Group Hospital, Surgical, Major Medical Insurance Sample Clauses

Group Hospital, Surgical, Major Medical Insurance. The board shall provide group hospitalization and major medical insurance at a shared cost to both the board and the employee for all full-time teachers and their eligible dependents. Spouses of covered employees who are eligible for other health insurance coverage through their employer or Medicare are required to enroll for at least single coverage where such availability for coverage exists. The district is currently a member of the Pickaway County Public Employee Benefits Consortium. The Board shall contribute for those unit members enrolling in the dependent coverage eighty percent (80%) of the dependent coverage cost. The Board shall contribute for those unit members enrolling in the single coverage ninety percent (90%) of the single coverage cost. As of July 1, 2019 all employed couples will pay twenty percent (20%) of the single coverage premium, to be deducted from the most senior spouse’s paycheck. Xxxxxxx employed, prior to July 1st 2019, who were paying 10% of a single coverage premium, will continue to pay the ten percent (10%) premium. The medical insurance opt-out payment will be $5,000 for CY 22 through CY24 if the number of teachers receiving said benefit is equal to or greater than twenty (20). If the number of teachers electing said payment drops below twenty (20), the payment in lieu of insurance will be $3,000. Requests for payment in-lieu of insurance, shall be submitted by employees to the treasurer by the 15th of December. Payments will be made with the last regular payroll in December. This request for payment will coincide with the district’s insurance open enrollment period.
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Group Hospital, Surgical, Major Medical Insurance. (a) Employees may participate in one of the medical insurance plan(s) maintained by the City. If the City determines that one of these plans shall no longer be in effect, or if the City adds a new plan, employees shall have the right to switch to another plan on a non-medical basis under rules established by those plans. (b) As of January 1, 2019, employees covered by PPO 1, PPO 2, HMO Illinois, and HMO Blue Advantage will continue to fall in the below tiers and contribute the following percentage (%) of total premium costs, which shall be deducted from their employee paychecks: Employee 10% Employee + 1 or 2 Children 8% Employee + Spouse/DP 9% Family 10% The contribution amounts for the Employee + 1 or 2 children and Employee + Spouse/DP tiers will be calculated as a percentage of the total family premium cost. (c) Effective January 1, 2020, employees will fall in the below tiers and contribute the following percentage (%) of total premium costs, which shall be deducted from their employee paychecks: Employee HMO 12% PPO 15% Employee + 1 HMO 10% PPO 13% Family HMO 12% PPO 15% The contribution amount for the Employee + 1 will be calculated as a percentage of the total family premium cost. As of January 1, 2020, the Employee + 1 or 2 children and Employee + Spouse/DP tiers no longer exist. Single In Network: $500 $1000 Family In Network: $1500 $2000 Single Out of Network: $1000 Family Out of Network: $3000 (d) Former bargaining unit employees who are retired and are receiving a current Illinois fire pension may elect insurance plan coverage under the rules and regulations established by the plans, so long as the retiree pays the entire group insurance premium, without any City contribution. Payment shall be by means of deduction from the pensioner’s Fire Pension Fund check. (e) Upon request, the City shall provide the Union with information and documents relating to existing programs and any proposed changes. The City will notify the Union of any changes made to the City’s medical insurance program 30 days prior to the effective date of such changes. The City will notify the Union of any changes made by the providers of the City’s medical insurance program within 15 days of receiving such notice from the provider. In the event, however, the City exercises the right to change insurance carriers for part or all of the life/medical insurance program or to self-insure any or all said programs, benefit levels shall remain substantially the same. In the event tha...
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Group Hospital, Surgical, Major Medical Insurance. A. The Town shall provide through the Maine Municipal Employees Health Trust (MMEHT) its point of service health care program. The Town will provide up to full family subscriber coverage. Employees may choose either the point of service (POS) C plan or point of service 200 plan. For employees who elect the POS-C plan, the Town shall pay eighty (80%) percent of the subscriber cost and the employee shall pay twenty (20%) percent. For employees who elect the POS 200 plan, the Town shall pay three hundred dollars ($300.00) greater than eighty-five (85%) percent of the subscriber cost and the employee shall pay fifteen (15%) percent, less three hundred dollars ($300.00). B. Any employee contribution towards the monthly health insurance premium shall be done on a pretax basis. C. The Town shall adopt a section 125 (cafeteria or flexible benefits plan) for the purpose of providing health insurance and related benefits described in this Article, and all such benefits shall be provided pursuant to that plan. Effective January 1, 2004 the Town will contribute $400 annually to this plan for each employee. For employees enrolled in the POS 200 plan, the Town will contribute $500 annually to the section 125 plan for each employee. D. Payment in lieu: For employees hired prior to July 1, 2014 who do not enroll in medical insurance under this contact will be paid 50% of the employer premium, less life insurance, that they would otherwise be eligible for. Employee hired on July 1, 2014 or after will receive 25% of the employer premium, less life insurance, they would otherwise be eligible for. This payment will be made on a fiscal year basis in two installments, the first on or about January 1st and the second on or about July 1st for each of the previous six months. To be eligible for this benefit the recipient must show proof, satisfactory to the Town that they have health insurance from another source. This health insurance must be substantially equal to the policy that would otherwise be offered by the Town.
