Common use of HOSPITALIZATION AND MAJOR MEDICAL INSURANCE Clause in Contracts

HOSPITALIZATION AND MAJOR MEDICAL INSURANCE. The Board, throughout the term of this Agreement, will maintain a group major medical and dental insurance policy. The Board reserves the right to institute cost containment measures relative to insurance coverage so long as the basic level of insurance benefits remains substantially similar to the insurance coverage in effect at that time. Such changes may include, but are not limited to, mandatory second opinions for elective surgery, pre- admission and continuing admission review, and prohibition on weekend admissions except in emergency situations, and mandatory outpatient elective surgery for certain designated surgical procedures. Through the term of this contract the Board will pay the individual member’s group major medical and dental insurance policy premium for all full-time employees. For purposes of this Article, full time employees are defined as employees who work and are paid for over 7.5 hours a day on a five-day a week basis for the school year. Full-time employees that elect to do so may choose dependent coverage with the premiums for the coverage paid through payroll deductions. Employees may elect to do so annually during the open enrollment window. In the event a current part-time employee becomes a full-time employee the employee shall be eligible to take advantage of this provision. For full time members that choose dependent coverage, the District will contribute 45% of the employee’s family dependent medical premium to offset the cost. In the event that other employee dependent options are available, the District will contribute 15% of the employee’s spouse only medical premium and 10% of the employee’s child/children only medical premium. The District will not contribute toward the employee’s dependent dental or vision insurance premium. Employees who choose not to take dependent health coverage during the annual open enrollment who experience life-changing circumstances that terminate other insurance coverage or add additional dependents may opt for dependent coverage outside the annual window with in thirty (30) days of said life-changing circumstances. A Board directed insurance committee, including members of the NBESS, shall convene annually no later than February to begin assessment of the current coverage. The committee will investigate alternative insurance carriers, coverage, and related matters to advise the Board. Nothing herein shall be construed to limit the Board’s discretion as to the carrier or the insurance policy at the time. The extent of coverage under any insurance policies referred to in this agreement shall be governed by the terms and conditions as set forth in the policies. Any questions or disputes concerning the insurance policies or benefits hereunder shall be resolved in accordance with the terms set forth in said policies and shall not be subject to the grievance and arbitration procedure set forth in this agreement. However, nothing in this agreement shall be construed to relieve and insurance carrier(s) from any liability that it may have to the Board, employee or beneficiary of an employee. Employees who qualified for insurance under the previous contract language will continue insurance coverage based upon the definition of full- time being over 6.5 hours per day as long as they continue in the same position, inclusive of being honorably dismissed and recalled to that same position. Through the term of this contract, all full-time Association members will pay a monthly contribution of $10 toward their major medical insurance.

HOSPITALIZATION AND MAJOR MEDICAL INSURANCE. The Boardgroup major medical, vision and dental insurance policy will be maintained by the District throughout the term of this Agreement, will maintain a group major medical and dental insurance policy. The Board District reserves the right to institute cost containment measures relative to insurance coverage so long as the basic level of insurance benefits remains substantially similar to the insurance coverage in effect at that timethe time of this Agreement. Such changes may include, but are not limited to, to mandatory second opinions for elective surgery, pre- pre-admission and continuing admission review, and prohibition on weekend admissions except in emergency situations, situations and mandatory outpatient out-patient elective surgery for certain designated surgical procedures. Through the term of this contract contract, the Board District will pay the individual member’s members group major medical medical, vision and dental insurance policy premium for all full-full time employeesfaculty. For purposes Through the term of this Articlecontract, all full time employees are defined as employees who work Association members will pay a monthly contribution toward their major medical insurance. All full time teachers will pay 9.5% of the cost of medical, dental, vision and are paid for over 7.5 hours life insurance not to exceed $840 per year. The District will pay a day on proportional share of the individual part time teacher’s medical/vision/dental insurance premium equivalent to the percentage of a five-day a school week basis for that the school yearpart time teacher works. Full-Any teacher employed less than 9/10th of 1.0 FTE will not be required to accept District insurance. Full time employees that faculty members may elect to do so may choose dependent coverage with the premiums for the coverage paid deducted through payroll deductions. Employees may elect to do so annually during the open enrollment window. In the event a current part-time employee becomes a full-time employee the employee shall be eligible to take advantage of this provision. For full time faculty members that choose dependent coverage, the District will contribute 4543% of the employee’s family dependent medical premium to offset the cost. In the event that other employee dependent options are availableavailable and the employee meets the qualifications in the preceding sentence, the District will contribute 