Health Care Program Clause Samples
The Health Care Program clause outlines the employer's obligation to provide health care benefits to employees. Typically, this clause specifies the types of health insurance coverage offered, eligibility requirements, and the extent of employer and employee contributions to premiums. For example, it may detail whether dependents are covered or if there are waiting periods before benefits begin. The core function of this clause is to ensure employees have access to medical coverage and to clarify the terms and conditions under which such benefits are provided, thereby reducing misunderstandings and supporting employee well-being.
Health Care Program. The Employer shall provide a health care program for all eligible members in the bargaining unit, which presently includes the following options: (1) Indemnity Plan, (2) PPO Plan, and (3) HMO Plan. If the District desires to change carriers or if one of the options is no longer available in the area, the District will (1) present the details of the change to the Association, (2) provide a reasonable time for the Association to analyze the proposed change, and (3) meet and discuss the issue with the Association. If a decision is made to change carriers there shall be no reduction in coverages and services. If one of the options is no longer available in the area, the parties shall met and discuss how to address the issue. The benefits provided under each plan shall be as specified in the Schedule of Benefits attached as Appendix A. Employees shall contribute toward the applicable premium of their chosen employee insurance plan on a monthly basis as follows: S 2 party Family 04-05 29 50 59 05-06 35 58 69 06-07 41 66 79 07-08 47 74 89 08-09 53 82 99 The employer will pay the remaining cost of the applicable premium. The employer will establish a Section 125 "premium only" plan to enable employees to pay their share of health coverage premiums on a pre-tax basis. In the event two spouses both work in the District and are both eligible for District-provided coverage, each spouse shall receive single coverage. For family coverage, the employee whose birthday is first during the year shall have parent and child(ren) coverage, unless agreed to otherwise by both spouses. The settlement or payment of claims shall not be subject to the grievance procedure included in this Agreement. When the Employer has properly provided said program, in no case and under no circumstances shall the Employer be required to provide a cash settlement or any other substitute benefit in any form in lieu of the health care benefits provided for in this Article.
Health Care Program. 1. For all eligible unit employees who have been appointed prior to November 15, 2000, the following is to apply.
a. Each eligible unit employee who regularly works four and one-half (4.5) or more hours on a daily basis may join any of the healthcare plans. The respective contribution rate is as follows: The employee is able to use the value listed above for any of the Co-pay healthcare plans offered by the district. There is a separate amount offered for those who choose not to use the district healthcare plan in Section 11.05. The employee contribution/cost of the plan is paid in deductions from his/her paycheck. Eligible unit employees are able to join the Genesee Area Health Care Plan High Deductible Option according to the benefit description in #3 below
2. For all eligible unit employees who have been appointed after November 15, 2000, but before July 1, 2012, and for those unit employees who become eligible after November 15, 2000, but before July 1, 2012 for health care benefits by virtue of working more hours per day on a regular basis, the following is to apply: Each eligible unit employee who works seven (7) or more hours on a daily basis may join any of these healthcare plans. The respective contribution rate is as follows: • 85% - The Non-Monroe County Municipal School District Blue Point 2 (NMCMSD) low option plan - $15 medical co-pay/$5-$15-$30 prescription co-pay. $15-$30 prescription co-pay or the Genesee Area Healthcare Plan $5- $10-$25 - whichever is the lesser cost. The employee is able to use the value listed above for any of the Co-pay healthcare plans offered by the district. There is a separate amount offered for those who choose not to use the district healthcare plan in Section 11.05. The employee contribution/cost of the plan is paid in deductions from his/her paycheck.
a. Each eligible unit member who regularly works at least five and one-half (5.5) hours, but less than seven (7) hours on a daily basis, may join any of these Co-pay healthcare plans. The District agrees to pay sixty percent (60%) of the cost of Blue Point 2 - The Non-Monroe County Municipal School District Blue Point 2 (NMCMSD) low option plan - $15 medical co-pay/$5-$15-$30 prescription co-pay for as long as so offered by the plan and the employee shall pay the remaining cost of the plan to be paid in deductions from his/her paycheck.
Health Care Program. A. All employees currently enrolled in the POS health Plan shall be eligi- ble for enrollment in the Direct Access Health Plan (subject to all employee premium contributions required by law). The prescription plan for employees shall be revised to reflect co-payments of $15/ $35/2x. Dental and vision coverage shall remain unchanged. The prescription drug plan will be as follows for all new employees effective July 1, 2017:
Health Care Program. In-Network Out-of-Network
Health Care Program. Effective July 1 ,2015 the district will offer the following health insurance plans.
