Health Care Insurance Protection Sample Clauses

Health Care Insurance Protection. A. The Board shall provide the following health care insurance.
AutoNDA by SimpleDocs
Health Care Insurance Protection. A. The Board shall provide the following health care insurance. 1. All employees shall receive full family health insurance coverage under the Cross/Blue Shield-Horizon Point of Service plan, or the New Jersey School Employees Health Benefits Plan Direct 10. In the event the Board decides to change carriers, the proposed new plan shall be submitted to the Association for review at least sixty (60) days before implementation. 2. All active employees and their spouses who are covered under Part B of the Federal Medicare Program shall receive a refund on the basic amount paid for timely enrollment in Part B. 3. The Board shall make available to each employee a description of the health-care insurance coverage provided under this ARTICLE which shall include a clear description of conditions and limits of coverage as listed above. 4. The health care insurance coverage shall include a non-binding second medical opinion for elective surgery at no cost to the administrator. The coverage shall also include a comprehensive major medical component with deductibles of $250 for employees and $500 for families. Co-insurance payments by employees shall be 20%, up to $3,000.00. B. The Board shall provide a prescription plan for each employee. The Board shall pay the full premium for individual or family coverage, if applicable with a $10 for mail order, $5 for generic drugs and $20 for name brands co-pay provision at participating pharmacies and it is the responsibility of the individual employee to remit the co-pay portion of the plan. When a generic alternative is available, the Plan only covers the cost of the generic medication. If a member chooses to get the name-brand medication, when a generic is available, the member must pay the generic co-pay, plus the difference in cost between the generic and the name-brand medication. C. The prescription plan and the comprehensive major medical coverage described hereinabove shall not permit any "flow through" of the co-pay portion of the employee's payment to the major medical portion of insurance coverage. D. In addition to the co-pays required in the current coverage plans, all employees shall make contributions towards health insurance premiums, through payroll deductions, in the amount prescribed by current law in each year of this Agreement.
Health Care Insurance Protection. A. Health Benefits Effective July 1, 2008 the Board shall provide the Healthcare Insurance designated below: A Preferred Provider Organization (PPO) Plan will be offered to all eligible employees and their dependents for the July 1, 2001 to June 30, 2002 year. Thereafter, 20% of any premium rate increase from the Insurance Company will be paid by the employees. The Board will pay the remainder of the premium until June 30, 2011. Effective July 1, 2008, the PPO Plan office visit copay will remain at $15.00. As of July 1, 2007, the new employee contribution schedule will be based on 20% of the difference between the July 1, 2004 PPO PLAN Base Rates and the July 1, 2007 policy period rates. The employee contributions will be frozen until June 30, 2010. Effective June 30, 2011 contributions will be 20% of the difference between the July 1, 2007 policy period rates and the July 1, 2011 policy period renewal rates A Point of Service Plan (POS) will continue to be offered to all eligible employees as an alternative to the PPO Plan above at no extra cost to the employee. If in any subsequent year the POS Plan rates exceed the 1998, - 99 PPO Plan rates, employees will be required to pay 20% of the premium that exceeds the 2001-2002 PPO rates. Effective July 1, 2005, the POS Plan employee contributions will be eliminated and the POS Plan will be provided free to employees, as long as the average cost of the POS Plan remains below the average cost of the HMO Plan. The average cost of both the POS and HMO Plans will be calculated as follows: Add all four
Health Care Insurance Protection. A. Health Benefits Effective July 1, 2002, the Board shall provide the healthcare insurance designated below: -Blue Card PPO Plan will be offered to all eligible employees (and their dependents). Using 2001-2002 as a base for the premium dollars, twenty percent (20%) of any premium rate increase from the Insurance Company will be paid by the employees in subsequent years. The Board will pay the remainder of the premium. An outline of the PPO Plan is shown in Exhibit A. - Blue Card Point of Service (POS) Plan will continue to be offered to all eligible employees as an alternative to the PPO Plan. If in any subsequent year, the Blue Card POS rates exceed the 2001-2002 PPO rates, employees will be required to pay 20% of the premium that exceeds the 2001-2002 PPO rates. -The existing Aetna/US Healtchare HMO will continue to be offered. These HMOs are: Aetna/US Healthcare and Blue Cross Blue Shield PPO/POS Plan If at any time there are less than 5 employees enrolled in any of these Plans, the Board will have the right to cancel that Plan as of the following July 1st. Employees will be required to pay the difference in premium (if any) between the PPO Plan and the HMO in which they are enrolled. The Pre-Admission Certification Review maximum penalty is $400.00 per incident. Deductible (Total combined per year) Hospital/Facility Professional/Supplemental None $200 single $400 family Coinsurance Hospital/Facility Professional Supplemental 100% 100% 80% (R&C) 80% (R&C) 80% (R&C) Catastrophic Limit (Svcs. reimbursed at 100% after limit is reached) None $2,000 per individual/ two individuals per family. Maximums Benefit period/Lifetime Unlimited Unlimited Out-of-pocket Protection 100% 80% after ded. of Single $400 Family $800 Room & Board (Semi-Private) 100% 80% after ded. Intensive Care & Other Hospital Services (therapy/diagnostic services, blood administration, general nursing, operating room, etc.) 100% 80% after ded. Maternity Benefits 100% after $10 copay 80% after ded. Organ Transplant (includes ABMT) 100% 80% after ded. Outpatient Services Routine Medical Care 100% $10 copay 80% after ded. (R & C) Hosptial Services (Operating room, gen. nursing, therapy/diagnostic, etc.) 100% 80% after ded. Blood Administration 80% after ded. Pre-Admission Testing 100% 80% after ded. Medical Emergency/Accidental Injury 100% after $25 copay 80% after ded. Surgical Center 100% 80% after ded. B. Dental Plan Effective July 1, 2002, each employee shall receive dental coverage from...
Health Care Insurance Protection. A. The Board shall provide the health care insurance protection designated below. The Board shall pay the full premium for each employee for point of service (POS), full family health insurance coverage. 1. All active employees and their spouses who are covered under Part B of the Federal Medicare Program shall receive a refund on the basic amount paid for timely enrollment in Part B. 2. The health insurance carrier shall be Horizon Blue Cross/Blue Shield of New Jersey; however, the Board reserves the right to change carriers at any time, in its sole judgment provided that the proposed new carrier shall provide substantially similar benefits to the existing Blue Cross/Blue Shield Point of Service plan, or the New Jersey School Employees Health Benefits Plan Direct 10. In the event the Board decides to change carriers, the proposed new plan shall be submitted to the Association for review at least sixty
Health Care Insurance Protection. The Board shall provide health care insurance benefits for employees and their dependents equivalent to or better than the benefits that currently exist.

