Common use of HEALTH CARE, DENTAL CARE Clause in Contracts

HEALTH CARE, DENTAL CARE. LIFE INSURANCE LONG-TERM DISABILITY INSURANCE AND LONG-TERM CARE‌ 12.1 The City shall provide medical, dental, and vision plans (with Kaiser Standard, Kaiser Deductible, Aetna Traditional, Aetna Preventive, and Delta Dental of Washington as self-insured plans, and Dental Health Services and Vision Services Plan) for all regular employees (and eligible dependents) represented by unions that are a party to the Memorandum of Agreement established to govern the plans. The selection, addition and/or elimination of medical, dental and vision benefit plans, and changes to such plans including, but not limited to, changes in benefit levels, co-pays and premiums, shall be established through the Labor- Management Health Care Committee in accordance with the provisions of the Memorandum of Agreement established to govern the functioning of said Committee. 12.1.1 The parties agree to continue the terms of the Memorandum of Agreement previously established by the parties in 2007 to govern the Joint Labor- Management Health Care Committee process (which shall be attached hereto as Appendix D and by reference is incorporated herein) as follows: a) The City shall pay up to one hundred seven percent (107%) of the City’s previous year’s costs to the extent required to cover increases in the total health care costs for a given program year (e.g. 2019, 2020 or 2021); b) The RSF shall be utilized for any given program year until it is exhausted to cover costs in excess of the City’s obligation identified in 1, above; c) After the RSF has been exhausted, additional costs shall be shared by the City paying eighty-five percent (85%) of the excess costs and employees paying fifteen percent (15%) of the excess costs; d) Intent: Plan designs are to be maintained during this Contract, not to be diminished. The respective health care plan benefit designs may only be modified by the Health Care Committee for either contract year by the written, mutual agreement of the parties (Coalition of City Unions and the City); e) Intent: Should the parties agree to reduce premium costs, the reduction would apply to City as well as employee premiums. Use of resources from the RSF during either contract year to reduce projected increase in health care costs that exceed the resources provided through 1, above, shall be authorized only if applied to the total, annual premiums of the respective health care plan(s); and f) No decision by the Health Care Committee shall be permitted that modifies the established percentages established in c), above. 12.2 Employees who retire and are under the age of 65 shall be eligible to enroll in retiree medical plans that are experience-rated with active employees.

HEALTH CARE, DENTAL CARE. LIFE INSURANCE LONG-LONG TERM DISABILITY INSURANCE AND LONG-LONG TERM CARE‌CARE 12.1 The City shall provide medical, dental, and vision plans (with Kaiser Standard, Kaiser Deductibleinitially Group Health, Aetna Traditional, Aetna Preventive, and Delta Washington Dental of Washington Services as self-self- insured plans, and Dental Health Services and Vision Services Plan) for all regular employees (and eligible dependents) represented by unions that are a party to the Memorandum of Agreement established to govern the plans. The selection, addition and/or elimination of medical, dental and vision benefit plans, and changes to such plans including, but not limited to, changes in benefit levels, co-pays and premiums, shall be established through the Labor- Management Health Care Committee in accordance with the provisions of the Memorandum of Agreement established to govern the functioning of said Committee. 12.1.1 The parties agree to continue the terms of the Memorandum of Agreement previously established by the parties in 2007 to govern the Joint Labor- Management Health Care Committee process (which shall be attached hereto as Appendix D and by reference is incorporated herein) as follows: a) The City shall pay up to one hundred seven percent (107%) of the City’s previous year’s costs to the extent required to cover increases in the total health care costs for a given program year (e.g. 20192009, 2020 or 20212010); b) The RSF shall be utilized for any given program year until it is exhausted to cover costs in excess of the City’s obligation identified in 1, above; c) After the RSF has been exhausted, additional costs shall be shared by the City paying eighty-five percent (85%) of the excess costs and employees paying fifteen percent (15%) of the excess costs; d) Intent: Plan designs are to be maintained during this Contract, not to be diminished. The respective health care plan benefit designs may only be modified by the Health Care Committee for either contract year by the written, mutual agreement of the parties (Coalition of City Unions and the City); e) Intent: Should the parties agree to reduce premium costs, the reduction would apply to City as well as employee premiums. Use of resources from the RSF during either contract year to reduce projected increase in health care costs that exceed the resources provided through 1, above, shall be authorized only if applied to the total, annual premiums of the respective health care plan(s); and f) No decision by the Health Care Committee shall be permitted that modifies the established percentages established in c), above. 12.2 Employees who retire and are under the age of 65 shall be eligible to enroll in retiree medical plans that are experience-rated with active employees.

