PLAN THREE Sample Clauses
The "PLAN THREE" clause establishes the terms and conditions specific to a third option or tier within a set of available plans in an agreement. This clause typically outlines the features, pricing, eligibility, and obligations associated with selecting Plan Three, distinguishing it from other plans such as Plan One or Plan Two. For example, it may specify higher service levels, additional benefits, or different payment structures. The core function of this clause is to clearly define what is included in Plan Three, ensuring both parties understand their rights and responsibilities under this particular plan and reducing the risk of misunderstandings.
PLAN THREE. (Flex Plan - Current Retirees Only) This health insurance plan shall incorporate an overall policy deductible of $200.00/single, $600.00/family with an 80%/20% split on the next $5,000, (80% County/20% Employee) and a drug plan of $0/$6. This plan requires precertification for in-patient elective surgery, out-patient elective surgery, non-emergency use of emergency room, and emergency hospital confinement with a penalty of $100.00 for failing to obtain precertification. NOTE: Retirees are not eligible for flexible spending accounts.
PLAN THREE. (Flex Plan) This health insurance plan shall incorporate an overall policy deductible of $200.00/single, $600.00/family with an 80%/20% split on the next $5,000, (80% County/20% Employee). Additional provisions of the plan are listed on Appendix "H" to this Agreement which is attached hereto and incorporated by reference herein. This plan requires precertification for in-patient elective surgery, out-patient elective surgery, non-emergency use of emergency room, and emergency hospital confinement with a penalty of $100.00 for failing to obtain precertification. For the 12 month period following implementation of precertification requirements, the County will reimburse an employee the full cost of the first penalty and 50% of the second penalty. Disputes may be subject to the grievance procedure. NOTE: Retirees are not eligible for flexible spending accounts.
PLAN THREE. (Flex Plan) This health insurance plan shall incorporate an overall policy deductible of $200.00/single, $600.00/family with an 80%/20% split on the next $5,000, (80% County/20% Employee). Additional provisions of the plan are listed on Appendix "Z" to this Agreement which is attached hereto and incorporated by reference herein. This plan requires precertification for in-patient elective surgery, out- patient elective surgery, non-emergency use of emergency room, and emergency hospital confinement with a penalty of $50.00 for failing to obtain precertification. Disputes may be subject to the grievance procedure. use.
PLAN THREE. (Flex Plan) This health insurance plan shall incorporate an overall policy deductible of $200.00/single, $600.00/family with an 80%/20% split on the next $5,000, (80% County/20% Employee). Additional provisions of the plan are listed on Appendix "E" to this Agreement which is attached hereto and incorporated by reference herein. This plan requires pre- certification of all hospital confinements and out- patient surgery (non-emergency pre-certification shall be made prior to hospital confinement and/or out-patient surgical procedure and emergency pre-certification shall be made within 48 hours after hospital confinement and/or outpatient surgical procedures) as well as non- emergency use of an emergency room with a penalty of $50.00 for failing to obtain precertification. For the 12 month period following implementation of precertification requirements, the County will reimburse an employee the full cost of the first penalty and 50% of the second penalty. Disputes may be subject to the grievance procedure. NOTE: Retirees are not eligible for flexible spending accounts. Care Center prior to, or no later than 24 hours of its use.
PLAN THREE. (Flex Plan) This health insurance plan shall incorporate an overall policy deductible of $200.00/single, $600.00/family with an 80%/20% split on the next $5,000, (80% County/20% Employee). This plan requires pre-certification of all hospital confinements and out-patient surgery (non- emergency pre-certification shall be made prior to hospital confinement and/or out-patient surgical procedure and emergency pre-certification shall be made within 48 hours after hospital confinement and/or outpatient surgical procedures) as well as non-emergency use of an emergency room with a penalty of $50.00 for failing to obtain precertification. For the 12 month period following implementation of precertification requirements, the County will reimburse an employee the full cost of the first penalty and 50% of the second penalty. Disputes may be subject to the grievance procedure. NOTE: Retirees are not eligible for flexible spending accounts.