Pre-Medicare Clause Samples
The Pre-Medicare clause defines the terms and conditions that apply to individuals who have not yet reached the age of eligibility for Medicare coverage. Typically, this clause outlines the specific benefits, coverage options, and premium structures available to employees or retirees before they qualify for Medicare, often addressing how health insurance is provided during this interim period. Its core function is to ensure continuous healthcare coverage and clarify the transition process for individuals moving from employer-sponsored or group health plans to Medicare, thereby preventing gaps in coverage and reducing uncertainty.
Pre-Medicare. Employees who retire on or after April 3, 2012, will be provided the same health care benefits, including but not limited to, cost sharing, that it provides to its active employees until the retiree becomes eligible for Medicare.
Pre-Medicare. Employees who retire on or after January 1, 2011, will be provided the same health care benefits, including but not limited to, cost sharing, that it provides to its active employees until the retiree becomes eligible for Medicare. In the event health care benefits for active employees are eliminated in their entirety, which shall include a change to a one-hundred (100%) percent employee contributory health savings plan, the last health care benefits plan in effect for retirees preceding the elimination of the plan shall remain in effect (absent a contrary order from a Court of competent jurisdiction) until the Employer again provides a health care benefits plan to active employees.
Pre-Medicare. The Employer shall make available to employees who separate from employment for purposes of retirement under the Monroe County Employees Retirement System Ordinance and are entitled to receive benefits under the Ordinance, but not eligible for Medicare benefits, a choice of coverage under one of the following health insurance plans:
(a) Blue Cross/Blue Shield of Michigan Community Blue PPO Option 1 Plan with Rx generic mandate $10 co-pay, brand name preferred formulary $20 co-pay, and brand name non-preferred formulary $30 co- pay; and mandatory purchase of all maintenance drugs through mail order with Rx generic mandate $20 co-pay, brand name preferred formulary $40 co-pay, and brand name non-preferred formulary $60 co- pay. Retirees shall be required to make the same contribution to the illustrated premium (in absolute dollars and cents, not percentage of illustrated premium) that employees were required to pay for coverage under this plan at the time of the retiree’s retirement.
(b) Blue Cross/Blue Shield of Michigan Community Blue PPO Option 2 Plan with Rx generic mandate $10 co-pay, brand name preferred formulary $20 co-pay, and brand name non-preferred formulary $30 co- pay; and mandatory purchase of all maintenance drugs through mail order with Rx generic mandate $20 co-pay, brand name preferred formulary $40 co-pay, and brand name non-preferred formulary $60 co- pay. Retirees shall be required to make the same contribution to the illustrated premium (in absolute dollars and cents, not percentage of illustrated premium) that employees were required to pay for coverage under this plan at the time of the retiree’s retirement.
(c) Blue Cross/Blue Shield of Michigan Community Blue PPO Option 3 Plan with Rx generic mandate $10 co-pay, brand name preferred formulary $20 co-pay, and brand name non-preferred formulary $30 co- pay; and mandatory purchase of all maintenance drugs through mail order with Rx generic mandate $20 co-pay, brand name preferred formulary $40 co-pay, and brand name non-preferred formulary $60 co- pay. Retirees shall be required to make the same contribution to the illustrated premium (in absolute dollars and cents, not percentage of illustrated premium) that employees were required to pay for coverage under this plan at the time of the retiree’s retirement.