Common use of Hospital/Surgical Insurance/Prescription Drug Clause in Contracts

Hospital/Surgical Insurance/Prescription Drug. A. The Board shall purchase basic hospital/surgical/ prescription drug insurance coverage for each full-time support staff member now or hereafter employed and his or her family, through a carrier chosen by the Board and licensed by the State of Ohio, which meets or exceeds through one plan design the specifications set forth in Exhibit A below. Exhibit A In-network coverage will include: Physician office visits $10/$20 copay Annual deductible $250 single/$500 family Maximum out of pocket $750 single/$1,500 family (excluding deductible) Emergency room visit $75 copay Urgent care facility $35 copay Prescription drug retail 30 day supply $15 generic/$25 formulary/ $40 non-formulary copay Prescription drug mail order 90 day supply $30 generic/$50 formulary/$80 non-formulary copay A complete description of plan benefits will be available to all eligible employees.

Hospital/Surgical Insurance/Prescription Drug. A. The Effective October 1, 2013, the Board shall purchase basic hospital/surgical/ surgical/prescription drug insurance coverage for each full-time full‐time support staff member now or hereafter employed and his or her family, through a carrier chosen by the Board and licensed by the State of Ohio, which meets or exceeds through one plan design the specifications set forth in Exhibit A below. Exhibit A In-network In‐network coverage will include: Physician office visits $10/$20 copay Annual deductible $250 single/$500 family Maximum out of pocket $750 single/$1,500 family (excluding deductible) Emergency room visit $75 copay Urgent care facility $35 copay Prescription drug retail 30 day supply $15 generic/$25 formulary/ $40 non-formulary formulary/$40 non‐formulary copay Prescription drug mail order 90 day supply $30 generic/$50 formulary/$80 non-formulary non‐formulary copay A complete description of plan benefits will be available to all eligible employees.

Hospital/Surgical Insurance/Prescription Drug. A. The Effective October 1, 2011, the Board shall purchase basic hospital/surgical/ surgical/prescription drug insurance coverage for each full-time support staff member now or hereafter employed and his or her family, through a carrier chosen by the Board and licensed by the State of Ohio, which meets or exceeds through one plan design the specifications set forth in Exhibit A below. Exhibit A In-network coverage will include: Physician office visits $10/$20 15 copay Annual deductible $250 single/$500 family Maximum out of pocket $750 single/$1,500 1,500 single/$3,000 family (excluding excludes deductible) Emergency room visit $75 copay Urgent care facility $35 copay Prescription drug retail 30 day supply $15 10 generic/$25 formulary/ $40 non-formulary/$40 non- formulary copay Prescription drug mail order 90 day supply $30 20 generic/$50 formulary/$80 non-non- formulary copay A complete description of plan benefits will be available to all eligible employees.

Hospital/Surgical Insurance/Prescription Drug. A. The 1. Effective October 1, 2011, the Board shall purchase basic hospital/surgical/ surgical/prescription drug insurance coverage for each full-time support certificated staff member now or hereafter employed and his or her family, through a carrier chosen by the Board and licensed by the State of Ohio, which meets or exceeds through one plan design the specifications set forth in Exhibit A below. Exhibit A In-network coverage will include: Physician office visits $10/$20 15 copay Annual deductible $250 single/$500 family Maximum out of pocket $750 single/$1,500 1,500 single/$3,000 family (excluding excludes deductible) Emergency room visit $75 copay Urgent care facility $35 copay Prescription drug retail 30 day supply $15 10 generic/$25 formulary/ $40 non-formulary/$40 non- formulary copay Prescription drug mail order 90 day supply $30 20 generic/$50 formulary/$80 non-non- formulary copay A complete description of plan benefits will be available to all eligible employees.

Hospital/Surgical Insurance/Prescription Drug. A. The Board shall purchase basic hospital/surgical/ surgical/prescription drug insurance coverage for each full-time support staff member now or hereafter employed and his or her family, through a carrier chosen by the Board and licensed by the State of Ohio, which meets or exceeds through one plan design the specifications set forth in Exhibit A below. Exhibit A In-network coverage will include: Physician office visits $10/$20 copay Annual deductible $250 single/$500 family Maximum out of pocket $750 single/$1,500 family (excluding deductible) Emergency room visit $75 copay Urgent care facility $35 copay Prescription drug retail 30 30-day supply $15 generic/$25 formulary/ $40 formulary/$40 non-formulary copay Prescription drug mail order 90 90-day supply $30 generic/$50 formulary/$80 non-formulary copay A complete description of plan benefits will be available to all eligible employees.