Group Health and Dental Sample Clauses

Group Health and Dental. 1. For the life of this Agreement, the Employer agrees to offer eligible bargaining unit employees group health and dental plan benefits according to the provisions of this Article. Newly hired employees will be eligible for enrollment in health and dental plan benefits after three months of continuous employment.
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Group Health and Dental. The Employer agrees to pay one-half (1/2) of the premiums of the Health Care and Dental Care Plans for all eligible employees. Participation in these plans shall be on a voluntary basis.
Group Health and Dental. The group health and dental plans coverages provisions will remain the same with respect to both active employment and retirement.
Group Health and Dental a. The premium for all benefits set forth in the Triton College Health and Dental Insurance Plan as adopted by the Board of Trustees shall be paid in part by the Board for each full-time faculty member covered by this Agreement. Each instructor will be provided with specifics regarding these insurance programs. Coverage shall be provided on a premium co-payment basis with the faculty member share being set forth as follows: The co-premium schedule is based on twenty-six (26) pay periods per year. The schedule will be prorated over twenty-one (21) pay periods per year for faculty members on that payroll option. A Preferred Provider Organization (PPO) and Prescription Drug Card (employee to pay $6 generic drugs/$10 brand-name drugs/$12 non- formulary) shall be a part of the health plan. Responsibility for benefit plan rates will shift to the Health Insurance Committee. Effective July 1, 2013 the health insurance co-premium will be revised through recommendation of the employee health insurance committee and as approved by the Board of Trustees. The co-premium amount shall be identical to the amount paid by any other full time employee group. The standard effective date shall thereafter be January 1 through December 31, however, the Board of Trustees at their discretion may revise the co-premium at any time with 180 days notice to the affected employees. The co-premium may be revised annually up to a cap of 18%. b. Insurance coverage begins immediately; employee has 31 days from the start of employment to enroll. Otherwise the next opportunity is during Open Enrollment (towards the end of the calendar year). 1. The college will reimburse faculty 40 years of age and older for the cost of an annual comprehensive physical examination up to a maximum of $300. The college will reimburse faculty under 40 years of age for the cost of an annual physical examination up to a maximum of $200. c. Maintenance of Efforts It is the intent of the parties that the benefits provided to faculty members under this health insurance program shall not be diminished during the term of this Agreement. Should, however, either the state or federal government pass legislation mandating all employees/employers to participate in a national or statewide health care plan that diminishes benefits to employees or substantially affects cost to employers, then it is agreed that the current health insurance program will be renegotiated and agreed to between the Association and the Board within s...
Group Health and Dental. 1. Effective for the life of this Agreement, the Employer agrees to continue to offer Group Health and Dental coverage based on the formula set forth below. All new employees shall be eligible for enrollment under the health insurance plan after three months of continuous employment. 2. The Employer agrees that the benefits provided by the Plan shall not be less than those provided under the Employer’s Plan in effect with the signing of this Agreement. 3. To receive the benefits of any of the plans specified in this article, the employee must participate in the Group Health or Dental plans for employees and eligible dependents. 4. Once annually, the Employer will provide $200 toward an eye examination or the cost of lenses or a combination thereof. Employees will be allowed carryovers from one year to the next with a maximum reimbursement of $600. 5. The Dental Plan includes orthodontic coverage that will provide reimbursement of up to fifty percent (50%) with a lifetime per-person cap of $1,000. 6. The health and dental plan design summary follows: Design Elements Basic Plan Premium Plan In Network Deductible (Ind/Fam) $250/$500 $150/$300 Coinsurance 90% 100% OOP Maximum $2,000/$4,000 NA (Ind/Fam) Inpatient Hospital Emergency Room Office Visits MHSA Visit Limit $250 co-pay, then 90% $75 co-pay $20 PCP/$30 SP 60 visits $200 co-pay $75 co-pay $20 PCP/$30 SP 60 visits Out-of-Network Deductible (Ind/Fam) $750/$1,500 $400/$800 Coinsurance 60% 70% OOP Maximum $5,000/$10,000 $2,000/$4,000 (Ind/Fam) 60% 70% Inpatient Hospital $75 co-pay $75 co-pay Emergency Room 60% 70% Office Visits MHSA Visit Limit 60 visits 60 visits Retail Generic $7 Brand Formulary $16 Brand Non-Formulary $22 Mail Order Generic $7 Brand Formulary $16 Brand Non-Formulary $22 Supply Limit Retail Mail 30 days 90 days The following restrictions will apply: Prior Authorization Physician must submit qualifying medical criteria to allow for utilization of medication within the following classes: ADHD/Narcolepsy, Anti-Obesity, Pain/Topical, Testosterone. Safety & Monitoring Solution Letter-based clinical intervention program designed to curb misuse or overuse of controlled substance medications (poly- pharmacy, poly-physician and total # Rx triggered). Mandatory Mail Program Program allows for two fills at a retail pharmacy before requiring participants to use the mail order benefit for subsequent refills. (An additional fill will be allowed for the first time an individual is denied the prescriptio...