1513% of the employee’s spouse only medical premium premium, and 10% of the employee’s child/children only medical premium. The District will not contribute toward the employee’s dependent dental or vision insurance premium. Employees A member who choose not to take dependent health coverage during waives the annual open enrollment who experience life-changing circumstances that terminate other insurance coverage or add additional dependents major medical benefit may opt for dependent District paid dental and vision coverage outside for the annual window with in thirty (30) days of said life-changing circumstancesmember and family. A Board District directed insurance committee, ; including members of the NBESS, Association shall convene annually no later than February February, and annually to begin assessment of the current coverage. The committee will investigate alternative insurance carriers, coverage, coverage and related matters to advise the BoardDistrict. Nothing herein shall be construed to limit the Board’s District's discretion as to the carrier or the insurance policy at the time. The extent of coverage under any insurance policies referred to in this agreement shall be governed by the terms and conditions as set forth in the policies. Any questions or disputes concerning the insurance policies or benefits hereunder there under shall be resolved in accordance with the terms set forth in said policies and shall not be subject to the grievance and arbitration procedure set forth in this agreement. The failure of any insurance carrier(s) to provide any benefit for which it is contracted or is obligated shall result in no liability to the District, nor shall such failure be considered by a breach of the District of any obligation undertaken under this or any other agreement. However, nothing in this agreement shall be construed to relieve and any insurance carrier(s) from any liability that it may have to the BoardDistrict, employee faculty member or beneficiary of an employee. Employees who qualified for insurance under the previous contract language will continue insurance coverage based upon the definition of full- time being over 6.5 hours per day as long as they continue in the same position, inclusive of being honorably dismissed and recalled to that same position. Through the term of this contract, all full-time Association members will pay a monthly contribution of $10 toward their major medical insuranceany faculty member.

HOSPITALIZATION AND MAJOR MEDICAL INSURANCE. ‌ The Boardgroup major medical, vision and dental insurance policy will be maintained by the District throughout the term of this Agreement, will maintain a group major medical and dental insurance policy. The Board District reserves the right to institute cost containment measures relative to insurance coverage so long as the basic level of insurance benefits remains substantially similar to the insurance coverage in effect at that timethe time of this Agreement. Such changes may include, but are not limited to, to mandatory second opinions for elective surgery, pre- pre-admission and continuing admission review, and prohibition on weekend admissions except in emergency situations, situations and mandatory outpatient out-patient elective surgery for certain designated surgical procedures. Through the term of this contract contract, the Board District will pay the individual member’s group major medical medical, vision and dental insurance policy premium for all full-full time employeesfaculty. Through the term of this contract, all full time Association members will pay a monthly contribution toward their major medical insurance. The monthly contribution amount per district insured individual will be dependent upon the annual rate increase and the number of insured lives. For purposes example, any District savings realized by a decrease in the number of District insured lives will be applied to the annual increase, thus lowering the contribution amount. The monthly contribution will not exceed $38 during the 2011-2012 school year. During the 2012-2013 school year, dependent on actual major medical insurance premium increases, Association members agree to contribute up to $60 per month. If premium increases exceed this Articlelevel, full the Board of Education will contribute up to $40 per month, per member. If premium increases exceed this level, the Association members and the Board of Education will split the costs of said increases equally. The District will pay a proportional share of the individual part time employees are defined as employees who work and are paid for over 7.5 hours a day on teacher’s medical/vision/dental insurance premium equivalent to the percentage of a five-day a school week basis for that the school yearpart time teacher works. Full-Any teacher employed less than 9/10 times will not be required to accept District insurance. Full time employees that faculty members may elect to do so may choose dependent coverage with the premiums for the coverage paid deducted through payroll deductions. Employees may elect to do so annually during the open enrollment window. In the event a current part-time employee becomes a full-time employee the employee shall be eligible to take advantage of this provision. For full time faculty members that choose dependent coverage, the District will contribute 45% of the employee’s family dependent medical premium to offset the cost. In the event that other employee dependent options are availableavailable and the employee meets the qualifications in the preceding sentence, the District will contribute 15% of the employee’s spouse only medical premium premium, and 10% of the employee’s child/children only medical premium. The District will not contribute toward the employee’s dependent dental or vision insurance premium. Employees A member who choose not to take dependent health coverage during waives the annual open enrollment who experience life-changing circumstances that terminate other insurance coverage or add additional dependents major medical benefit may opt for dependent District paid dental and