Common use of Health and Dental Insurance Clause in Contracts

Health and Dental Insurance. The City shall make available to all eligible employees and their dependents health insurance programs to include medical, prescription and dental coverage subject to the applicable carriers’ requirements and eligibility. The plan coverage and premium as determined by the City will be the same as that provided to all non-bargaining unit employees. Deductibles, out-of-pocket maximums, and co-pay structures are components of plan design. As such they will be established by the City and will be the same as those for non-bargaining unit employees. The City has the right to insure or self-insure and to choose the insurance carriers, third- party administrators, network of physicians or providers, or any other operational components of the Medical and Dental Plans. HSA’s will be funded on a prorated basis, under a banking arrangement selected by the City. The City will pay all routine charges for the banking arrangement such as set up charges and routine monthly fees, with the employee responsible for other charges such as overdrafts, checks and investment fees. Once placed in the employee’s HSA, the money becomes the possession of the employee, and as such, money the employee does not spend in the HSA for medical expenses is carried forward for future years use and is the employee’s to take with him or her at termination, as authorized by then current IRS and other controlling state and federal regulations. Under circumstances where the employee does not have adequate funds in the HSA for expenses incurred before the end of the year, due to legitimate expenditures to meet the deductible, the City will contribute an amount to the account, at the employee’s request, up to the annual City contribution limits specified above. Employees joining the City mid-year, eligible for health insurance coverage, will be placed in a similar High Deductible Consumer Driven Health Plan, but may be enrolled in a Health Reimbursement Account (HRA) or Health Savings Account (HSA) at the discretion of the City. In the event the employee is placed in an HRA, amounts will be available for reimbursement similar to those specified for HSA accounts above. At the end of the year, if enrolled in an HRA, any money not spent is retained by the City and the employee is thus enrolled in the HSA in the following year. The HRA system may also be used for other employees who do not qualify for the HSA under IRS provisions such as those enrolled in Medicare. Employees in an HSA will have available a Limited Flexible Spending Account (Limited FSA) with the option for them to contribute up to the maximum allowable limit under IRS provisions. Other controlling aspects of the FSA and health plans, such as timing of enrollment, are subject to provisions of the Medical Plan.

Health and Dental Insurance. The City shall make available to all eligible employees and their dependents health insurance programs to include medical, prescription and dental coverage subject to the applicable carriers’ requirements and eligibility. The plan coverage and premium as determined by the City will be the same as that provided to all non-bargaining unit employees. Deductibles, out-of-pocket maximums, and co-pay structures are components of plan design. As such they will be established by the City and will be the same as those for non-bargaining unit employees. The City has the right to insure or self-insure and to choose the insurance carriers, third- third-party administrators, network of physicians or providers, or any other operational components of the Medical and Dental Plans. Through the duration of the agreement the City shall pay 90% and the employee shall pay 10% of the premium for the Dental Insurance Plan. If the City changes the premium for dental plan, the dental premium for these bargaining unit employees shall be the same as the non-bargaining unit employees. Through the duration of the agreement, the City shall pay 83% and the employee shall pay 17% of the premiums for the Medical Insurance Plan. If however, the City reduces the Medical Insurance Plan employee premium share below 17% for non-bargaining unit employees, such reduction shall also apply to the Firefighters. Through the duration of the agreement the City will fund the employee’s HSA at no less than 60% of the network deductible of the High Deductible Health Plan (other plans excluded). However, if at any time during the duration of this agreement it is necessary to reduce the City’s share of the HSA funding on the High Deductible Plan below 55% in order to avoid the “Cadillac” excise tax pursuant to the Affordable Care Act, the City may at its option reduce the funding percentage to not less than 50%. Through the duration of this agreement the network deductible of the High Deductible Health Plan shall not exceed $2500 for a single plan and $5000 for a family plan. HSA’s will be funded on a prorated basis, under a banking arrangement selected by the City. The City will pay all routine charges for the banking arrangement such as set up charges and routine monthly fees, with the employee responsible for other charges such as overdrafts, checks and investment fees. Once placed in the employee’s HSA, the money becomes the possession of the employee, and as such, money the employee does not spend in the HSA for medical expenses is carried forward for future years use and is the employee’s to take with him or her at termination, as authorized by then current IRS and other controlling state and federal regulations. Under circumstances where the employee does not have adequate funds in the HSA for expenses incurred before the end of the year, due to legitimate expenditures to meet the deductible, the City will contribute an amount to the account, at the employee’s request, up to the annual City contribution limits specified above. Employees joining the City mid-year, eligible for health insurance coverage, will be placed in a similar High Deductible Consumer Driven Health Plan, but may be enrolled in a Health Reimbursement Account (HRA) or Health Savings Account (HSA) at the discretion of the City. In the event the employee is placed in an HRA, amounts will be available for reimbursement similar to those specified for HSA accounts above. At the end of the year, if enrolled in an HRA, any money not spent is retained by the City and the employee is thus enrolled in the HSA in the following subsequent year. The HRA system may also be used for other employees who do not qualify for the HSA under IRS provisions such as those enrolled in Medicare. Employees in an HSA will have available a Limited limited Flexible Spending Account (Limited FSA) with the option for them to contribute up to the maximum allowable limit under IRS provisions. Other controlling aspects of the FSA and health plans, such as timing of enrollment, are subject to provisions of the Medical Plan.

