Voluntary Health Plan Opt Out of Medical Plan with Financial Sample Clauses

Voluntary Health Plan Opt Out of Medical Plan with Financial. Incentive Guild members will be eligible to receive a City financial incentive paid to employees declining coverage on the City’s medical plan in accordance with the City Opt-Out Policy. The Employer will provide an incentive for Medical Opt-out to employees who voluntarily opt-out of the City medical coverage. Effective January 1, 2017, the medical opt-out incentive shall be calculated as fifty percent of the average of the City's monthly contributions to the two most expensive plans at each coverage tier. • Payable monthly as taxable wages. Capped at employee, one spouse and two children. • Paid only if opt-out (un-enrollment) causes a decrease in the actual premiums the City is paying. APPENDIX G MEDICAL RELEASE I, , hereby release Dr. to provide the following medical information to my employer. In accordance with sections 102(c)(B), 102(c)(C) and 102(c)(4)(C) of the Americans with Disabilities Act, the above-named doctor is required to maintain all medical records in association with the examination of me on separate forms and in separate medical files and must treat those records as a confidential record with the following exceptions: The above-named doctor may advise my employer regarding: Psychological or physical fitness to perform all the essential functions of my current job classification; If unable to perform all those functions, the duties that I am able to perform and which duties I am not able to perform; If unable to work at this time, when I can reasonably be expected to return to work at my regular duties; Any necessary restrictions on my work or duties; Any necessary accommodations which may be required to allow me to perform the essential functions of my current job classification; and Any recommendation for psychotherapy or other form of therapy, counseling or medical treatment. This Release is intended to grant no further access to my confidential medical records than the Americans with Disabilities Act allows, and the examining physician is instructed accordingly.
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