1. The District has a group health care program furnished by the Finger Lakes Area School Health Plan (FLASHP) called Blue Point 2 Extended (High Option) with an employee co-pay of $5 for doctor visits and a prescription drug plan that provides a $5 generic/$20 preferred brand name and $35 non preferred brand name drug coverage.
2. The District shall provide a FLASHP Blue Point Plan Select with an employee co-pay of $15 for doctor visits and a prescription drug plan that provides a $5 generic/$20 preferred brand name and/$35 non preferred brand name drug coverage. This plan shall be known as the Base Plan.
3. The District shall provide a FLASHP plan called Healthy Blue plan, $15-$150 IP/$75 OP with drug plan $5 generic/$25 preferred/$50 non preferred drugs. Existing unit members can enroll in the Healthy Blue plan at an open enrollment period as set out by the plan.
4. For all unit members the District agrees to contribute to the health care program as follows:
a. The District agrees to pay eighty-three percent (83%) of the cost of the base plan and the unit employee shall pay seventeen percent (17%) employee contribution which is the remainder of the cost of the base plan by payroll deductions.
5. Where the District employs a husband and wife, the District will only be obligated to provide and pay contributions for one (1) family health care insurance premium. The District will not be obligated to provide and pay for separate individual or separate family coverage for the other spouse. In such case the District agrees to pay the full premium cost for the family plan. In such a case neither husband nor wife is eligible for the opt out payment for declining participation in the District's health care program.
6. Eligible unit employees may change health care program coverage during the open window period as set by the insurance carrier.
Health Care Program. A. Effective January 1, 2021, all employees hired on or after July 1, 2020 must enroll and remain in the New Jersey Educator’s Health Plan (or Garden State Health Plan (GSHP) once available) until January 1, 2028. All employees currently enrolled in the POS health Plan shall be eligi- ble for enrollment in the Direct Access Health Plan (subject to all employee premium contributions required by law). The prescription plan for employees shall be revised to reflect co-payments of $15/ $35/2x. Dental and vision coverage shall remain unchanged. The prescription drug plan will be as follows for all new employees effective July 1, 2017:
Health Care Program. Newly hired custodians, maintenance workers, or bus drivers begin- ning in the 2008-2009 school year will receive PPO coverage from the current medical carrier at no cost at the following levels: Prescription $10/$30 Doctor Visits $20 Out of Network Deductibles $300/$600 Any newly hired custodian, maintenance worker or bus driver starting in the 2008-2009 school year who wishes to be enrolled in the current PPO must pay 3% of the annual premium cost.
Health Care Program. A. The Board shall grant health care insurance protection as provided in the master contracts with the carrier(s).
B. All local 1 members who have traditional plan coverage will make an annual contribution of 3% of those premium costs starting in January 2008. All current PPO participants will make no contribution, nor will their coverage change for the years covered by this Agreement. Starting in the 2008-09 year all new hires will receive at no cost a PPO plan with higher co-pays for medical and prescription. If they wish to be enrolled in the current PPO plan they will contribute 3% to those premium costs. (See Section K)
Health Care Program. A. All members of Local 1 shall be enrolled in a POS 10 plan for medi- cal and prescription coverage. Prescription coverage will be at 10/20, 2X mail order RX. Dental and vision coverage shall remain un- changed.
B. Local 1 members will contribute 1.5% of their base annual salary to- ▇▇▇▇ the cost of their health care premium, as required by law.
C. Should the Board determine that a change in carrier(s) shall be effec- tuated, it shall consult with the Union prior to said change.
D. Regular part-time employees and employees on the probationary pe- riod may purchase the health care program directly from the Board. Employees must make a decision to purchase entire health plan within fifteen (15) calendar days after their initial employment and decision cannot be changed.
F. Employees on approved unpaid leaves of absence may continue cov- erage at their own expense by direct payment to the Board for the duration of the leave, not to exceed a period of one year.
Health Care Program. To the Knowledge of BMH, BMH meets the conditions for participation in the Medicare and Medicaid programs and there is no pending or threatened proceeding or investigation under a Government Health Care Program.