Common use of Health Care Options -- Flexible Benefits Plan Clause in Contracts

Health Care Options -- Flexible Benefits Plan. The specific coverage in each of the health care options shall be mutually determined by the Board and the employee organization(s) representing covered employees, and shall be provided in writing each year to the employees. The Board shall provide a prescription drug benefit for Cigna OAP and Cigna OAPIN plan members, as well as a mail order Prescription Drug Program for the purchase of maintenance type prescription drugs, including insulin and related supplies. Generic substitutions will be mandatory. Option 1 - Employees may choose to enroll in the Cigna Open Access Plus (OAP) plan that allows for in network and out of network coverage. The employee price tag will be 19% of the annual premium through December 31, 2016 according to the schedule in Appendix B-1, (20% for those hired on or after January 1, 2013); 20% as of January 1, 2017; 20% as of January 1, 2018; 22% as of January 1, 2019; 24% as of January 1, 2020; and 25% as of January 1, 2021. Beginning January 1, 2013 through December 31, 2021, the prescription co-pay structure shall be as follows: Cigna OAP: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non-formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non-formulary. Also, the hospital emergency room co-pay will be $70 per visit and is waived if admitted. Option 2 - Employees may choose to enroll in the Cigna Open Access Plus In Network (OAPIN) plan that allows for in network coverage only. The employee price tag will be 14% of the annual premium through December 31, 2016 according to the schedule in Appendix B, (15% for those hired on or after January 1, 2013; 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 2021. Beginning January 1, 2013 through December 31, 2021, the prescription co-pay structure shall be as follows: Cigna OAPIN: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non-formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non- formulary. Also, the hospital emergency co-pay will be $50 per visit and is waived if admitted. Option 3 - Employees may choose to enroll in a qualified prepaid health maintenance organization (HMO) plan offered by Xxxxxx Permanente that provides comprehensive medical care through a network of participating hospitals, physicians and other health care providers. The employee price tag will be 14% through December 31, 2016 according to the schedule in Appendix B, (15% for those hired on or after January 1, 2013); 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 2021. A prescription drug benefit is included with the HMO offered. The co-pay structure through December 31, 2021 shall be as follows: up to 60-day supply - $5 generic; $5 brand; at participating community pharmacy - $15 generic; $15 brand; Mail Order - 90-day supply - $5 generic; $5 brand. The employee price tag for those hired on or after January 1, 2019 will be as follows: Cigna OAP – 25%; Cigna OAPIN – 15%; Kaiser HMO – 15% according to the schedule in B-2. Options 4A and 4B - These options provide for two (2) Medicare Supplement Plans: 4A – Cigna Medicare Surround; 4B – Xxxxxx Permanente Medicare Plus. These plan options will only be available to retirees who have attained the age of 65. The Board contribution toward the premium for health insurance for Medicare- eligible retirees will be according to Chart B in Article 8, Section 8. For retirees covered by the Cigna Medicare Surround plan, the mail order prescription drug co-pay for generics will be $20 beginning January 1, 2013. Other co-pays for retail and mail order purchases will remain as specified in the Retiree Benefits Guide.

Health Care Options -- Flexible Benefits Plan. The specific coverage in each of the health care options shall be mutually determined by the Board and the employee organization(s) representing covered employees, and shall be provided in writing each year to the employees. The Board shall provide a prescription drug benefit for Cigna OAP and Cigna OAPIN plan members, as well as a mail order Prescription Drug Program for the purchase of maintenance type prescription drugs, including insulin and related supplies. Generic substitutions will be mandatory. Option 1 - Employees may choose to enroll in the Cigna Open Access Plus (OAP) plan that allows for in network and out of network coverage. The employee price tag will be 19% of the annual premium through December 31, 2016 2016, according to the schedule in Appendix B-1B, (20% for those hired on or after January 1, 2013); 20% as of January 1, 2017; 20% as of January 1, 2018; 22% as of January 1, 2019; 24% as of January 1, 2020; and 25% as of January 1, 2021. Beginning January 1, 2013 through December 31, 20212023, the prescription co-pay structure shall be as follows: Cigna OAP: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non-formulary; Retail – up to a 90-day supply - $30 for generic; $60 for formulary; $105 for non-formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non-formulary. Also, the hospital emergency room co-pay will be $70 100 per visit and is waived if admitted. Option 2 - Employees may choose to enroll in the Cigna Open Access Plus In Network (OAPIN) plan that allows for in network coverage only. The employee price tag will be 14% of the annual premium through December 31, 2016 2016, according to the schedule in Appendix B, (15% for those hired on or after January 1, 2013; 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 20212023. Beginning January 1, 2013 through December 31, 20212023, the prescription co-pay structure shall be as follows: Cigna OAPIN: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non-formulary; Retail – up to a 90-day supply - $30 for generic; $60 for formulary; $105 for non-formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non- non-formulary. Also, the hospital emergency co-pay will be $50 35 per visit and is waived if admitted. Option 3 - Employees may choose to enroll in a qualified prepaid health maintenance organization (HMO) plan offered by Xxxxxx Permanente that provides comprehensive medical care through a network of participating hospitals, physicians and other health care providers. The employee price tag will be 14% through December 31, 2016 2016, according to the schedule in Appendix B, (15% for those hired on or after January 1, 2013); 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 20212023. A prescription drug benefit is included with the HMO offered. The prescription co-pay structure through December 31, 2021 shall be as follows: Retail – up to 60a 30-day supply - $5 12 for generic; $5 brand; at participating community pharmacy - $15 generic20 for formulary; $15 brand45 for non-formulary; Mail Order - Retail – up to a 90-day supply - $5 for generic; $5 brand60 for formulary; $90 for non-formulary; mail order: - 90-day supply of maintenance prescriptions - $24 for generic; $60 for formulary; $90 for non-formulary. Also, the hospital emergency room co-pay will be $100 per visit and is waived if admitted. The employee price tag for those hired on or after January 1, 2019 will be as follows: Cigna OAP – 25%; Cigna OAPIN – 15%; Kaiser Xxxxxx HMO – 15% according to the schedule in B-2. B. Options 4A and 4B - These options provide for two (2) Medicare Supplement Plans: 4A – Cigna Medicare Surround, Cigna True Choice Medicare, and United American; 4B – Xxxxxx Permanente Medicare Plus. These plan options will only be available to retirees who have attained the age of 65. The Board contribution toward the premium for health insurance for Medicare- Medicare-eligible retirees will be according to Chart B in Article 8, Section 8. For retirees covered by the Cigna Medicare Surround plan, Cigna True Choice Medicare, and United American, the mail order prescription drug co-pay for generics will be $20 beginning January 1, 2013. Other Xxxxxx co-pays for retail and mail order purchases will remain as specified in the Retiree Benefits Guide.

