Common use of Waiver of Coverage Clause in Contracts

Waiver of Coverage. During the term of this agreement, all teachers employed by the District for a period of two consecutive years and who are enrolled in a District Health Plan under either individual or family coverage as of said date, may elect to withdraw from such Plan and waive either coverage as of said date. A teacher waiving coverage shall be entitled to receive a total of fifty (50% percent of the premium monies actually saved by the District (i.e. fifty (50%) percent of the District’s portion of the premium), for each full year the teacher elects to withdraw from coverage. Such sum shall be paid out in equal installments each payroll period. An election to withdraw from the Plan and waive coverage shall be submitted to the Business Office in writing, on or before March 1, of any year, on forms and in the manner prescribed by the District. Such withdrawal and waiver of coverage shall take effect on July 1 of the ensuing school year. The District’s portion of such premium to be shared by the employee shall be determined as of the first effective date of the withdrawal and waiver (i.e. July 1 next following written election of withdrawal and waiver of coverage) and subsequent right to re-entry, shall be subject to requirements of the insurer and the insuring contract and/or any law or rules and regulations of any governmental agency having the force of law. It is further understood that such withdrawal/waiver shall not occur or continue if it prevents compliance with insurers’ requirements as to the percentage and/or number of unit participants for District continuation or renewal of participation in the affected Plan. The teacher shall have the right to elect to re-enter the plan subject to previous conditions, but shall be entitled only to a pro-rata share fifty (50%) percent of any actual savings for the District if the re-entry occurs during the calendar year. Under this section, teachers may elect to waive coverage and withdraw from family to individual coverage, or no coverage, or from individual to no coverage, provided that membership in each plan must be for a minimum of two consecutive years. Any claim by a teacher under this provision shall be limited to reimbursement issues only; in no event shall the district be liable for any medical bill or a claim for any monies outside of the portion of premium saved by the District.

Waiver of Coverage. i. During the term of this agreementAgreement, all teachers full-time Teaching Assistants employed by the District for a period of two (2) consecutive years and who are enrolled in a District Health Plan health plan under either individual or family coverage as of said date, may elect to withdraw from such Plan plan and waive either coverage as of said date. A teacher Teaching Assistant waiving coverage shall be entitled to receive a total of fifty (50% %) percent of the premium monies actually saved by the District (i.e. i.e., fifty (50%) percent of the District’s portion of the premium), for each full year the teacher Teaching Assistant elects to withdraw from coverage. Such sum shall be paid out in equal installments each payroll period. An election to withdraw from the Plan and waive coverage shall be submitted to the Business Office Human Resources Department in writing, on or before March 1, of any year, on forms and or in the manner prescribed by the District. Such withdrawal and waiver of coverage shall take effect on July 1 of on the ensuing school year. The District’s portion of such premium to be shared by the employee shall be determined as of the first effective date of the withdrawal and waiver (i.e. i.e., July 1 next following written election of withdrawal and waiver of coverage) and the subsequent right to re-entryentry (as delineated below), shall be subject to the requirements of the insurer and the insuring contract and/or any law or rules and regulations of any governmental agency or the Plan, or having the force of law. It is further understood that such withdrawal/withdrawal or waiver shall not occur or continue if it prevents compliance with insurers’ the insurer’s or the Plan’s requirements as to the percentage and/or number of unit participants for District continuation or the renewal of participation in the affected effected Plan. The teacher shall have the right to elect to re-enter the plan subject to previous conditions, but shall be entitled only to a pro-rata share fifty (50%) percent of any actual savings for the District if the re-entry occurs during the calendar year. Under this section, teachers Teaching Assistants may elect to waive coverage and withdraw from family to individual coverage, or no coverage, or from individual to no coverage, provided that membership in each plan must be for a minimum of two (2) consecutive years. Any claim by a teacher Teaching Assistant under this provision shall be limited to reimbursement issues only; in no event shall the district District be liable for any medical bill or a claim for any monies outside of the portion of premium premiums saved by the District.

Waiver of Coverage. During the term of this agreement, all teachers employed by the District for a period of two consecutive years and who are enrolled in a District Health Plan under either individual or family coverage as of said date, may elect to withdraw from such Plan and waive either coverage as of said date. A teacher waiving coverage shall be entitled to receive a total of fifty (50% percent of the premium monies actually saved by the District (i.e. fifty (50%) percent of the District’s portion of the premium), for each full year the teacher elects to withdraw from coverage. Such sum shall be paid out in equal installments each payroll period. An election to withdraw from the Plan and waive coverage shall be submitted to the Business Office in writing, on or before March 1, of any year, on forms and in the manner prescribed by the District. Such withdrawal and waiver of coverage shall take effect on July 1 of the ensuing school year. The District’s portion of such premium to be shared by the employee shall be determined as of the first effective date of the withdrawal and waiver (i.e. July 1 next following written election of withdrawal and waiver of coverage) and subsequent right to re-entry, shall be subject to requirements of the insurer and the insuring contract and/or any law or rules and regulations of any governmental agency having the force of law. It is further understood that such withdrawal/waiver shall not occur or continue if it prevents compliance with insurers’ requirements as to the percentage and/or number of unit participants for District continuation or renewal of participation in the affected Plan. The teacher shall have the right to elect to re-enter the plan subject to previous conditions, but shall be entitled only to a pro-rata share fifty (50%) percent of any actual savings for the District if the re-entry occurs during the calendar year. Under this section, teachers may elect to waive coverage and withdraw from family to individual coverage, or no coverage, or from individual to no coverage, provided that membership in each plan must be for a minimum of two consecutive years. Any claim by a teacher under this provision shall be limited to reimbursement issues only; in no event shall the district be liable for any medical bill or a claim for any monies outside of the portion of premium saved by the District. The New York State Civil Service Department, and New York State Health Insurance Plan Policy Memorandum 122r3 of May 15, 2012, purports to prohibit health insurance declination payments under certain circumstances delineated therein. The District shall comply with the requirements and/or rules changes delineated within the aforementioned bulletin for as long as same remain valid. In the event the requirements and/or rules changes are revoked or there is a final adjudication or determination (which is not subject to appeal) that such requirements or rules changes are illegal or invalid by a Court or other governmental, judicial or other agency having jurisdiction and authority over the parties and the subject matter, and/or the Employee Benefits Division of the New York State Department of Civil Service, those members who had previously been denied the declination payment shall once again be eligible for same retroactive (if the District is ordered to make payments retroactively) to the date established by the courts (etc.) accordingly. In the event of such adjudication or determination, the parties shall meet in order to implement any rule change or modification.