Sample 1
Group Hospital, Surgical, Major Medical Insurance a) Employees may participate in one of the medical insurance plan(s) maintained by the City. If the City determines that one of these plans shall no longer be in effect, or if the City adds a new plan, employees shall have the right to switch to another plan on a non-medical basis under rules established by those plans. b) Employees covered by PPO 1, HMO Illinois, and HMO Blue Advantage will contribute the following percentage (%) of total premium costs, which shall be deducted from their employee paychecks: The contribution amounts for the Employee +1 or 2 children and Employee + Spouse/DP tiers will be calculated as a percentage of the total family premium cost. Deductible amounts for PPO 1 as follows: Single In Network: $350 Family In Network: $1050 Single Out of Network: $700 Family Out of Network: $2100 c) Former bargaining unit employees who are retired and are receiving a current Illinois fire pension may elect insurance plan coverage under the rules and regulations established by the plans, so long as the retiree pays the entire group insurance premium, without any City contribution. Payment shall be by means of deduction from the pensioner’s Fire Pension Fund check. d) Upon request, the City shall provide the Union with information and documents relating to existing programs and any proposed changes. The City will notify the Union of any changes made to the City’s medical insurance program 30 days prior to the effective date of such changes. The City will notify the Union of any changes made by the providers of the City’s medical insurance program within 15 days of receiving such notice from the provider. In the event, however, the City exercises the right to change insurance carriers for part or all of the life/medical insurance program or to self-insure any or all said programs, benefit levels shall remain substantially the same. In the event that City-instituted changes result in overall benefit levels that are no longer reasonably comparable to those which predated the changes, the Union shall have the right, within thirty (30) days of the insurance changes taking effect, to demand impact and effects bargaining over the City’s changes by so notifying the Director of Human Resources in writing. The parties shall then promptly meet and negotiate in good faith over the impact and effects of the changes. The City may elect to implement the changes during the pendency of impact and effects negotiations. The Union shall have the right to identify an...
Sample 1
Group Hospital, Surgical, Major Medical Insurance a) Employees may participate in one of the medical insurance plan(s) maintained by the City. If the City determines that one of these plans shall no longer be in effect, or if the City adds a new plan, employees shall have the right to switch to another plan on a non-medical basis under rules established by those plans. b) Employees covered by PPO 1, PPO 2, HMO Illinois, and HMO Blue Advantage will contribute the following percentage (%) of total premium costs, which shall be deducted from their employee paychecks: Employee 10% Employee + 1 or 2 Children 8% Employee + Spouse/DP 9% Family 10% The contribution amounts for the Employee + 1 or 2 children and Employee + Spouse/DP tiers will be calculated as a percentage of the total family premium cost. Single In Network: $500 $1000 Family In Network: $1500 $2000 Single Out of Network: $1000 Family Out of Network: $3000
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Group Hospital, Surgical, Major Medical Insurance. The Board shall provide group hospitalization and major medical insurance and shall pay the full cost of individual coverage for all full-time teachers. Beginning July 1, 2006, the District will implement the Pickaway-Xxxx Consortium Plan 3-C. The Board shall contribute for those unit members enrolling in the dependent coverage eighty percent (80%) of the dependent coverage cost. The Board shall contribute for those unit members enrolling in the single coverage ninety-two percent (92%) of the single coverage cost. All employed couples will pay ten percent (10%) of the single coverage premium, to be deducted from the most senior spouse’s paycheck. Each member of the bargaining unit who waives health insurance coverage by the Circleville City Schools shall be eligible for and receive fifteen hundred dollars ($1,500) each year. Requests for payment, in-lieu of participation, shall be submitted by employees to the Treasurer by the 15th of June. Payments will be made August 15 with the regular paycheck.
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Related to Group Hospital, Surgical, Major Medical Insurance

  • Medical Insurance The Company shall provide to Executive, Executive's spouse and children, at its sole cost, such health, dental and optical insurance as the Company may from time to time make available to its other executive employees.