Related to Health Care Insurance Protection

  • Health Care Insurance While a faculty member is on an approved leave of this type, the faculty member will be advised regarding the right to continue health care benefits in accordance with COBRA during the period of unpaid absence.

  • INSURANCE PROTECTION A. The Board shall provide MESSA Plan 1 or Plan 2 described below by making payment of insurance premiums for a full twelve (12) month period each year of this Agreement for the teacher and his/her eligible dependents as defined by MESSA, subject to the provisions below. B. Each teacher shall elect either Plan 1 or Plan 2, provided, however, that if a husband and wife are both members of the bargaining unit, one shall select Plan 1 and the other Plan 2. Part-time teachers shall receive the Plan 1 premium rate on a pro rata basis (e.g., a teacher employed for three days per week will receive three-fifths of the premium rate due to a full-time teacher eligible for the same coverage). Those part-time Teacher electing Plan 1 shall pay the difference between the prorated amount and the full cost of the appropriate health insurance by direct payment or payroll deduction. C. The employer shall pay 80% of the total cost of the MESSA medical premium and deductible. 100% of the non-medical benefits. Additionally, the Board agrees to maintain this 80/20 cost-sharing provision during the life of this Agreement. Employees shall contribute 20% of the medical premium and the annual deductible. Employer shall fund 100% of the MESSA ABC Plan 1 annual deductible (minus the employees 20% contribution) to the employees’ Health Equity (HEQ) Health Savings Account (HSA) for each plan year. Deposits would be made in quarterly installments beginning on January 1, then April 1, then July 1, and the last installment on October 1 of each year. The District will fund the balance of the deductible due ahead of schedule for any member who incurs significant medical claims prior to receiving all four quarterly deposits. For teachers hired after January 1, the Employer will fund a percentage of the MESSA ABC Plan I annual deductible to the employees’ Health Equity” (HEQ) Health Savings Account (HSA) for each plan year equal to the percentage of the calendar year they work. Employee contributions shall be payroll deducted. Payments will start with the first pay date after the open enrollment period ends. The annual payment amount will be distributed equally throughout the remainder of the payroll dates for the school year through a qualified Section 125 plan and shall not be subject to withholding. The Employer’s qualified Section 125 plan shall include any and all of the provisions necessary for pre-tax contributions to employees’ HSA accounts. In the event an employee is not qualified for a Health Savings Account for any of the months of the deductible plan year, the employer shall contribute the negotiated amount of funding as set forth in the agreement to either a Flexible Spending Account (“FSA”) or a 403(b). Affected employees shall notify the employer where to contribute the money on or before December 15 of each school year. Employees may contribute, through payroll deduction and electronic transfer additional money towards their HSA up to the maximum amounts allowed by Federal Law. The parties understand that in the event the minimum deductible necessary for a medical plan to comply with HSA eligibility is increased beyond the current deductible level in MESSA ABC Plan 1, the deductible (and the Employer’s funding of the deductible) will automatically adjust to meet the federal minimum requirement. D. Benefit Plan 1 Plan 2 1. Health Insurance MESSA ABC Plan 1 Deductible $1400/$2800 ABC Rx SO OL/OV/SV $0 Coinsurance 2. Long Term Disability MESSA Same as Plan 1 Coverage 66 2/3% of salary up to $7,500 monthly maximum 90 calendar days modified fill Pre-existing condition waiver Alcohol/drug (same as any other illness) Mental/Nervous (same as any other illness) Soc. Sec. Offset- Primary Own- Occupation 2 years COLA- No SS Freeze- Yes 3. Dental Insurance MESSA/Delta Dental Same as Plan 1 Coverage Diag & Prev – 80% Basic Services- 80% (X Rays) Major services 80% Annual Max- $1800 Orthodontics- 80% Lifetime Max- UCR Riders- 2 cleanings, AO 4. Life Insurance MESSA Negotiated Term Same as Plan 1 Life $45,000 with $45,000 AD&D, Waiver of Premium 5. Vision Insurance MESSA Vision Enhanced Same as Plan 1 6. Options Not Available Pursuant to the terms of the District’s Section 125 Plan, All teachers electing to take the Plan 2 option in lieu of medical insurance shall receive 80% of the amount of the single subscriber premium rate for the insurance plan provided to other members of the association. (prorated for part-time Teacher). Cash in lieu payments will start with the first pay date after the open enrollment period ends. The annual payment amount will be distributed equally throughout the remainder of the payroll dates for the school year. Any modifications of the Section 125 Plan which affect bargaining unit members will be subject to negotiations with the Association.

