Common use of Prescription Program Clause in Contracts

Prescription Program. The Board shall provide to all full-time employees and their dependents a prescription program for the term of their contract only, and only in the manner set out in the 1995 modification of the annual prescription plan as follows: 1. Secretarial Unit personnel will be reimbursed 100 percent of the amount of claims up to $200 (up to $100 per association member and up to $100 for dependents). 2. Secretarial Unit personnel shall also be reimbursed for 20% of the cost of all covered prescription charges up to an amount of $2,000 per person, annually, following the first $100 per individual member and $100 for dependents. It is agreed that these reimbursements cannot exceed the following monetary limitations: less the maximum to be deducted for clerical and administrative costs incurred for administering the prescription program ($410). 3. It is further agreed and understood between the parties that the Board shall pay all costs of prescriptions not covered by major medical insurance provided by the Board, or by other insurance coverage covering the member or individual family members to an amount not to exceed an aggregate of $3,000. This $3,000 amount is separate and apart from the monetary limitation provided for in Article V, Section 5.1, B2. 4. Benefits for employees who leave the system prior to June 30 of each contract year shall terminate as of date of severance. 5. It is distinctly understood and agreed that should claims exceeding the limits set forth in subparagraph B2 above be presented, all approved claims shall be paid on a pro-rata basis out of said amounts, and that approved claims shall be paid by September 30 of each year. 6. This prescription program shall cover for drugs and medicines (except for vitamins) which under Federal or State law may only be dispensed upon a written prescription by a licensed physician for the treatment or prevention of an illness, injury or condition, and if dispensed by a licensed pharmacy or by a legally constituted and operated hospital for an insured employee or dependent who is not then a bed patient in that hospital. 7. The prescription program does not cover any charge for a drug and/or medicine expense: a. If the expense is not required in accordance with accepted standards of medical practice; b. To the extent that the charge exceeds the reasonable and customary charge for the particular drug and/or medicine; c. To the extent that such charge is covered by any other insurance under which the member of the unit and/or dependent is covered; d. If the expense is not prescribed by a duly licensed doctor in charge of the case; e. If the expense is incurred in connection with care beyond the scope of the license of the person rendering it; f. If the expense is incurred for drugs, which do not require a prescription; g. If the expense is incurred for prescription devices such as, but not limited to, contraceptive devices, therapeutic devices, artificial appliances, hypodermic needles, syringes, or similar devices; h. If the expense is incurred in connection with prescription dispensed to a member or a dependent while a patient in a hospital, nursing home, or other treatment institution; i. If the expense is incurred in connection with contraceptive drugs; j. If the expense is incurred in connection with prescription dispensed to a member or a dependent while a patient in a hospital, nursing home, or other treatment institution; k. If the expense is incurred for drugs in connection with cosmetic surgery and/or treatment; l. If the expense is incurred in connection with the care of disease where the principal diagnosis is of a psychiatric illness; m. If the expense is incurred in connection with the care of drug addiction or chronic alcoholism. 8. Claims must be made in writing in accordance with instructions from the Board Secretary not later than August 1 of each contract year, signed by the member; and annexed to said claim must be receipted invoices from the licensed pharmacy setting forth the following information: a. The date purchase of drug was made; b. Name of the patient to whom the drug was prescribed; c. If not the member, the relationship of the person to the member; d. The prescription number; e. The name of the pharmacy; f. The name of the doctor signing the prescription; g. The cost of the drug. 9. It is understood and agreed that no claims will be approved and/or paid prior to September 30 of each contract year, to allow the Board time to accumulate all claims and to determine the mode of payment of approval claims in accordance with available funds.

