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. The City shall pay 90% and the employee shall pay 10% of the premium for the Dental Insurance Plan. Effective as of January 1, 2018, 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. Effective January 1, 2018 and 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 Patrol Officers. Effective January 1, 2018 the City will fund 65% of the employee’s High Deductible Platinum Health Plan network deductible by placing $1300/yr. single and $2600/yr. family into a Health Savings Account (HSA). Effective January 1, 2019 the City will fund the employee’s HSA at no less than 60% of the network deductible of the High Deductible Platinum Health Plan (other plans excluded). In the event it is necessary in insurance plan year 2019, 2020 and/or 2021 to reduce the City’s share of the HSA funding on the High Deductible Platinum Health 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%. The network deductible of the High Deductible Health Plan shall not exceed $2500 for a single plan and $5000 for a family plan for plan years 2019, 2020 and 2021. 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 an 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 an HSA 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. Employees eligible to receive City-provided medical insurance coverage, either a Family Plan or a Single Plan, may elect to decline such coverage and in lieu thereof receive cash payments from the City of $3,000 per year. However, if the $3,000 cash payment in lieu of coverage creates an affordability calculation penalty for the City and/or Cadillac excise tax liability under the Affordable Care Act, the City shall have the ability to then eliminate said cash payment. In order to qualify for such cash payments, an employee must remain covered by other medical insurance that is not from the City, COBRA, Medicare or as a dependent under a parental plan, and must provide acceptable proof of such other medical insurance coverage to the City. The timing of when an employee may elect to receive such cash payments, in lieu of medical insurance coverage, is subject to provisions of the City’s Medical Plan, Flexible Spending Account Plan Document and applicable provisions of IRS Section 125.

Appears in 3 contracts

Samples: Collective Bargaining Agreement, Collective Bargaining Agreement, Collective Bargaining Agreement

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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- 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. The City shall pay 90% and the employee shall pay 10% of the premium for the Dental Insurance Plan. Effective as of January 1, 2018, 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. Effective January 1, 2018 and 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 Patrol Command Officers. Effective January 1, 2018 the City will fund 65% of the employee’s High Deductible Platinum Health Plan network deductible by placing $1300/yr. single and $2600/yr. family into a Health Savings Account (HSA). Effective January 1, 2019 the City will fund the employee’s HSA at no less than 60% of the network deductible of the High Deductible Platinum Health Plan (other plans excluded). In the event it is necessary in insurance plan year 2019, 2020 and/or 2021 to reduce the City’s share of the HSA funding on the High Deductible Platinum Health 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%. The network deductible of the High Deductible Health Plan shall not exceed $2500 for a single plan and $5000 for a family plan for plan years 2019, 2020 and 2021. HSA’s will be funded quarterly 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 an 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, year if enrolled in an HRA, any money not spent is retained by the City and the employee is thus enrolled in an 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. Employees eligible to receive City-provided medical insurance coverage, either a Family Plan or a Single Plan, may elect to decline such coverage and in lieu thereof receive cash payments from the City of $3,000 per year. However, if the $3,000 cash payment in lieu of coverage creates an affordability calculation penalty for the City and/or Cadillac excise tax liability under the Affordable Care Act, the City shall have the ability to then eliminate said cash payment. In order to qualify for such cash payments, an employee must remain covered by other medical insurance that is not from the City, COBRA, Medicare or as a dependent under a parental plan, and must provide acceptable proof of such other medical insurance coverage to the City. The timing of when an employee may elect to receive such cash payments, in lieu of medical insurance coverage, is subject to provisions of the City’s Medical Plan, Flexible Spending Account Plan Document and applicable provisions of IRS Section 125.