  • Health Care Coverage The Company shall continue to provide Executive with medical, dental, vision and mental health care coverage at or equivalent to the level of coverage that the Executive had at the time of the termination of employment (including coverage for the Executive’s dependents to the extent such dependents were covered immediately prior to such termination of employment) for the remainder of the Term of Employment, provided, however that in the event such coverage may no longer be extended to Executive following termination of Executive’s employment either by the terms of the Company’s health care plans or under then applicable law, the Company shall instead reimburse Executive for the amount equivalent to the Company’s cost of substantially equivalent health care coverage to Executive under ERISA Section 601 and thereafter and Section 4980B of the Internal Revenue Code (i.e., COBRA coverage) for a period not to exceed the lesser of (A) 18 months after the termination of Executive’s employment or (B) the remainder of the Term of Employment, and provided further that (1) any such health care coverage or reimbursement for health care coverage shall cease at such time that Executive becomes eligible for health care coverage through another employer and (2) any such reimbursement shall be made no later than the last day of the calendar year following the end of the calendar year with respect to which such coverage or reimbursement is provided. The Company shall have no further obligations to the Executive as a result of termination of employment described in this Section 8(a) except as set forth in Section 12.

  • Insurance Programs 35.1 Fringe Benefits a. The Board agrees to provide the: Individual core plan premium on behalf of each regular full time employee Part-time regular employees may receive pro-rated insurance benefits if eligible by the carrier. b. When an employee and legally recognized spouse are both employed by the district and are eligible for the school district group plan, the district shall, at the employees' option, combine the district's insurance contribution toward the family plan.

  • Health Overcoming or managing one’s disease(s) as well as living in a physically and emotionally healthy way;

  • Vision Care Insurance The District agrees to provide vision care insurance for 39 eligible employees. The Medical Eye Services plan provides one (1) comprehensive 40 examination every twelve (12) consecutive months; two (2) pairs of lenses in any 41 twenty-four (24) consecutive months. Employee is responsible for paying a ten 42 dollar ($10) deductible per calendar year. Prior enrollment in the plan is required. 43

  • Long Term Care Insurance The University offers full-time faculty the opportunity to purchase Long-Term Care Insurance through a voluntary Long-Term Care Insurance policy. Faculty members are responsible for 100% of the premium, which may be remitted through payroll deduction.

