after the deductible will be $750. Once the Major Medical out-of–pocket maximum has been reached, there will be no Major Medical co-pay for that individual. The Major Medical deductible and out-of-pocket maximums are based on covered health plan expenses the amounts of which are the usual, customary, and reasonable amount, or actual expenses, whichever is less. Further details of the health plan are as described in the Group Health Plan booklet. The foregoing coverage will be provided for by the Board irrespective of any other medical insurance carried by the individual or the spouse or domestic partner of the individual. Article XXIV: Insurance, Credit Union/Bank, Annuities, Income Protection Plan, Tuition Waivers The District shall have the prerogative to seek other group health insurance coverage. It is hereby agreed that premium cost quotes on such other coverage shall be based on a health insurance plan with benefits at least equivalent to the Statewide Plan in effect in the 1981 calendar year. A joint Administrative-ITA Committee may be established to investigate possible upgrading or changes in health insurance coverage.
