Flexible Benefits Insurance Program
FLEXIBLE BENEFITS PROGRAM 24-1 All employees covered by this agreement are eligible to participate in CMU Choices, the University's Flexible Benefit Program.
Flexible Benefits Plan A flexible benefits plan, which is in accordance with Section 125 of the Internal Revenue Code, was implemented for eligible employees covered by this Agreement on October 1, 1990.
Flexible Benefit Plan The Board shall provide the following flexible benefit plan to employees who are paid more than twenty (20) hours per week. All employee benefits plans provided by the Board under this Article shall have plan years based on the calendar year. No Coverage - Employees who produce proof of other medical insurance coverage may elect no coverage. Those electing no coverage as of June 30, 2001, will receive a cash "buy-out" equal to 40% of the annual premium for the “Point-of-Service Plan Individual Coverage” up to $1,220.44 per year. Any employee receiving a cash “buy-out” who elects coverage on or after July 1, 2001will no longer be eligible to receive the cash “buy-out” at a later date. DENTAL Traditional - See Traditional Dental Chart below. No Coverage - Employees may elect no coverage. Those electing no coverage as of June 30, 2001, will receive a cash "buy-out" equal to 40% of the annual premium for "Traditional Individual Coverage” up to $89.70 per year. Any employee receiving a cash “buy-out” who elects coverage on or after July 1, 2001, will no longer be eligible to receive the cash “buy-out” at a later date. TRADITIONAL DENTAL NO DEDUCTIBLE 100%** Emergency treatment Oral examinations X-Rays Teeth cleaning Fluoride treatments for children to age 19 Space maintainers Preventative Services PER PERSON PER CALENDAR YEAR DEDUCTIBLE* 80%** Laboratory tests Fillings Amalgam Silicate Acrylic Root canal Repair and maintenance of bridgework and dentures Periodontal services Extractions and other oral surgery Anesthesia Basic Services PER PERSON PER CALENDAR YEAR DEDUCTIBLE* 50%** Gold and porcelain fillings and crowns Installation of bridgework and crowns Orthodontia (subject to separate $2,500 lifetime maximum per person) – Effective January 1, 2017 Major Services $1,500 Per Person - Calendar Year Maximum** $2,000 Per Person – Calendar Year Maximum** (Effective January 1, 2017) * $50 per person; $150 - Family maximum - when three (3) Family Members have each met the $50 Deductible - See the Schedule of Insurance. **Paid by Traditional Dental.
Individual Accounts An individual account is an account owned by one depositor including any individual, corporation, partnership, trust, or other organization qualified for Credit Union membership. If the account is an individual account, the interest of a deceased individual owner will pass, subject to applicable law, to the decedent’s estate or payable on death (“POD”) beneficiary, if applicable.
PRESCRIPTION MEDICATION BENEFITS, LIMITATIONS AND EXCLUSIONS The following items are limited or excluded from your Prescription Medication coverage:
STATEMENT OF MUTUAL BENEFIT AND INTERESTS In consideration of the above premises, the parties agree as follows:
Other New Individual Accounts With respect to New Individual Accounts not described in paragraph A of this section, upon account opening (or within 90 days after the end of the calendar year in which the account ceases to be described in paragraph A of this section), the Reporting Finnish Financial Institution must obtain a self-certification, which may be part of the account opening documentation, that allows the Reporting Finnish Financial Institution to determine whether the Account Holder is resident in the United States for tax purposes (for this purpose, a U.S. citizen is considered to be resident in the United States for tax purposes, even if the Account Holder is also a tax resident of another jurisdiction) and confirm the reasonableness of such self-certification based on the information obtained by the Reporting Finnish Financial Institution in connection with the opening of the account, including any documentation collected pursuant to AML/KYC Procedures.