  • Basic Medical Insurance All regular Employees may choose to be covered by the medical plan for which the British Columbia Medical Plan is the licensed carrier. Benefits and premiums shall be in accordance with the existing policy of the plan. The Employer will pay one hundred percent (100%) of the regular premium.

  • Retiree Medical Insurance Retiree insurance coverage is included within each medical plan for all retirees under the age of 65 years, through self-payment. The Employer shall make available an appropriate medical plan for all eligible retirees ages 65 years or older.

  • Durable Medical Equipment (DME), Medical Supplies, Prosthetic Devices, Enteral Formula or Food, and Hair Prosthesis (Wigs) This plan covers durable medical equipment and supplies, prosthetic devices and enteral formula or food as described in this section. DME is equipment which: • can withstand repeated use; • is primarily and customarily used to serve a medical purpose; • is not useful to a person in the absence of an illness or injury; and • is for use in the home. DME includes supplies necessary for the effective use of the equipment. This plan covers the following DME: • wheelchairs, hospital beds, and other DME items used only for medical treatment; and • replacement of purchased equipment which is needed due to a change in your medical condition or if the device is not functional, no longer under warranty, or cannot be repaired. DME may be classified as a rental item or a purchased item. In most cases, this plan only pays for a rental DME up to our allowance for a purchased DME. Repairs and supplies for rental DME are included in the rental allowance. Medical supplies are consumable supplies that are disposable and not intended for re- use. Medical supplies require an order by a physician and must be essential for the care or treatment of an illness, injury, or congenital defect. Covered medical supplies include: • essential accessories such as hoses, tubes and mouthpieces for use with medically necessary DME (these accessories are included as part of the rental allowance for rented DME); • catheters, colostomy and ileostomy supplies, irrigation trays and surgical dressings; and • respiratory therapy equipment. This plan covers diabetic equipment and supplies for the treatment of diabetes in accordance with R.I. General Law §27-20-30. Covered diabetic equipment and supplies include: • therapeutic or molded shoes and inserts for custom-molded shoes for the prevention of amputation; • blood glucose monitors including those with special features for the legally blind, external insulin infusion pumps and accessories, insulin infusion devices and injection aids; and • lancets and test strips for glucose monitors including those with special features for the legally blind, and infusion sets for external insulin pumps. The amount you pay differs based on whether the equipment and supplies are bought from a durable medical equipment provider or from a pharmacy. See the Summary of Pharmacy Benefits and the Summary of Medical Benefits for details. Coverage for some diabetic equipment and supplies may only be available from either a DME provider or from a pharmacy. Visit our website to determine if this is applicable or call our Customer Service Department. Prosthetic devices replace or substitute all or part of an internal body part, including contiguous tissue, or replace all or part of the function of a permanently inoperative or malfunctioning body part and alleviate functional loss or impairment due to an illness, injury or congenital defect. Prosthetic devices do not include dental prosthetics. This plan covers the following prosthetic devices as required under R.I. General Law § 27-20-52: • prosthetic appliances such as artificial limbs, breasts, larynxes and eyes; • replacement or adjustment of prosthetic appliances if there is a change in your medical condition or if the device is not functional, no longer under warranty and cannot be repaired; • devices, accessories, batteries and supplies necessary for prosthetic devices; • orthopedic braces except corrective shoes and orthotic devices used in connection with footwear; and • breast prosthesis following a mastectomy, in accordance with the Women’s Health and Cancer Rights Act of 1998 and R.I. General Law 27-20-29. The prosthetic device must be ordered or provided by a physician, or by a provider under the direction of a physician. When you are prescribed a prosthetic device as an inpatient and it is billed by a provider other than the hospital where you are an inpatient, the outpatient benefit limit will apply. Enteral formula or food is nutrition that is absorbed through the intestinal tract, whether delivered through a feeding tube or taken orally. Enteral nutrition is covered when it is the sole source of nutrition and prescribed by the physician for home use. In accordance with R.I. General Law §27-20-56, this plan covers enteral formula taken orally for the treatment of: • malabsorption caused by Crohn’s Disease; • ulcerative colitis; • gastroesophageal reflux; • chronic intestinal pseudo obstruction; and • inherited diseases of amino acids and organic acids. Food products modified to be low protein are covered for the treatment of inherited diseases of amino acids and organic acids. Preauthorization may be required. The amount that you pay may differ depending on whether the nutrition is delivered through a feeding tube or taken orally. When enteral formula is delivered through a feeding tube, associated supplies are also covered. This plan covers hair prosthetics (wigs) worn for hair loss suffered as a result of cancer treatment in accordance with R.I. General Law § 27-20-54 and subject to the benefit limit and copayment listed in the Summary of Medical Benefits. This plan will reimburse the lesser of the provider’s charge or the benefit limit shown in the Summary of Medical Benefits. If the provider’s charge is more than the benefit limit, you are responsible for paying any difference. This plan covers Early Intervention Services in accordance with R.I. General Law §27- 20-50. Early Intervention Services are educational, developmental, health, and social services provided to children from birth to thirty-six (36) months. The child must be certified by the Rhode Island Department of Human Services (DHS) to enroll in an approved Early Intervention Services program. Services must be provided by a licensed Early Intervention provider and rendered to a Rhode Island resident. Members not living in Rhode Island may seek services from the state in which they reside; however, those services are not covered under this plan. Early Intervention Services as defined by DHS include but are not limited to the following: • speech and language therapy; • physical and occupational therapy; • evaluation; • case management; • nutrition; • service plan development and review; • nursing services; and • assistive technology services and devices.