  • Standard Hazard Insurance and Flood Insurance Policies (a) For each Mortgage Loan, the Master Servicer shall enforce any obligation of the Servicers under the related Servicing Agreements to maintain or cause to be maintained standard fire and casualty insurance and, where applicable, flood insurance, all in accordance with the provisions of the related Servicing Agreements. It is understood and agreed that such insurance shall be with insurers meeting the eligibility requirements set forth in the applicable Servicing Agreement and that no earthquake or other additional insurance is to be required of any Mortgagor or to be maintained on property acquired in respect of a defaulted loan, other than pursuant to such applicable laws and regulations as shall at any time be in force and as shall require such additional insurance. (b) Pursuant to Section 4.01 and 4.02, any amounts collected by the Servicers or the Master Servicer, or by any Servicer, under any insurance policies (other than amounts to be applied to the restoration or repair of the property subject to the related Mortgage or released to the Mortgagor in accordance with the applicable Servicing Agreement) shall be deposited into the Master Servicer Collection Account, subject to withdrawal pursuant to Section 4.02 and 4.03. Any cost incurred by the Master Servicer or any Servicer in maintaining any such insurance if the Mortgagor defaults in its obligation to do so shall be added to the amount owing under the Mortgage Loan where the terms of the Mortgage Loan so permit; provided, however, that the addition of any such cost shall not be taken into account for purposes of calculating the distributions to be made to Certificateholders and shall be recoverable by the Master Servicer or such Servicer pursuant to Section 4.02 and 4.03.

  • Health Care Benefits A. Each regular, full-time employee may elect coverage for himself and his eligible dependents* under one of the following health insurance plans: 1. Blue Cross/Blue Shield of Michigan Flexible Blue 3 with Flexible Blue Rx Prescription Drug Coverage with a Health Savings Account (hereinafter collectively referred to as the “H.S.A Plan”). The Employer shall pay for the illustrated premium cost of this coverage and make an annual contribution to each participating employee’s Health Savings Account in the amount of $500 for those selecting single coverage and $1,000 for those selecting Employee & Spouse, Employee Child(ren) or Family coverage, or the maximum annual amount the Employer is permitted to pay under Section 3 of the Publicly Funded Health Insurance Contribution Act, Public Act 152 of the Michigan Public Acts of 2011, whichever results in the lesser Employer contribution to the cost of such plan. Employees may, at their option, make additional contributions through bi-weekly pre-tax payroll deduction as permitted by applicable law. 2. Blue Cross/Blue Shield of Michigan Community Blue PPO Option 3 Revised Plan with Blue Preferred Rx Prescription Drug Coverage with a 50% co-pay ($5 floor and a $50 ceiling). Employees shall pay the difference between the illustrated premium cost of this coverage and the amount of the Employer’s total contribution towards the cost of coverage under the H.S.A. Plan as described in Section 1 (a) (1), for the same level of benefit (i.e. single, employee/spouse, employee/child(ren) and family), or pay the difference between the total cost of such coverage and the maximum annual amount the Employer is permitted to pay under Section 3 of the Publicly Funded Health Insurance Contribution Act, Public Act 152 of the Michigan Public Acts of 2011, whichever results in the greater employee contribution. 3. Blue Cross/Blue Shield of Michigan Community Blue PPO Option 6 Revised Plan with Blue Preferred Rx Prescription Drug Coverage with a 50% co-pay ($5 floor and a $50 ceiling). Employees shall pay the difference between the illustrated premium cost of this coverage and the amount of the Employer’s total contribution towards the cost of coverage under the H.S.A. Plan as described in Section 1 (a) (1), for the same level of benefit (i.e. single, employee/spouse, employee/child(ren) and family), or pay the difference between the total cost of such coverage and the maximum annual amount the Employer is permitted to pay under Section 3 of the Publicly Funded Health Insurance Contribution Act, Public Act 152 of the Michigan Public Acts of 2011, whichever results in the greater employee contribution. (a) All coverage under any of the foregoing plans shall be subject to such terms, conditions, exclusions, limitations, deductibles, co-payments premium cost-sharing, and other provisions of the plans. Coverage shall commence on the employee’s ninetieth (90th) day of continuous employment. The employee’s contribution to the cost of such coverage shall be payable on a bi-weekly basis through automatic payroll deduction. (b) To qualify for health care benefits as above described each employee must individually enroll and make proper application for such benefits at the Human Resources Department upon the commencement of his regular employment with the Employer. (c) Except as otherwise provided under the Family and Medical Leave Act, when on an authorized unpaid leave of absence of more than two weeks, the employee will be responsible for paying all his benefit costs for the period he is not on the active payroll. Proper application and arrangements for the payment of such continued benefits must be made at the Human Resources Department prior to the commencement of the leave. If such application and arrangements are not made as herein described, the employee's health care benefits shall automatically terminate upon the effective date of the unpaid leave of absence. (d) Except as otherwise provided under this Agreement and/or under COBRA, an employee's health care benefits shall terminate on the date the employee goes on a leave of absence for more than two weeks, terminates, retires or is laid off. Upon return from a leave of absence or layoff, an employee's health care benefits coverage shall be reinstated commencing with the employee's return. (e) An employee who is on layoff or leave of absence for more than two weeks or who terminates may elect under COBRA to continue the coverage herein provided at his own expense. (f) The Employer reserves the right to change a carrier(s), a plan(s), and/or the manner in which it provides the above benefits, provided that the benefits and conditions are equal to or better than the benefits and conditions outlined above. (g) To be eligible for health care benefits as provided above, an employee must document all coverage available to him under his spouse's medical plan and cooperate in the coordination of coverage to limit the Employer's expense. If an employee’s spouse or eligible dependent children work for an employer who provides medical coverage, they are required to elect medical coverage with their employer, so long as the spouse’s or monthly contribution to the premium does not exceed 20% of the total premium cost of said coverage. The Monroe County Plan shall provide secondary coverage. (h) Each employee is responsible for notifying the Human Resources Department of any change in his status, which might affect his insurance coverage or benefits, such as, marriage, divorce, births, adoptions, deaths, etc.

