HMO Plan. Brief description of coverage: Effective March 1, 2013, this plan will be 3 referred as the HMO TALB plan. The ability to move between the HMO 4 and Comprehensive Major Medical is no longer available. Continuation of 5 existing plan without modification of benefits, except as noted. 6 7 HMO. Office visits, $10; no deductible; hospitalization 100% covered.
HMO Plan. The Hospitals may, after sixty (60) days’ notice to the Union, reduce the actuarial value of the HMO Plan by up to two percent (2%) over the life of this Agreement. Upon the Union’s request, the Hospital shall meet and confer with the Union over the proposal.
HMO Plan. The City shall offer an HMO plan, which will be the same plan that is offered to the City’s non-represented employees as of the effective date of this Agreement. The City can change the HMO plan from time-to-time, consistent with Article 18, Section A, as long as such changes apply equally to FOP employees as they are applied to the non-represented employees. All changes will be communicated during Open Enrollment for the upcoming insurance plan year and will be effective no sooner than January 1 of the first plan year after which the changes are communicated. Deductible: • Single $2,500 • Family $5,000 Out-of-Pocket: • Single $2,750 (includes deductible) • Family $6,850 (includes deductible) Emergency Room copay – Deductible applies, then 100% • Deductible applies, then 100% • The High Deductible Health Plan shall have associated with it a Health Savings Account (HSA). To the extent permitted by IRS regulations, employer contributions to the HSA shall be 50% of the deductibles for single and family coverage • Pursuant to the above formula, the City will make the following HSA contributions annually on behalf of current employees who enroll in the HDHP plan (not retirees) o $1,250 for employees with single coverage o $2,500 for employees with family coverage • In 2018 only, any current employee (not retirees) who enrolls in the HDHP Plan will receive a one-time cash payment as follows: o $500 for single coverage o $1,000 for family coverage o Employees can voluntarily elect to put this money into their HSA account. Subject to IRS rules, such voluntary contributions may be entitled to special tax treatment. Any employee who receives the bonus payment must remain in the HDHP plan for 36 months. If the employee opts out of the HDHP having participated in the plan less than 36 months, he will be required to repay the bonus via payroll deduction. Deductible: Single $2,000 Out-of-Pocket: Single $2,500 Emergency Room copay - $100 Chiropractic Services unlimited Pharmacy 30 day supply – local 90 day supply – mail order Generic $25 Generic $25 Formulary $50 Formulary $50 Namebrand $75 Namebrand $75 Mandatory mail order on maintenance drugs (90 day maximum fill). Retail fill (30 days maximum fill) allowed up to 3 months, then must go under mail order or pay the full retail price. If physician allows generic substitution, and individual requests name brand, then the charge will be the $75 name brand fill co-pay PLUS the cost difference between the generic drug to...
HMO Plan. (a) individual coverage;
(b) individual plus one coverage;
(c) family coverage;
HMO Plan. (a) Effective January 1, 2004 2003, employees enrolled in the HMO plans shall make a monthly contribution toward the cost of providing the HMO, at the rate of 12.5% of the actual premium charged by the HMO for plan year 2004 2003. The monthly contribution shall be divided equally and withheld during the first two pay periods of each month for the following tiers: Employee Only Employee plus spouse Employee plus child Employee plus children Employee plus spouse, plus children Effective January 1, 2005 2004, the employee monthly contribution toward the cost of providing the HMO will be 15% of the actual premium charged by the HMO for plan year 2004.
(b) The parties adopt the level of benefits for the Community Care HMO at Alternate Plan 3, as described in the letter of May 7, 2002 to the City. The parties adopt the level of benefits for the PacifiCare of Oklahoma LG $10/100% (Alternate Plan 2), as described in PacifiCare’s quoted benefits to the City of April 17, 2002
2. The parties will continue to evaluate proposals with the intent of maintaining or improving benefit levels, through the HMO Selection Committee and the Joint Insurance Committee. Any changes made in benefit levels must be mutually agreed upon by the American Federation of State, County and Municipal Employees, Local 2406 and The City.