Prescription Program. The Board shall provide to all full-time employees and their dependents a prescription program for the term of their this contract only, and only in the manner set out in the 1995 modification of the annual prescription plan as follows: 1. Secretarial Unit Building service personnel will be reimbursed 100 percent of the amount of claims up to $200 (up to $100 per association member and up to $100 for dependents). 2. Secretarial Unit Building service personnel shall also be reimbursed for 20% of the cost of all covered prescription charges up to an amount of $2,000 per person, annually, following the first $100 per individual member and $100 for dependents. It is agreed that these reimbursements cannot exceed the following monetary limitations: $6,038 per year for each year of this agreement, less the maximum to be deducted for clerical and administrative costs incurred for administering the prescription program ($410325). 3. It is further agreed and understood between the parties that the Board shall pay all costs of prescriptions not covered by major medical insurance provided by the Board, or by other insurance coverage covering the member or individual family members to an amount not to exceed an aggregate of $3,000. This $3,000 amount is separate and apart from the monetary limitation provided for in Article VVIII, Section 5.1, B28.1 (Building Service Unit). 4. Benefits for employees members who leave the system prior to June 30 of each contract year shall terminate as of date of severance. 5. It is distinctly understood and agreed that should claims exceeding the limits set forth in subparagraph B2 above be presented, all approved claims shall be paid on a pro-rata basis out of said amounts, and that approved claims shall be paid by September 30 of each year. Claims must be submitted no later than August 1. 6. This prescription program shall cover for drugs and medicines (except for vitamins) which under Federal federal or State state law may only be dispensed upon a written prescription by a licensed physician for the treatment or prevention of an illness, injury or condition, and if dispensed by a licensed pharmacy pharmacist or by a legally constituted and operated hospital for an insured building service employee or dependent who is not then a bed patient in that hospital. 7. The prescription program does not cover any charge for a drug and/or medicine expense: a. If the expense is not required in accordance with accepted standards of medical practice; b. To the extent that the charge exceeds the reasonable and customary charge for the particular drug and/or medicine; c. To the extent that such charge is covered by any other insurance under which the member of the unit and/or dependent is covered; d. If the expense is not prescribed by a duly licensed doctor in charge of the case; e. If the expense is incurred in connection with care beyond the scope of the license of the person rendering it; f. If the expense is incurred for drugs, drugs which do not require a prescription; g. If the expense is incurred for prescription devices such as, but not limited to, contraceptive devices, therapeutic devices, artificial appliances, hypodermic needles, syringes, or similar devices; h. If the expense is incurred in connection with prescription dispensed to a member the administration or a dependent while a patient in a hospital, nursing home, or other treatment institutioninjection of any drug and/or medicine; i. If the expense is incurred in connection with contraceptive drugs; j. If the expense is incurred in connection with prescription prescriptions dispensed to a member or a dependent while a patient in a hospital, nursing home, or other treatment institution; k. If the expense is incurred for drugs in connection with cosmetic surgery and/or treatment; l. If the expense is incurred in connection with the care of disease where the principal diagnosis is of a psychiatric illness; m. If the expense is incurred in connection with the care of drug addiction or chronic alcoholism. 8. Claims must be made in writing in accordance with instructions from the Board Secretary not later than August 1 of each contract year, signed by the memberemployee; and annexed to said claim must be receipted invoices from the licensed pharmacy setting forth the following information: a. The date purchase of drug was made; b. Name of the patient to whom the drug was prescribed; c. If not the memberemployee, the relationship of the person to the memberemployee; d. The prescription number; e. The name of the pharmacy; f. The name of the doctor signing the prescription; g. The cost of the drug. 9. It is understood and agreed that no claims will be approved and/or paid prior to September 30 of each contract year, to allow the Board time to accumulate all claims and to determine the mode of payment of approval approved claims in accordance with available funds.

Prescription Program. The Board shall provide to all full-time employees and their dependents a prescription program for the term of their contract only, and only in the manner set out in the 1995 modification of the annual prescription plan as follows: 1. Secretarial Unit personnel will be reimbursed 100 percent of the amount of claims up to $200 (up to $100 per association member and up to $100 for dependents). 2. Secretarial Unit personnel shall also be reimbursed for up to 20% of the cost of all covered prescription charges up to an amount of $2,000 per person, annually, following the first $100 per individual member and $100 for dependents. It is agreed that these reimbursements cannot exceed the following monetary limitations: less the maximum to be deducted for clerical and administrative costs incurred for administering the prescription program ($410). 3. It is further agreed and understood between the parties that the Board shall pay all costs of prescriptions not covered by major medical insurance provided by the Board, or by other insurance coverage covering the member or individual family members to an amount not to exceed an aggregate of $3,000. This $3,000 amount is separate and apart from the monetary limitation provided for in Article V, Section 5.1, B2. 4. Benefits for employees who leave the system prior to June 30 of each contract year shall terminate as of date of severance. 5. It is distinctly understood and agreed that should claims exceeding the limits set forth in subparagraph B2 above be presented, all approved claims shall be paid on a pro-rata basis out of said amounts, and that approved claims shall be paid by September 30 of each year. 6. This prescription program shall cover for drugs and medicines (except for vitamins) which under Federal or State law may only be dispensed upon a written prescription by a licensed physician for the treatment or prevention of an illness, injury or condition, and if dispensed by a licensed pharmacy or by a legally constituted and operated hospital for an insured employee or dependent who is not then a bed patient in that hospital. 7. The prescription program does not cover any charge for a drug and/or medicine expense: a. If the expense is not required in accordance with accepted standards of medical practice; b. To the extent that the charge exceeds the reasonable and customary charge for the particular drug and/or medicine; c. To the extent that such charge is covered by any other insurance under which the member of the unit and/or dependent is covered; d. If the expense is not prescribed by a duly licensed doctor in charge of the case; e. If the expense is incurred in connection with care beyond the scope of the license of the person rendering it; f. If the expense is incurred for drugs, which do not require a prescription; g. If the expense is incurred for prescription devices such as, but not limited to, contraceptive devices, therapeutic devices, artificial appliances, hypodermic needles, syringes, or similar devices; h. If the expense is incurred in connection with prescription dispensed to a member or a dependent while a patient in a hospital, nursing home, or other treatment institution; i. If the expense is incurred in connection with contraceptive drugs; j. If the expense is incurred in connection with prescription dispensed to a member or a dependent while a patient in a hospital, nursing home, or other treatment institution; k. If the expense is incurred for drugs in connection with cosmetic surgery and/or treatment; l. If the expense is incurred in connection with the care of disease where the principal diagnosis is of a psychiatric illness; m. If the expense is incurred in connection with the care of drug addiction or chronic alcoholism. 8. Claims must be made in writing in accordance with instructions from the Board Secretary not later than August 1 of each contract year, signed by the member; and annexed to said claim must be receipted invoices from the licensed pharmacy setting forth the following information: a. The date purchase of drug was made; b. Name of the patient to whom the drug was prescribed; c. If not the member, the relationship of the person to the member; d. The prescription number; e. The name of the pharmacy; f. The name of the doctor signing the prescription; g. The cost of the drug. 9. It is understood and agreed that no claims will be approved and/or paid prior to September 30 of each contract year, to allow the Board time to accumulate all claims and to determine the mode of payment of approval claims in accordance with available funds.