HEALTH CARE, DENTAL CARE. LIFE INSURANCE LONG-INSURANCE, AND LONG TERM DISABILITY INSURANCE AND LONG-TERM CARE‌INSURANCE 12.1 The 14.1 Effective January 1, 2015, the City shall provide medical, dental, and vision plans (with Kaiser Standard, Kaiser Deductibleinitially Group Health, Aetna Traditional, Traditional and Aetna Preventive, and Delta Dental of Washington Preventive as self-insured plans, and Washington Dental Health Services Service, Willamette Dental Service and Vision Services Plan) for all regular employees (and eligible dependents) represented by unions that are a party to the Memorandum of Agreement established to govern the plans. The For calendar years 2015, 2016, 2017 and 2018, the selection, addition and/or elimination of medical, dental and vision benefit plans, and changes to such plans including, but not limited to, changes in benefit levels, co-pays copays and premiums, shall be established through the Labor- Management Health Care Committee in accordance with the provisions of the Memorandum of Agreement established to govern the functioning of said Committee. 12.1.1 14.2 For the 2008 contract term, employee premium sharing and the status of the Rate Stabilization Fund shall be maintained as determined by the Health Care Committee at the last meeting of the Committee in September, 2004. In addition, The City will pay the equivalent of $1 million, annualized, for the following enhanced benefits implemented in 2005, which shall become a part of the “base” determined by HC2. Further, the parties agree that eleven thousand dollars ($11,000) shall be utilized from the “Special” Rate Stabilization Fund (RSF) for the purpose of paying Aon Consulting to complete an analysis of the City’s self-insured claims experience to identify potential Wellness and Disease Management Programs that would be best targeted to address the City’s claims experience. Also, the parties commit to support Wellness and Disease Management Programs identified as a result of the Aon study for implementation in 2006, utilizing “Special” RSF through the Health Care Committee processes. 14.3 The parties agree to continue amend for the terms of 2015 - 2018 contract years the Memorandum of Agreement previously established by the parties in 2007 to govern the Joint Labor- Labor-Management Health Care Committee process (which shall be attached hereto as Appendix D Exhibit 1 and by reference is incorporated herein) as follows: a) A. The City shall pay up to one hundred seven percent (107%) % of the City’s previous year’s costs to the extent required to cover increases in the total health care costs for a given program year (e.g. 2019e.g., 2020 2015 or 20212016); b) B. The RSF shall be utilized for any given program year until it is exhausted to cover costs in excess of the City’s obligation identified in 1, above; c) C. After the RSF has been exhausted, additional costs shall be shared by the City paying eighty-five percent (85%) of the excess costs and employees paying fifteen percent (15%) of the excess costs; d) D. Intent: Plan designs are to be maintained during this Contract, not to be diminished. The respective health care plan benefit designs may only be modified by the Health Care Committee for either contract year by the written, mutual agreement of the parties (Coalition of City Unions and the City); e) Intent: Should the parties agree to reduce premium costs, the reduction would apply to City as well as employee premiums. Use of resources from the RSF during either contract year to reduce projected increase in health care costs that exceed the resources provided through 1, above, shall be authorized only if applied to the total, annual premiums of the respective health care plan(s); and f) No decision by the Health Care Committee shall be permitted that modifies the established percentages established in c), above. 12.2 Employees who retire and are under the age of 65 shall be eligible to enroll in retiree medical plans that are experience-rated with active employees.