Related to Group Health and Dental

  • Medical and Dental If an employee is not actively at work on the initial effective date of coverage due to a reason other than hospitalization or medical disability of the employee or dependent, medical and dental coverage will be effective on the first day of the employee’s return to work. The effective date of a change in coverage is not delayed in the event that, on the date the coverage change would be effective, an employee is on an unpaid leave of absence or layoff.

  • Health and Dental Coverage A dependent child is an eligible employee’s child to age twenty-six (26).

  • Health and Life Insurance In the event Employee’s employment is terminated hereunder, the Company shall provide the following health and life insurance benefits: (a) Upon Employee’s termination of employment under this Agreement other than upon Employee’s termination for Cause or upon Employee’s death, the Company shall be responsible for a one-year period following Employee’s Termination Date, the scheduled premium payments (on or before their due dates) on any universal life insurance policy covering Employee’s life which is in force immediately prior to the Termination Date; provided, however, that the Company shall be obligated to pay any such premiums only to the extent that, and on the same basis as, payments are made by the Company on the universal life insurance policies covering officers of the Company with same or similar coverage and further provided that during the period of six months immediately following the Employee’s Termination Date, the Employee shall be obligated to pay the Company the full cost for any such premium payments, and the Company shall reimburse the Employee for any such payments on the first business day that is more than six months after the Employee’s Termination Date, together with interest on such amount from the Termination Date through the date of payment at the Interest Rate. (b) Upon Employee’s termination of employment under this Agreement other than upon a Change of Control (which shall be governed by the COC Severance Plan), Employee’s termination for Cause, or upon Employee’s death, the Company shall, at its expense, provide such medical and dental coverage as in effect immediately prior to the Termination Date for Employee and Employee’s then covered dependents until the end of the period designated for payments to be made hereunder. Thereafter, Employee and his qualified beneficiaries shall be entitled to continue health insurance benefits, under and through the terms of the applicable COBRA law and regulations, at Employee’s own expense until the expiration of COBRA coverage. (c) In the event of Employee’s death during the Term of Employment for a twelve-month period after his death the Company shall make available at its expense medical and dental insurance covering Employee’s spouse and his dependents (collectively, “Employee’s Beneficiaries”) who would have been covered (if the Term of Employment had continued) by the Company’s medical and dental insurance policies as then in effect, and (ii) thereafter for an additional six-month period, such medical and dental insurance in effect from time to time shall be provided to Employee’s Beneficiaries, with Employee’s Beneficiaries (or estate if applicable) to reimburse the Company for the cost of comparable coverage under the provisions of this clause (ii), unless otherwise prohibited by applicable law Thereafter, Employee and his qualified beneficiaries shall be entitled to continue health insurance benefits, under and through the terms of the applicable COBRA law and regulations, at Employee’s own expense until the expiration of COBRA coverage. (d) Any taxable welfare benefits provided pursuant to this Section 13 that are not “disability pay” or “death benefits” within the meaning of Treasury Regulation Section 1.409A-1(a)(5) (collectively, the “Applicable Benefits”) shall be subject to the following requirements in order to comply with Section 409A of the Code. The amount of any Applicable Benefit provided during one taxable year shall not affect the amount of the Applicable Benefit provided in any other taxable year, except that with respect to any Applicable Benefit that consists of the reimbursement of expenses referred to in Section 105(b) of the Code, a limitation may be imposed on the amount of such reimbursements over some or all of the applicable severance period, as described in Treasury Regulation Section 1.409A-3(i)(iv)(B). To the extent that any Applicable Benefit consists of the reimbursement of eligible expenses, such reimbursement must be made on or before the last day of the calendar year following the calendar year in which the expense was incurred. No Applicable Benefit may be liquidated or exchanged for another benefit.