Prescription Program. The Board shall provide to all full-time employees and their dependents a prescription program for the term of their this contract only, and only in the manner set out in the 1995 modification of the annual prescription plan as follows: 1. Secretarial Unit Building service personnel will be reimbursed 100 percent of the amount of claims up to $200 (up to $100 per association member and up to $100 for dependents). 2. Secretarial Unit Building service personnel shall also be reimbursed for up to 20% of the cost of all covered prescription charges up to an amount of $2,000 per person, annually, following the first $100 per individual member and $100 for dependents. It is agreed that these reimbursements cannot exceed the following monetary limitations: $6,038 per year for each year of this agreement, less the maximum to be deducted for clerical and administrative costs incurred for administering the prescription program ($410325). 3. It is further agreed and understood between the parties that the Board shall pay all costs of prescriptions not covered by major medical insurance provided by the Board, or by other insurance coverage covering the member or individual family members to an amount not to exceed an aggregate of $3,000. This $3,000 amount is separate and apart from the monetary limitation provided for in Article VVIII, Section 5.1, B28.1 (Building Service Unit). 4. Benefits for employees members who leave the system prior to June 30 of each contract year shall terminate as of date of severance. 5. It is distinctly understood and agreed that should claims exceeding the limits set forth in subparagraph B2 above be presented, all approved claims shall be paid on a pro-rata basis out of said amounts, and that approved claims shall be paid by September 30 of each year. Claims must be submitted no later than August 1. 6. This prescription program shall cover for drugs and medicines (except for vitamins) which under Federal federal or State state law may only be dispensed upon a written prescription by a licensed physician for the treatment or prevention of an illness, injury or condition, and if dispensed by a licensed pharmacy pharmacist or by a legally constituted and operated hospital for an insured building service employee or dependent who is not then a bed patient in that hospital. 7. The prescription program does not cover any charge for a drug and/or medicine expense: a. If the expense is not required in accordance with accepted standards of medical practice; b. To the extent that the charge exceeds the reasonable and customary charge for the particular drug and/or medicine; c. To the extent that such charge is covered by any other insurance under which the member of the unit and/or dependent is covered; d. If the expense is not prescribed by a duly licensed doctor in charge of the case; e. If the expense is incurred in connection with care beyond the scope of the license of the person rendering it; f. If the expense is incurred for drugs, drugs which do not require a prescription; g. If the expense is incurred for prescription devices such as, but not limited to, contraceptive devices, therapeutic devices, artificial appliances, hypodermic needles, syringes, or similar devices; h. If the expense is incurred in connection with prescription dispensed to a member the administration or a dependent while a patient in a hospital, nursing home, or other treatment institutioninjection of any drug and/or medicine; i. If the expense is incurred in connection with contraceptive drugs; j. If the expense is incurred in connection with prescription prescriptions dispensed to a member or a dependent while a patient in a hospital, nursing home, or other treatment institution; k. If the expense is incurred for drugs in connection with cosmetic surgery and/or treatment; l. If the expense is incurred in connection with the care of disease where the principal diagnosis is of a psychiatric illness; m. If the expense is incurred in connection with the care of drug addiction or chronic alcoholism. 8. Claims must be made in writing in accordance with instructions from the Board Secretary not later than August 1 of each contract year, signed by the memberemployee; and annexed to said claim must be receipted invoices from the licensed pharmacy setting forth the following information: a. The date purchase of drug was made; b. Name of the patient to whom the drug was prescribed; c. If not the memberemployee, the relationship of the person to the memberemployee; d. The prescription number; e. The name of the pharmacy; f. The name of the doctor signing the prescription; g. The cost of the drug. 9. It is understood and agreed that no claims will be approved and/or paid prior to September 30 of each contract year, to allow the Board time to accumulate all claims and to determine the mode of payment of approval approved claims in accordance with available funds.