Appears in 3 contracts

Samples: Collective Bargaining Agreement, Collective Bargaining Agreement, Collective Bargaining Agreement

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- 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. The City shall pay 90% and the employee shall pay 10% of the premium for the Dental Insurance Plan. Effective as of January 1, 2018, if the City changes the premium for the dental plan, the dental premium for these bargaining unit employees shall be the same as the non-bargaining unit employees. Effective January 1, 2018 and 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 Patrol OfficersRegular Full-Time Fire Captains. Effective January 1, 2018 the City will fund 65% of the employee’s High Deductible Platinum Health Plan network deductible by placing $1300/yr. single and $2600/yr. family into a Health Savings Account (HSA). Effective January 1, 2019 and 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 Platinum Health Plan (other plans excluded). In However, in the event it is necessary in insurance plan year 2019, 2019 and/or 2020 and/or 2021 to reduce the City’s share of the HSA funding on the High Deductible Platinum Health 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%. The network deductible of the High Deductible Platinum Health Plan shall not exceed $2500 for a single plan and $5000 for a family plan for plan years 2019, 2020 2019 and 20212020. 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 an 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 an 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. Employees eligible to receive City-provided medical insurance coverage, either a Family Plan or a Single Plan, may elect to decline such coverage and in lieu thereof receive cash payments from the City of $3,000 per year. However, if the $3,000 cash payment in lieu of coverage creates an affordability calculation penalty for the City and/or Cadillac excise tax liability under the Affordable Care Act, the City shall have the ability to then eliminate said cash payment. In order to qualify for such cash payments, an employee must remain covered by other medical insurance that is not from the City, COBRA, Medicare or as a dependent under a parental plan, and must provide acceptable proof of such other medical insurance coverage to the City. The timing of when an employee may elect to receive such cash payments, in lieu of medical insurance coverage, is subject to provisions of the City’s Medical Plan, Flexible Spending Account Plan Document and applicable provisions of IRS Section 125.

Appears in 2 contracts

Samples: Collective Bargaining Agreement, Collective Bargaining Agreement

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- 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. The City shall pay 90% and the employee shall pay 10% of the premium for the Dental Insurance Plan. Effective as of January 1, 20182024, 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. Effective January 1, 2018 2024 and 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 Patrol Officersthese bargaining unit employees. Effective January 1, 2018 2025 and through the City will fund 65% duration of the employee’s High Deductible Platinum Health Plan network deductible by placing $1300/yr. single and $2600/yr. family into a Health Savings Account (HSA). Effective January 1, 2019 agreement the City will fund the employee’s HSA at no less than 6050% of the network deductible of the High Deductible Platinum Health Plan (other plans excluded). In the event it is necessary in insurance plan year 2019, 2020 and/or 2021 to reduce the City’s share of the HSA funding on the High Deductible Platinum Health 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%. The network deductible of the High Deductible Health Plan shall not exceed $2500 3,000 for a single plan and $5000 6,000 for a family plan for plan years 2019, 2020 2025 and 20212026. 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 the employee 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 an 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 an HSA the following yearCity. 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. Employees eligible The City agrees to receive City-provided medical insurance coverage, either a Family Plan or a Single Plan, may elect meet with the Union at least once per year to decline such coverage discuss benefits and in lieu thereof receive cash payments from the City of $3,000 per year. However, if the $3,000 cash payment in lieu of coverage creates an affordability calculation penalty for the City and/or Cadillac excise tax liability under the Affordable Care Act, the City shall have the ability to then eliminate said cash payment. In order to qualify for such cash payments, an employee must remain covered by other medical insurance that is not from the City, COBRA, Medicare or as a dependent under a parental plan, and must provide acceptable proof of such other medical insurance coverage to the City. The timing of when an employee may elect to receive such cash payments, in lieu of medical insurance coverage, is subject to provisions of the City’s Medical Plan, Flexible Spending Account Plan Document and applicable provisions of IRS Section 125plan performance.

