Common use of HEALTH BENEFITS "OPT OUT" Clause in Contracts

HEALTH BENEFITS "OPT OUT". An employee who has health benefit coverage through a spouse or from another source and who can demonstrate same to the Business Administrator, may elect to forego all or a portion of his/her health benefit coverage for a full school year and receive a cash payment of twenty-five percent (25%) of the premium savings or $5,000.00, whichever is the lesser, to the Board of Education on June 30th of the school year. Said payment will not be considered salary, nor will it be considered pensionable. The Board shall establish an IRS Section 125 plan. The individual unit member shall be responsible for any tax liability. The employee shall complete the forms by which an employee shall waive coverage and apply for payment. (See attached Waiver of Health Benefits form) An employee who has waived all or a portion of his/her health benefit coverage will be allowed to restore such coverage on an immediate basis, without the necessity of a health questionnaire for the employee or his/her family members, in the event of a hardship or change of life event. Reentry into all health benefit coverage for reason of hardship or change of life applies only in the following situations, which result in the loss of health benefits coverage through the employee's spouse or other source: Termination of employment (proof of termination of benefits required) Legal Separation (a copy of decree is required) Group contract/policy terminated (proof of termination of benefits required) Disability of spouse which eliminates benefits (proof of termination of benefits required) Divorce (a copy of the decree is required) Death of Spouse (a copy of death certificate is required) Military Discharge (a copy of DD214 is required) In addition, any employee who has waived all his/her health benefit coverage may automatically restore his/her coverage by applying during the open enrollment period during any school year. The reinstatement date under such conditions will be April 1. It will not be necessary for any employee or his/her family members to complete a Statement of Health (proof of insurability) to restore coverage during the open enrollment period.

HEALTH BENEFITS "OPT OUT". An employee who has health benefit coverage through a spouse or from another source and who can demonstrate same to the Business Administrator, may elect to forego all or a portion of his/her health benefit coverage for a full school year and receive a cash payment of twenty-five percent (25%) of the premium savings or $5,000.003,000.00, whichever is the lesser, to the Board of Education on June 30th of the school year. Said payment will not be considered salary, nor will it be considered pensionable. The Board shall establish an IRS Section 125 plan. The individual unit member shall be responsible for any tax liability. The employee shall complete the forms by which an employee shall waive coverage and apply for payment. (See attached Waiver of Health Benefits form.) An employee who has waived all or a portion of his/her health benefit coverage will be allowed to restore such coverage on an immediate basis, without the necessity of a health questionnaire for the employee or his/her family members, in the event of a hardship or change of life event. Reentry into all health benefit coverage for reason of hardship or change of life applies only in the following situations, which result in the loss of health benefits coverage through the employee's spouse or other source: • Termination of employment (proof of termination of benefits required) • Legal Separation (a copy of decree is required) • Group contract/policy terminated (proof of termination of benefits required) • Disability of spouse which eliminates benefits (proof of termination of benefits required) Divorce (a copy of the decree is required) • Death of Spouse (a copy of death certificate is required) • Military Discharge (a copy of DD214 is required) In addition, any employee who has waived all his/her health benefit coverage may automatically restore his/her coverage by applying during the open enrollment period during any school year. The reinstatement date under such conditions will be April 1. It will not be necessary for any employee or his/her family members to complete a Statement of Health (proof of insurability) to restore coverage during the open enrollment period.

HEALTH BENEFITS "OPT OUT". An employee who has health benefit coverage through a spouse or from another source and who can demonstrate same to the Business Administrator, may elect to forego all or a portion of his/her health benefit coverage for a full school year and receive a cash payment of twenty-five percent (25%) of the premium savings or $5,000.00, whichever is the lesser, to the Board of Education on June 30th of the school year. Said payment will not be considered salary, nor will it be considered pensionable. The Board shall establish an IRS Section 125 plan. The individual unit member shall be responsible for any tax liability. The employee shall complete the forms by which an employee shall waive coverage and apply for payment. (See attached Waiver of Health Benefits form) An employee who has waived all or a portion of his/her health benefit coverage will be allowed to restore such coverage on an immediate basis, without the necessity of a health questionnaire for the employee or his/her family members, in the event of a hardship or change of life event. Reentry into all health benefit coverage for reason of hardship or change of life applies only in the following situations, situations which result in the loss of health benefits coverage through the employee's spouse or other source: Termination of employment (proof of termination of benefits required) Legal Separation (a copy of decree is required) Group contractcontact/policy terminated (proof of termination of benefits required) Disability of spouse which eliminates benefits (proof of termination of benefits required) Divorce (a copy of the decree is required) Death of Spouse (a copy of death certificate is required) Military Discharge (a copy of DD214 is required) In addition, any employee who has waived all his/her health benefit coverage may automatically restore his/her coverage by applying during the open enrollment period during any school year. The reinstatement date under such conditions will be April 1. It will not be necessary for any employee or his/her family members to complete a Statement of Health (proof of insurability) to restore coverage during the open enrollment period.

