Common use of Payment in Lieu of Health Benefits Clause in Contracts

Payment in Lieu of Health Benefits. This provision is designed and applicable to those employees who currently have dual health insurance coverage or who have the ability to acquire health insurance from another source, other than in a government run health exchange. To take advantage of this offer employees must complete the “Waiver of Insurance Agreement” and provide documentation of alternate coverage. An employee may request participation in this program in June of each year although new employees can enroll at the time they are initially appointed. The annual payment to the employee who terminates their coverage is $1,500, $2,300 and $3,000 for single, two person or family coverage respectively. Payments will be made semiannually in July and January and if an employee terminates or rejoins the program at any time following the date of payment, the employee shall refund that portion of payment following their reenrollment or termination on a prorated basis. Employees may reenroll in the Town’s group health insurance program if the coverage that the employee had through another plan is terminated; if the employee or their dependents become ineligible for coverage under the other plan; if the employee acquires a new dependent and the dependent is not covered under the other plan. Employees wishing to re-enroll under any of the above conditions shall provide required documentation and notify the Town in writing. Provided that all information is received by the Twentieth of the month and subject to any restrictions from the carrier, the Town shall enroll the employee in the group health care plan effective the first of the month following the notification.