Health and Dental Insurance. The City shall make available to all eligible employees and their dependents health insurance programs to include medical, prescription and dental coverage subject to the applicable carriers’ requirements and eligibility. The plan coverage and premium as determined by the City will be the same as that provided to all non-bargaining unit employees. Deductibles, out-of-pocket maximums, and co-pay structures are components of plan design. As such they will be established by the City and will be the same as those for non-bargaining unit employees. The City has the right to insure or self-insure and to choose the insurance carriers, third- third-party administrators, network of physicians or providers, or any other operational components of the Medical and Dental Plans. Through the duration of the agreement the City shall pay 90% and the employee shall pay 10% of the premium for the Dental Insurance Plan. If the City changes the premium for dental plan, the dental premium for these bargaining unit employees shall be the same as the non-bargaining unit employees. Through the duration of the agreement, the City shall pay 83% and the employee shall pay 17% of the premiums for the Medical Insurance Plan. If however, the City reduces the Medical Insurance Plan employee premium share below 17% for non-bargaining unit employees, such reduction shall also apply to the regular full-time fire captains and regular full-time firefighters. Through the duration of the agreement the City will fund the employee’s HSA at no less than 60% of the network deductible of the High Deductible Health Plan (other plans excluded). However, if at any time during the duration of this agreement it is necessary to reduce the City’s share of the HSA funding on the High Deductible Plan below 55% in order to avoid the “Cadillac” excise tax pursuant to the Affordable Care Act, the City may at its option reduce the funding percentage to not less than 50%. Through the duration of this agreement the network deductible of the High Deductible Health Plan shall not exceed $2500 for a single plan and $5000 for a family plan. HSA’s will be funded on a prorated basis, under a banking arrangement selected by the City. The City will pay all routine charges for the banking arrangement such as set up charges and routine monthly fees, with the employee responsible for other charges such as overdrafts, checks and investment fees. Once placed in the employee’s HSA, the money becomes the possession of the employee, and as such, money the employee does not spend in the HSA for medical expenses is carried forward for future years use and is the employee’s to take with him or her at termination, as authorized by then current IRS and other controlling state and federal regulations. Under circumstances where the employee does not have adequate funds in the HSA for expenses incurred before the end of the year, due to legitimate expenditures to meet the deductible, the City will contribute an amount to the account, at the employee’s request, up to the annual City contribution limits specified above. Employees joining the City mid-year, eligible for health insurance coverage, will be placed in a similar High Deductible Consumer Driven Health Plan, but may be enrolled in a Health Reimbursement Account (HRA) or Health Savings Account (HSA) at the discretion of the City. In the event the employee is placed in an HRA, amounts will be available for reimbursement similar to those specified for HSA accounts above. At the end of the year, if enrolled in an HRA, any money not spent is retained by the City and the employee is thus enrolled in the HSA in the following subsequent year. The HRA system may also be used for other employees who do not qualify for the HSA under IRS provisions such as those enrolled in Medicare. Employees in an HSA will have available a Limited limited Flexible Spending Account (Limited FSA) with the option for them to contribute up to the maximum allowable limit under IRS provisions. Other controlling aspects of the FSA and health plans, such as timing of enrollment, are subject to provisions of the Medical Plan.