Common use of MEDICAL BENEFITS AND INSURANCE Clause in Contracts

MEDICAL BENEFITS AND INSURANCE. A. HEALTH INSURANCE Health insurance, which includes medical, dental and vision insurance, for new full time employees shall commence on the first day of full-time employment with the College. The benefits shall be provided on the basis of a “coordination of benefits” clause. For new full-time members, coverage shall commence on or as soon after the first working day of his/her employment as per stipulation of carrier. Coverage with Joliet Junior College will terminate the last day of the month of termination of employment with the College. The Master Agreement between the College and the insurance company shall be controlling in any case; however, in no instance shall the enumerated benefits be reduced. B. UTILIZATION REVIEW This program requires that the Utilization Review Service be called via an 800 number prior to an elective hospital stay, within 48 hours of an emergency hospital stay, or prior to any surgery regardless of location, other than minor surgery performed in the physician’s office. If notification is not complied with, there is a $250 penalty; however, there are no penalties for difference of opinion between the physician and the Utilization Review Service provider. Extraordinary circumstances will be taken into consideration prior to the penalty being imposed.

MEDICAL BENEFITS AND INSURANCE. A. HEALTH INSURANCE Health insurance, which includes medical, dental and vision insurance, for new full time employees shall commence on the first day of full-time employment with the College. The benefits shall be provided on the basis of a “coordination of benefits” benefits clause. For new full-time clerical members, coverage shall commence on or as soon after the first working day of his/her employment as per stipulation of carrier. Coverage with Joliet Junior College will terminate thirty (30) days after the last day of the month of termination of employment with the College. The Master Agreement between the College and the insurance company shall be controlling in any case; however, in no instance shall the enumerated benefits be reduced. B. UTILIZATION REVIEW This program requires that the Utilization Review Service be called via an 800 number prior to an elective hospital stay, within 48 hours of an emergency hospital stay, or prior to any surgery regardless of location, other than minor surgery performed in the physician’s office. If notification is not complied with, there is a $250 penalty; however, there are no penalties for difference of opinion between the physician and the Utilization Review Service provider. Extraordinary circumstances will be taken into consideration prior to the penalty being imposed.