Health Care Provisions. Tenant hereby agrees, covenants, represents ---------------------- and warrants with and to Lender as follows:
Health Care Provisions. In working with Anthem Blue Cross and The Xxxxx Company to effect the agreed upon Century Plan changes, Personnel has been advised that under the Healthcare Reform Act the City of New London must maintain the Firefighter’s Century Health Insurance Plan exactly intact. Under the law, the City is required to provide any union that has negotiated an agreement accepting the “Firefighter plan” with the original Firefighter plan. As a result the Emergency Room co-pay in the negotiated plan must remain at $75, not the agreed-upon $200 as proposed by the City. The city is requesting nothing for this enhanced benefit. Any other agreements related to the emergency room co-payment and/or vision care reimbursement remain in effect, as they do not affect the actual plan document but are solely between the City and the Union. On the following pages is the corrected document as originally presented to the MEU during negotiations, with the only change being the plan numbers. City of New London Firefighters (now City of Xxx Xxxxxx Xxxx) 000000-000, 001, 005, 027, 028 CENTURY PREFERRED $20/$100/$75/$50 Century Preferred is a preferred provider organization (PPO) plan. COST SHARE PROVISIONS In-Network Member pays: Out-of-Network Member pays: Office Visit (OV) Copayment $20 per visit Deductible & Coinsurance Hospital (HSP) Copayment $100 Deductible & Coinsurance Urgent Care (UR) Copayment $25 Not Covered Emergency Room (ER) Copayment – waived if admitted $75 $75 Outpatient Surgery (OS) Copayment $50 Deductible & Coinsurance Annual Deductible (individual/2-member family/3+ member family) Not Applicable $200/$400/$500 Coinsurance 20% after deductible up to $800/ $1600/ $2,000 Cost Share Maximum (individual/2-member family/3+member family) $1,000 / $2,000 / $2,500 Lifetime Maximum Unlimited $1,000,000 PREVENTIVE CARE Well child care OV Copayment Deductible & Coinsurance Periodic, routine health examinations OV Copayment Routine eye exams (once every 2 years) OV Copayment Routine OB/GYN visits (one visit per year) OV Copayment Mammography No Charge Hearing screening (once every 2 years) OV Copayment MEDICAL CARE Office visits OV Copayment Deductible & Coinsurance Outpatient mental health & substance abuse - prior authorization required OV Copayment OB/GYN care OV Copayment Maternity care – initial visit subject to copayment, no charge thereafter OV Copayment Diagnostic lab and x-ray No Charge High-cost outpatient diagnostic : MRI, MRA, CAT, CTA, PET, SPECT scans No Charge Allergy...
Health Care Provisions
