A Summary of Covered Benefits – Comprehensive Major Medical Sample Clauses

A Summary of Covered Benefits – Comprehensive Major Medical. Medical Insurance The Board shall provide a comprehensive major medical plan, as described below, along with prescription drug benefits. The Board shall arrange to have the employees ten percent (10%) cost calculated for pretax compensation. The Minimum Value Based plan, as described below, shall also be available for those eligible employees who elect coverage under it. Sheffield-Sheffield Lake City Schools Summary of Plan Designs Premium Min. Value Based Design for ACA In-Network Deductible (In-network) $750/$1,500 $4,000/$8,000 - Earned Incentive Award ($250)/($500) ($250/$500) Deductible (In-network) $500/$1,000 $3,750/$7,500 Coinsurance 90% 70% Coinsurance Out-of-Pocket Max (does not include deductible) $1,500/$3,000 $2,250/$4,500 Out-of-Pocket Max (includes deductibles, coinsurance and medical/drug copays) $6,600/$13,200 $6,600/$13,200 Out-of-Network Deductible (Out-of-network) $1,500/$3,000 $4,000/$8,000 Coinsurance 60% 50% Coinsurance Out-of-Pocket Max (does not include deductible) $3,000/$6,000 $10,000/$20,000 Out-of-Pocket Max (includes deductibles, coinsurance and medical/drug copays)) Unlimited Unlimited Office and Emergency Visits OV Copay $25 $50 Urgent Care Visit $40 $100 Specialist Visit $40 $100 ER Copay - Emergency $100 $300 ER Copay - Non-Emergency $200 $300 Preventive Services Immunizations 100% In-network 100% In-network Routine Physical 100% In-network 100% In-network Routine PSA 100% In-network 100% In-network Endoscopies 100% In-network 100% In-network Pap Test Exam 100% In-network 100% In-network PPACA Expanded Wellness Svcs 100% In-network 100% In-network Prescription Drug Benefit Retail Drug Card $10/$25/$50 Ded. then $10/$50/$100 Mail Order $20/$50/$100 Ded. then $20/$100/$200 Specialty Medications $60 Ded. then $200 Step Therapy YES YES Mandatory Mail Order YES YES Maintenance Choice YES YES All maintenance drugs shall be mandatory mail order or maintenance choice. The Board shall offer a Section 125 Flexible Spending Account, whereby participants may elect to contribute pre-tax contributions to offset eligible medical expenses and the employee’s share of premiums.
Sample 1Sample 2Sample 3See All (6)
AutoNDA by SimpleDocs
A Summary of Covered Benefits – Comprehensive Major Medical. Medical Insurance The Board shall provide a comprehensive major medical plan, as described below, along with prescription drug benefits. The Board shall arrange to have the employees ten percent (10%) cost calculated for pretax compensation. The Minimum Value Based plan, as described below, shall also be available for those eligible employees who elect coverage under it. Sheffield-Sheffield Lake City Schools
Sample 1Sample 2
A Summary of Covered Benefits – Comprehensive Major Medical. Medical Insurance The Board shall provide a comprehensive major medical plan along with prescription drug benefits. The plan parameters listed below are effective March 1, 2004. Also, effective March 1, 2004, theThe Board shall arrange to have the employees 10% cost calculated for pre tax compensation. Deductibles In Network Out-of-Network $ 75 Single $150 Single $125 Family $250 Family Out-of-Pocket Limitations In Network Out-of-Network $325 Single $650 Single $375 Family $750 Family Hospital Services In-Network – SuperMed 90%/10% In-Network – Emerald 90%/10% Out-of-Network 80%/20% Co-pay on all Doctor Office Visits $5.00 Out-of-Network 80%/20% Physician Services
Sample 1
A Summary of Covered Benefits – Comprehensive Major Medical 
Sample 1

Related to A Summary of Covered Benefits – Comprehensive Major Medical

  • Comprehensive Assessment an initial and ongoing part of the member-centered planning process employed by the interdisciplinary team (IDT) to identify the member’s outcomes and the services and supports needed to help support those outcomes. It includes an ongoing process of using the knowledge and expertise of the member and caregivers to collect information about:

  • Workplace Safety Insurance Benefits (WSIB) Top Up Benefits If the employee is in a class of employees that, on August 31, 2012, was entitled to use unused sick leave credits for the purpose of topping up benefits received under the Workplace Safety and Insurance Act, 1997;

  • Hospitals of Ontario Voluntary Life Insurance Plan The Hospital also agrees to make the Hospitals of Ontario Voluntary Life Insurance Plan (HOOVLIP) available to the nurses subject to the provisions of HOOVLIP at no cost to the Hospital.

  • Comprehensive Insurance The Employer agrees to provide comprehensive insurance covering tools, reference texts and instruments owned by the employees and required to be used in the performance of their duties at the request of the Employer.

  • Financial Services Compensation Scheme We are a participant in the Financial Services Compensation Scheme (the “FSCS”). As a retail client you may be eligible to claim compensation from the FSCS in certain circumstances if we, any approved bank, our nominee company or eligible custodian are in default. Most types of investment business are covered in full for the first £85,000 of any eligible claim. Not every investor is eligible to claim under this scheme: for further information please contact us, or the FSCS directly at xxx.xxxx.xxx.xx.

  • PREGNANCY LEAVE BENEFITS Common Central Provisions a) The Employer shall provide for permanent and long-term occasional teachers and teachers hired into a term position who access such leaves, a SEB plan to top up their E.I.

  • Emergency Mode Operation Plan Contractor must establish a documented plan to enable continuation of critical business processes and protection of the security of electronic DHCS PHI or PI in the event of an emergency. Emergency means any circumstance or situation that causes normal computer operations to become unavailable for use in performing the work required under this Agreement for more than 24 hours.

  • Comprehensive Agreement Clauses, written in simple and understandable language, cover all situations that may become issues between landlord and tenant.

  • ’ Compensation/Employer’s Liability Insurance If Contractor has employees, it shall maintain workers’ compensation insurance as required by law. Employer’s liability limits shall be not less than $1,000,000 for each accident, $1,000,000 as the aggregate disease policy limit, and $1,000,000 as the disease limit for each employee. If Contractor does not have employees, it shall provide a letter, on company letterhead, to the Judicial Council certifying, under penalty of perjury, that it does not have employees. Upon the Judicial Council’s receipt of the letter, Contractor shall not be required to maintain workers’ compensation insurance.

  • Compensation and Employers Liability Insurance a. Statutory California Workers' Compensation coverage including broad form all-states coverage.

Time is Money Join Law Insider Premium to draft better contracts faster.