Health, Hospitalization, Surgical and Major Medical Sample Clauses

Health, Hospitalization, Surgical and Major Medical. For the duration of this Agreement, the Employer shall maintain for all bargaining unit members health, hospitalization, surgical, major medical coverage, and prescription card plans. Current coverages shall remain in effect until the Franklin County Commissioners determine the need to modify that plan for all non-bargaining employees. If the Franklin County Commissioners determine the need to modify that plan, the Union will be consulted. The parties recognize the desirability of maintaining one insurance plan for all employees. Further, any changes implemented in the overall health plan design or formulary will be discussed with the Union prior to implementation of the change. All employees who work in a position scheduled for less than 1,560 hours per year will not be eligible for health insurance benefits. For the duration of this agreement all bargaining unit employees shall pay no more than what all non-bargaining unit employees pay for the monthly health insurance premium to cover themselves and any child(ren) they may have or for spousal coverage. All employee contributions paid by the employee will be paid for under IRS Chapter 125 on a pre-tax basis in accordance with the rules set forth by the IRS.
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Health, Hospitalization, Surgical and Major Medical. For the duration of this Agreement, the Employer shall maintain for all bargaining unit member’s health, hospitalization, surgical, major medical coverage, and prescription card plans. Current coverages shall remain in effect until the County determines the need to modify that plan for all County employees. If the County determines the need to modify that plan, the Lodge will be consulted as members of the Joint Benefits Committee. Any changes in the overall County plan design will be discussed prior to implementation with the Joint Benefits Committee. Routine changes in prescription formulary are not part of the plan design. All employees who work in a position scheduled for less than 1,560 hours per year will not be eligible for health insurance benefits (i.e., regular part-time employees). Employees are currently paying $140 per month for employees to cover themselves and any child(ren) they may have and $312 per month for employees who choose to cover their spouse or domestic partner. This $312 is not in addition to the $140, that is to say, in the event that an employee chooses to cover him/herself, any child(ren) and his/her spouse or domestic partner, he/she will pay no more than $312 per month to cover them all. This represents approximately a 12% contribution of the total health insurance premium amount by the employee and approximately 88% contribution by the employer. Effective the first pay period following ratification of this Agreement, employees will continue to pay no more than 12.4% of the health insurance premium and the employer will continue to pay the remainder. In no event shall the FOP bargaining unit employees be required to pay a greater dollar amount of monthly contribution than the lowest dollar amount of monthly contribution paid by any other non- bargaining employees under the direct auspices of the County Commissioners and employees of the Sheriff’s Office, except for employees who earn premium contribution incentives. All employee contributions paid by the employee will be paid for under IRS Chapter 125 on a pre-tax basis in accordance with the rules set forth by the IRS. The prescription current co-pay formula will apply to the bargaining unit members, except that the County may propose changes as indicated in this section.
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Related to Health, Hospitalization, Surgical and Major Medical

  • Hospitals a. In every Hospital:

  • Hospital This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. Residential Treatment Facility This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. Intermediate Care Services This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.

  • Medical Care Leave An Employee who is unable to make the necessary arrangements for maintenance of personal health care outside of scheduled work time, shall be granted time off with pay. Such time off shall not exceed sixteen (16) working hours per calendar year. Hours in excess of sixteen (16) hours per calendar year shall be deducted from the Employee's sick leave accumulation.

  • 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.

  • Orthodontics We Cover orthodontics used to help restore oral structures to health and function and to treat serious medical conditions such as: cleft palate and cleft lip; maxillary/mandibular micrognathia (underdeveloped upper or lower jaw); extreme mandibular prognathism; severe asymmetry (craniofacial anomalies); ankylosis of the temporomandibular joint; and other significant skeletal dysplasias. Procedures include but are not limited to: • Rapid Palatal Expansion (RPE); • Placement of component parts (e.g. brackets, bands); • Interceptive orthodontic treatment; • Comprehensive orthodontic treatment (during which orthodontic appliances are placed for active treatment and periodically adjusted); • Removable appliance therapy; and • Orthodontic retention (removal of appliances, construction and placement of retainers).

  • Medical There shall be an open enrollment period for medical coverage in each year of this Agreement. An employee may elect no medical coverage during any open enrollment period. An employee who has elected no medical coverage may elect medical coverage during an open enrollment period. No pre-existing condition limitations will apply.

  • Health Care Operations Health Care Operations shall have the meaning set out in its definition at 45 C.F.R. § 164.501, as such provision is currently drafted and as it is subsequently updated, amended or revised.

  • Prosthodontics We Cover prosthodontic services as follows: • Removable complete or partial dentures, for Members 15 years of age and above, including six (6) months follow-up care; • Additional services including insertion of identification slips, repairs, relines and rebases and treatment of cleft palate; and • Interim prosthesis for Members five (5) to 15 years of age. We do not Cover implants or implant related services. Fixed bridges are not Covered unless they are required: • For replacement of a single upper anterior (central/lateral incisor or cuspid) in a patient with an otherwise full complement of natural, functional and/or restored teeth; • For cleft palate stabilization; or • Due to the presence of any neurologic or physiologic condition that would preclude the placement of a removable prosthesis, as demonstrated by medical documentation.

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