Appears in 1 contract

Samples: Collective Bargaining Agreement

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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- 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. The City shall pay 90% and the employee shall pay 10% of the premium for the Dental Insurance Plan. Effective as of January 1, 2018, 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. Effective January 1, 2018 and 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 Patrol Officersthese bargaining unit employees. Effective January 1, 2018 the City will fund 65% of the employee’s High Deductible Platinum Health Plan network deductible by placing $1300/yr. single and $2600/yr. family into a Health Savings Account (HSA). Effective January 1, 2019 and 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 Platinum Health Plan (other plans excluded). In However, in the event it is necessary in insurance plan year 2019, 2020 and/or 2021 to reduce the City’s share of the HSA funding on the High Deductible Platinum Health 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%. The network deductible of the High Deductible Health Plan shall not exceed $2500 for a single plan and $5000 for a family plan for plan years 2019, 2020 and 2021. 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 an 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 an HSA the following yearCity. 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. Employees eligible The City agrees to receive City-provided medical insurance coverage, either a Family Plan or a Single Plan, may elect meet with the Union at least once per year to decline such coverage discuss benefits and in lieu thereof receive cash payments from the City of $3,000 per year. However, if the $3,000 cash payment in lieu of coverage creates an affordability calculation penalty for the City and/or Cadillac excise tax liability under the Affordable Care Act, the City shall have the ability to then eliminate said cash payment. In order to qualify for such cash payments, an employee must remain covered by other medical insurance that is not from the City, COBRA, Medicare or as a dependent under a parental plan, and must provide acceptable proof of such other medical insurance coverage to the City. The timing of when an employee may elect to receive such cash payments, in lieu of medical insurance coverage, is subject to provisions of the City’s Medical Plan, Flexible Spending Account Plan Document and applicable provisions of IRS Section 125plan performance.

Appears in 1 contract

Samples: Collective Bargaining Agreement

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- 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. The City shall pay 90% and the employee shall pay 10% of the premium for the Dental Insurance Plan. Effective as of January 1, 20182016, 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. Effective January 1, 2018 2015 and 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 Patrol OfficersFirefighters. Effective January 1, 2018 2015 the City will fund 6575% of the employee’s High Deductible Platinum Health Plan network deductible by placing $13001500/yr. single and $26003000/yr. family into a Health Savings Account (HSA). Effective January 1, 2019 2016 the City will fund the employee’s HSA at no less than 65% of the network deductible of the High Deductible Health Plan (other plans excluded). Effective January 1, 2017 the City will fund the employee’s HSA at no less than 60% of the network deductible of the High Deductible Platinum Health Plan (other plans excluded). In the event it is necessary in insurance plan year 2019, 2020 and/or 2021 2018 to reduce the City’s share of the HSA funding on the High Deductible Platinum Health 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%. The network deductible of the High Deductible Health Plan shall not exceed $2500 for a single plan and $5000 for a family plan for plan years 2019, 2020 2016 and 20212017. HSA’s will be funded quarterly 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 fourth quarter 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 will be enrolled in a Health Reimbursement Account (HRA) or Health Savings Account (HSA) at the discretion of the City. In the event an employee is placed in an HRA, with similar amounts will be available for reimbursement similar to as those specified for HSA accounts above. At , but 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 an 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 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. Employees eligible to receive City-provided medical insurance coverage, either a Family Plan or a Single Plan, may elect to decline such coverage and in lieu thereof receive cash payments from the City of $3,000 per year. However, if the $3,000 cash payment in lieu of coverage creates an affordability calculation penalty for the City and/or Cadillac excise tax liability under the Affordable Care Act, the City shall have the ability to then eliminate said cash payment. In order to qualify for such cash payments, an employee must remain covered by other medical insurance that is not from the City, COBRA, Medicare or as a dependent under a parental plan, and must provide acceptable proof of such other medical insurance coverage to the City. The timing of when an employee may elect to receive such cash payments, in lieu of medical insurance coverage, is subject to provisions of the City’s Medical Plan, Flexible Spending Account Plan Document and applicable provisions of IRS Section 125.

Appears in 1 contract

Samples: Collective Bargaining Agreement

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