Health Maintenance Organizations. The Employer may offer up to three federally qualified Health Maintenance Organization (HMO) plans to active employees as an alternative to the PPO medical plan in paragraph 24.2A above. Additional federally qualified HMO plans may be added or replaced by the Employer as alternatives as they become available. The co-pays and deductibles upon ratification of this Agreement will remain in effect for the duration of this agreement. Information about Plan benefits and open enrollment periods may be obtained from the University’s Benefit and Compensation Services Office and provided by the medical carriers. All benefits of the HMO plans described above are subject to specific HMO policy provisions and the Group Operating Agreements between Oakland University and the HMO.
Health Maintenance Organizations. The University offers multiple HMO plans. All HMOs will offer two (2) levels of benefits - Enhanced and Standard. The chart below contains the key features of all HMOs. A detailed description, including how members will qualify for the Enhanced or Standard coverage, will be provided in the annual open enrollment materials that are distributed to each member. Enhanced Standard Deductible (Single/Family) $0 $200/$400 Co-Insurance N/A 80%/20% Out of Pocket Max (including deductible) N/A $2,200/$4,400 Office/Urgent Care Co-Pay $20 $30 Prescription Co-Pay Generic $7 $10 Preferred Brand Name $15 $20 Non-Preferred Brand Name $30 $50 Note: the Standard Prescription Co-Pays for Priority Health are $7/$15/$30 Information about Plan benefits, plan design, and open enrollment materials may be obtained from the University's Benefit and Compensation Service Office and will be provided by the medical carriers. All benefits of the HMO plans are subject to specific HMO policy provisions and the Group Operating Agreements between Oakland University and the HMO. Any employee enrolled in one (1) of the HMO offerings shall not be eligible for benefits set forth in paragraph 51.2A.
Health Maintenance Organizations. The University offers multiple HMO Plans. All HMOs will offer two (2) levels of benefits – Enhanced and Standard. The chart below contains the key features of all HMOs. A detailed description, including how members will qualify for the Enhanced or Standard coverage, will be provided in the annual open enrollment materials that are distributed to each member. Enhanced Standard Deductible (Single/Family) $0 $200/$400 Co-Insurance N/A 80%/20% Out of Pocket Max (including deductible) N/A $2,200/$4,400 Office/Urgent Care Co-Pay $20 $30 Prescription Co-Pay Generic $7 $10 Preferred Brand Name $15 $20 Non-Preferred Brand Name $30 $50 Note: the Standard Prescription Co-Pays for Priority Health are $7/$15/$30 Information about Plan benefits, plan design and open enrollment materials may be obtained from the University’s Benefit and Compensation Services Office and will be provided by the medical carriers. All benefits of the HMO plans are subject to specific HMO policy provisions and the Group Operating Agreements between Oakland University and the HMO. 199. Medical Insurance Opt Out. Employees who are covered by another health insurance plan shall have the option to decline health insurance coverage from the University. Employees who elect to opt out of the health insurance coverage shall be paid $1,000 per year by the University. A signed waiver form must be completed and submitted to the Benefit and Compensation Services Office every year during open enrollment to be eligible for the opt out payment. Employees who are hired after January 1 or who experience a life-altering event may elect payment in lieu of enrollment, but will be paid on a prorated basis. An employee must provide proof of other health insurance prior to being authorized to opt out and receive payment.
Health Maintenance Organizations. The University may offer up to three federally qualified Health Maintenance Organization (HMO) plans to active employees as an alternative to the PPO medical plans in paragraph 116 1A above. Additional federally qualified HMO plans may be added or replaced by the University as alternatives as they become available. Information about Plan benefits and open enrollment periods may be obtained from the University’s Benefit and Compensation Services Office and additional information will be provided by the medical carriers. Any employee enrolled in one of the HMO offerings shall not be eligible for benefits set forth in paragraph 116 1A.
Health Maintenance Organizations. A. Employees who qualify for health insurance under the terms and conditions of this Agreement shall be given the option to participate in health insurance plans offered by the Hospital. Any future additions of this benefit for the classified employees, shall automatically apply on the same terms and conditions to bargaining unit employees without the need for bargaining over the decision(s) or the effects of those decision(s). However, the Hospital will notify the Union and be available, upon request, to discuss the details of the additional health insurance plan.
Health Maintenance Organizations. Effective January 1, 2007, employees who elect or continue with Health Maintenance Organizations (HMO) Health coverage for a period of one year shall receive a one-time bonus payment (less applicable withholding) of $500.00. This bonus shall be in effect from January 1, 2007 to December 31, 2007. Subsequent year continuation of this program shall be at VILLAGE discretion.
Health Maintenance Organizations. 1. The Board shall additionally provide opportunity to members of the bargaining unit to enroll in a prepaid Health Maintenance Organization (hereinafter referred to as “HMO”) available in the area under the following provisions:
Health Maintenance Organizations. Novaxxx xxx no reason to believe that the representations and warranties contained in Section 3.8 of the Note Purchase Agreement contemplated by the Arkansas Transaction are inaccurate in any material respect.
Health Maintenance Organizations. Eligible employees in the State Health Insurance Plan may elect to participate in a federally qualified or state certified Health Maintenance Organization which has been approved to participate in the State Health Insurance Program by the Joint Committee on Health Benefits. If more than one HMO services the same geographic area, the Joint Committee on Health Benefits reserves the right to approve a contract with only such organization(s) deemed to be a quality, cost effective option(s). The Joint Committee on Health Benefits will work with the State through the HMO Workgroup to identify and mutually agree upon appropriate incentives for HMO alternatives to become more competitive in quality of care provided and efficient in cost to payers. Employees may change their health insurance option each year during the month of November, unless another period is mutually agreed upon by the State and the Joint Committee on Health Benefits. If the rate renewals are not available by the time of the open option transfer period, then the open transfer period shall be extended to assure ample time for employees to transfer.
Health Maintenance Organizations. − (HMOs) Employees will be permitted to participate in HMOs approved by the Authority and the Union. The following will be provided: HMO Plan Designs Effective 12/31/03 Unicare HMO In network Out of network Office Visit Copay $10 None Emergency Room Copay $15 Prescription Drug Copay Rx – Retail $3/$5/$15 copay (generic/formulary/non-formulary) Rx – Mail (90 day supply v. 30) Covered w/2x retail copay 2003 Employee Contribution (S/F) per Mos. $21.50/$55.68 HMO Illinois In network Out of network Office Visit Copay $10 None Emergency Room Copay $15 Prescription Drug Copay Rx – Retail $3/$5/$15 copay (generic/formulary/non-formulary) Rx – Mail (90 day supply v. 30) Covered w/2x retail copay 2003 Employee Contribution (S/F) per Mos. $34.19/$73.78 Opt Out Option Effective 12/31/03, CTA will buy back benefits at nine hundred and fifty dollars ($950)/year per eligible active employee. Eligibility requires proof of alternative coverage. The nine hundred and fifty dollars ($950) will be paid on a pro-rata basis each month during the year with payments reflected as a separate item on employees’ payroll checks. An employee may opt back into any of the effective Health Care Plan Designs, at any time, subject to proof that a change has occurred in the employee’s alternative coverage. Effective 12/31/03, the Employee Premium deduction formula of the Agreement (reflecting seventy-five (75) percent of the premium increase, 2003 over 2002 and the caps of eleven cents ($0.11) per hour and twenty cents ($0.20) per hour single/family, respectively) will be utilized.
