Basic Coverage Contractor shall provide and maintain at the JBE’s discretion and Contractor’s expense the following insurance during the Term:
Retiree Coverage 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. Medicare: Retirees must enroll in the Part B Medicare program commencing on the date they first become eligible to participate in the program. Retirees shall be responsible for the cost of such coverage. The Employer shall make available to those retirees who are properly enrolled in the Part B Medicare Program as above provided, a Supplemental Plan, with a $100 deductible. Such Plan will have the same Rx drug benefits the County provides its active employees. In the event Rx drug 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 Rx drug benefits last in effect for retirees preceding the elimination of the Rx drug benefits for active employees shall remain in effect (absent a contrary order from a Court of competent jurisdiction) until the Employer again provides Rx drug benefits to active employees.
Optional Coverage No later than 30 days prior to the date established by the City, an employee in active service or who after that date retires on disability and under the age of 65 eligible for and taking base coverage, shall be eligible to apply for supplemental coverage effective January 1, 1994, at his/her option in increments of $1,000 to a maximum of 1.5 times his/her annual basic salary rounded to the next higher thousand dollars of earnings. This coverage shall be made available to eligible employees applying for supplemental coverage no later than 30 days prior to the date established by the City and annually thereafter during periods of open enrollment.
Continuation of Optional Coverages During Unpaid Leave or Layoff An employee who takes an unpaid leave of absence or who is laid off may discontinue premium payments on optional policies during the period of leave or layoff. If the employee returns within one (1) year, the employee shall be permitted to pick up all optionals held prior to the leave or layoff. For purposes of reinstating such optional coverages, the following limitations shall be applicable. For the first twenty-four (24) months of long-term disability coverage after such a period of leave or layoff during which long-term disability coverage was discontinued, any such disability coverage shall exclude coverage for pre-existing conditions. For disability purposes, a pre-existing condition is defined as any disability which is caused by, or results from, any injury, sickness or pregnancy which occurred, was diagnosed, or for which medical care was received during the period of leave or layoff. In addition, any pre-existing condition limitations that would have been in effect under the policy but for the discontinuance of coverage shall continue to apply as provided in the policy. The limitations set forth above do not apply to leaves that qualify under the Family Medical Leave Act (FMLA).
Effective Date of Coverage An eligible employee is entitled to benefits provided he is actively at work on the first day the Long Term Disability Benefit Plan becomes effective. An eligible employee absent from work due to sickness or accident at the effective date of the Plan, shall only be eligible for Long Term Disability Plan benefits upon the return to continuous active full-time employment for a period of more than four consecutive weeks. The Company shall have the right to give medical examinations to employees returning from such lay-off to determine their eligibility under the Plan.
Basic Coverages Subd. 1. Faculty
Optional Coverages If chosen by You, and shown as applicable on the Declarations Page, the following optional coverages apply separately to each Pet per Policy year. Some coverage options may be restricted by Pets age at time of sign-up. Defender/DefenderPlus We will reimburse You, if shown on the Declarations Page, for the Preventive Care listed below that Your Pet(s) receives from a licensed Veterinarian during the Policy period. Benefits will not exceed the Maximum Allowable Limits shown below. Coinsurance and Deductible requirements do not apply to Preventive Benefits. Our total liability of each Pet for each Policy Year is shown in the Maximum Allowable Limits. Benefit Schedule Maximum Allowable Limits Preventive Benefit Defender DefenderPlus Spay/Neuter or Teeth Cleaning $0 $150 Rabies Vaccine $15 $15 Flea/Tick/Heartworm Prevention $80 $95 Vaccination/Titer $30 $40 Wellness Exam $50 $50 Heartworm test or FELV (Feline Leukemia Virus) screen $25 $30 Blood, fecal, parasite exam $50 $70 Microchip $20 $40 Urinalysis or ERD Test (Early Renal Disease Test) $15 $25 Deworming $20 $20 *Benefits may be combined or separate up to the maximum allowable limit. SupportPlus Coverage We will reimburse You, if shown on the Declarations Page, for the cost of final expenses for necropsy, cremation and urns upon the death of each Pet covered for such costs incurred after the Waiting Period and during the Coverage Period up to a maximum benefit of three hundred dollars ($300) subject to the Annual Limit amount. Coinsurance and Deductible provisions do not apply to SupportPlus Coverage. ExamPlus Coverage We will reimburse You, if shown on the Declarations Page, for the Covered Expenses that occur during the Coverage Period subject to Policy limits and exclusion including, but not limited to, Coinsurance, Deductible and Annual Limit for physical examination; including costs and/or fees for telephone consultation; to diagnose a current covered Injury. This endorsement does not provide coverage for annual wellness office exams.
Term of Coverage Except as otherwise specified in the contract, the insurance will commence on or prior to the effective date of the contract and will be maintained in force throughout the duration of the contract. Completed operations coverage may be required to be maintained on specific commercial general liability policies effective on the date of substantial completion or the termination of the contract, whichever is earlier. If a policy is written on a claims made form, the retroactive date must be shown and this date must be before the earlier of the date of the execution of the contract or the beginning of contract work, and the coverage must respond to all claims reported within three years following the period for which coverage is required unless stated otherwise in the contract.
Waiting Periods for Coverage There is a two (2) day Waiting Period per Pet before We will cover an Injury. There is a three hundred and sixty-five (365) day Waiting Period per Pet before We will cover a Pre-existing Condition. Waiting Periods are waived for subsequent renewals and add-on coverage from a preceding Policy year provided You maintain an active Policy, with no gap in coverage, annually renewed and continuously in-force.
Commencement of Coverage Coverage under the provisions of this article shall apply to regular full-time and regular part-time employees who work 15 regular hours or more per week and shall commence on the first day of the calendar month immediately following the completion of the employee's probationary period.
