Group Hospital and Surgery Insurance. The district group health plan approved by the Board if such a plan is selected by the Board. A.1 The Board will pay in addition to salary, a fringe benefit for full-time certified teachers for coverage in the district's group health and dental insurance plan. The maximum to be paid will be the cost of single low option coverage and will be subject to the limits of Section A.2. The benefit amount shall apply to the group health and dental benefits and carriers as selected by the Board and may not be taken as cash or any other benefit. Upon termination for any reason, all Board payments of fringe benefits shall terminate on the date employment with the district ceases. Ratified: 8/15/94 Amended: 5/14/01 Amended: 7/8/02 A.2 The Board shall be responsible for any increase in the cost of single coverage in the district’s group health and dental insurance plan that exceeds the previous year’s cost up to twelve percent (12%) of such increase. The teacher shall be responsible for any increase in the cost of single coverage in the district’s group health and dental insurance plan that exceeds the prior year’s cost by more than twelve percent (12%). This provision will only apply if the district is no longer part of the KEIT group for health insurance.

Group Hospital and Surgery Insurance. The district group health plan approved by the Board if such a plan is selected by the Board. A.1 The Board will pay in addition to salary, a fringe benefit for full-time certified teachers valued at $509.15 per month/$6,109.80 per year for coverage in the district's group health and dental insurance plan. The maximum to be paid will be the cost of single low option coverage and will be subject to the limits of Section A.2. The benefit amount shall apply to the group health and dental benefits and carriers as selected by the Board and may not be taken as cash or any other benefit. Upon termination for any reason, all Board payments of fringe benefits shall terminate on the date employment with the district ceases. Ratified: 8/15/94 Amended: 5/14/01 Amended: 7/8/02 Amended: 8/13/18? A.2 The Board shall be responsible for any increase in the cost of single coverage in the district’s group health and dental insurance plan that exceeds the previous year’s cost up to twelve percent (12%) of such increase. The teacher shall be responsible for any increase in the cost of single coverage in the district’s group health and dental insurance plan that exceeds the prior year’s cost by more than twelve percent (12%). This provision will only apply if the district is no longer part of the KEIT group for health insurance. A.3 Any health insurance refunds shall first be used to reduce the cost of the next year's health insurance premiums. If for any reason the district receives a cash refund for group health insurance, the amount of refund shall be made available for professional improvement as outlined under 8.2. A.4 Retired employees, spouses, and their dependents not eligible for Early Retirement benefits outlined in section 16.0 of this agreement shall be entitled to continued coverage under the district-sponsored group health insurance program according to the following requirements: • The retired employee makes written application with the clerk of the Board of education for such continued coverage within thirty

Group Hospital and Surgery Insurance. The terms, conditions, and limitations for the Group Hospital and Surgery Insurance will be set forth in the insurance policy or policies described below: (See Section V of the Plan Document) Blue Shield Policy# VH0113‌

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Income Protection, Trauma and Journey Insurance The Employer is, and will remain during the life of this Agreement, a participating employer in the Nominated Redundancy Fund and an employer member of IPT Agency Co Ltd. IPT Agency Co Ltd administers the insurance schemes covering income protection, trauma and journey accidents (Income Protection, Trauma and Journey Accidents Insurance Schemes).
Hospital This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.
Medical, Dental and Vision Insurance a. Effective July 1, 2002, medical benefits shall be offered through CalPERS Health Plans. b. The Employer shall pay up to eight percent (8%) of future premium increases for medical, dental, and vision plans. In the event that a medical plan has a premium decrease (<0%), the Employer will apply ninety percent (90%) of the premium decrease towards Employer contribution and ten percent (10%) towards employee plan premiums. c. Each employee shall pay through payroll deduction any premium cost in excess of the Employer’s contribution. Each employee may select from among the plans made available by the Employer and the Union.
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
Health Plan An appropriately licensed entity that has entered into a contract with Subcontractor, either directly or indirectly, under which Subcontractor provides certain administrative services for Health Plan pursuant to the State Contract. For purposes of this Appendix, Health Plan refers to UnitedHealthcare Insurance Company.
Long Term Disability Insurance Plan The Employer shall provide a mutually acceptable long-term disability insurance plan, a copy of which shall appear in Appendix “A” – Long-Term Disability Insurance Plan. The plan shall provide post-probationary regular employees with salary continuation as per Appendix “A” until age sixty-five (65) in the event of a disability. The cost of the plan shall be borne by the Employer.
Group Insurance Plan The carriers, coverage, and terms and conditions of participation under the District’s Group Insurance Plan are subject to change in accordance with the applicable provisions of Title I, Division 4, Chapter 10 of the California Government Code (Section 3500 et seq.) (Xxxxxx‐Milias‐Xxxxx Act). a. The District contracts with CalPERS for health plan coverage for all regular and newly hired employees (eligibility to be defined by the “CalPERS health plan”). Booklets on the insurance plans will be available to all participants. b. Employees may choose from the available plans offered by CalPERS. Additional premiums will be borne by the employee through payroll deductions and paid to CalPERS by the District each month; and the additional cost for monthly premiums will be deducted evenly from the first and second payroll period of each month. To the extent allowed by law, the District will attempt to deduct the employee’s premium contribution from pre‐tax dollars.
Healthcare Section 1. Bargaining unit employees with one (1) year or more of service will be provided coverage for the duration of this contract through the “Full Coverage” Team Care Plan (“Team Care MM200”), which includes dental, vision, life, short term disability, medical and prescription drug benefits. Prior to January 1, 2020, bargaining unit employees with less than one (1) year of service will be provided coverage through the “Medical Only” plan. On January 1, 2020, all bargaining unit employees enrolled in the Medical Only plan shall be enrolled in the Full Coverage plan, and the Medical Only plan will eliminated. The rates for 2019 and a further description of the plan and rates are referenced
Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services. This plan covers dental care for members until the last day of the month in which they turn nineteen (19). This plan covers services only if they meet all of the following requirements: • listed as a covered dental care service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered dental care service under this plan. • dentally necessary, consistent with our dental policies and related guidelines at the time the services are provided. • not listed in Exclusions section. • received while a member is enrolled in the plan. • consistent with applicable state or federal law. • services are provided by a network provider.
Hospital Services The Hospital will: 6.1.1 achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; 6.1.2 not reduce, stop, start, expand, cease to provide or transfer the provision of Hospital Services to another hospital or to another site of the Hospital if such action would result in the Hospital being unable to achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; and 6.1.3 not restrict or refuse the provision of Hospital Services that are funded by the Funder to an individual, directly or indirectly, based on the geographic area in which the person resides in Ontario, and will establish a policy prohibiting any health care professional providing services at the Hospital, including physicians, from doing the same.

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