Hospitalization - Surgical - Medical Sample Clauses

Hospitalization - Surgical - Medical. The Employer will make available for all eligible employees who elect to participate, a group insurance program covering certain hospitalization, surgical and medical expenses. The insurance program shall be on a voluntary basis for eligible employees. The cost of the required monthly premium for coverage under the insurance program becomes effective within thirty (30) days following date of hire. Other specific terms and conditions governing the group insurance program, including termination and continuance of coverage provisions, are set forth in detail in the master policies and agreements issued by the insurance carrier. The health insurance coverage will be the Blue Cross/Blue Shield BCN Healthy Blue Living 2 HMO Plan with group dental and vision coverage. Please reference the attached ‘Benefits at a Glance’ for details of the Healthy Blue Living 2 plan including its features, coverage’s, requirements, and any limitations/exclusions. The cost of the required monthly premium coverage under the insurance program shall be paid in full by the Employer for all eligible employees who elect to participate. Health insurance - active employees: Effective January 1, 2004, or as soon thereafter as practical, health insurance for employees hired prior to April 1, 2001 will be Blue Cross/Blue Shield Community Blue PPO Plan 2 (see Appendix B), with group dental and vision coverage. The co-payment for the prescription drugs will be $10 for generic and $40 for name brand. Mail order prescription drugs will be covered, with two (2) co- payments required for three months’ supply. The County will not reimburse an employee for prescription drugs. The office visit co-pay will be $20. The deductible is $100/$200. The County will self-insure the difference between $500 and $1,000 on the annual (in network) family co-pay providing the employee submits the corresponding explanation of benefits and receipts. Submission can be made after the employee reaches $500 or at year-end. The cost of the required monthly premium coverage under the insurance program shall be paid in full by the Employer for all eligible employees who elect to participate. For employees hired on or after April 1, 2001, the County will provide the health insurance listed in the previous paragraph for the employee only. The employee may purchase health insurance for their spouse and/or dependants on a pre-tax basis. After the employee has worked for the County for five continuous years, the employee may have...
Sample 1
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Hospitalization - Surgical - Medical. The Board shall purchase from a carrier licensed by the State of Ohio, basic hospital/surgical coverage for each teacher and his or her family which meets or exceeds the specifications listed in Appendix E. The Board shall pay fifty percent of its share of insurance premium costs for each member of the bargaining unit who is employed under a one-half time or less contract. The Board shall pay its full share of insurance premium costs for members of the bargaining unit who are employed under a greater than one-half time contract. Effective July 2, 2018, the Board shall pay eighty-five (85%) of the premium for any policy referred to in Appendix E, which includes a seven percent (7%) cap increase from previous year premium. Appendix E is the current plan that is in effect for Hospital and Surgical Benefits. The current health care plan coverage’s and benefits are subject to change through the actions of the District Insurance Committee.
Sample 1

Related to Hospitalization - Surgical - Medical

  • Medical There shall be an open enrollment period for medical coverage in each year of this Agreement. An employee may elect no medical coverage during any open enrollment period. An employee who has elected no medical coverage may elect medical coverage during an open enrollment period. No pre-existing condition limitations will apply.

  • Hospital This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.

  • Dental Care Plan The Welfare Plan will include a Dental Care Plan which will reimburse members for expenses incurred in respect of the coverages summarized in Appendix "1". The Plan will not duplicate benefits provided now or which may be provided in the future by any government program.

  • Clinical Management for Behavioral Health Services (CMBHS) System 1. request access to CMBHS via the CMBHS Helpline at (000) 000-0000. 2. use the CMBHS time frames specified by System Agency. 3. use System Agency-specified functionality of the CMBHS in its entirety. 4. submit all bills and reports to System Agency through the CMBHS, unless otherwise instructed.

  • Medical Care Leave An Employee who is unable to make the necessary arrangements for maintenance of personal health care outside of scheduled work time, shall be granted time off with pay. Such time off shall not exceed sixteen (16) working hours per calendar year. Hours in excess of sixteen (16) hours per calendar year shall be deducted from the Employee's sick leave accumulation.

  • HEALTH PROGRAM 3701 Health examinations required by the Employer shall be provided by the Employer and shall be at the expense of the Employer. 3702 Time off without loss of regular pay shall be allowed at a time determined by the Employer for such medical examinations and laboratory tests, provided that these are performed on the Employer’s premises, or at a facility designated by the Employer. 3703 With the approval of the Employer, a nurse may choose to be examined by a physician of her/his own choice, at her/his own expense, as long as the Employer receives a statement as to the fitness of the nurse from the physician. 3704 Time off for medical and dental examinations and/or treatments may be granted and such time off, including necessary travel time, shall be chargeable against accumulated income protection benefits.

  • Orthodontics We Cover orthodontics used to help restore oral structures to health and function and to treat serious medical conditions such as: cleft palate and cleft lip; maxillary/mandibular micrognathia (underdeveloped upper or lower jaw); extreme mandibular prognathism; severe asymmetry (craniofacial anomalies); ankylosis of the temporomandibular joint; and other significant skeletal dysplasias.

  • Hospice Individuals whose permanent residence and principal work location are outside the State of Minnesota and outside of the service areas of the health plans participating in Advantage. If these individuals use the plan administrator’s national preferred provider organization in their area, services will be covered at Benefit Level Two. If a national preferred provider is not available in their area, services will be covered at Benefit Level Two through any other provider available in their area. If the national preferred provider organization is available but not used, benefits will be paid at the POS level described in paragraph “i” below. All terms and conditions outlined in the Summary of Benefits will apply.

  • Wellness i. To support the statewide goal for a healthy and productive workforce, employees are encouraged to participate in a Well-Being Assessment survey. Employees will be granted work time and may use a state computer to complete the survey. ii. The Coalition of Unions agrees to partner with the Employer to educate their members on the wellness program and encourage participation. Eligible, enrolled subscribers who register for the Smart Health Program and complete the Well-Being Assessment will be eligible to receive a twenty-five dollar ($25) gift certificate. In addition, eligible, enrolled subscribers shall have the option to earn an annual one hundred twenty-five dollars ($125.00) or more wellness incentive in the form of reduction in deductible or deposit into the Health Savings Account upon successful completion of required Smart Health Program activities. During the term of this Agreement, the Steering Committee created by Executive Order 13-06 shall make recommendations to the PEBB regarding changes to the wellness incentive or the elements of the Smart Health Program.

  • Medical Care The Parents must comply with the School Welfare Officer's recommendations which may include a reasonable decision to release the Pupil home or to his / her education guardian when s/he is unwell.

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