  • Group Health Insurance The Employer shall provide a comprehensive health care insurance program for all permanent full-time and part-time employees. Health Plan characteristics and benefits shall be as provided in the Employer’s Agreement with the Ohio Civil Service Employees Association (hereinafter OCSEA). Regardless of the plan, employees will pay fifteen percent (15%) of the premium and the Employer will pay eighty-five percent (85%) of the premium; however for any alternative plans offered pursuant to the Agreement with OCSEA, the employees’ premium share will be determined by the Director of DAS, but will not exceed fifteen percent (15%) of the premium. The Employer’s premium share shall be paid on behalf of eligible employees as provided in the Employer’s Agreement with OCSEA. Employees who include a spouse as a dependent for healthcare coverage shall pay a surcharge as provided in the Employer’s Agreement with OCSEA. Eligibility provisions for employees enrolling in State provided health care plans shall remain the same as those in effect in the Employer’s Agreement with OCSEA. The Employer reserves the right to perform dependent eligibility audits upon recommendation of the Joint Health Care Committee. Health care costs paid on behalf of ineligible dependents will be subject to recovery. Deductibles, co-payments, and other plan design provisions for all benefit programs shall be the same as those prescribed in the Employer’s Agreement with OCSEA. Every year the Employer shall conduct an open enrollment period, at which time employees shall be able to enroll in a health plan, continue enrollment in their current plan, switch to another plan, subject to plan availability in their area, or waive coverage. The timing of the open enrollment period shall be established by the Director of the Department of Administrative Services (DAS), in consultation with the Joint Health Care Committee. Changes outside of open enrollment may only occur as prescribed in the Employer’s Agreement with OCSEA. Open Enrollment Fairs shall be held in accordance with Employer’s Agreement with OCSEA. There shall be established a Joint Health Care Committee composed of representatives of management, and of the various labor Unions representing State employees. The Committee shall meet regularly to monitor the operation of the State’s health care plans, and to make recommendations for the improvement of the plans and cost containment procedures. The Employer shall provide funding for dental, vision and the life benefits as described in Article 21 of the Employer’s Agreement with OCSEA and the Union’s Benefits Trust. Employee health insurance payments will be deducted from every paycheck. In the event an employee is receiving disability leave or Workers’ Compensation benefits, the Employer- policyholder shall continue, at no cost to the employee, the coverage of group health insurance for such employee for the period of such leave, but not beyond twelve (12) months. If the employee’s leave extends beyond twelve

  • Home Health Care This plan covers the following home care services when provided by a certified home healthcare agency: • nursing services; • services of a home health aide; • visits from a social worker; • medical supplies; and • physical, occupational and speech therapy.

  • Health and Dental Insurance ☐ Husband ☐ Wife shall maintain coverage for each minor child under the medical and dental insurance provided through his/her employment. To facilitate the use of such coverage for the child(ren), the Couple shall cooperate fully and in a timely manner, including, but not limited to, obtaining and providing all necessary insurance cards and claim forms, completing and submitting all necessary documents, and delivering all insurance payments. For purposes of duration and modification, this provision shall be deemed part of the child support orders made by the local court in the Couples’ dissolution action.

