Medical Premium Subsidy definition

Medical Premium Subsidy for Eligible Post-2016 Retirees Hired on or Before December 31, 2020. At age sixty-five (65) or older, or Medicare eligibility if earlier, an eligible retiree shall receive a Medical Premium Subsidy toward the monthly premium of the Xxxxxx Permanente Senior Advantage plan (KPSA plan) where the retiree resides, or as further described in the “Medical Premium Subsidy” rules below. These Xxxxxx Permanente Senior Advantage plans (KPSA) are offered to individuals in the communities we serve, and have the same premiums, deductibles, copayments and out-of- pocket maximums as the commercially available basic Senior Advantage Medicare plans in the covered location. The Medical Premium Subsidy for 2017 for a KPSA plan shall be the following for an eligible retiree who retired from a position in the applicable region: » $186 per month for a Northern California retiree; » $106 per month for a Southern California retiree; » $80 per month for a Colorado retiree; » $33 per month for a Northwest retiree; » $33 per month for a Georgia retiree; » $33 per month for a Hawaii retiree; and » $33 per month for a Mid-Atlantic retiree. Starting in 2018, the Medical Premium Subsidy for each region shall increase by 3% on January 1 of each year. The Medical Premium Subsidy for an eligible spouse or domestic partner shall be equal to the retiree’s Medical Premium Subsidy. The Medical Premium Subsidy for a spouse or eligible domestic partner will not apply until the retiree commences the Medical Premium Subsidy. If the retiree’s eligible dependent is not yet Medicare eligible when the retiree commences the Medical Premium Subsidy, the dependent coverage shall be the same as the retiree medical benefit applicable to pre-Medicare dependents of pre-2017 retirees. That pre-Medicare dependent coverage ends when the dependent becomes eligible for Medicare.

Medical Premium Subsidy. Rules of Application (Category 1 only) 383 Medical Premium Subsidy applies only to the premium amount of the lowest cost KPSAP coverage (including prescription drug coverage) available to the retiree (and not for any premium plan or non-Xxxxxx Permanente plan except as noted below). If the Medical Premium Subsidy amount exceeds the premium costs, then the excess amount will be forfeited. Any cost of medical coverage above the Medical Premium Subsidy shall be borne by the retiree. A retiree who does not pay the retiree’s share of KPSAP premiums shall lose coverage in accordance with KPSAP terms. If a retiree does not pay the retiree’s share of KPSAP premiums for his or her Medicare-eligible spouse or domestic partner, the spouse or domestic partner shall lose coverage in accordance with KPSAP terms. Within the Northern California Region or another Xxxxxx Permanente Service Area, Medical Premium Subsidy applies only to the premium amount of the lowest cost KPSAP coverage (including prescription drug coverage) available to the retiree (and not for any premium plan or non-Xxxxxx Permanente plan, except as noted below). A retiree must enroll in Medicare Parts A & B and any other relevant Parts of Medicare, assign his or her Medicare rights to the applicable Xxxxxx Permanente Plan, and take such other action as the applicable Xxxxxx Permanente Plan determines is necessary to assign/coordinate Medicare. The spouse or domestic partner must also take the same actions when eligible. If a Category 1 retiree and/or his or her eligible dependents reside outside of a Xxxxxx Permanente service area, the Medical Premium Subsidy can be used for any medical premiums permitted by the Internal Revenue Code. 384 The Medical Subsidy for a Category 1 retiree, for his or her spouse or eligible domestic partner, and coverage for the Category 1 retiree’s eligible dependent children, shall not apply until the Category 1 retiree attains age 65 or is Medicare eligible unless the retiree meets the definition of Category 3: Disabled Employees as described in Section 2. 385 In the event of a Category 1 retiree’s death, the 100% Medical Subsidy for a surviving spouse or eligible domestic partner will continue for the survivor until remarriage/recommitment or death. 386 Retiree Medical Health Reimbursement Account (“HRA”) For Category 1 and 2 Employees 387 A Category 1 employee will receive an Employer allocation to an unfunded Retiree Medical Health Reimbursement Account (“HRA”) at the ti...

