HEALTH CARE PLANS. Notwithstanding the references to the Pacific Blue Cross Plans in this article, the parties agree that Employers, who are not currently providing benefits under the Pacific Blue Cross Plans may continue to provide the benefits through another carrier providing that the overall level of benefits is comparable to the level of benefits under the Pacific Blue Cross Plans.
HEALTH CARE PLANS. 39.01 Medical Plan
HEALTH CARE PLANS. UMMC offers three health plan choices and the flexibility to waive coverage if you have insurance elsewhere. All of the plans are contributory for all levels of coverage. All three plans — Gold, Silver and Bronze — will pay higher benefits, and cost you less money out of pocket if you go to a physician or hospital in the UMMS Choice Network. The Gold Plan cost more out of your paycheck, and has the highest level of coverage with fewer out-of-pocket expenses at the time of service. The Silver Plan has a lower cost out of your paycheck but higher costs at the time of service. The Bronze Plan is a high-deductible option, meaning you will pay out of pocket for all of your expenses until your deductible is met. However, the premiums are lower. (Deductible does not apply to preventative care services.) Employees enrolled in the Bronze Plan also have the option of utilizing a Health Savings Account (HSA). HSAs are like personal savings accounts used specifically for health care expenses. Prescription Drug Benefits - All of the health care plans offer prescription benefits. There are two dental plans to choose from, a standard plan and an enhanced plan. Both plans are through Delta Dental and provide a variety of services up to a maximum of $1,250 for the basic plan and $2,000 for the enhanced plan per member each plan year. For some services there is a plan year deductible of $50 for individuals and $150 per family. The employee contributes toward the cost of the plan. Vision plan benefits are provided through Group Vision Services (GVS). You may receive services and materials from any licensed optometrist, ophthalmologist, or dispensing optician, including those in retail locations. If you see a provider in the GVS network, you pay only copays (fixed-dollar amounts) for a vision exam and standard eyeglass lenses and get discounted pricing for other services and materials. Coverage Ends on the last day of the payroll period in which the termination/status change is effective. If you have been on a leave for a continuous 12 months, benefits will end on the last day of the payroll period in which the 12 month period is reached. Resident/Fellow Agreement
HEALTH CARE PLANS. The Employer shall provide hospitalization coverage for which the payment schedule is based on site of care. Employees will be offered a 90/10 percent coinsurance (after any applicable deductibles). The University will also offer a CDHP all years of the contract. All new hires into the bargaining unit may only select CDHP as the medical option. During the term of this agreement, the University agrees to provide primary care appointments for sick visits within 24 normal business hours to UT Family Medicine Physicians, UT General Internal Medicine Physicians, and/or UT Pediatricians for employee and/or dependents covered by employee’s health plan. Services are billed to employee’s insurance plan. An employee who experiences a medical issue after reporting to work may call for an appointment at a UTMC or GMC practice as outlined above for purposes of determining if the employee should remain at work. If an appointment is available, the employee with approval from their supervisor shall clock out to attend the appointment. The employee will not receive points to attend the appointment. If the employee is instructed that he or she may return to work the employee shall clock back in. Upon returning to work, employee will submit a request for reimbursement for time used during appointment. Appropriate documentation including physician release slip will be required. If the employee is instructed to go home, the employee must use sick leave for the remainder of the shift and will receive sick day equivalent points.
HEALTH CARE PLANS. For the duration of this Agreement, the Employer shall continue to make available to eligible employees the benefits as agreed, including any details included below in the separate sections. Coverage for eligible employees under the following plans shall commence on the first day of the month following the month in which the employee becomes a regular status employee. Coverage under the provisions of these plans shall apply to regular employees scheduled an average of twenty (20) or more hours a week on a regular basis.
HEALTH CARE PLANS. At such time on or after the Effective Time as FirstMerit shall deem appropriate, FirstMerit and its Subsidiaries will provide CoBancorp and CoBancorp Subsidiaries employees hired by FirstMerit with such coverage under the FirstMerit health care plan as they then provide their employees, with all service with CoBancorp or any of the CoBancorp Subsidiaries credited for purposes of determining such employee's eligibility to participate in such plan and without any "prior existing condition" exclusion. The CoBancorp health care plans will be continued until the employees so hired can participate in the FirstMerit health care plans. No benefits currently provided CoBancorp or the CoBancorp Subsidiaries employees, which exceed those provided by FirstMerit and its subsidiaries, will be grandfathered or provided, except if required by law. Other than otherwise expressly stated herein, FirstMerit shall not assume any other health care benefit plans or benefits. FirstMerit, where such right currently exists, retains the existing rights to amend or terminate any such plan which have been reserved by the plan sponsor in the plan document or otherwise.
HEALTH CARE PLANS. A. Effective January 1, 2014, and for 2015 plan year, the current plan design for BCBS/PPO and Blue Care Network programs shall be offered to employees of MSU who are represented by members of the Coalition. For plan years 2016 and 2017, Third Party Administrator services will be reviewed. The University’s contribution toward the cost of either program shall be the amount the University pays for the program having the lower rates in each plan year. This will be known as the base plan. In each of the aforementioned plan years, the cost of the base health care plan shall be borne fully by the University for full-time employees and proportionately for part-time employees (in accordance with the conditions for part-time employees set forth in C below). Employees electing to enroll in a plan other than the base health care plan will receive the applicable University single, two-person or family base plan contribution toward the plan cost, with the difference, if any, payable by the employee.
B. The Coalition and the University shall monitor the performance of the health plan programs on an ongoing basis. Performance factors that shall be monitored for each program will include the accuracy of cost projections and data, the cost of each program, the success of cost containment initiatives, cooperation in providing relevant data, responsiveness to other needs and concerns identified by the parties, quality of service, accuracy of claims administration and/or such other factors as may be mutually defined. Notwithstanding what is stated in A. above, as a result of this monitoring process, the Coalition and the University may mutually decide during the life of this Agreement to replace one or both of the aforementioned programs, to designate or change the base plan, to limit or freeze new enrollments in a particular plan, and/or establish or revise the amounts payable by employees enrolling in the plan.
C. Health Care Plan Contributions for Part-time Staff Effective July 1, 2002, part-time staff will receive a proportional University contribution toward the cost of health benefits based on the single, two-person or family premium for the lower cost plan. Part-time staff electing to participate in the University’s health care programs shall pay the remaining monthly premium.
a. Bargaining unit members who were employed by the University by June 30, 1998, and who are or become part-time, will be eligible to apply for a special dispensation to the University part-time ...
HEALTH CARE PLANS. Coordination of Benefits Change in Carrier
HEALTH CARE PLANS. Current provisions and cost sharing apply. See Appendix A.
HEALTH CARE PLANS. During the Employment Period, the Executive and/or the Executive’s family (as the terms allow) shall participate in all health care benefit plans, programs or arrangements maintained by the Company from time to time on or after the Effective Date for the benefit of employees and/or senior executives or employees of the Company. The Company agrees to pay the Executive’s entire premium amounts to participate in such health care plans.
