Common use of Health Benefits Program Clause in Contracts

Health Benefits Program. The Commission shall make available a health benefits program to full-time employees and their eligible dependents. Part-time employees who are regularly scheduled to work at least twenty-two and a half (22.5) hours per week are eligible to participate in the health benefits program by contributing a pro-rata portion of the premium, based on the percentage of full-time hours worked. Employees who are regularly scheduled to work part-time hours as of May 31, 1998 will not be required to contribute towards the cost of the program, except as provided below. The Commission will offer employees a choice of benefit plans from which to choose, as described below. The effective date of coverage eligibility shall be the first of the month after completing two full calendar months of employment. 1. Standard Health Insurance Point of Service Program providing complete medical-surgical benefits and hospitalization (pre-certification for all in-patient stays), with a minimal co-pay for services provided within the Plan's established network. For services provided outside of the Plan's established network, there will be a maximum 80% co-payment (after a $250 single/$500 family deductible has been met) to a maximum co-insurance limit of $1000 single ($2000 family coverage). As of January 1, 2007, the deductible for out-of-network benefits will be $500 per person/$1,000 per family. The following also shall be effective January 1, 2007: a. The employee co-pay for office visits to a Primary Care Physician will be $15. b. The employee co-pay for office visits to Specialists will be $20. c. Out-of-network reimbursement will be 80% of reasonable and customary charges for all services, including in-patient hospitalization. 2. Basic Health Maintenance Organization (HMO) plans providing a choice of up to two different HMOs covering hospitalization and surgical and medical care and additional supplemental benefits with a nominal fee required for each visit/service, but no deductible. For employees who elect to enroll in an HMO plan, the Commission will pay the same amount towards the HMO Plan premium as it would contribute for that employee towards the Standard Health Insurance described in paragraph A1. Any additional cost will be paid by the employee through payroll deductions. 3. Effective January 1, 2003, the following changes relative to health insurance will be implemented: a. The Standard Health Insurance Point Of Service Program will be enhanced by providing all participants with a Prescription Card, instead of processing prescriptions through the reimbursement procedures. The prescription card will be a three-tier plan. b. Full-time employees and employees who were regularly scheduled to work part-time hours of at least twenty-two and a half (22.5) hours per week will contribute 10% of the difference between the cost of dependent coverage selected (e.g., P/C, H/W, family) and the cost of the annual health insurance premium for single coverage. Eligible part-time employees who are regularly scheduled to work at least twenty-two and a half (22.5) hours per week are eligible to participate in the health benefits program by contributing a pro-rata portion of the annual health insurance premium, based on the percentage of full-time hours worked, plus 10% of the difference between the cost of dependent coverage selected (e.g., P/C, H/W, family) and the cost of the annual health insurance premium for single coverage. c. If the annual HMO premium is less than the annual Point of Service health insurance premium, then employees selecting an HMO will contribute 10% of the difference between the cost of dependent coverage selected (e.g., P/C, H/W, family) and the cost of the annual HMO premium for single coverage. If the annual HMO premium is greater than the annual Point of Service health insurance premium, then employees selecting an HMO will contribute 10% of the difference between the cost of dependent coverage selected (e.g., P/C, H/W, family) and the cost of the annual HMO premium for single coverage, plus 100% of the amount that the annual HMO premium for the coverage selected exceeds the cost of the annual Point of Service premium. d. Contributions will be payable during each payroll period during the year, regardless of which of the plan options (Point of Service or HMO) an employee selects. e. Health insurance benefits under this section will be continued for employees absent on an approved leave of absence, in the same manner as prior to the leave. During an approved leave of absence under Article 14, employees must continue to make benefit contributions.

Health Benefits Program. The Commission shall make available a health benefits program to full-time employees and their eligible dependents. Part-time employees who are regularly scheduled to work at least twenty-two and a half (22.5) hours per week are eligible to participate in the health benefits program by contributing a pro-rata portion of the premium, based on the percentage of full-time hours worked. Employees who are regularly scheduled to work part-time hours as of May 31, 1998 will not be required to contribute towards the cost of the program, except as provided below. The Commission will offer employees a choice of benefit plans from which to choose, as described below. The effective date of coverage eligibility shall be the first of the month after completing two full calendar months of employment. 1. Standard Health Insurance Point of Service Program providing complete medical-surgical benefits and hospitalization (pre-certification for all in-patient stays), with a minimal co-pay for services provided within the Plan's established network. For services provided outside of the Plan's established network, there will be a maximum 80% co-payment (after a $250 single/$500 family deductible has been met) to a maximum co-insurance limit of $1000 single ($2000 family coverage). As of January 1, 2007, the deductible for out-of-network benefits will be $500 per person/$1,000 per family. The following also shall be effective January 1, 2007: a. The employee co-pay for office visits to a Primary Care Physician will be $15. b. The employee co-pay for office visits to Specialists will be $20. c. Out-of-network reimbursement will be 80% of reasonable and customary charges for all services, including in-patient hospitalization. 2. Basic Health Maintenance Organization (HMO) plans providing a choice of up to two different HMOs covering hospitalization and surgical and medical care and additional supplemental benefits with a nominal fee required for each visit/service, but no deductible. For employees who elect to enroll in an HMO plan, the Commission will pay the same amount towards the HMO Plan premium as it would contribute for that employee towards the Standard Health Insurance described in paragraph A1. Any additional cost will be paid by the employee through payroll deductions. 3. Effective January 1, 2003, the following changes relative to health insurance will be implemented: a. The Standard Health Insurance Point Of Service Program will be enhanced by providing all participants with a Prescription Card, instead of processing prescriptions through the reimbursement procedures. The prescription card will be a three-tier plan. b. Full-time employees and employees employee who were regularly scheduled to work part-time hours of at least twenty-two and a half (22.5) hours per week will contribute 10% of the difference between the cost of dependent coverage selected (e.g., P/C, H/W, family) and the cost of the annual health insurance premium for single coverage. Eligible part-time employees who are regularly scheduled to work at least twenty-two and a half (22.5) hours per week are eligible to participate in the health benefits program by contributing a pro-rata portion of the annual health insurance premium, based on the percentage of full-time hours worked, plus 10% of the difference between the cost of dependent coverage selected (e.g., P/C, H/W, family) and the cost of the annual health insurance premium for single coverage. c. If the annual HMO premium is less than the annual Point of Service health insurance premium, then employees selecting an HMO will contribute 10% of the difference between the cost of dependent coverage selected (e.g., P/C, H/W, family) and the cost of the annual HMO premium for single coverage. If the annual HMO premium is greater than the annual Point of Service health insurance premium, then employees selecting an HMO will contribute 10% of the difference between the cost of dependent coverage selected (e.g., P/C, H/W, family) and the cost of the annual HMO premium for single coverage, plus 100% of the amount that the annual HMO premium for the coverage selected exceeds the cost of the annual Point of Service premium. d. Contributions will be payable during each payroll period during the year, regardless of which of the plan options (Point of Service or HMO) an employee selects. e. . Health insurance benefits under this section will be continued for employees absent on an approved leave of absence, as set out in the same manner as prior to the leaveArticle 14 of this Agreement. During an approved leave of absence under Article 14, Part-time employees must continue to make benefit contributionscontributions in order to continue benefits during an approved leave of absence.