HMO Plan. (a) Effective January 1, 2018 2017, employees enrolled in the HMO plans shall make a monthly contribution toward the cost of providing the HMO, at the rate of 15% of the actual premium charged by the HMO for plan year 2018 2017, (as based upon the plan design going into effect January 1, 2018). The monthly contribution shall be divided equally and withheld during the first two pay periods of each month. The monthly contribution is as follows for the following tiers: Employee Only $119.24 Employee plus spouse $268.32 Employee plus child $208.70 Employee plus children $256.40 Employee plus spouse, plus children $369.70
(b) Effective January 1, 2018, the parties adopt the level of benefits for the United Healthcare medical plan of N8V/N9V and prescription drug plan of ON7. The general features of these plans are as follows: Calendar year deductible Individual $0 Family $0 Primary Care Physician (PCP) Office Visits $15 copayment Specialist Physician (PCP) Office Visits $15 copayment Inpatient Hospitalization $100 copayment/admission Outpatient Surgery $50 copayment Emergency Room Services $50 copayment ($0 if admitted as an inpatient from the ER) Annual out-of-pocket maximum Individual $1,500 Family $3,000 Retail Generic Formulary Prescriptions $10 Retail Brand Formulary Prescriptions $25 Retail Non-Formulary Prescriptions $40 Mail Order Generic Prescriptions $20 Mail Order Brand Prescriptions $50 Mail Order Non-Formulary $80 For other benefits available under these plans, please refer to plan documents N8V/N9V and ON7 from United Healthcare. Should any legal restriction upon the term of this agreement make this addendum voidable, the parties can reaffirm their intent in a subsequent agreement.
(a) Effective May 1, 2018 eEmployees enrolled in the HMO plans shall make a monthly contribution toward the cost of providing the HMO, at the rate of 15% of the actual premium charged by the HMO for plan year 2018, (as based upon the plan design going into effect May 1, 2018). The monthly contribution shall be divided equally and withheld during the first two pay periods of each month. The monthly contribution is as follows for the following tiers: The monthly contributions in effect on July 1, 2018, will remain in effect through December 31, 2018, as follows: Employee Only $113.41 Employee plus spouse $255.20 Employee plus child $198.49 Employee plus children $243.86 Employee plus spouse, plus children $351.61 For plan year 2019, effective January 1, 2019, the monthly ...
HMO Plan. Employee - $13.55 per week Employee + child (ren) - $26.71 per week PPO Plan: Employee - $36.74 per week Employee + child (ren) - $80.31 per week This article applies only to employees with sixty (60) days or more of seniority but does not apply to part-time employees.
HMO Plan. Term of Contract -– Not to exceed 10% of the total HMO premium for whichever coverage is selected.
HMO Plan. 1. (a) Effective January 1, 2006 2005, employees enrolled in the HMO plans shall make a monthly contribution toward the cost of providing the HMO, at the rate of 15% 12.5% of the actual premium charged by the HMO for plan year 2006 2005. The monthly contribution shall be divided equally and withheld during the first two pay periods of each month for the following tiers: Employee Only Employee plus spouse Employee plus child Employee plus children Employee plus spouse, plus children
HMO Plan. Brief description of coverage: Effective March 1, 2013, this plan will be referred as the HMO TALB plan. The ability to move between the HMO and Comprehensive Major Medical is no longer available. Continuation of existing plan without modification of benefits, except as noted. Emergency Room Visit: $100 co-pay, effective 3/1/2013. The fee is waived if the person is admitted to the hospital. Chiropractic Care (Blue Shield HMO): $5 co-pay, up to 30 visits per year, effective 1/1/07. Prescription Plan: Effective 3/1/2013, prescriptions will be carved into the HMO plan. Retail co-pay per thirty (30) day prescription: $5 generic; $10 formulary; and $35 non-formulary. Mail order co-pay for up to ninety
