Common use of Hospital/Medical Benefits Clause in Contracts

Hospital/Medical Benefits. In the event the Board of Education selects an insurance carrier other than Blue Cross, the Board will meet with the Union prior to such selection, show the policy and establish comparable coverage. Please note the following rates include the 20% medical contribution as well as the FSA ceded amount. The following rates are subject to change after the current plan year of 10/01/12 – 06/30/13. Office Visit co-pay $15.00 In-network Deductible $100 Single/$200 Family Emergency Room co-pay $50.00 Urgent Care co-pay $15.00 PRESCRIPTION PLAN WILL BE PROVIDED to include a $10.00 co-pay (Generic) and $40.00 co-pay (Brand). Lifestyle drugs which are cosmetic or performance enhancement shall not be included in coverage, unless medically necessary. Single $166.44 Couple $385.47 Family $479.33 Office Visit co-pay $20.00 In-network Deductible $250 Single/$500 Family Emergency Room co-pay $50.00 Urgent Care co-pay $20.00 Single $98.24 Couple $221.77 Family $274.71 The following BCBSM PPO Basic Plan is the only option available to those hired after July 1, 2010, other employees may elect to have this plan during open enrollment. Office Visit co-pay $30.00 In-network Deductible $500 Single/$1000 Family Emergency Room co-pay $100 Urgent Care co-pay $30.00 PRESCRIPTION PLAN WILL BE PROVIDED to include a $10.00 co-pay (Generic) and $40.00 co-pay (Brand). Lifestyle drugs which are cosmetic or performance enhancement shall not be included in coverage, unless medically necessary. Single $90.53 Couple $203.27 Family $251.58 Office Visit co-pay $15.00 Emergency Room co-pay $50.00 Urgent Care co-pay $30.00 PRESCRIPTION PLAN WILL BE PROVIDED to include a $10.00 co-pay (Generic) and $40.00 co-pay (Brand). Lifestyle drugs which are cosmetic or performance enhancement shall not be included in coverage, unless medically necessary. Single $110.34 Couple $250.82 Family $311.02 All full-time employees will receive a $600 employer-funded contribution (pro-rated to $400 for the shortened benefit year of 10/1/12 to 6/30/13) to either the FSA or the DCA. Part-time employees who are paying 50% of their premium will also be eligible to receive a $530 (pro-rated to $353.33 for the shortened benefit year of 10/1/12 to 6/30/13) employer-funded contribution to either the FSA or the DCA. The Board of Education agrees to continue these coverages throughout the term of this Agreement. To implement these coverages, the Board agrees to pay for each subscriber on the following basis: Full Time Part Time (3-6) Single Subscriber 2 Person Employee & Family Single Subscriber Entire Amount Entire Amount Entire Amount 1/2 Entire Amount hours per day) 2 Person Employee & Family 1/2 Entire Amount 1/2 Entire Amount Hardship Cases Single Subscriber 1/2 Entire Amount (less than 3 hours 2 Person 1/2 Entire Amount by approval of the Superintendent only) Employee & Family 1/2 Entire Amount Part Time Participation (less Single Subscriber Employee pays Entire Amount than 3 hours on a 2 Person Employee pays Entire Amount regular basis) Employee & Family Employee pays Entire Amount It is further understood that the part-time voluntary participation category constitutes employees who are not participants in the other three categories listed above. The following is also agreed to:

Hospital/Medical Benefits. In the event the Board of Education selects an insurance carrier other than Blue Cross, the Board will meet with the Union prior to such selection, show the policy and establish comparable coverage. Please note Employees, who wish to remain in the following rates include the 20% medical Traditional Plan, will be required to pay an employee contribution (stipulated as well as the FSA ceded amount$97/mo until July 1, 2007). The following rates are subject to change after the current plan year of 10/01/12 – 06/30/13. BCBSM (or comparable) PPO Plan Office Visit co-pay $15.00 In-network Deductible $100 Single/$200 Family Emergency Room co-pay $50.00 Urgent Care co-pay $15.00 PRESCRIPTION PLAN WILL BE PROVIDED to include a $10.00 co-pay (Generic) and $40.00 co-15.00 co- pay (Brand). Lifestyle drugs which are cosmetic or performance enhancement shall not be included in coverage, unless medically necessary. Single $166.44 Couple $385.47 Family $479.33 Office Visit co-pay $20.00 In-network Deductible $250 Single/$500 Family Emergency Room co-pay $50.00 Urgent Care co-pay $20.00 Single $98.24 Couple $221.77 Family $274.71 The following BCBSM PPO Basic Health Alliance Plan is the only option available to those hired after July 1, 2010, other employees may elect to have this plan during open enrollment. Office Visit co-pay $30.00 In-network Deductible $500 Single/$1000 Family Emergency Room co-pay $100 Urgent Care co-pay $30.00 PRESCRIPTION PLAN WILL BE PROVIDED to include a $10.00 co-pay (GenericHAP) and $40.00 co-pay (Brand). Lifestyle drugs which are cosmetic or performance enhancement shall not be included in coverage, unless medically necessary. Single $90.53 Couple $203.27 Family $251.58 comparable) HMO Plan Office Visit co-pay $15.00 Emergency Room co-pay $50.00 Urgent Care co-pay $30.00 PRESCRIPTION PLAN WILL BE PROVIDED to include a $10.00 co-pay (Generic) and $40.00 co-15.00 co- pay (Brand). Lifestyle drugs which are cosmetic or performance enhancement shall not be included in coverage, unless medically necessary. Single Blue Care Network (BCN) or (comparable) HMO Plan Office Visit co-pay $110.34 Couple 15.00 Emergency Room co-pay $250.82 Family 50.00 Urgent Care co-pay $311.02 50.00 PRESCRIPTION PLAN WILL BE PROVIDED to include a $7.00 co-pay (Generic) and $15.00 co- pay (Brand). Lifestyle drugs which are cosmetic or performance enhancement shall not be included in coverage, unless medically necessary. All full-time employees will receive a $600 400 employer-funded contribution (pro-rated to $400 for the shortened benefit year of 10/1/12 to 6/30/13) to either the FSA or the DCA. Part-time employees who are paying 50% of their premium will also be eligible to receive a $530 (pro-rated to $353.33 for the shortened benefit year of 10/1/12 to 6/30/13) 400 employer-funded contribution to either the FSA or the DCA. The Board of Education agrees to continue these coverages throughout the term of this Agreement. To implement these coverages, the Board agrees to pay for each subscriber on the following basis: Full Time Part Time (3-6) Single Subscriber 2 Person Employee & Family Single Subscriber Entire Amount 2 Person Entire Amount Entire Amount 1/2 Entire Amount hours per day) 2 Person Employee & Family 1/2 Entire Amount 1/2 Entire Amount Hardship Cases Single Subscriber 1/2 Entire Amount (less than 3 hours 2 Person 1/2 Entire Amount by approval of the Superintendent only) Employee & Family 1/2 Entire Amount Superintendent only) Part Time Participation (less Single Subscriber Employee pays Entire Amount than 3 hours on a 2 Person Employee pays Entire Amount regular basis) Employee & Family Employee pays Entire Amount It is further understood that the part-time voluntary participation category constitutes employees who are not participants in the other three categories listed above. The following is also agreed to: