HOSPITALIZATION MEDICAL COVERAGE Sample Clauses

HOSPITALIZATION MEDICAL COVERAGE. A. The Employer will provide Blue Care Network (HMO) with a $10 generic / $20 name brand drug rider as the base rate health insurance program and initial base cost with the Blue Cross for Dental and Vision. Beginning in 2005, the employee became responsible for 25% of any increase in monthly premiums with a cap of a $25.00 increase per month per year. B. Employees may elect the County’s alternative health insurance options at a monthly cost, subject to payroll deduction, which will be based on the premium amount in excess of the current benefit rates and upon dependents covered. The employee will be responsible to pay the difference in premium expense from the base rate health insurance, if the alternative health insurance rate is higher. C. The benefit rate and employee cost is established as identified in the Compensation Appendix (Appendix B). D. The employee may select at their own expense and subject to payroll deduction the family continuation and/or sponsored dependent riders. E. The County has established an IRS 125 Plan that will be available to employees covered by this Contract consistent with the County plan. F. Employees covered by this Agreement who elect not to take Health, Prescription, Vision, and Dental coverage will receive a monthly buy-out payment as established in the Compensation Exhibit, which can be applied to 125 Benefits or taken as a cash option. If taken as a cash option, all taxes due will be the responsibility of the employee. Employees must provide proof of other medical coverage if this cash option is selected. G. The Employer agrees to continue selected health insurance coverage, as agreed upon above, under the terms and conditions set forth below: 1) In the event of layoff, the Employer will continue to provide the benefit option selected by the Employee for one (1) month beyond the month in which the employee was laid off, with the understanding that the Employee makes their applicable payments as agreed. 2) In the event of absence due to illness, the Employer will continue to provide the benefit option selected by the Employee in the Employee's absence not to exceed one (1) year, with the understanding that the Employee makes their applicable payments as agreed. 3) In the event of absence due to a workmen's compensation illness or accident, the Employer will continue to provide option selected by the Employee during the Employee's absence, not to exceed two (2) years, with the understanding that the Employee makes their...

HOSPITALIZATION MEDICAL COVERAGE. A. Health Insurance Program Effective January 1, 2006, the EMPLOYER will offer the following health insurance programs for eligible full-time employees and legal dependents. BCBSM-POS: Blue Choice Certificate, POS DR 250/500, POS CR 80/20, POS AA, POS OV 20, POS ET 50 Prescription drug coverage will be provided by the EMPLOYER through a pharmacy benefits manager. Prescription Drug Plan 1: Prescription drug copayments for generic drugs will be $0.00. Prescription drug copayments for brand drugs will be based on a formulary. Brands listed under “Generic Copay” heading will have a $0.00 copay. Formulary brand copay will be 20%, but not more than $35.00. Non formulary brand copay will 25%, but not less than $25.00 and not more than $45.00. Maximum out-of-pocket expenses for drugs for each health care plan participant contract will be $1,100.00 per year. Coverage for mail order will also be provided, and a 90-day supply of any properly prescribed drug will only be available through mail order. A 90-day supply of designated maintenance drugs shall also be available at retail pharmacies. The formulary and list of medications available in 90-day quantities at retail pharmacies shall be subject to periodic review and revision. PHP Plus (Point-of-Service) Plan ▇▇▇▇▇-▇▇▇-▇▇▇ Prescription drug coverage will be provided by the EMPLOYER through a pharmacy benefits manager. Prescription Drug Plan 1: Prescription drug copayments for generic drugs will be $0.00. Prescription drug copayments for brand drugs will be based on a formulary. Brands listed under “Generic Copay” heading will have a $0.00 copay. Formulary brand copay will be 20%, but not more than $35.00. Non formulary brand copay will 25%, but not less than $25.00 and not more than $45.00. Maximum out-of-pocket expenses for drugs for each health care plan participant contract will be $1,100.00 per year. Coverage for mail order will also be provided, and a 90-day supply of any properly prescribed drug will only be available through mail order. A 90-day supply of designated maintenance drugs shall also be available at retail pharmacies. The formulary and list of medications available in 90-day quantities at retail pharmacies shall be subject to periodic review and revision. Health Advantage - High Plan Prescription drug coverage will be provided by the EMPLOYER through a pharmacy benefits manager. Prescription Drug Plan 1: Prescription drug copayments for generic drugs will be $0.00. Prescription drug copayments for...

HOSPITALIZATION MEDICAL COVERAGE. Section 1. Health Insurance Program. A. Effective January 1, 2018, the Employer will provide the following Health Insurance Program for eligible full-time employees and legal dependents. The out-of-network costs for the Standard Plan shall be fully covered through the Employer’s premium contribution. Prescription drug coverage will be provided by the Employer through Physicians Health Plan using the CVS/Caremark as the Pharmacy Benefit Manager.