HEALTH CARE, DENTAL CARE. LIFE INSURANCE LONG-TERM DISABILITY INSURANCE AND LONG-TERM CARE‌ 12.1 (a) The City School Committee shall provide medicalall certified/licensed personnel with Medical and Dental insurance with benefits and coverage network equivalent to the benefits and coverages provided by the 100/80/250 Coinsurance Plan and the dental plan in effect at the time of the execution of this agreement. The summaries of these plans and their benefits for are appended to this agreement as Appendix J and incorporated herein by reference. The Committee shall further continue to provide all health care, dentaldental and/or prescription riders which were in effect at the time of the execution of this agreement. (b) The Committee shall provide family coverage to all certified/licensed personnel who are married, party to a civil union, have a domestic partner, have dependent children, and/or who are otherwise eligible. (c) Certified/Licensed personnel shall pay the following co-shares annually toward the cost of health care premiums: (d) The School Committee agrees to make available to all certified licensed personnel on leave of absence all health and dental benefits available under this Contract at no cost to the Pawtucket School Department. (e) Effective October 31, 2003 no person covered by this agreement may join Classic Blue Cross as a Health Care Plan. Any person covered by Classic Blue Cross on that date may continue their coverage. (f) The School Committee may change health care/dental care plan providers only if each of the following criteria are met: i. The new plan provider shall provide coverage for all pre-existing conditions covered under the previous plan of all certified/licensed personnel. ii. The specific benefits and coverages afforded shall be at least equal to the benefits which are presently provided by the Committee. iii. The extent of the choice of participating health and/or dental providers, including physicians, under any new plan shall not be substantially less than the choices available to the bargaining unit members under the plan(s) in effect at the time of the change. iv. All other aspects of the plan provided by the new health care/dental care plan provider must be at least substantially equivalent to the plan(s) in effect at the time of the change. (g) In the event that the School Committee seeks to change health care/dental care plan providers, it shall provide notice in writing, and vision plans all relevant documentation regarding benefits, coverages and coverage network afforded by the proposed new provider, to the Alliance, no later than ninety (90) days prior to the proposed effective date of the change. In the event that the Alliance does not believe that the proposed plan meets the criteria set forth above, it may demand arbitration by providing notice to the Committee in writing, no later than forty-five (45) days after receiving the notice of the proposed change. The arbitration shall be conducted pursuant to the expedited arbitration rules of the American Arbitration Association. The arbitrator selected shall have experience with Kaiser Standardhealth care issues and shall render a decision within thirty (30) days of the expedited hearing. No change to the health/dental providers shall be implemented until the arbitration process is complete and unless permitted by the arbitrator’s award. Timelines regarding arbitration contained in this subsection may be enlarged by written agreement of the parties. (h) The School Committee agrees to a paid life insurance plan in the amount of $50,000 for all certified/licensed personnel (i) Upon expiration of sick leave, Kaiser Deductiblethe School Committee agrees to provide health and dental insurance and life insurance for certified/licensed personnel who are ill, Aetna Traditionaluntil September 30th of the following school year. The extent of these benefits will be the same as that provided active certified/licensed personnel no on sick leave. (j) A certified/licensed personnel who has been in the Pawtucket School System for fifteen (15) years or more and is eligible to retire under the Rhode Island Teachers’ Retirement System shall receive all health and dental benefits afforded current employees. This benefit shall extend until the retired teacher is eligible for coverage under Medicare. (k) Effective with the 2009-2010 school year, Aetna PreventiveBuy Back of medical coverage is optional for everyone. An active certified/licensed personnel who so chooses shall have the option of receiving payment in the amount of three thousand ($3000) dollars in lieu of family medical/dental coverage, and Delta Dental one thousand, five hundred ($1500) dollars in lieu of Washington as selfindividual medical/dental coverage. Payment will be made by the end of the months indicated in the following schedule: Policy Period Payment School Year 2017-insured plans2018 2018-2019 2019-2020 Oct.-Dec. 1 Dec., and Dental Health Services and Vision Services Plan2017 Dec., 2018 Dec., 2019 Jan.-March 2 Mar., 2018 Mar., 2019 Mar., 2020 April-June 3 June, 2018 June, 2019 June, 2020 July-Sept. 4 Sept.,2018 Sept.,2019 Sept. 2020 Any change in family status (death, divorce, separation, etc.) for all regular employees (and eligible dependents) represented by unions that are a party to of the Memorandum certified/licensed personnel will result in reinstatement of Agreement established to govern the plans. The selection, addition and/or elimination of medical, dental and vision benefit plans, and changes to such plans including, but not limited to, changes in benefit levels, co-pays and premiums, shall be established through the Labor- Management Health Care Committee coverage in accordance with the provisions of the Memorandum of Agreement established to govern the functioning of said Committee. 