Board Of Aldermen - Agenda - 1/12/2021 - P71
HMO Co-pays and Deductibles:
The HMO shall have the following co-pays and deductibles:
(a) Twenty-five Dollars ($25.00) per medical visit;
(b) | One Hundred Dollars ($100.00) per emergency room visit;
(c) One Thousand Five Hundred Dollars ($1,500.00) Per Person, Three Thousand
Dollars ($3,000.00) Per 2 Person/Family Inpatient/Outpatient Facility Deductible;
and
(d)_ _Three Tier Pharmacy Benefit _of $10/$30/$50 ($20/$60/$100 Mail Order).
High Deductible Health Plan with Health Savings Account (HDHP w/ HSA):
The deductibles in the High Deductible Health Plan with Health Savings Account (HDHP w/
HSA) are $2,000 individual / $4.000 2-person or family. The City’s contribution to Health
Savings Accounts is $1,500 individual / $3,000 2-person or family. The City HSA contribution
will be distributed in 2 installments, one on or about July 1 and on one or about October 1,
provided however that if an employee is required to pay more towards his / her deductible than
the initial 50% contribution, upon presentation of suitable documentation, the City will
contribute the remaining 50% before October 1. Employees who join the HDHP_w/ HLS.A. at
any time other than July 1 will receive a pro-rated City contribution of $125 monthly for a single
plan and $250 monthly for 2-person or family plan for each full month remaining in that fiscal
year,
A.2.__City Contributions and Enrollment
The City shall contribute 70% of the POS premium of option (a) and 80% of the HMO and
HDHP w/HSA.
Coverage for new employees is available on the 1“ of the month following date of hire if hired
on or before the 15" of the month; and on the 1% of the month following a full month of
employment if hired after the 15" of the month. Employees who do not enroll on their initial
eligibility date may subsequently only do so during the annual open enrollment_period or
following a “qualifying event.” Employees may also transfer to another plan during the annual
open enrollment period.
Spouse Rule: In the event that an employee's spouse is employed by the City of Nashua, the
Nashua School District, or another agency of the City, the employee shall be entitled to health
insurance premium coverage either pursuant to this article or pursuant to the coverage afforded
to the spouse, but not both.
A.3. Joint Labor / Management Committee _- For the duration of this Agreement, either
party to the Agreement may request that a Joint Labor/Management Committee be convened to
consider the performance of the aforementioned plans, any changes thereto.
A.4. _ Annual Audit - The City of Nashua hereby agrees to conduct a yearly loss ratio analysis
of all Health Insurance plans offered to employees and return all employee overpayments in the
form of a Health Insurance Premium Holiday at the completion of the analysis.
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