HEALTH BENEFITS "OPT OUT". An employee who has health benefit coverage through a spouse or from another source and who can demonstrate same to the Business Administrator, may elect to forego all or a portion of his/her health benefit coverage for a full school year and receive a cash payment of twenty-five percent (25%) of the premium savings or $5,000.00, whichever is the lesser, to the Board of Education on June 30th of the school year. Said payment will not be considered salary, nor will it be considered pensionable. The Board shall establish an IRS Section 125 plan. The individual unit member shall be responsible for any tax liability. The employee shall complete the forms by which an employee shall waive coverage and apply for payment. (See attached Waiver of Health Benefits form) An employee who has waived all or a portion of his/her health benefit coverage will be allowed to restore such coverage on an immediate basis, without the necessity of a health questionnaire for the employee or his/her family members, in the event of a hardship or change of life event. Reentry into all health benefit coverage for reason of hardship or change of life applies only in the following situations, which result in the loss of health benefits coverage through the employee's spouse or other source: Termination of employment (proof of termination of benefits required) Legal Separation (a copy of decree is required) Group contractcontact/policy terminated (proof of termination of benefits required) Disability of spouse which eliminates benefits (proof of termination of benefits required) Divorce (a copy of the decree is required) Death of Spouse (a copy of death certificate is required) Military Discharge (a copy of DD214 is required) In addition, any employee who has waived all his/her health benefit coverage may automatically restore his/her coverage by applying during the open enrollment period during any school year. The reinstatement date under such conditions will be April 1. It will not be necessary for any employee or his/her family members to complete a Statement of Health (proof of insurability) to restore coverage during the open enrollment period.

HEALTH BENEFITS "OPT OUT". An employee who has health benefit coverage through a spouse or from another source and who can demonstrate same to the Business Administrator, may elect to forego all or a portion of his/her health benefit coverage for a full school year and receive a cash payment of twenty-five percent (25%) of the premium savings or $5,000.00, whichever is the lesser, to the Board of Education Education, not to exceed five thousand dollars ($5,000), on June 30th of the school year. Said payment will not be considered salary, nor will it be considered pensionable. The Board shall establish an IRS Section 125 plan. The individual unit member shall be responsible for any tax liability. The employee shall complete the forms by which an employee shall waive coverage and apply for payment. (See attached Waiver of Health Benefits form) An employee who has waived all or a portion of his/her health benefit coverage will be allowed to restore such coverage on an immediate basis, without the necessity of a health questionnaire for the employee or his/her family members, in the event of a hardship or change of life event. Reentry into all health benefit coverage for reason of hardship or change of life applies only in the following situations, situations which result in the loss of health benefits coverage through the employee's spouse or other source: Termination of employment (proof of termination of benefits required) Legal Separation (a copy of decree is required) Group contractcontact/policy terminated (proof of termination of benefits required) Disability of spouse which eliminates benefits (proof of termination of benefits required) Divorce (a copy of the decree is required) Death of Spouse (a copy of death certificate is required) Military Discharge (a copy of DD214 is required) In addition, any employee who has waived all his/her health benefit coverage may automatically restore his/her coverage by applying during the open enrollment period during any school year. The reinstatement date under such conditions will be April 1. It will not be necessary for any employee or his/her family members to complete a Statement of Health (proof of insurability) to restore coverage during the open enrollment period.

HEALTH BENEFITS "OPT OUT". An employee who has health benefit coverage through a spouse or from another source and who can demonstrate same to the Business Administrator, may elect to forego all or a portion of his/her health benefit coverage for a full school year and receive a cash payment of twenty-five percent (25%) of the premium savings or $5,000.00, whichever is the lesser, to the Board of Education Education, not to exceed five thousand dollars ($5,000), on June 30th of the school year. Said payment will not be considered salary, nor will it be considered pensionable. The Board shall establish an IRS Section 125 plan. The individual unit member shall be responsible for any tax liability. The employee shall complete the forms by which an employee shall waive coverage and apply for payment. (See attached Waiver of Health Benefits form) An employee who has waived all or a portion of his/her health benefit coverage will be allowed to restore such coverage on an immediate basis, without the necessity of a health questionnaire for the employee or his/her family members, in the event of a hardship or change of life event. Reentry into all health benefit coverage for reason of hardship or change of life applies only in the following situations, which result in the loss of health benefits coverage through the employee's spouse or other source: Termination of employment (proof of termination of benefits required) Legal Separation (a copy of decree is required) Group contractcontact/policy terminated (proof of termination of benefits required) Disability of spouse which eliminates benefits (proof of termination of benefits required) Divorce (a copy of the decree is required) Death of Spouse (a copy of death certificate is required) Military Discharge (a copy of DD214 is required) In addition, any employee who has waived all his/her health benefit coverage may automatically restore his/her coverage by applying during the open enrollment period during any school year. The reinstatement date under such conditions will be April 1. It will not be necessary for any employee or his/her family members to complete a Statement of Health (proof of insurability) to restore coverage during the open enrollment period.