vision coverage outside for the annual window with in thirty (30) days of said life-changing circumstancesmember and family. A Board District directed insurance committee, including members of the NBESSAssociation, shall convene annually no later than February February, and annually to begin assessment of the current coverage. The committee will investigate alternative insurance carriers, coverage, coverage and related matters to advise the BoardDistrict. Nothing herein shall be construed to limit the Board’s District's discretion as to the carrier or the insurance policy at the time. The extent of coverage under any insurance policies referred to in this agreement shall be governed by the terms and conditions as set forth in the policies. Any questions or disputes concerning the insurance policies or benefits hereunder there under shall be resolved in accordance with the terms set forth in said policies and shall not be subject to the grievance and arbitration procedure set forth in this agreement. The failure of any insurance carrier(s) to provide any benefit for which it is contracted or is obligated shall result in no liability to the District, nor shall such failure be considered by a breach of the District of any obligation undertaken under this or any other agreement. However, nothing in this agreement shall be construed to relieve and any insurance carrier(s) from any liability that it may have to the BoardDistrict, employee faculty member or beneficiary of an employee. Employees who qualified for insurance under the previous contract language will continue insurance coverage based upon the definition of full- time being over 6.5 hours per day as long as they continue in the same position, inclusive of being honorably dismissed and recalled to that same position. Through the term of this contract, all full-time Association members will pay a monthly contribution of $10 toward their major medical insuranceany faculty member.

HOSPITALIZATION AND MAJOR MEDICAL INSURANCE. The Board, throughout the term of this Agreement, will maintain a group major medical and dental insurance policy. A. Certified Employees The Board reserves the right shall provide, at no cost to institute cost containment measures relative to insurance coverage so long as the basic level of insurance benefits remains substantially similar to the insurance coverage in effect at that time. Such changes may include, but are not limited to, mandatory second opinions for elective surgery, pre- admission and continuing admission review, and prohibition on weekend admissions except in emergency situations, and mandatory outpatient elective surgery for certain designated surgical procedures. Through the term of this contract the Board will pay the individual member’s group major medical and dental insurance policy premium for all each full-time employees. For purposes of this Article, full time employees are defined as employees who work employee and are paid for over 7.5 hours a day on a five-day a week basis for the school year. Full-time employees that elect to do so may choose dependent coverage with the premiums for the coverage paid through payroll deductions. Employees may elect to do so annually during the open enrollment window. In the event a current each part-time employee becomes working 50% or more time, a full-time employee hospitalization and major medical insurance plan. The cost of dependent care coverage will be paid by the employee shall be eligible employee. If the District moves to take advantage a different insurance carrier during the terms of this provision. For full time members that choose dependent coveragecontract, the District will contribute 45% of the employee’s family dependent medical premium to offset the cost. In the event that other employee dependent options are available, the District will contribute 15% of the employee’s spouse only medical premium and 10% of the employee’s child/children only medical premium. The District will not contribute toward the employee’s dependent dental or vision insurance premium. Employees who choose not to take dependent health coverage during the annual open enrollment who experience life-changing circumstances that terminate other shall provide insurance coverage equal to or add additional dependents may opt for dependent coverage outside the annual window with in thirty (30) days of said life-changing circumstances. A Board directed insurance committee, including members of the NBESS, shall convene annually no later greater than February to begin assessment of the current coverage. The committee will investigate alternative insurance carriers, coverage, and related matters to advise the Board. Nothing herein shall be construed to limit the Board’s discretion as to the carrier or the insurance policy at coverage provided by the time2023-2024 health insurance plan. The extent All certified employees who provided evidence of coverage under any their spouse’s insurance policies referred plan or other insurance program and elected to in waive entitlement to insurance coverage under this agreement shall be governed by provision to receive a monthly bonus payment of $100.00 per month, minus regular payroll deductions, for each month the terms and conditions as set forth employee waived insurance under this provision, during 2017- 2018, may continue to waive insurance in the policiesfuture. Any questions or disputes concerning the insurance policies or benefits hereunder The parties agree that any bonus paid under this provision shall be resolved in accordance with the terms set forth in said policies constitute a monthly bonus and shall not be considered perpetual salary and shall not be placed on the salary schedule. The parties further agree that in the event Egyptian Area Schools Employee Trust notifies the District that the District is subject to a penalty due to an excessive number of employees who waive their insurance coverage with Egyptian Area Schools Employee Trust, the grievance District shall have the right to reduce the number of employees waiving insurance coverage under this provision. Employees, in