  • Health and Life Insurance In the event Employee’s employment is terminated hereunder, the Company shall provide the following health and life insurance benefits: (a) Upon Employee’s termination of employment under this Agreement other than upon Employee’s termination for Cause or upon Employee’s death, the Company shall be responsible for a one-year period following Employee’s Termination Date, the scheduled premium payments (on or before their due dates) on any universal life insurance policy covering Employee’s life which is in force immediately prior to the Termination Date; provided, however, that the Company shall be obligated to pay any such premiums only to the extent that, and on the same basis as, payments are made by the Company on the universal life insurance policies covering officers of the Company with same or similar coverage and further provided that during the period of six months immediately following the Employee’s Termination Date, the Employee shall be obligated to pay the Company the full cost for any such premium payments, and the Company shall reimburse the Employee for any such payments on the first business day that is more than six months after the Employee’s Termination Date, together with interest on such amount from the Termination Date through the date of payment at the Interest Rate. (b) Upon Employee’s termination of employment under this Agreement other than upon a Change of Control (which shall be governed by the COC Severance Plan), Employee’s termination for Cause, or upon Employee’s death, the Company shall, at its expense, provide such medical and dental coverage as in effect immediately prior to the Termination Date for Employee and Employee’s then covered dependents until the end of the period designated for payments to be made hereunder. Thereafter, Employee and his qualified beneficiaries shall be entitled to continue health insurance benefits, under and through the terms of the applicable COBRA law and regulations, at Employee’s own expense until the expiration of COBRA coverage. (c) In the event of Employee’s death during the Term of Employment for a twelve-month period after his death the Company shall make available at its expense medical and dental insurance covering Employee’s spouse and his dependents (collectively, “Employee’s Beneficiaries”) who would have been covered (if the Term of Employment had continued) by the Company’s medical and dental insurance policies as then in effect, and (ii) thereafter for an additional six-month period, such medical and dental insurance in effect from time to time shall be provided to Employee’s Beneficiaries, with Employee’s Beneficiaries (or estate if applicable) to reimburse the Company for the cost of comparable coverage under the provisions of this clause (ii), unless otherwise prohibited by applicable law Thereafter, Employee and his qualified beneficiaries shall be entitled to continue health insurance benefits, under and through the terms of the applicable COBRA law and regulations, at Employee’s own expense until the expiration of COBRA coverage. (d) Any taxable welfare benefits provided pursuant to this Section 13 that are not “disability pay” or “death benefits” within the meaning of Treasury Regulation Section 1.409A-1(a)(5) (collectively, the “Applicable Benefits”) shall be subject to the following requirements in order to comply with Section 409A of the Code. The amount of any Applicable Benefit provided during one taxable year shall not affect the amount of the Applicable Benefit provided in any other taxable year, except that with respect to any Applicable Benefit that consists of the reimbursement of expenses referred to in Section 105(b) of the Code, a limitation may be imposed on the amount of such reimbursements over some or all of the applicable severance period, as described in Treasury Regulation Section 1.409A-3(i)(iv)(B). To the extent that any Applicable Benefit consists of the reimbursement of eligible expenses, such reimbursement must be made on or before the last day of the calendar year following the calendar year in which the expense was incurred. No Applicable Benefit may be liquidated or exchanged for another benefit.

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!