HOSPITALIZATION MEDICAL COVERAGE. A. The Employer agrees to pay eighty percent (80%) of the premium for medical and prescription coverage. Employees shall pay twenty percent (20%) of their medical and prescription coverage. The Employer will provide and pay one hundred percent (100%) for dental and vision coverage. The plan shall apply to all employees covered by the terms of this Agreement. Should the Employer change carriers, the Employer agrees to provide coverage equal to or better than that presently in effect. B. Payments will be deducted in equal amounts, spread over the premium year, and shall commence the first pay date of this Agreement. Subsequent increases shall be implemented in the first pay date of the July for each year. C. While an employee is laid off, the Employer agrees to continue to fund the Employer’s portion of the medical, dental, and vision premiums in affect at the time the layoff commences, for a period not to exceed four (4) months. In order to be eligible, an employee must have at least two (2) years of seniority. D. In the event that the Federal Government provides nationalized medical, dental, and/or vision insurance, the Employer, and the Union mutually agree meet to discuss the option of utilizing such service. E. Any employee that can demonstrate the ability to obtain medical, dental, and vision insurance from another source, may elect to decline the Employer’s plan. Any employee who declines to participate in the Employer’s plan shall be paid the corresponding insurance deferral payments: Any employee who defers the Employer’s medical insurance shall be required to provide proof of coverage from another insurance provider. An employee’s ability to join the Employer’s medical insurance plan following a period of deferral shall be subject to the open enrollment requirements of the City’s insurance provider.

HOSPITALIZATION MEDICAL COVERAGE. (a) The Employer agrees to pay the premium for hospitalization medical coverage under the following schedule paragraph:

HOSPITALIZATION MEDICAL COVERAGE. The Board shall provide premiums as described in Article 41 for Messa Pak insurance coverage as follows: MESSA CHOICES II - $10/$10-RX $10.00 Office Visit Co-payment Option Delta Dental 80/80/80: $1,000 annual maximum 80 $1,300 lifetime maximum Vision VSP 3 Negotiated Life $5,000.00 with AD&D Employees will receive a $200.00 Stipend for health care. This offer sunsets on June 30, 2010. MESSA CHOICES II - $10/$20-RX $200.00/$400.00 In-Network deductible $10.00 Office Visit Co-payment Option Delta Dental 80/80/80: $1,000 annual maximum 80 $1,300 lifetime maximum Vision VSP 3 Negotiated Life $5,000.00 with AD&D Coverage will be provided for a full twelve month period for the employee and his/her entire family and any other eligible dependents as defined by MESSA. Any employee not electing health care Pak-A Plan as provided above, may, upon written application receive: Pak-B Plan: Vision VSP 3 Negotiated Life $5,000.00 with AD&D Eligible employees not electing the health insurance program cited above shall be eligible for a Board paid subsidy in the amount of $150 per month. This Board paid subsidy may be used for one of the following: A. Tax sheltered annuity B. Paid semi-annually in December and June of each year.

HOSPITALIZATION MEDICAL COVERAGE. 1. The Board of Education shall provide Medical Mutual of Ohio Insurance, or its equivalent, either full family or single coverage as appropriate, to the bargaining unit members working at least seven (7) hours per day. The bargaining unit member may elect to receive SuperMed Plus or the minimum value plan, the current schedules of benefits for which are set forth generally below and more fully explained and detailed in the current certificate benefits booklets, which shall serve as the authority for determining coverage issues. Each bargaining unit member working at least seven (7) hours per day electing to receive Board coverage will pay fifteen percent (15%) of the Board’s cost of medical/prescription drug coverage. For all bargaining unit members working less than seven (7) hours per day, and hired on or before July 31, 2013, and electing to receive family medical/prescription coverage, the Board shall pay sixty percent (60%) of the complete family coverage with the employee paying forty percent (40%) of the complete family coverage. Those employees hired on or after August 1, 2013 and working at least four (4) hour but less than seven (7) hours, are eligible for family coverage and the Board shall pay sixty percent (60%) of the complete family coverage with the employee paying forty percent (40%) of the complete family coverage. All employees working less than seven hours electing to receive single coverage will pay fifteen percent (15%) of the Board’s cost of medical/prescription drug coverage. Effective August 1, 2018, the total monthly employee contribution for all insurance coverage (Medical and prescription drug) shall be capped at $141.50 per month for family coverage and $83.00 per month for single coverage. Effective August 1, 2019, the total monthly employee contribution for all insurance coverage (Medical and prescription drug) shall be capped at $158.00 per month for family coverage and $91.00 per month for single coverage. Effective August 1, 2020, the total monthly employee contribution for all insurance coverage (Medical and prescription drug) shall be capped at $175.00 per month for family coverage and $100.00 per month for single coverage. Contributions will be deducted twice per month for staff members receiving 26 paychecks per year. Any bargaining unit member who does not receive twenty-six (26) paychecks a year will pay the insurance amount as if he/she had received twenty-six (26) paychecks. The total amount owed will be evenly ta...