Medical Premium Subsidy. For Disabled Employees 397 A Category 3 disabled retiree shall be entitled to a Medical Subsidy equal to the greater of $186 per month or the monthly plan premium of the highest cost individual Northern California Region Xxxxxx Permanente Senior Advantage Plan or its successor ("KPSAP") as of January 1, 2017. After 2017, the Medical Subsidy shall increase by three percent (3%) each year. Unless the Category 3 disabled retiree also meets the requirements in Category 1, a Category 3 disabled retiree’s spouse, eligible domestic partner and non-disabled children shall not receive a Medical Subsidy. Disabled dependent children shall be covered under the active employee plan in effect at the time services are received. If the Category 3 disabled retiree also meets the requirements in Category 1, see Category 1, above for 100% Medical Subsidy for spouse/domestic partner, and for coverage for non-disabled children. 398 The Retiree Medical Program “Medical Premium Subsidy” Rules of Application above, for Category 1 Retirees shall also apply for Category 3, Disabled Retirees. 399 Employer Allocation to Retiree Medical Health Reimbursement Account (“HRA”) For Disabled Employees 400 A Category 3 disabled retiree will receive an Employer allocation to an unfunded Retiree Medical HRA at the time of retirement (separation from service) in the amount equal to the greater of $15,000 or $2,000 per year of service. On or after January 1, 2017, a year of service is equal to two thousand (2,000) compensated hours, and prorated for each year in which the employee has at least 1,000 hours but fewer than 2,000 hours. 401 A Category 3 employee who retires on or after January 1, 2022 will receive an allocation to the HRA equal to $10,000 when the retiree reaches age eighty-five (85). 402 The Retiree Medical HRA Rules of Application above for Category 1 and 2 retirees shall also apply to Category 3, Disabled Retirees.

Examples of Medical Premium Subsidy in a sentence

• If the retiree’s eligible dependent is not yet Medicare eligible when the retiree commences the Medical Premium Subsidy, the dependent coverage shall be the same as the retiree medical benefit applicable to pre-Medicare dependents of pre-2017 retirees.

• If a retiree and/or their eligible dependents reside outside of a Xxxxxx Permanente service area, the Medical Premium Subsidy can be used for any Medicare Advantage or Medicare “Medigap” plan premiums.

• Any cost of medical coverage above the Medical Premium Subsidy shall be borne by the retiree.

• Employees in a regular position scheduled for a minimum of forty (40) hours per pay period are eligible to receive the Medical Premium Subsidy towards the cost of health benefits.

• Within any Xxxxxx Permanente Service Area, Medical Premium Subsidy applies only for the amount of the lowest-cost KPSA coverage (including prescription drug coverage) available to the retiree (and not for any premium plan or non- Xxxxxx Permanente plan).

• Employees who are on approved leave, pursuant to applicable law, and whose paid hours in a pay period are less than the required number of hours designated in sub-section (b) above will continue to receive the Medical Premium Subsidy for up to a total of six (6) pay periods in any rolling twelve (12) month period.

• In the event of an eligible retiree’s death, the Medical Premium Subsidy will be available for a surviving spouse or domestic partner, subject to the same rules.

• The Medical Premium Subsidy for a spouse or eligible domestic partner will not apply until the retiree commences the Medical Premium Subsidy.

• At age sixty-five (65) or older, or Medicare eligibility if earlier, an eligible retiree shall receive a Medical Premium Subsidy toward the monthly premium of the Xxxxxx Permanente Senior Advantage plan (KPSA plan) where the retiree resides, or as further described in the “Medical Premium Subsidy” rules below.

• However, employees must be paid for at least one-half plus one hour of their scheduled hours in order to actually receive the Medical Premium Subsidy towards the cost of health benefits.

More Definitions of Medical Premium Subsidy

Medical Premium Subsidy. Employees who select the MBO shall receive MPS in the following amounts: Coverage Type MPS Employee Only $137.51/pay period Employee + 1 $274.76/pay period Employee + 2 $383.77/pay period Effective August 14, 2021 Coverage Type MPS Employee Only $150.20/pay period Employee + 1 $300.15/pay period Employee + 2 $419.70/pay period Effective July 16, 2022: Coverage Type MPS Employee Only $162.89/pay period Employee + 1 $325.54/pay period Employee + 2 $455.63/pay period Effective July 15, 2023: Coverage Type MPS Employee Only $175.58/pay period Employee + 1 $350.93/pay period Employee + 2 $491.56/pay period Effective July 13, 2024: Coverage Type MPS Employee Only $188.27/pay period Employee + 1 $376.32/pay period Employee + 2 $527.49/pay period Flexible Spending Account (FSA): Employees who select the MBO shall be eligible to participate in the FSA as provided in the FSA Article; provided, however, that employees who select the MBO and enroll in the Blue Shield PPO Bronze Plan and the FSA shall be eligible for up to a $20.00 per pay period match to the FSA, to be credited on a quarterly basis. Paid Time Off (PTO)