Common use of Medical Plan Design Changes Clause in Contracts

Medical Plan Design Changes. The medical benefit plan design and co-pays will remain unchanged during the term of this agreement with the exception of the addition of Applied Behavioral Analysis (ABA) treatment for Autism as a covered expense , and those changes which may be required by law during the term of this agreement. The annual out-of-pocket maximums for SCPH and UHC(Individual/Family) HDHP plans are as follows: In-Network SCPH and UHC Out-of-Network UHC $3,000 / $6,000 $5,000 / $10,000 The annual out-of-pocket maximums for SCPH and Anthem (Individual/Family) EPO plans are as follows: SCPH and Anthem $1,500 / $3,000 Premium Reimbursement The County has agreed to offer a premium reimbursement program to employees who are enrolled in a County Xxxxxx medical plan (or enrolled in a County Anthem Blue Cross medical plan if the employee lives in the SCPH local service area) prior to the start of the 2014 open enrollment period. In order to receive the premium reimbursement, the eligible employee must waive coverage with the County and enroll in a non-County qualified medical insurance program, individual or group coverage, meeting minimum standards under the Patient Protection and Affordable Care Act (ACA). Employees receiving a premium reimbursement are not eligible to receive a medical waive credit. The County’s premium reimbursement rate will not exceed 80% of the eligible employee’s out-of-pocket medical insurance premium cost for the new medical plan, or 75% of the County’s monthly medical premium contribution for County EPO plans, whichever amount is lower. In order to receive reimbursement, the employee must provide proof of other coverage and proof of cost to the employee as required by the County. The County will implement a process prior to open enrollment in October 2014 to establish the guidelines for employees to participate in the premium reimbursement. In no event, shall the premium reimbursement impact the compensation eligible for employee pensions or employer-paid deferred compensation. Employees may only return to the County medical insurance program during annual open enrollment periods, or anytime the employee experiences a qualifying event in accordance with County benefit policies. If an employee who is receiving a premium reimbursement elects to return to the County’s medical insurance program, they will no longer be eligible to receive the premium reimbursement should they choose to opt out of the County’s medical insurance program in the future. Employees who enroll in a non-County qualified medical insurance program are not eligible to receive any County provided HSA contributions.

Medical Plan Design Changes. The medical benefit plan design and co-pays will remain unchanged during the term of this agreement with the exception of the addition of Applied Behavioral Analysis (ABA) treatment for Autism as a covered expense attached changes that were agreed to by the parties during the meet and confer process, and those changes which may be required by law during the term of this agreement. The annual out-of-pocket maximums for SCPH and UHC(IndividualAnthem (Individual/Family) HDHP plans are as follows: In-Network SCPH and UHC Anthem Out-of-Network UHC Anthem $3,000 / $6,000 $5,000 / $10,000 The annual out-of-pocket maximums for SCPH and Anthem (Individual/Family) EPO plans are as follows: SCPH and Anthem $1,500 / $3,000 Premium Reimbursement The County has agreed to offer a premium reimbursement program to employees who are enrolled in a County Xxxxxx medical plan (or enrolled in a County Anthem Blue Cross medical plan if the employee lives in the SCPH local service area) prior to the start of the 2014 open enrollment period. In order to receive the premium reimbursement, the eligible employee must waive coverage with the County and enroll in a non-County qualified medical insurance program, individual or group coverage, meeting minimum standards under the Patient Protection and Affordable Care Act (ACA). Employees receiving a premium reimbursement are not eligible to receive a medical waive credit. The County’s premium reimbursement rate will not exceed 80% of the eligible employee’s out-of-pocket medical insurance premium cost for the new medical plan, or 75% of the County’s monthly medical premium contribution for County EPO plans, whichever amount is lower. In order to receive reimbursement, the employee must provide proof of other coverage and proof of cost to the employee as required by the County. The County will implement a process prior to open enrollment in October 2014 to establish the guidelines for employees to participate in the premium reimbursement. In no event, shall the premium reimbursement impact the compensation eligible for employee pensions or employer-employer- paid deferred compensation. Employees may only return to the County medical insurance program during annual open enrollment periods, or anytime the employee experiences a qualifying event in accordance with County benefit policies. If an employee who is receiving a premium reimbursement elects to return to the County’s medical insurance program, they will no longer be eligible to receive the premium reimbursement should they choose to opt out of the County’s medical insurance program in the future. Employees who enroll in a non-County qualified medical insurance program are not eligible to receive any County provided HSA contributions.

Medical Plan Design Changes. The medical benefit plan design and co-pays will remain unchanged during the term of this agreement with the exception of the addition of Applied Behavioral Analysis (ABA) treatment for Autism as a covered expense attached changes that were agreed to by the parties during the meet and confer process, and those changes which may be required by law during the term of this agreement. The annual out-of-pocket maximums for SCPH and UHC(IndividualAnthem (Individual/Family) HDHP plans are as follows: In-Network SCPH and UHC Anthem Out-of-Network UHC Anthem $3,000 / $6,000 $5,000 / $10,000 The annual out-of-pocket maximums for SCPH and Anthem (Individual/Family) EPO plans are as follows: SCPH and Anthem $1,500 / $3,000 Premium Reimbursement The County has agreed to offer a premium reimbursement program to employees who are enrolled in a County Xxxxxx Kaiser medical plan (or enrolled in a County Anthem Blue Cross medical plan if the employee lives in the SCPH local service area) prior to the start of the 2014 open enrollment period. In order to receive the premium reimbursement, the eligible employee must waive coverage with the County and enroll in a non-County qualified medical insurance program, individual or group coverage, meeting minimum standards under the Patient Protection and Affordable Care Act (ACA). Employees receiving a premium reimbursement are not eligible to receive a medical waive credit. The County’s premium reimbursement rate will not exceed 80% of the eligible employee’s out-of-pocket medical insurance premium cost for the new medical plan, or 75% of the County’s monthly medical premium contribution for County EPO plans, whichever amount is lower. In order to receive reimbursement, the employee must provide proof of other coverage and proof of cost to the employee as required by the County. The County will implement a process prior to open enrollment in October 2014 to establish the guidelines for employees to participate in the premium reimbursement. In no event, shall the premium reimbursement impact the compensation eligible for employee pensions or employer-employer- paid deferred compensation. Employees may only return to the County medical insurance program during annual open enrollment periods, or anytime the employee experiences a qualifying event in accordance with County benefit policies. If an employee who is receiving a premium reimbursement elects to return to the County’s medical insurance program, they will no longer be eligible to receive the premium reimbursement should they choose to opt out of the County’s medical insurance program in the future. Employees who enroll in a non-County qualified medical insurance program are not eligible to receive any County provided HSA contributions.