HOSPITALIZATION MEDICAL COVERAGE. A. All employees will have the choice of the following group health insurance (which includes hospitalization, dental, vision, and prescription drug coverage) for each eligible employee, spouse, and dependents under the age of twenty-six (26) years of age. If the Federal Health Care (Affordable Care Act) laws regarding mandatory dependent coverage are subsequently changed, the coverage age will be revised to twenty-three (23) years of age. 1. Hospitalization: Blue Cross Blue Shield Community Blue Plan 3: (Community Blue Basic, ASFP, BMT,CB-PCB, CRNA, CNM, CNP, DXTMG, EBMT, ECIP, ESRD, FC DC, GCO, GLE-1, HMN, ICMP, K260, PTFS-COMPS, PTS-PSG, SUBRO2, SOTPE, RAPS) 2. Prescription: Blue Cross Blue Shield Drug Rider: PD-CR $15.00 GENERIC/$30.00 BRAND, MOPD $15.00 GENERIC/$30.00 BRAND, PREFERRED RX, PD-BC2X, RXDAA 3. Dental: Blue Cross Blue Shield Group Dental Care: Class I - 100%; Class II - 80%, Class III - 50% with a $50 per person/$100 per family deductible; $1,000.00 per year for Classes I, II, III; Class IV - Orthodontics Services 50% lifetime limitation $1000.00 up to age 19. (K1000, CDC-FC, DXTMG, RDC-DENTAL, SUBRO2, OS-50-1000, FC DC, GCO) 4. Vision: Blue Cross Blue Shield Vision Plan: VCA-80, FLVS (A), FC DC, GCOC. The City will be responsible for the remaining premium cost of this coverage, after the required contribution is made by the employee in accordance with Public Act 152 of 2011 (Publicly Funded Health Insurance Contribution Act). All employees may voluntarily elect the following coverages (Community Blue Plan 1 PPO, Blue Care Network HMO) with the difference in cost from the Community Blue Plan 3 PPO Base Plan (described above), including the employee contribution under PA 152 of 2011, being borne by the employee through payroll deduction. 1. Hospitalization: Blue Cross Blue Shield Community Blue Plan 1: (Community Blue Basic, ASFP, BMT,CB-PCB, CRNA, CNM, CNP, DXTMG, EBMT, ECIP, ESRD, FC DC, GCO, GLE-1, HMN, ICMP, K260, PTFS-COMPS, PTS-PSG, SUBRO2, SOTPE, RAPS) 2. Prescription: Blue Cross Blue Shield Drug Rider: PD-CR $15.00 GENERIC/$30.00 BRAND, MOPD $15.00 GENERIC/$30.00 BRAND, PREFERRED RX, PD-BC2X, RXDAA 3. Dental: Blue Cross Blue Shield Group Dental Care: Class I - 100%; Class II - 80%, Class III - 50% with a $50 per person/$100 per family deductible; $1,000.00 per year for Classes I, II, III; Class IV - Orthodontics Services 50% lifetime limitation $1000.00 up to age 19. (K1000, CDC-FC, DXTMG, RDC-DENTAL, SUBRO2, OS-50-1000, FC DC, GCO)...

HOSPITALIZATION MEDICAL COVERAGE. Section 32.01 Effective January 1, 2017, the University shall provide and maintain the following medical benefits for each employee regularly assigned to work twenty (20) hours or more per week, commencing with the employee’s ninety first (91) day of employment. Section 32.02 Effective January 1, 2017 employees shall have the option of participating in the Preferred Provider Organization (PPO5), Health Maintenance Organization (HMO) or Health Savings Account eligible PPO health plans with benefits as described in each plan design. The prescription drug coverage plan is also found in the Health Care Options Booklet and within each plan design. Section 32.03 Participants in the University’s health insurance plans are required to make cost-sharing contributions for the plan of their choice in addition to any applicable deductibles and copays. Employee cost-sharing information for each plan is found in Appendix I, Healthcare Plan Design and Cost Share Table. The health insurance plan rates change in January 2017, 2018 and 2019. Section 32.04 Employees who obtain age sixty-five (65) are eligible for Medicare benefits. With the passage of the Tax Equity and Fiscal Responsibility Act (TEFRA), the Employer provided health insurance plan becomes the primary health insurance carrier. Section 32.05 Medicare becomes the secondary health carrier for active employees who are age 65 and over. Section 32.06 To qualify for the medical benefits as above described, each employee must individually enroll and make proper application for such benefits at the Benefits Office within thirty (30) calendar days of the commencement of his or her regular employment with the University. An employee who fails to enroll and make proper application as herein provided is specifically and expressly excluded from such benefits plan until such time as he or she enrolls and makes proper application during an open enrollment period. Section 32.07 Employees hired on and after the date this agreement is ratified by the Union and the University shall not be covered by these medical benefits until the employee has completed his/her 90th day of service to the University. Draft Section 32.08 Additions and changes to an employee’s health care coverage must be made within thirty (30) calendar days of the event (marriage, divorce, birth, and adoption) by contacting the Benefits Office and completing the appropriate change forms. Failure to make these changes as herein provided will result in the additio...