Health Care Options -- Flexible Benefits Plan. The specific coverage in each of the health care options shall be mutually determined by the Board and the employee organization(s) representing covered employees, and shall be provided in writing each year to the employees. The Board shall provide a prescription drug benefit for Cigna OAP and Cigna OAPIN plan members, as well as a mail order Prescription Drug Program for the purchase of maintenance type prescription drugs, including insulin and related supplies. Generic substitutions will be mandatory. Option 1 - Employees may choose to enroll in the Cigna Open Access Plus (OAP) plan that allows for in network and out of network coverage. The employee price tag will be 19% of the annual premium through December 31, 2016 2016, according to the schedule in Appendix B-1B, (20% for those hired on or after January 1, 2013); 20% as of January 1, 2017; 20% as of January 1, 2018; 22% as of January 1, 2019; 24% as of January 1, 2020; and 25% as of January 1, 2021. Beginning January 1, 2013 through December 31, 20212023, the prescription co-pay structure shall be as follows: Cigna OAP: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non-formulary; Retail – up to a 90-day supply - $30 for generic; $60 for formulary; $105 for non-formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non-formulary. Also, the hospital emergency room co-pay will be $70 100 per visit and is waived if admitted. Option 2 - Employees may choose to enroll in the Cigna Open Access Plus In Network (OAPIN) plan that allows for in network coverage only. The employee price tag will be 14% of the annual premium through December 31, 2016 2016, according to the schedule in Appendix B, (15% for those hired on or after January 1, 2013; 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 20212023. Beginning January 1, 2013 through December 31, 20212023, the prescription co-pay structure shall be as follows: Cigna OAPIN: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non-formulary; Retail – up to a 90-day supply - $30 for generic; $60 for formulary; $105 for non-formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non- non-formulary. Also, the hospital emergency co-pay will be $50 35 per visit and is waived if admitted. Option 3 - Employees may choose to enroll in a qualified prepaid health maintenance organization (HMO) plan offered by Xxxxxx Permanente that provides comprehensive medical care through a network of participating hospitals, physicians and other health care providers. The employee price tag will be 14% through December 31, 2016 2016, according to the schedule in Appendix B, (15% for those hired on or after January 1, 2013); 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 20212023. A prescription drug benefit is included with the HMO offered. The prescription co-pay structure through December 31, 2021 shall be as follows: Retail – up to 60a 30-day supply - $5 12 for generic; $5 brand; at participating community pharmacy - $15 generic20 for formulary; $15 brand45 for non-formulary; Mail Order - Retail – up to a 90-day supply - $5 for generic; $5 brand60 for formulary; $90 for non-formulary; mail order: - 90-day supply of maintenance prescriptions - $24 for generic; $60 for formulary; $90 for non-formulary. Also, the hospital emergency room co-pay will be $100 per visit and is waived if admitted. The employee price tag for those hired on or after January 1, 2019 will be as follows: Cigna OAP – 25%; Cigna OAPIN – 15%; Kaiser HMO – 15% according to the schedule in B-2. B. Options 4A and 4B - These options provide for two (2) Medicare Supplement Plans: 4A – Cigna Medicare Surround, Cigna True Choice Medicare, and United American; 4B – Xxxxxx Permanente Medicare Plus. These plan options will only be available to retirees who have attained the age of 65. The Board contribution toward the premium for health insurance for Medicare- Medicare-eligible retirees will be according to Chart B in Article 8, Section 8. For retirees covered by the Cigna Medicare Surround plan, Cigna True Choice Medicare, and United American, the mail order prescription drug co-pay for generics will be $20 beginning January 1, 2013. Other Kaiser co-pays for retail and mail order purchases will remain as specified in the Retiree Benefits Guide.