  • Leave for Medical and Dental Care (a) Where it is not possible to schedule medical and/or dental appointments or appointments with a registered midwife outside regularly scheduled working hours, reasonable time off for such appointments for employees or for dependent children shall be permitted, but where any such absence exceeds two hours, the full-time absence shall be charged to the entitlement described in Clause 20.12. "Medical, dental and/or registered midwife appointments" include only those services covered by the BC Medical Services Plan, the Public Service Dental Plan, the Extended Health Benefit Plan and assessment appointments with the Employee and Family Assistance Program. (b) Employees in areas where adequate medical and dental facilities are not available shall be allowed to deduct from their credit described in Clause 20.12 the necessary time including travel and treatment time up to a maximum of three days to receive medical and dental care at the nearest medical centre for the employee, their spouse, dependent child and a dependent parent permanently residing in the employee's household or with whom the employee permanently resides. The Employer may request a certificate of a qualified medical or dental practitioner, as the case may be, stating that treatment could not be provided by facilities or services available at the employee's place of residence. An employee on leave provided by this clause shall be entitled to reimbursement of reasonable receipted expenses for accommodation and travel to a maximum of $510 effective April 1, 2019, $520 effective April 1, 2020, and $530 effective April 1, 2021 per calendar year. (c) An employee otherwise entitled to leave pursuant to (b) above who chooses to travel on a vacation day or a day of rest or to remain at work and not accompany their spouse, dependent child or dependent parent, as provided in (b) above, may claim the reimbursement of receipted expenses under the conditions stipulated. (d) Employees in receipt of STIIP benefits who would otherwise qualify for leave under this clause shall be eligible to claim expenses in the manner described above. (e) Where leave pursuant to (b) above would be reduced, the Employer may approve airfare payment for the employee in lieu of the $510 effective April 1, 2019, $520 effective April 1, 2020, and $530 effective April 1, 2021 reimbursement, once per calendar year. (f) For the purpose of this clause, "child" includes a child over the age of 18 residing in the employee's household who is permanently dependent on the employee due to mental or physical impairment.

  • Family and Medical Leave (FMLA FMLA leave shall be granted pursuant to applicable law.

  • Medical and Dental Benefits If Executive’s employment is subject to a Termination, then to the extent that Executive or any of Executive’s dependents may be covered under the terms of any medical or dental plans of the Company (or an Affiliate) for active employees immediately prior to the Termination Date, then, provided Executive is eligible for and elects coverage under the health care continuation rules of COBRA, the Company shall provide Executive and those dependents with coverage equivalent to the coverage in effect immediately prior to the Termination. For a period of twelve (12) months (18 months for a Termination during a Covered Period), Executive shall be required to pay the same amount as Executive would pay if Executive continued in employment with the Company during such period and thereafter Executive shall be responsible for the full cost of such continued coverage; provided, however, that such coverage shall be provided only to the extent that it does not result in any additional tax or other penalty being imposed on the Company (or an Affiliate) or violate any nondiscrimination requirements then applicable with respect to the applicable plans. The coverages under this Section 4(e) may be procured directly by the Company (or an Affiliate, if appropriate) apart from, and outside of the terms of the respective plans, provided that Executive and Executive’s dependents comply with all of the terms of the substitute medical or dental plans, and provided, further, that the cost to the Company and its Affiliates shall not exceed the cost for continued COBRA coverage under the Company’s (or an Affiliate’s) plans, as set forth in the immediately preceding sentence. In the event Executive or any of Executive’s dependents is or becomes eligible for coverage under the terms of any other medical and/or dental plan of a subsequent employer with plan benefits that are comparable to Company (or Affiliate) plan benefits, the Company’s and its Affiliates’ obligations under this Section 4(e) shall cease with respect to the eligible Executive and/or dependent. Executive and Executive’s dependents must notify the Company of any subsequent employment and provide information regarding medical and/or dental coverage available.

  • Family and Medical Leave The Employer shall provide employees with the benefits of the Family and Medical Leave Act on a fair and equitable basis in accordance with applicable law and regulation.

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