12.1.1 The parties agree to continue the terms of the Memorandum of Agreement previously established by the parties in 2007 to govern the Joint Labor- Management Health Care Committee process plan. A Peer Assistance & Review Program (which shall PAR) will be attached hereto as Appendix D reviewed for consideration and by reference is incorporated herein) as follows: a) The City shall pay up to one hundred seven percent (107%) of the City’s previous year’s costs to the extent required to cover increases possible implementation in the total Pawtucket School Department. Should a Peer Assistance and Review program be implemented in the Pawtucket School Department, it may, with a thirty (30) day notice, be cancelled by either the Pawtucket School Department or the Pawtucket Teachers’ Alliance. Double family coverage is eliminated where two certified/licensed personnel are in a relationship which would qualify them for family health care costs and dental coverage. In the event that the couple selects a single family plan, they shall receive the appropriate buy back for a given program year (e.g. 2019, 2020 or 2021); b) The RSF shall be utilized for any given program year until it is exhausted to cover costs in excess of the City’s obligation identified in 1, above; c) After certified/licensed member who does not carry the RSF has been exhausted, additional costs shall be shared by the City paying eighty-five percent (85%) of the excess costs and employees paying fifteen percent (15%) of the excess costs; d) Intent: Plan designs are to be maintained during this Contract, not to be diminishedcoverage. The respective health care plan benefit designs may only be modified by the Health Care Committee for either contract year by the written, mutual agreement of the parties (Coalition of City Unions and the City); e) Intent: Should the parties agree to reduce premium costs, the reduction would apply to City as well as employee premiums. Use of resources from the RSF during either contract year to reduce projected increase in health care costs that exceed the resources provided through 1, above, couple shall be authorized only if applied to the total, annual premiums of the respective health care plan(s); and f) No decision by the Health Care Committee shall also be permitted that modifies the established percentages established to elect two individual health plans, in c), abovelieu of a family plan. 12.2 Employees who retire and are under the age of 65 shall be eligible to enroll in retiree medical plans that are experience-rated with active employees.

HEALTH CARE, DENTAL CARE. LIFE INSURANCE LONG-TERM DISABILITY INSURANCE AND LONG-TERM CARE‌ 12.1 (a) The City School Committee shall provide medicalall certified/licensed personnel with Medical and Dental insurance with benefits and coverage network equivalent to the benefits and coverages provided by the 100/80/250 Coinsurance Plan and the dental plan in effect at the time of the execution of this agreement. The summaries of these plans and their benefits for are appended to this agreement as Appendix J and incorporated herein by reference. The Committee shall further continue to provide all health care, dentaldental and/or prescription riders which were in effect at the time of the execution of this agreement. (b) The Committee shall provide family coverage to all certified/licensed personnel who are married, party to a civil union, have a domestic partner, have dependent children, and/or who are otherwise eligible. (c) Certified/Licensed personnel shall pay the following co-shares annually toward the cost of health care premiums: 2014-2015 2015-2016 2016-2017 13% 15% 17% (d) The School Committee agrees to make available to all certified licensed personnel on leave of absence all health and dental benefits available under this Contract at no cost to the Pawtucket School Department. (e) Effective October 31, 2003 no person covered by this agreement may join Classic Blue Cross as a Health Care Plan. Any person covered by Classic Blue Cross on that date may continue their coverage. (f) The School Committee may change health care/dental care plan providers only if each of the following criteria are met: i. The new plan provider shall provide coverage for all pre-existing conditions covered under the previous plan of all certified/licensed personnel. ii. The specific benefits and coverages afforded shall be at least equal to the benefits which are presently provided by the Committee. iii. The extent of the choice of participating health and/or dental providers, including physicians, under any new plan shall not be substantially less than the choices available to the bargaining unit members under the plan(s) in effect at the time of the change. iv. All other aspects of the plan provided by the new health care/dental care plan provider must be at least substantially equivalent to the plan(s) in effect at the time of the change. (g) In the event that the School Committee seeks to change health care/dental care plan providers, it shall provide notice in writing, and vision plans all relevant documentation regarding benefits, coverages and coverage network afforded by the proposed new provider, to the Alliance, no later than ninety (90) days prior to the proposed effective date of the change. In the event that the Alliance does not believe that the proposed plan meets the criteria set forth above, it