Provisions Applicable to All Plans. (1) The City will not pay for any services or supplies that are unnecessary according to acceptable medical procedures.
(2) The City shall have the right to require employees to execute a medical authorization to the applicable Group to examine employee medical and/or dental records for auditing purposes.
(3) The City shall have the right to establish methods, measures and procedures it deems necessary to restrict abuses and/or excessive costs in application of the benefits provided under subsections 1.a. through 1.e., above.
(4) The City, in conjunction with its insurance carrier, shall have the right to develop and implement any other cost containment measures it deems necessary.
(5) An employee's health care/dental coverage provided by this Article shall terminate on the last day of the calendar month in which the employee is removed from the Police Department payroll; provided however, that when an employee is suspended from duty without pay, such benefits shall not terminate on the last day of the calendar month in which the suspension begins if the suspension ends prior to the last day of the next following calendar month. The Police Department Administration will provide written advance notice to an employee indicating the date on which his/her health care/dental coverage will be terminated. Notwithstanding the foregoing, an employee's health care coverage shall not terminate so long as he/she and/or his/her dependent(s) are eligible for and receiving health care coverage under the specific provisions of this Agreement that are applicable to individuals not on the Department payroll. Except for suspensions (as provided above) this exception does not extend the termination date of an employee's dental coverage beyond the last day of the calendar month in which the employee is removed from the Department payroll.
(6) A Health Risk Assessment (HRA), which shall include basic biometrics, a written health risk assessment questionnaire and a blood draw, shall be administered on an annual basis.
(7) Both a Wellness and Prevention Program and Committee shall be implemented. A description of both the program and the committee is appended hereto as Appendix G.
Provisions Applicable to All Plans. (1) The City will not pay for any services or supplies that are unnecessary according to acceptable medical procedures.
(2) The City shall have the right to require employees to execute a medical authorization to the applicable Group to examine employee medical and/or dental records for auditing purposes.
(3) The City shall have the right to establish methods, measures and procedures it deems necessary to restrict abuses and/or excessive costs in application of the benefits provided under subsections 1.a. through 1.d., inclusive, of this Article, above.
(4) The City, in conjunction with its insurance carrier, shall have the right to develop and implement any other cost containment measures it deems necessary.
(5) An employee's health/dental insurance benefits provided by this Article shall terminate on the last day of the calendar month in which the employee is removed from the Fire Department payroll; provided however, that when an employee is suspended from duty without pay, such benefits shall not terminate on the last day of the calendar month in which the suspension begins if the suspension ends prior to the last day of the next following calendar month. The Fire Department Administration will provide written advance notice to an employee indicating the date on which his/her health/dental insurance coverage will be terminated. Notwithstanding the foregoing, an employee's health insurance coverage shall not terminate so long as he/she and/or his/her dependent(s) are eligible for and receiving health insurance coverage under the specific provisions of this Agreement that are applicable to individuals not on the Department payroll. This exception does not extend the termination date of an employee's dental insurance coverage beyond the last day of the calendar month in which the employee is removed from the Department payroll.
Provisions Applicable to All Plans. (1) The City will not pay for any services or supplies that are unnecessary according to acceptable medical procedures.
(2) The City shall have the right to require an employee to execute a medical authorization to the applicable Group to examine employee medical and/or dental records for auditing purposes.
(3) The City shall have the right to establish the methods, measures and procedures it deems necessary to restrict excessive costs in the application of the benefits provided under subsections 1.a. through 1.d. of this Article.
(4) The City, in conjunction with its insurance administrator, carrier, or provider shall have the right to develop and implement any other cost containment measures it deems necessary.
(5) An employee' s health/dental insurance benefits shall terminate on the last day of the calendar month in which the employee is removed from the payroll except if continued benefits are provided in this Article or by the City, unless the employee does not accept the continued benefit.
Provisions Applicable to All Plans. (1) Lifetime maximum benefits will be limited to $2,000,000 per participant under each of the three plans and will be based upon reasonable and customary fees. A carve out provision that limits the total medical expense reimbursed from more than one plan to an amount that does not exceed the limit of the Metro Plan (Metro Premium, Metro Preferred or Metro Economy) in which the participant is enrolled.
(2) The Plans will cover chiropractic coverage up to calendar year maximum benefits of five hundred dollars ($500.00) per participant. The annual maximum will include all services provided by a chiropractor such as initial examinations, assessments, x-rays, office visits, etc. Benefits will be paid at ninety percent (90%) after the Annual Deductible has been satisfied.
(3) Otherwise eligible dependent children who are full-time students will be eligible for coverage until December 31 of the year of their twenty-fourth (24th) birthday.
(4) Effective November 6, 1992, in accordance with provisions of Section 125 of the U.S. Internal Revenue Code as amended, employee contributions towards medical and dental coverage provided in this Agreement, which are collected through an employee’s paycheck, will be made on a pre-tax basis under the Agency’s Earnings Reduction Plan.
Provisions Applicable to All Plans. (1) The City will not pay for any services or supplies that are unnecessary according to 24 acceptable medical procedures.
Provisions Applicable to All Plans. (1) The City will not pay for any services or supplies that are unnecessary according to acceptable medical procedures.
(2) The City shall have the right to require an employee to execute a medical authorization to the applicable Group to examine employee medical and/or dental records for auditing purposes.
(3) The City shall have the right to establish the methods, measures and procedures it deems necessary to restrict excessive costs in the application of the benefits provided under subsections 23.1.a. through 23.1.d. of this Article.
(4) The City, in conjunction with its insurance administrator, carrier, or provider shall have the right to develop and implement any other cost containment measures it deems necessary.
(5) An annual Health Risk Assessment (HRA), which shall include basic biometrics, a written health risk assessment questionnaire and a blood draw, shall be implemented as soon as practicable following execution of this Agreement.
(6) Both a Wellness and Prevention Program and Committee shall be implemented. A description of both the program and the committee is appended hereto as Appendix B.
Provisions Applicable to All Plans