  • Optical Insurance 1. The Board shall provide Group I employees a vision plan comparable to the VSP 3 plan. 2. The Board shall provide Group II employees a vision plan comparable to the VSP 1 plan.

  • Durable Medical Equipment Durable Medical Equipment is equipment that is Medically Necessary for treatment of an illness or Accidental Injury or to prevent further deterioration. This equipment is designed for repeated use and used to treat a medical condition or illness, and includes items such as oxygen equipment, functional wheelchairs, and crutches. Durable Medical Equipment may require Prior Authorization. Only Durable Medical Equipment considered standard and/or basic as defined by nationally recognized guidelines are Covered.

  • HEALTH PROGRAM 3701 Health examinations required by the Employer shall be provided by the Employer and shall be at the expense of the Employer. 3702 Time off without loss of regular pay shall be allowed at a time determined by the Employer for such medical examinations and laboratory tests, provided that these are performed on the Employer’s premises, or at a facility designated by the Employer. 3703 With the approval of the Employer, a nurse may choose to be examined by a physician of her/his own choice, at her/his own expense, as long as the Employer receives a statement as to the fitness of the nurse from the physician. 3704 Time off for medical and dental examinations and/or treatments may be granted and such time off, including necessary travel time, shall be chargeable against accumulated income protection benefits.

  • 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.

  • Trauma Insurance All employees will be covered by an Incolink administered lump sum insurance policy providing financial compensation in the event of a major work related (ie. WorkCover) accident resulting in death or permanent total disablement. The full and precise conditions of this cover will be in accordance with the terms of the policy, but in general will provide that, in the event of a workplace accident occurring which results in either the death or total permanent disablement of a worker covered by this Agreement, a lump sum payment as specified below will made. The defined payments are: With dependants $250,000 Without dependants $150,000 This benefit has been agreed to by the company on the grounds that premium costs have been set at $7 per week/worker and will not exceed that amount. In the event of insurance costs rising, it is agreed that the table of defined benefits will be reduced so as to maintain the $7 premium figure. To maintain this cover the company agrees to pay the amounts every week for each employee.

  • Major Medical Program provides benefits after basic coverage is exhausted, and for medical office visits, ambulance care and durable equipment. Deductible $100 per individual, $300/family Coinsurance 80/20 Stop Loss $2,000 per individual Outpatient Psychiatric Per State Mandate

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