ENHANCED AND SUPPLEMENTAL SERVICES BY COUNTY (Continued) 2 ongoing services that SHERIFF otherwise would provide to CITY pursuant to 3 this Agreement. Such supplemental services shall be provided only by 4 regularly appointed full-time peace officers, at rates of pay governed by a 5 Memorandum of Understanding between COUNTY and the bargaining unit 6 representing the peace officers providing the services. Such supplemental 7 services shall include only law enforcement duties and shall not include 8 services authorized to be provided by a private patrol operator, as defined in 9 Section 7582.1 of the Business and Professions Code. Law enforcement 10 support functions, including, but not limited to, clerical functions and forensic 11 science services, may be performed by non-peace officer personnel if the 12 services do not involve patrol or keeping the peace and are incidental to the 13 provision of law enforcement services. CITY shall reimburse COUNTY its 14 full, actual costs of providing such supplemental services at an amount 15 computed by SHERIFF, based on the current year's COUNTY law 16 enforcement cost study. The cost of these supplemental services shall be in 17 addition to the Maximum Obligation of CITY set forth in Subsection G-2 of 18 this Agreement. SHERIFF shall xxxx CITY immediately after each such event.
Dental Services - Accidental Injury (Emergency Emergency room - When services are due to accidental injury to sound natural teeth. 0% - After deductible The level of coverage is the same as network provider. In a physician’s/dentist’s office - When services are due to accidental injury to sound natural teeth. 0% - After deductible 40% - After deductible Dental Services - Outpatient Services connected to dental care when performed in an outpatient facility * 0% - After deductible 40% - After deductible Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay Dental Care (Pediatric) - for members under age 19 See Dental Services in Section 3 for benefit limits and details. These services only apply to an enrolled member under the age of 19. Oral evaluations 0% - After deductible 0% - After deductible X-rays 0% - After deductible 0% - After deductible Cleanings (prophylaxis) 0% - After deductible 0% - After deductible Fluoride treatments 0% - After deductible 0% - After deductible Sealants 0% - After deductible 0% - After deductible Space Maintainers 0% - After deductible 0% - After deductible Palliative treatment 50% - After deductible 50% - After deductible Fillings 50% - After deductible 50% - After deductible Simple extractions 50% - After deductible 50% - After deductible Denture repairs and relines/rebasing 50% - After deductible 50% - After deductible Crowns & onlays 50% - After deductible 50% - After deductible Therapeutic Pulpotomies 50% - After deductible 50% - After deductible Root canal therapy 50% - After deductible 50% - After deductible Non-surgical periodontal services 50% - After deductible 50% - After deductible Surgical periodontal services 50% - After deductible 50% - After deductible Periodontal maintenance 50% - After deductible 50% - After deductible Fixed bridges and dentures 50% - After deductible 50% - After deductible Implants 50% - After deductible 50% - After deductible Oral surgery services 50% - After deductible 50% - After deductible General anesthesia or IV sedation - dental office 50% - After deductible 50% - After deductible Biopsies 50% - After deductible 50% - After deductible Occlusal (night) guards 50% - After deductible 50% - After deductible Orthodontic services (braces) - when medically necessary. 50% - After deductible 50% - After deductible Dialysis Services Inpatient/outpatient/in your home 0% - After deductible 40% - After deductible Durable Medical Equipment (DME), Medical Supplies, Diabetic Supplies, Prosthetic Devices, and Enteral Formula or Food, Hair Prosthetics Outpatient durable medical equipment* - Must be provided by a licensed medical supply provider. 20% - After deductible 40% - After deductible Outpatient medical supplies* - Must be provided by a licensed medical supply provider. 20% - After deductible 40% - After deductible Outpatient diabetic supplies/equipment purchased at licensed medical supply provider (other than a pharmacy). See the Summary of Pharmacy Benefits for supplies purchased at a pharmacy. 20% - After deductible 40% - After deductible Outpatient prosthesis* - Must be provided by a licensed medical supply provider. 20% - After deductible 40% - After deductible Enteral formula delivered through a feeding tube. Must be sole source of nutrition. 20% - After deductible 40% - After deductible Enteral formula or food taken orally * 20% - After deductible The level of coverage is the same as network provider. Hair prosthesis (wigs) - The benefit limit is $350 per hair prosthesis (wig) when worn for hair loss suffered as a result of cancer treatment. 20% - After deductible The level of coverage is the same as network provider.
