Health Plans. A. The health plans offered and benefits provided by those plans shall be those recommended by the JLMBC, approved by the City Council, and administered by the Personnel Department in accordance with LAAC Section 4.
Health Plans. All MAMP Benefit Plans that are group health plans, including health care flexible spending accounts, have been operated in compliance in all material respects with the requirements of Section 4980B of the Code and Parts 6 and 7 of Title I of ERISA, to the extent those requirements are applicable. No MAMP Benefit Plan provides (or has any obligation to provide) postretirement medical or life insurance benefits to any Service Providers, except as otherwise required under state or Federal benefits continuation Laws. No MAMP Benefit Plan that is a Welfare Plan is (i) a “multiple employer welfare arrangement” within the meaning of Section 3(40) of ERISA, or (ii) a “voluntary employees’ beneficiary association” within the meaning of 501(c)(9) of the Code or other funding arrangement for the provision of welfare benefits (such disclosure to include the amount of any such funding), or (iii) self-insured by MAMP or any MAMP Subsidiary. None of MAMP, the MAMP Subsidiaries or the MAMP Benefit Plans have failed to comply with the Patient Protection and Affordable Care Act and its companion xxxx, the Health Care and Education Reconciliation Act of 2010, to the extent applicable, whether as a matter of substantive Law or in order to maintain any intended Tax qualification, and no excise Tax, penalty, or assessable payment under the Patient Protection and Affordable Care Act of 2010, as amended, and all regulations thereunder, including Section 4980H of the Code, is outstanding, has accrued, or has arisen with respect to any period prior to the Closing.
Health Plans. (i) Trident shall cause Fountain to establish the Fountain Health Plans (including the Fountain Retiree Medical Plans) effective no later than the Fountain Distribution Date and, correspondingly, Fountain Employees and their dependents shall cease participating in the Trident Health Plans on the dates the new plans are established and effective. The newly established Fountain Health Plans shall be substantially similar to the Trident Health Plans. After the Fountain Distribution Date (except as otherwise provided below): (A) Fountain shall be solely responsible for the management and administration of the Fountain Health Plans and solely responsible for the payment of all employer-related costs in establishing and maintaining the Fountain Health Plans, and for the collection and remittance of participant contributions and premiums and shall establish and appoint a plan administrator and a HIPAA privacy official, and shall establish a claims and appeals process with its claims administrator(s), and (B) Trident shall retain sole responsibility for all Liabilities under the Trident Health Plans and sole responsibility for the payment of all employer-related costs in maintaining the Trident Health Plans, and for the collection and remittance of participant contributions and premiums.
(ii) Except as provided below, Fountain shall be solely responsible for the adjudication of any claims filed by a Fountain Employee or Former Fountain Employee (or any dependent thereof) before, on or after the Fountain Distribution Date under a Trident Health Plan or Fountain Health Plan. Notwithstanding the previous sentence, Trident shall be solely responsible for the adjudication of any claims filed by a Fountain Employee or Former Fountain Employee (or any dependent thereof) under a Trident Health Plan or Fountain Health Plan before the Fountain Distribution Date that (A) has not been finally adjudicated by Trident on the day immediately preceding the Fountain Distribution Date; and (B) under the applicable claims procedure, Trident’s plan administrator or other authorized person or committee will have a less than sixty (60) day period after the Fountain Distribution Date to respond to such claim. Notwithstanding the previous sentence, if Trident’s response to such claim does not finally adjudicate the claim, Trident shall immediately upon sending its response to the claimant transfer administration of such claim to Fountain for final adjudication.
(iii) Any determination mad...
Health Plans. During the term of this MOU, Management agrees to continue contributing for each full-time employee a monthly subsidy equal to the cost of his/her medical plan but not to exceed the Xxxxxx Permanente Family rate. During the term of this MOU, Management agrees to continue contributing for each regular half- time employee a monthly subsidy equal to the cost of his/her medical plan but not to exceed the Xxxxxx Permanente Single Party rate. Management will apply the subsidy first to the employee's coverage. Any remaining balance will be applied to the coverage of the employee's qualified dependents named under the plan. During the term of this MOU, the City’s contribution to health care plan costs (monthly health care subsidy) shall be adjusted based on changes in the Xxxxxx Permanente Family Rate for full-time employees and in the Xxxxxx Permanente Single Party Rate for regular half-time employees. Changes in the monthly subsidy shall be effective at the beginning of the pay period in which the Xxxxxx Permanente yearly premium rate change is implemented. Employees who transfer from full-time to half-time status under Family and Medical Leave provisions contained herein shall continue to receive the same subsidy as full-time employees and shall be subject to any adjustments applied to that subsidy as provided in this Article. During the term of this MOU, the JLMBC will review all rate changes and their impact on the Health Plans. The following provisions will apply to unit members enrolled in a City-sponsored health care plan and eligible for the health care subsidy. Effective January 1, 2016, unit members shall pay 10% of the City’s monthly health care premium (deducted on a biweekly basis) when the amount of their monthly health care premium for the health care plan in which they are enrolled is less than or equal to the amount of the City's maximum monthly health care subsidy. In the event that unit members are enrolled in a health care plan that has a monthly premium that exceeds the City's maximum monthly subsidy, then, effective January 1, 2016, such members shall pay on a biweekly basis the total of the difference between the cost of their monthly health care premium and the City's maximum monthly health care subsidy, plus half of 10% of the City's maximum monthly health care subsidy (deducted on a biweekly basis).