reverse order of seniority, shall be notified that they may no longer waive coverage and arbitration procedure set forth in this agreementshall no longer receive the $100.00 per month bonus payment. This provision is only available to employees who received the bonus during the 2017-2018 school year and is not applicable for any new employee or any existing employee who changes their insurance status. The Board agrees to establish a 125 Cafeteria Plan, which allows each employee the option of sheltering his/her share of the District's group health insurance premiums as well as other insurance premiums determined to be permissible under the plan. B. Non-Certified Employees The Board shall pay fifty percent (50%) of the monthly premium to provide the hospitalization and major medical insurance plan to each employee who requests such coverage, has completed three (3) years of uninterrupted employment with the District and is normally scheduled to work at least six (6) hours per day. Notwithstanding the above paragraph, the Board of Education shall pay one hundred percent (100%) of the monthly premium to provide the hospitalization and major medical insurance plan to Xxxxx Xxxxx and Xxxxx Xxxx. However, nothing in this agreement shall the cost of dependent care coverage, if elected, will be construed to relieve and insurance carrier(s) from any liability that it may have to paid by the Board, employee or beneficiary of an employee. Employees The employee portion of the premium will be paid by payroll deduction. All employees who qualified for select medical insurance will be required to receive their compensation over twelve months. Personal Care Aides that are not rehired within forty-five (45) days will not be considered as having continuous employment. Part-time employees shall have the option of purchasing the insurance by paying the entire premium by payroll deduction. The Board agrees to establish a 125 Cafeteria Plan, which allows each employee the option of sheltering his/her share of the District's group health insurance premiums as well as other insurance premiums determined to be permissible under the previous contract language will continue insurance coverage based upon the definition of full- time being over 6.5 hours per day as long as they continue in the same position, inclusive of being honorably dismissed and recalled to that same position. Through the term of this contract, all full-time Association members will pay a monthly contribution of $10 toward their major medical insuranceplan.

HOSPITALIZATION AND MAJOR MEDICAL INSURANCE. The Board, throughout the term of this Agreement, will maintain a group major medical and dental insurance policy. The Board reserves the right to institute cost containment measures relative to insurance coverage so long as the basic level of insurance benefits remains substantially similar to the insurance coverage in effect at that time. Such changes may include, but are not limited to, mandatory second opinions for elective surgery, pre- pre-admission and continuing admission review, and prohibition on weekend admissions except in emergency situations, and mandatory outpatient elective surgery for certain designated surgical procedures. Through the term of this contract the Board will pay the individual member’s group major medical and dental insurance policy premium for all full-time employees. For purposes of this Article, full time employees are defined as employees who work and are paid for over 7.5 6.5 hours a day on a five-day a week basis for the school year. Full-time employees that elect to do so may choose dependent coverage with the premiums for the coverage paid through payroll deductions. Employees may elect to do so annually during the open enrollment window. In the event a current part-time employee becomes a full-time employee the employee shall be eligible to take advantage of this provision. For full time members that choose dependent coverage, the District will contribute 45% of the employee’s family dependent medical premium to offset the cost. In the event that other employee dependent options are available, the District will contribute 15% of the employee’s spouse only medical premium and 10% of the employee’s child/children only medical premium. The District will not contribute toward the employee’s dependent dental or vision insurance premium. Employees who choose not to take dependent health coverage during the annual open enrollment who experience life-changing circumstances that terminate other insurance coverage or add additional dependents may opt for dependent coverage outside the annual window with in thirty (30) days of said life-changing circumstances. A Board directed insurance committee, including members of the NBESS, shall convene annually no later than February to begin assessment of the current coverage. The committee will investigate alternative insurance carriers, coverage, and related matters to advise the Board. Nothing herein shall be construed to limit the Board’s discretion as to the carrier or the insurance policy at the time. The extent of coverage under any insurance policies referred to in this agreement shall be governed by the terms and conditions as set forth in the policies. Any questions or disputes concerning the insurance policies or benefits hereunder shall be resolved in accordance with the terms set forth in said policies and shall not be subject to the grievance and arbitration procedure set forth in this agreement. However, nothing in this agreement shall be construed to relieve and insurance carrier(s) from any liability that it may have to the Board, employee or beneficiary of an employee. Employees who qualified for insurance under the previous contract language will continue insurance coverage based upon the definition of full- time being over 6.5 hours per day as long as they continue in the same position, inclusive of being honorably dismissed and recalled to that same position. Through the term of this contract, all full-time Association members will pay a monthly contribution of $10 toward their major medical insurance.

