Common use of Hospital-Medical Insurance Clause in Contracts

Hospital-Medical Insurance. ‌ 1. The Board agrees to purchase for teachers not covered by any other employer paid group hospital-medical insurance full family hospital-medical insurance. The parties agree that effective July 1, 2013, the plan offered will be the MESSA ABC Plan 1 with the Rx Saver with a deductible that meets IRS guidelines for a High Deductible Plan. The parties may mutually agree to offer other plan options where appropriate. Effective with the ratification of this agreement, the District shall pay on a monthly basis the maximum permitted annual amounts as determined by the State Treasurer under PA 152 of 2011 toward the total cost of the MESSA medical premium. If the aggregate costs of the medical premium are less than the aggregate maximum amounts payable, the differential will be redistributed to those members enrolled in the medical plan in the form of HSA contributions in an agreed upon manner. Should the aggregate costs of the medical premiums exceed the aggregate maximum amounts payable under PA 152 of 2011, the remaining cost for the teacher’s elected medical premiums for each school year shall be paid by the teacher through pre-tax payroll deductions. The maximum amounts payable by the Board shall be adjusted each July 1 to the maximum permitted based on inflationary adjustments calculated the previous October as included in PA 152 of 2011. Notwithstanding any other obligations in this Agreement, the Employer reserves the right to, in its sole discretion, select a health insurance carrier with offers a “bronze” plan that provides “minimum coverage” pursuant to 26 USC Section 36(B)(c)(C)(ii). 2. The Board may require each teacher to certify, in writing, that s/he is not covered by any other employer paid hospital-medical insurance. Any teacher who has signed up for and is covered by hospitalization-medical coverage in violation of this Article will re-pay to the employer, all premium monies which the employer has paid for such benefits.

Hospital-Medical Insurance. ‌ 1. The Board agrees to purchase for teachers not covered by any other employer paid group hospital-medical insurance full family hospital-medical insurance. The parties agree that effective July 1, 2013, the plan offered will be the MESSA ABC Plan 1 with the Rx Saver with a deductible that meets IRS guidelines for a High Deductible Plan. The parties may mutually agree to offer other plan options where appropriate. Effective with the ratification of this agreement, the District shall pay on a monthly basis the maximum permitted annual amounts as determined by the State Treasurer under PA 152 of 2011 toward the total cost of the MESSA medical premium. If the aggregate costs of the medical premium are less than the aggregate maximum amounts payable, the differential will be redistributed to those members enrolled in the medical plan in the form of HSA contributions in an agreed upon manner. Should the aggregate costs of the medical premiums exceed the aggregate maximum amounts payable under PA 152 of 2011, the remaining cost for the teacher’s elected medical premiums for each school year shall be paid by the teacher through pre-tax payroll deductions. The maximum amounts payable by the Board shall be adjusted each July 1 to the maximum permitted based on inflationary adjustments calculated the previous October as included in PA 152 of 2011. Notwithstanding any other obligations in this Agreement, the Employer reserves the right to, in its sole discretion, select a health insurance carrier with offers a “bronze” plan that provides “minimum coverage” pursuant to 26 USC Section 36(B)(c)(C)(ii). 2. The Board may require each teacher to certify, in writing, that s/he is not covered by any other employer paid hospital-medical insurance. Any teacher who has signed up for and is covered by hospitalization-medical coverage in violation of this Article will re-pay to the employer, all premium monies which the employer has paid for such benefits.

Hospital-Medical Insurance. ‌ 1. The Board agrees to purchase for teachers not covered by any other employer paid group hospital-medical insurance full family hospital-medical insurance. The parties agree that effective July 1, 2013, the plan offered will be the MESSA ABC Plan 1 with the Rx Saver with a deductible that meets IRS guidelines of $1,250 per year for a High Deductible Plan. The parties may mutually agree to offer other plan options where appropriatesingle and $2,500 per year for individual and spouse and for full family. Effective with the ratification of this agreement, the District shall pay on a monthly basis the maximum permitted annual amounts as determined by the State Treasurer under PA 152 of 2011 toward the total cost of the MESSA medical premium. If the aggregate costs of the medical premium are less than the aggregate maximum amounts payable, the differential will be redistributed to those members enrolled in the medical plan in the form of HSA contributions in an agreed upon manner. Should the aggregate costs of the medical premiums exceed the aggregate maximum amounts payable under PA 152 of 2011, the remaining cost for the teacher’s elected medical premiums for each school year shall be paid by the teacher through pre-tax payroll deductions. The maximum amounts payable by the Board shall be adjusted each July 1 to the maximum permitted based on inflationary adjustments calculated the previous October as included in PA 152 of 2011. Notwithstanding Not withstanding any other obligations in this Agreement, the Employer reserves the right to, in its sole discretion, select a health insurance carrier with offers a “bronze” plan that provides “minimum coverage” pursuant to 26 USC Section 36(B)(c)(C)(ii). Effective with the ratification of this Agreement, teachers receiving cash in lieu of medical insurance will receive the balance of the amount owed for the 2012- 13 school year. The cash in lieu option will then be discontinued. 2. The Board may require each teacher to certify, in writing, that s/he is not covered by any other employer paid hospital-medical insurance. Any teacher who has signed up for and is covered by hospitalization-medical coverage in violation of this Article will re-pay to the employer, all premium monies which the employer has paid for such benefits. 3. Effective with the 2006-07 school year, and through the reimbursement for the 2011-12 expenses as outlined herein, a fund (the Rx Pool) of $100,000 will be set aside each year to reimburse members for incurred prescription co-pays in excess of $400. After submitting proof by November 30 of each year that the family has incurred $400 in Rx co-pays covered under a WWCSD sponsored health insurance plan, a member can submit proof of additional covered Rx co- pays ($10 or $20) for reimbursement. Proof of payment must include date, amount of co-pay, member or dependent’s name, but the name of the Rx may be redacted. The yearly reimbursement period for Rx co-pays will be between November 1 and October 31. If the total of the collectively submitted claims exceed the Rx Pool Maximum payments will be made on a prorated basis. Expenses reimbursed under the Section 125 plan are not eligible for reimbursement under this provision. Only those WWEA members taking health care through the District are eligible for the Rx Pool. There shall be no Rx Pool beyond the 2012-13 school year and none of the expenses outlined herein shall be reimbursed. 4. Effective with the 2011-12 school year, all WWEA members who receive WWCSD sponsored health insurance will pay 10% of the combined total costs for medical, pharmacy, dental, vision, disability, long-term disability or any other type of benefit that would constitute a health care services benefit. This premium share will be paid through the District sponsored Section 125 plan on a pre-tax basis. Payments will be made in the form of a payroll deduction for 20 pay periods. Payments under this provision will stop at the end of the 2012- 13 school year.