may demand arbitration by providing notice to the Committee in writing, no later than forty-five (45) days after receiving the notice of the proposed change. The arbitration shall be conducted pursuant to the expedited arbitration rules of the American Arbitration Association. The arbitrator selected shall have experience with Kaiser Standardhealth care issues and shall render a decision within thirty (30) days of the expedited hearing. No change to the health/dental providers shall be implemented until the arbitration process is complete and unless permitted by the arbitrator’s award. Timelines regarding arbitration contained in this subsection may be enlarged by written agreement of the parties. (h) The School Committee agrees to a paid life insurance plan in the amount of $50,000 for all certified/licensed personnel (i) Upon expiration of sick leave, Kaiser Deductiblethe School Committee agrees to provide health and dental insurance and life insurance for certified/licensed personnel who are ill, Aetna Traditionaluntil September 30th of the following school year. The extent of these benefits will be the same as that provided active certified/licensed personnel no on sick leave. (j) A certified/licensed personnel who has been in the Pawtucket School System for fifteen (15) years or more and is eligible to retire under the Rhode Island Teachers’ Retirement System shall receive all health and dental benefits afforded current employees. This benefit shall extend until the retired teacher is eligible for coverage under Medicare. (k) Effective with the 2009-2010 school year, Aetna PreventiveBuy Back of medical coverage is optional for everyone. An active certified/licensed personnel who so chooses shall have the option of receiving payment in the amount of three thousand ($3000) dollars in lieu of family medical/dental coverage, and Delta Dental one thousand, five hundred ($1500) dollars in lieu of Washington as selfindividual medical/dental coverage. Payment will be made by the end of the months indicated in the following schedule: Policy Period Payment School Year 2014-insured plans2015 2015-2016 2016-2017 Oct.-Dec. 1 Dec., and Dental Health Services and Vision Services Plan2014 Dec., 2015 Dec., 2016 Jan.-March 2 Mar., 2015 Mar., 2016 Mar., 2017 April-June 3 June, 2015 June, 2016 June, 2017 July-Sept. 4 Sept.,2015 Sept.,2016 Sept. 2017 Any change in family status (death, divorce, separation, etc.) for all regular employees (and eligible dependents) represented by unions that are a party to of the Memorandum certified/licensed personnel will result in reinstatement of Agreement established to govern the plans. The selection, addition and/or elimination of medical, dental and vision benefit plans, and changes to such plans including, but not limited to, changes in benefit levels, co-pays and premiums, shall be established through the Labor- Management Health Care Committee coverage in accordance with the provisions of the Memorandum of Agreement established to govern the functioning of said Committee. 12.1.1 The parties agree to continue the terms of the Memorandum of Agreement previously established by the parties in 2007 to govern the Joint Labor- Management Health Care Committee process plan. A Peer Assistance & Review Program (which shall PAR) will be attached hereto as Appendix D reviewed for consideration and by reference is incorporated herein) as follows: a) The City shall pay up to one hundred seven percent (107%) of the City’s previous year’s costs to the extent required to cover increases possible implementation in the total Pawtucket School Department. Should a Peer Assistance and Review program be implemented in the Pawtucket School Department, it may, with a thirty (30) day notice, be cancelled by either the Pawtucket School Department or the Pawtucket Teachers’ Alliance. Double family coverage is eliminated where two certified/licensed personnel are in a relationship which would qualify them for family health care costs and dental coverage. In the event that the couple selects a single family plan, they shall receive the appropriate buy back for a given program year (e.g. 2019, 2020 or 2021); b) The RSF shall be utilized for any given program year until it is exhausted to cover costs in excess of the City’s obligation identified in 1, above; c) After certified/licensed member who does not carry the RSF has been exhausted, additional costs shall be shared by the City paying eighty-five percent (85%) of the excess costs and employees paying fifteen percent (15%) of the excess costs; d) Intent: Plan designs are to be maintained during this Contract, not to be diminishedcoverage. The respective health care plan benefit designs may only be modified by the Health Care Committee for either contract year by the written, mutual agreement of the parties (Coalition of City Unions and the City); e) Intent: Should the parties agree to reduce premium costs, the reduction would apply to City as well as employee premiums. Use of resources from the RSF during either contract year to reduce projected increase in health care costs that exceed the resources provided through 1, above, couple shall be authorized only if applied to the total, annual premiums of the respective health care plan(s); and f) No decision by the Health Care Committee shall also be permitted that modifies the established percentages established to elect two individual health plans, in c), abovelieu of a family plan. 12.2 Employees who retire and are under the age of 65 shall be eligible to enroll in retiree medical plans that are experience-rated with active employees.