HOSPITALIZATION AND MAJOR MEDICAL INSURANCE. The Boardgroup major medical, vision and dental insurance policy will be maintained by the District throughout the term of this Agreement, will maintain a group major medical and dental insurance policy. The Board District reserves the right to institute cost containment measures relative to insurance coverage so long as the basic level of insurance benefits remains substantially similar to the insurance coverage in effect at that timethe time of this Agreement. Such changes may include, but are not limited to, to mandatory second opinions for elective surgery, pre- pre-admission and continuing admission review, and prohibition on weekend admissions except in emergency situations, situations and mandatory outpatient out-patient elective surgery for certain designated surgical procedures. Through the term of this contract contract, the Board District will pay the individual member’s members group major medical medical, vision and dental insurance policy premium for all full-time employees. For purposes of this Article, full time employees are defined as employees who work faculty. Any individual members group medical, vision and are paid for over 7.5 hours dental insurance policy premium increase below (5.0) five percent per year will be District savings available to the individual member in additional Extended Formal Education tuition money and / or toward an annual insurance out-of-pocket expense reimbursement. The District will pay a day on proportional share of the individual part time teacher’s medical/vision/dental insurance premium equivalent to the percentage of a five-day a school week basis for that the school yearpart time teacher works. Full-Any teacher employed less than 9/10 times will not be required to accept District insurance. Full time employees that faculty members may elect to do so may choose dependent coverage with the premiums for the coverage paid deducted through payroll deductions. Employees may elect to do so annually during the open enrollment window. In the event a current part-time employee becomes a full-time employee the employee shall be eligible to take advantage of this provision. For full time faculty members that choose dependent coverage, the District will contribute 45% of the employee’s family dependent medical premium to offset the cost. In the event that other employee dependent options are availableavailable and the employee meets the qualifications in the preceding sentence, the District will contribute 15% of the employee’s spouse only medical premium premium, and 10% of the employee’s child/children only medical premium. The District will not contribute toward the employee’s dependent dental or vision insurance premium. Employees who choose A member may not to take dependent health coverage during waive the annual open enrollment who experience life-changing circumstances that terminate other insurance coverage or add additional dependents may opt for dependent coverage outside the annual window with benefits in thirty (30) days of said life-changing circumstancestotality. A Board District directed insurance committee, ; including members of the NBESS, Association shall convene annually no later than February February, and annually to begin assessment of the current coverage. The committee will investigate alternative insurance carriers, coverage, coverage and related matters to advise the BoardDistrict. Nothing herein shall be construed to limit the Board’s District's discretion as to the carrier or the insurance policy at the time. The extent of coverage under any insurance policies referred to in this agreement shall be governed by the terms and conditions as set forth in the policies. Any questions or disputes concerning the insurance policies or benefits hereunder there under shall be resolved in accordance with the terms set forth in said policies and shall not be subject to the grievance and arbitration procedure set forth in this agreement. The failure of any insurance carrier(s) to provide any benefit for which it is contracted or is obligated shall result in no liability to the District, nor shall such failure be considered by a breach of the District of any obligation undertaken under this or any other agreement. However, nothing in this agreement shall be construed to relieve and any insurance carrier(s) from any liability that it may have to the BoardDistrict, employee faculty member or beneficiary of an employee. Employees who qualified for insurance under the previous contract language will continue insurance coverage based upon the definition of full- time being over 6.5 hours per day as long as they continue in the same position, inclusive of being honorably dismissed and recalled to that same position. Through the term of this contract, all full-time Association members will pay a monthly contribution of $10 toward their major medical insuranceany faculty member.