Health Plans. The health plans offered and benefits provided by those plans shall be those approved by the City’s Joint Labor-Management Benefits Committee and administered by the Personnel Department in accordance with LAAC Section 4.303. Effective January 1, 2015, Management agrees to contribute a monthly sum not to exceed the Kaiser family rate (“maximum monthly health care subsidy”) per full-time employee toward the cost of a City-sponsored health plan for employees who are members of the Los Angeles City Employees' Retirement System (LACERS). During the term of this MOU, Management’s monthly health care subsidy for full-time employees shall increase by the increase in the Xxxxxx Permanente family rate. Increases in this monthly health care subsidy shall be effective at the beginning of the pay period in which the Xxxxxx Permanente yearly premium rate change is implemented. Management will apply the subsidy first to the employee’s coverage. Any remaining balance will be applied toward the coverage of the employee’s dependents under the plan. Management agrees to contribute for each half-time employee, as defined by Section
Health Plans. The health plans offered and benefits provided by those plans shall be those approved by the City’s Joint Labor-Management Benefits Committee and administered by the Personnel Department in accordance with LAAC Section 4.303. Effective January 1, 2007, Management agrees to contribute a monthly sum not to exceed $857.02 per month per full-time employee, effective the beginning of the pay period in which the Kaiser yearly premium rate change is implemented, toward the cost of a City- sponsored health plan for employees who are members of the Los Angeles City Employees' Retirement System (LACERS). Effective January 1, 2008, Management agrees to contribute for each full-time employee who is a member of LACERS a subsidy equal to the cost of his/her medical plan, not to exceed $948.36. Management will apply the subsidy first to the employee's coverage. Any remaining balance will be applied toward the coverage of the employee's dependents under the plan. During the term of this MOU, Management's monthly subsidy for full-time employees shall increase by the increase in the Xxxxxx Permanente family rate. Increases in this monthly subsidy shall be effective at the beginning of the pay period in which the Xxxxxx Permanente yearly premium rate change is implemented. Management agrees to contribute for each half-time employee, as defined by Article 49 of this MOU, who became a member of LACERS following July 24, 1989, and for each employee who transfers from full-time to half-time status following July 24, 1989, a monthly subsidy not to exceed $329.62, effective January 1, 2007. Half-time employees who, prior to July 24, 1989, were receiving the same subsidy as full-time employees shall continue to receive that subsidy and shall be eligible to receive any increases applied to that subsidy as provided in this Article. Effective January 1, 2008, Management agrees to contribute for each half-time employee a monthly subsidy not to exceed $364.76 per employee. During the term of this MOU, Management's monthly subsidy for half-time employees shall increase by the increase in the Xxxxxx Permanente single-party rate. Increases in this monthly subsidy shall be effective at the beginning of the pay period in which the Xxxxxx Permanente yearly premium rate change is implemented. Any employee who was receiving a full health subsidy as of July 24, 1989, in accordance with this Article, who transfers to half-time status following that date shall continue to be eligible for the full ...
Health Plans. If, at the time of separation from service, Executive is a "specified employee" within the meaning of Section 409A(a)(2)(B)(i) and the Treasury Regulations, Executive shall pay the full cost of coverage for Executive and his dependent(s) under Employer's health care and hospitalization plan(s), determined according to the rates for continuation coverage under COBRA (but excluding the additional two percent (2%) administrative fee) for the first six (6) months of coverage following Executive's separation from the service of Employer as defined in Code section 409A(a)(2)(A)(i) and the Treasury Regulations. Beginning with the seventh (7th) month following Executive's separation from the service of Employer as defined in Code section 409A(a)(2)(A)(i) and the Treasury Regulations if Executive is a "specified employee," or beginning with the first month of coverage if, at the time of separation from service, Executive is not a "specified employee," Executive shall pay the same cost for coverage under the health plan as active employees of Employer. Coverage for Executive and Executive's dependents shall terminate on the last day of the month in which Executive's 65th birthday shall occur. All claims made by Executive and Executive's dependents under the health plan shall be paid no later than the last day of the calendar year following the calendar year in which such claims were incurred. Executive agrees that he will promptly reimburse Employer for any claims that are paid after the last day of the calendar year following the calendar year in which such claims were incurred.
Health Plans. All group health plans of the Company, each Subsidiary of the Company and any ERISA Affiliate have been operated in compliance in all material respects with the group health plan continuation coverage requirements of Section 4980B of the Code. Except as required under Section 4980B of the Code or as provided in the Company's Employee Severance Plan, neither the Company, any Subsidiary of the Company nor any ERISA Affiliate has any obligation to provide health benefits to any employee following termination of employment.
Health Plans. It is agreed that Kaiser, Anthem Blue Cross HMO or Anthem Blue Cross EPO will be approved programs available to eligible unit members. It is further agreed either party may suggest additional or different programs as they become available. Adding or changing any such program shall be only with concurrence of each party after consultation.
21.6.4.1 The health plans may be changed by mutual agreement of the District and United Faculty. If a carrier fails to renew the program under current conditions or otherwise ceases to offer the program, then the parties will negotiate concerning the replacement of the carrier. No more than two representatives of the District and two represen- tatives of the United Faculty (who may be a health care expert and/or consultant) will meet on request of either party to consult on this issue, before referring the issue to negotiations. Representatives of other employee groups may also be present. The District agrees that all data needed by the consultants shall be provided. All replacement carriers must meet at least the following conditions:
21.6.4.1.1 All HMO health plans shall be provided with the prescription option.
21.6.4.1.2 Provide retiree coverage.
21.6.4.1.3 Allow open enrollment periods for retirees.
Health Plans. House Officers are eligible for the same health insurance/HMO plans as those for state employees or for Health Science Center students. Other health insurance may be chosen if desired and paid for by House Officers. As a condition of employment, House Officers agree to maintain one of these health plans or another plan with equal or better benefits.
